South Pacific Island Nation First Country to Ban Environmentally Harmful Sunscreens

MedicalResearch.com Interview with:
"Protect Coral Reefs" by NOAA's National Ocean Service is licensed under CC BY 2.0Ariel Kushmaro and Esti Kramarsky-Winter
Department of Biotechnology Engineering, Ben Gurion University
Beer Sheva, Israel

The Republic of Palau, a South Pacific island nation, became the world’s first country to ban sunscreen products containing environmentally harmful ingredients

MedicalResearch.com: What is the background for this announcement? What are the main findings? 

Response: Coral reefs are important ecosystems that are under threat due to global human driven climate change. In addition to global changes, local hazards such as point pollution by eutrophication, dredging and chemical pollution are exacerbating and promoting reef destruction at local levels. This destruction affects not only island nations that depend on these reefs for protection and livelihood, they affect humanity as a whole as they are an important source for food and novel drugs and new materials.

Our recent studies have shown that chemicals found in most commercial sunscreens and creams used to protect humans from deleterious effects of UV A and UVB wash off into the environment are persistent, have endocrine disruptive effects, and thus deleteriously affect marine organisms including corals.  Continue reading

Prenatal Exposure to Phthalates Linked to Language Delay in Preschool Children

MedicalResearch.com Interview with:

Carl-Gustaf Bornehag, PhD Professor, Department of Health Sciences Karlstad University, Karlstad, Sweden Icahn School of Medicine at Mount Sinai New York 

Prof. Bornehag

Carl-Gustaf Bornehag, PhD
Professor, Department of Health Sciences
Karlstad University, Karlstad, Sweden
Icahn School of Medicine at Mount Sinai
New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Phthalates have been known for long time as potential endocrine disrupters. Exposure for these kind of compounds during pregnancy have been associated to impacted sexual development, most often seen in boys. However, there is also findings showing that prenatal exposure for phthalates can be associated to neurodevelopment in offspring children.

This study is focusing on prenatal exposure for phthalates and language delay at 30-37 months of age and were conducted in Sweden (the SELMA study including 963 children) and the U.S. (the TIDES study including 370 children) with the same design, measurements and protocols.

In these two independent studies, prenatal exposure for two phthalates (DBP and BBzP) was associated to language delay in pre-school children. Unique things with this study is that we are measuring the exposure during early pregnancy (1st trimester), the size of the study, and that we examined it in two independent populations, one in Europe and one in the U.S. with similar results. 

MedicalResearch.com: What should readers take away from your report?

 Response: These compounds identified in this study are banned in many products, but since many of these (e.g., older vinyl flooring, electric cables, toys, etc.) have long life length, they can exposure people for several decades. From a consumers point of view it is good to try to find information on ingredients in these kind of products, but that can be difficult. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: We need other kind of more experimental studies that can tell us the biological mechanisms behind these effects. 

Citation:

Bornehag C, Lindh C, Reichenberg A, et al. Association of Prenatal Phthalate Exposure With Language Development in Early Childhood. JAMA Pediatr. Published online October 29, 2018. doi:10.1001/jamapediatrics.2018.3115

Oct 31, 2018 @ 6:31 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Low Level Lead Exposure Linked to Resistant Hypertension

MedicalResearch.com Interview with:

Sung Kyun Park Sc.D. M.P.H. Associate professor of epidemiology and environmental health sciences University of Michigan School of Public Health, Ann Arbor, Michiga

Dr. Park

Sung Kyun Park Sc.D. M.P.H.
Associate professor of epidemiology and environmental health sciences
University of Michigan School of Public Health
Ann Arbor, Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is poorly understood that why some patients need more drugs to control high blood pressure than others. Resistant hypertension is that blood pressure is not controlled with 3 medications of different classes including diuretics or is required 4 or more medications of different classes for blood pressure controls. Genes, obesity, physical inactivity, high salt diet, pain medications may do something. Lead is a widespread environmental toxin that can influence high blood pressure. In this study, we examined whether long-term exposure to lead, measured as bone lead, is associated with the risk of resistant hypertension.

Bone lead offers a better method over blood lead measurement to discern long-term lead exposure and accumulation.

The main finding of our study is that low-level lead exposure, measured in the tibia (hard bone), is associated with higher risk of development of resistant hypertension in a cohort of patients diagnosed with hypertension.  Continue reading

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health

MedicalResearch.com Interview with:
John W. Stanifer, MD MSc
Duke Health

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The key take home for me is that Perfluorinated Chemicals (PFAS) are a globally ubiquitous pollutant with high human exposure and concerning chemical properties that appear to be capable of kidney kidney disease through several plausible different mechanisms; yet, we know almost nothing about long term kidney health outcomes, who is at greatest risk for adverse outcomes, or which communities may be most negatively impacted.

The original impetus for the study was the discovery of GenX in the drinking water of Wilmington NC, a pollutant from a company upstream (see: https://www.newsobserver.com/news/politics-government/state-politics/article199846619.html ). It has been a huge story in NC and every day more and more is being discovered about how pervasive the pollution has become (https://www.usnews.com/news/best-states/north-carolina/articles/2017-12-05/genx-compound-now-detected-in-food-product-in-n-carolina). While this was what caught my attention, as a North Carolinian, I quickly realized that these news stories are all over the place as any quick google search will reveal towns and communities contaminated with these from truly all of the United States. As a health disparities researcher in kidney disease,

I have been studying disparate rural populations in North Carolina, including American Indians, who live in communities with exceptionally high rates of kidney disease, which does not appear to be fully explained by “traditional” risk factors alone such as diabetes, hypertension, obesity, etc. So with that context in mind, I really have begun to focus on these chemicals as potential second-hits or augmenters of kidney disease; we have been doing preliminary studies, in which we have found them in the serum of individuals from these areas, but before we can go further, we really needed to understand what all is known about them and the plausibility that they could cause kidney disease. Therefore, we conducted this comprehensive study to characterize what the potential mechanisms between these chemicals and kidney disease are and where the biggest gaps are.

MedicalResearch.com: Were you surprised by any of the findings?

Response: I was actually surprised by a few things about it. I thought that the link between these chemicals and kidney disease would be pretty weak, with very little to suggest these could be primary drivers of kidney disease. And while the epidemiological studies provided conflicting evidence that mostly but not overwhelmingly pointed toward an association, the toxicology and pharmacokinetic studies demonstrated several key mechanisms that could explain how these chemicals cause kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2– related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.

It was also very interesting to learn that these compounds are taken up by the very same proximal tubule transporters that several known nephrotoxic drugs are taken up, including most notably the herb Aristocholic Acid which was of course responsible for the Balken Endemic Nephropathy that perplexed everyone for so long.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Many gaps still exist. The biggest ones to me are that there are literally 1000s of these compounds, with only slight chemical variations, which make detection and regulation challenging. In fact most are still under proprietary aegis which prevents any type of study on them, and several of the “alternative” or “newer” PFCs (e.g. GEnX) have chemical properties that are particularly concerning, despite being marketed as “less toxic”. It is also very concerning to me that children and adolescents have the highest exposure; yet the long-term consequences are completely unknown and life-course epidemiology studies are very much needed. Finally, in the context of kidney disease, these are like so many other environmental toxins in that we don’t know how they interact to worsen or augment kidney disease in people with other risk factors such as diabetes or hypertension. So for example, wonder if you have diabetic nephropathy and are being exposed to these in high quantities? What does that mean for disparities in kidney disease and outcomes??

None of the authors have any disclosures with regards to this work.

 

Citation:

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health
A Scoping Review

John W. Stanifer, Heather M. Stapleton, Tomokazu Souma, Ashley Wittmer, Xinlu Zhao and L. Ebony Boulware

CJASN September 2018, CJN.04670418; DOI: https://doi.org/10.2215/CJN.04670418 

Sep 19, 2018 @ 2:20 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Cadmium, Smoking and Atherosclerosis Linked to Decreased Visual Function

MedicalResearch.com Interview with:
“Vision” by Victoria Ford is licensed under CC BY 2.0Adam J. Paulsen MS

Associate Researcher
EpiSense Research Program
Department of Ophthalmology&  Visual Sciences
University of Wisconsin – Madison

MedicalResearch.com: What is the background for this study?

Response: Contrast Sensitivity is a measure of visual function that indicates how well a person is able to distinguish an object against its background.  Tests of CS determine how faint a visual signal can be identified.  CS can be diminished even in those with appropriately corrected visual acuity, has been shown to have effects on daily activities (including near vision tasks), risk of falls, and driving ability.  The causes of and risks for CS impairment are understudied.  Cadmium (Cd) and Lead (Pb) are known neurotoxins that have been shown to accumulate in the retina.  Both Cd and Pb have common sources of exposure in the general population.  Our studied aimed to investigate risk factors for incident CS impairment, including Cd and Pb exposure.

Continue reading

Interventions Reduced Childhood Lead Levels, But Did Not Improve Neurobehavioral Outcomes

MedicalResearch.com Interview with:

Joseph M. Braun, MSPH, PhD  Associate Professor of Epidemiology Epidemiology Master's Program Director  Brown University School of Public Health

Dr. Braun

Joseph M. Braun, MSPH, PhD
Associate Professor of Epidemiology
Epidemiology Master’s Program Director
Brown University School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented.

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Flushing May Not Get the Lead Out of Water Lines

MedicalResearch.com Interview with:
“Pipe” by Sharon Mollerus is licensed under CC BY 2.0Adrienne Katner, DEnv
Assistant Research Professor of Environmental & Occupational Health Sciences
LSU Health
New Orleans School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Ever since Flint, there’s been a lot of interest by the public in how to reduce exposures to lead in water. Several news articles suggested that many consumers and school officials have been considering flushing as a routine exposure prevention measure.

But before Flint, we had a much worse lead in water crisis which didn’t get as much public attention- an event which happened in Washington DC between 2001 and 2004. That event demonstrated that flushing for only 15–30 seconds would expose people to lead in cities which had lead service lines- these are water pipes which bring water from the main in the street to the home. A decade of follow up research confirmed that flushing protocols are highly dependent on variables that are difficult or impossible to control, including the length, material, condition and disturbance of water service lines, and water use patterns.

However, this knowledge has not translated into widespread changes in public health messaging. In fact, the EPA still requires water utilities to promote flushing as an exposure prevention measure. The original required messaging was to run the water for 15–30 seconds. EPA eventually recognized the need for longer flush times in homes with lead service lines, and they revised the regulations to allow utilities to modify flush times, but many water utilities continued to rely on the same messaging year after year.

We thought it was about time to test the recommendations in one of these cities- New Orleans, LA.  Best estimates from the mid-1990s suggested that lead service lines may comprise 65–80% of the city’s service line system. The city’s water utility encouraged residents to flush their taps for 30 sec to 2 min daily under normal use conditions.

New Orleans is unique in that extensive hurricane damage to water infrastructure has necessitated a historically unprecedented scale of infrastructure replacement.  While over ten years have passed since Hurricane Katrina, the rebuilding process is ongoing—city and utility officials are in the process of conducting 16,000 partial lead service lines replacements- activities which are well known to destabilize scale that has been intentionally built up in the pipes over time to reduce lead from leaching into the water. We had previously observed high water lead levels in homes after line replacements- along the order of 200 ppb. To put that into perspective, the EPA’s water standard for lead is 15 ppb. But even in undisturbed normal use homes we observed lead levels as high as 58 ppb.

To evaluate whether flushing could effectively reduce water lead levels, we collected over 1400 water samples from 376 residential sites. Samples were collected at first draw, and after incremental flushes of 30–45 s; 2.5–3 min; and 5.5–6 min. We also collected survey data to better understand water use habits, homes treatment systems, and flushing practices.

Continue reading

Animal Model Suggests BPA May Have Multigenerational Effect On Communication Patterns

MedicalResearch.com Interview with:

Cheryl Rosenfeld PhD DVS Professor of biomedical sciences in the College of Veterinary Medicine investigator in the Bond Life Sciences Center, and  research faculty member for the Thompson Center for Autism and Neurobehavioral Disorders University of Missouri

Dr. Rosenfeld

Cheryl Rosenfeld PhD DVS
Professor of biomedical sciences in the College of Veterinary Medicine
investigator in the Bond Life Sciences Center, and
research faculty member for the Thompson Center for Autism and Neurobehavioral Disorders
University of Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: My laboratory has been examining the effects of developmental exposure to the endocrine disrupting chemical (EDC), bisphenol A (BPA) on later neurobehavioral responses in a variety of rodent models, including California mice. This species is unique in that both parents rear the pups and they have monogamous social structure, similar to most human societies.

We had previously found that developmental exposure to BPA or another EDC, ethinyl estradiol (EE), disrupted later maternal and paternal care by F1 offspringto their F2 pups. Rodent pups use vocalizations both in the range of human hearing (20,000 hertz or below) and outside of the range of human hearing (20,000 hertz) to communicate with each other and their parents, and for the latter, such communications serve as a trigger to provide additional parental care in the form of nutrition or warmth to the pups.

Thus, in the current studies we sought to determine if exposure of the grandparents to BPA or EE could lead to disruptions in their grandoffspring (F2 generation) pup communications that might then at least partially account for the parental neglect of their F1 parents.

We found that early on female BPA pups took longer to call to their parents but later during the neonatal period they vocalized more than pups whose grandparents were not exposed to either chemical. Such vocalization changes could be due to multigenerational exposure to BPA and/or indicate that the pups are perceiving and responding to the reduced parental care and attempting but failing to signal to their F1 parents that they need more attention.

Continue reading

ADHD More Common if Grandmother Used DES During Pregnancy

MedicalResearch.com Interview with:

Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University 

Dr. Kioumourtzoglou

Marianthi-Anna Kioumourtzoglou ScD
Assistant Professor
Environmental Health Sciences
Mailman School of Public Health
Columbia University 

MedicalResearch.com: What is the background for this study?

Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high.

Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations.

For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment.

Continue reading

No Link Found Between Autism and Maternal Fish Ingested During Pregnancy

MedicalResearch.com Interview with:
“Fish” by Dhruvaraj S is licensed under CC BY 2.0Dr Caroline M Taylor
Wellcome Trust Research Fellow
Centre for Child and Adolescent Health
Bristol Medical School, University of Bristol
Oakfield House, Oakfield Grove, Bristol

MedicalResearch.com: What is the background for this study?

Response: Mercury is a toxic metal that is widespread in the environment. In pregnancy, mercury in the mother’ bloodstream is transferred through the placenta to the fetus, where is can affect development of the nervous system. Mercury from vaccines has been the focus of attention particularly in regard to a link with autism in children. However, the amount of mercury used in the vaccines is small in comparison with mercury from the diet and atmospheric pollution, and in the EU at least, childhood vaccines no longer contain this preservative. The fear that mercury is linked to autism has persisted, despite increasing evidence that this is not the case.

The aim of our study was to look at mercury from the diet rather than vaccines – specifically from fish – in pregnant women. We measured the women’s mercury levels in their blood and asked them about how much fish they ate. We then followed up their children for 9 years and recorded how many of them had autism diagnosed within that time. We also measured how many of them had autist traits by measuring their social and communication difficulties.  The data were part of the Children of the 90s study (Avon Longitudinal Study of Parents and Children – ALSPAC), which is based in Bristol, UK.

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ADHD More Common in Grandchildren of Women Who Used DES During Pregnancy

MedicalResearch.com Interview with:

Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University 

MarianthiAnna Kioumourtzoglou ScD
Assistant Professor
Environmental Health Sciences
Mailman School of Public Health
Columbia University 

MedicalResearch.com: What is the background for this study?

Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high.

Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations.

For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment. Continue reading

Current Lead Levels in Flint Michigan Children at Historic Lows

MedicalResearch.com Interview with:

Dr. Hernan F. Gomez MD Department of Emergency Medicine, Hurley Medical Center, Flint, MI Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 

Dr. Gomez

Dr. Hernan F. Gomez MD
Department of Emergency Medicine, Hurley Medical Center
Flint, MI
Department of Emergency Medicine, University of Michigan
Ann Arbor, MI 

MedicalResearch.com: Why did you decide to do this study?

Response: Although the Flint water crisis drew recent, national attention to childhood lead exposure, environmental lead exposure has been a longtime, widespread problem in the United States.

I have recollections of far higher blood lead levels in children during my training as a young pediatrician in an economically challenged city with roughly the same population as Flint. As a medical toxicologist I have not seen any children with lead levels requiring medical treatment in years. The last time a child required inpatient chelation treatment for elevated lead levels in Flint was during the 1980s.

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Carbon Monoxide Poisoning: Acute Brain Lesions on MRI Can Predict Delayed Sequelae

MedicalResearch.com Interview with:
“Danger Carbon Monoxide” by SmartSign is licensed under CC BY 2.0Won Young Kim, MD PhD
Department of Emergency Medicine
Asan Medical Center
University of Ulsan College of Medicine
Seoul, Korea

MedicalResearch.com: What is the background for this study?

Response: Neurological symptoms of carbon monoxide (CO) poisoning can manifest not only immediately but also as late as 2 to 6 weeks after successful initial resuscitation as delayed neurological sequelae (DNS). To date, no reliable methods of assessing the probability of DNS after acute CO poisoning have been developed, which make it difficult to research the pathophysiology of DNS and targeting prevention.

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Brightly Colored or Black Older Plastic Toys Can Contain Cadmium, Lead or Bromine

MedicalResearch.com Interview with:
“Toys” by Holger Zscheyge is licensed under CC BY 2.0Dr Andrew Turner

Reader in Environmental Science (Biogeochemistry and Toxicology)
School of Geography, Earth and Environmental Sciences
University of Plymouth, UK

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The study arose through a larger investigation into hazardous substances in consumer plastics, both old and new.

The main finding of the present research was the widespread occurrence of restricted elements in old plastic toys, and in particular cadmium, lead and bromine (the latter an indicator of the presence of flame retardants); in many cases, these elements could migrate from the plastic under conditions simulating the human digestive system.

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Decorative Drinking Glasses Can Contain Harmful Levels of Metals

MedicalResearch.com Interview with:
Themed Merchandised products affectedDr Andrew Turner

Reader in Environmental Science (Biogeochemistry and Toxicology)
School of Geography, Earth and Environmental Sciences
University of Plymouth, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We had a project looking at toxic metals in consumer plastics and paints and as part of the study analysed decorated glassware product. With respect to the latter, and from a health perspective, it is concerning that metals that have been banned or restricted by so many industries over the past few decades are still used to decorate contemporary drinking glassware. Drinking glasses that are most hazardous are those where the décor extends into the lip area within 2 cm of the rim, and those that target children.

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Adulterated Proprietary Chinese Medicines Pose Serious Health Hazards

“Pills” by Victor is licensed under CC BY 2.0MedicalResearch.com Interview with:
Tony Wing Lai Mak , MBChB, MBA, FRCPath, FRCPA, FHKCPath, FHKAM(Path 

Hospital Authority Toxicology Reference Laboratory
Princess Margaret Hospital, Hong Kong

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Proprietary Chinese medicines (pCMs) and health products are generally believed to be natural and safe. However, the safety of pCMs and health products has been compromised by the illicit practice of adulteration with undeclared drugs. Such adulteration can have serious and even fatal consequences. Previous reports of pCM and health product adulteration were mainly routine surveillance data or case reports/series with a small number of affected patients.

The present study in Hong Kong, to our knowledge, is the largest case series that reports an overview of the use of various adulterated Proprietary Chinese medicine and health products and the resulting adverse effects. From 2005 to 2015, we have identified 404 cases involving the use of 487 adulterated pCMs or health products with a total of 1234 adulterants detected. The adulterants consisted of approved drugs, banned drugs, drug analogues and animal thyroid tissue.

The six most common categories of adulterants detected were nonsteroidal ant-inflammatory drugs (18%), anorectics (15%), corticosteroids (14%), diuretics and laxatives (11%), oral antidiabetic agents (10%), and erectile dysfunction drugs (6%). Sibutramine, an anorectic that has been withdrawn from the market owing to its association with increased cardiovascular events and strokes, was the most common adulterant identified. A significant proportion of patients (65.1%) had adverse effects that were attributable to these illicit products, including 14 severe and two fatal cases. These illicit Proprietary Chinese medicine and health products pose severe health hazards to the public.

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Folic Acid May Reduce Risk of Autism Associated With Pesticide Exposure During Pregnancy

MedicalResearch.com Interview with:

Rebecca J. Schmidt, M.S., Ph.D.  Assistant Professor, Public Health Sciences UC Davis California

Dr. Schmidt

Rebecca J. Schmidt, M.S., Ph.D. 
Assistant Professor, Public Health Sciences
UC Davis California

MedicalResearch.com: What is the background for this study?

Response: Maternal folic acid taken near conception has been linked to reduced risk for autism in the child in previous studies.

Separate studies show that exposure to pesticides during pregnancy is associated with increased risk for autism.

Animal studies demonstrate that folic acid and other B-vitamins can attenuate effects of certain environmental contaminants, including pesticides.

This case-control study examined combined maternal folic acid and pesticide exposures in relation to autism in the child.

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Adverse Birth Outcomes and Agricultural Pesticide Use in the San Joaquin Valley of California

MedicalResearch.com Interview with:

Ashley Larsen, PhD Assistant professor Bren School of Environmental Science & Management University of California, Santa Barbara

Dr. Larsen

Ashley Larsen, PhD
Assistant professor
Bren School of Environmental Science & Management
University of California, Santa Barbara

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The relationship between pesticides and adverse birth outcomes has been recognized as an important question for quite some time, and there have been many good studies on the topic. Since randomly exposing people to different levels of pesticides is clearly unethical, researchers focused on the health consequences of non-occupational pesticide exposure often have to choose between detailed studies that follow a couple hundred or couple thousand individuals through pregnancy or larger scale studies that use easier to observe, but less accurate metrics of pesticide exposure (e.g. nearby crops or crop types). Here we tried to provide complementary insight by bridging the gap between detail and scale using detailed pesticide use data and individual birth certificate records for hundreds of thousands of births in an agriculturally dominated region of California. While we found negative effects of pesticide use on birth outcomes including low birth weight, preterm birth and birth abnormalities, these effects were generally in the magnitude of a 5-9% increase in probability of an adverse outcome, and only observed for individuals exposed to very high levels of pesticides.

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Arsenic Still Found In Infant Rice Products

MedicalResearch.com Interview with:

Dr. Antonio J. Signes-Pastor, PhD Institute for Global Food Security Queen’s University Belfast Belfast, Northern Ireland, United Kingdom, Department of Epidemiology, Geisel School of Medicine Dartmouth College Lebanon, NH

Dr. Signes-Pastor

Dr. Antonio J. Signes-Pastor, PhD
Institute for Global Food Security
Queen’s University Belfast
Belfast, Northern Ireland, United Kingdom,
Department of Epidemiology, Geisel School of Medicine
Dartmouth College Lebanon, NH

MedicalResearch.com: What is the background for this study?

Response: Inorganic arsenic is a human carcinogen, which has also been associated with several adverse health effects including neurological, cardiovascular, respiratory, and metabolic outcomes. Early life exposure is of particular concern since it may adversely impact on lifetime health outcomes. If low inorganic arsenic drinking water is available the main source of exposure is the diet, especially rice and rice-based products, which are widely used during weaning and to feed infants and young children. In order to reduce exposure, the EU has recently regulated (1st January 2016) the inorganic arsenic maximum level of 0.1 mg/kg for rice products addressed to infants and young children. This level is also under consideration by the US FDA.

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Excessive Rainfall May Be Linked To Autism Through Nitrous Oxide Exposure

MedicalResearch.com Interview with:
Keith Fluegge BS
Institute of Health and Environmental Research (IHER) Cleveland
Graduate School, The Ohio State University, Columbus
Ohio

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The research letter discusses the possible link between rainfall precipitation and risk of autism. Earlier research suggested a link, although there remained quite a bit of skepticism surrounding the findings at the time.

The purpose of the study was to briefly highlight the role of environmental exposure to the agricultural and combustion pollutant, nitrous oxide (N2O), as a possible etiological factor in neurodevelopmental disorders. We have published a series of epidemiological investigations, reviews, and correspondences discussing this possibility. In my continued research on this topic, I learned that rainfall and extreme weather-related events, like hurricanes, drive N2O emissions, especially from nitrogen amended soils. Exposure to this particular air pollutant may, therefore, plausibly undergird the relationship between rainfall precipitation and risk of autism.

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Exposure to BPA Substitute, BPS, Multiplies Breast Cancer Cells

Sumi Dinda

Dr. Sumi Dinda

MedicalResearch.com Interview with:
Sumi Dinda, PhD, NRP, IC.

Associate Professor
Biomedical Diagnostic and Therapeutic Sciences,
School of Health Sciences and
Adjunct Associate Professor
Department of Biological Sciences
School of Health Sciences
Oakland University
Rochester, MI 48309.


MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Bisphenol-S (BPS), a substitute for bisphenol-A (BPA), has been suggested to be an endocrine disrupting compound interfering with normal hormonal activity. This bisphenol analogue is found in plastic substitutes, paper currency, and most products marked “BPA free.” Endocrine disrupting compounds interfere with the normal hormonal activity in the body.

Bisphenols, specifically, disrupt the proper functioning of estrogen receptors, such as ERα causing interference with the normal activity of the hormone estrogen. Studies suggest BPS induces ERα pathways via its estrogen-mimicking properties in the body causing increased cell proliferation resulting in increased breast cancer risk. Despite the hope of a safer substitute, studies have shown that BPS exhibits similar estrogenic activity compared to its analogue BPA, due to their structural commonalities.

BRCA1 is a commonly mutated gene in breast cancer; therefore, it is also important to study the effects of BPS on the expression of this protein. The potency of the endocrine disrupting abilities of BPS compared to BPA could show whether BPS is a suitable alternative to BPA in many everyday products.

The results of this study may contribute to the understanding of the relationship between ERα, BRCA1 expression and Bisphenol-S in breast cancer treatment and prevention.

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Pyrethroid Pesticides Linked To Earlier Puberty in Boys

MedicalResearch.com Interview with:

Jing Liu, Ph.D. Associate Professor College of Environmental & Resource Sciences Zhejiang University Hangzhou, China

Dr. Jing Liu

Jing Liu, Ph.D.
Associate Professor
College of Environmental & Resource Sciences
Zhejiang University
Hangzhou, China

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In addition to consistent observations of earlier pubertal onset in female since late 19th century, acceleration in male pubertal development also has been reported in more recent studies. Improved nutrition, health and living conditions may contribute to the secular trend towards an earlier pubertal onset. However, the potential role of environmental agents, specifically endocrine-disrupting chemicals (EDCs), also has been emphasized.

Pyrethroids are among the currently used pesticide classes placed on the list of the US Environmental Protection Agency (EPA) as potential EDCs. Pyrethroids are one of the top 10 classes of pesticides and account for greater than 30% of global insecticide usage. Increased human exposure to pyrethroids is thought to occur mainly via residues in diets and indoor residential use. The metabolites of pyrethroids have been widely identified in urine samples of adults, children and adolescents worldwide and the detection rate is usually more than 60% in human populations.

Here, we recognize pyrethroids as a new environmental contributor to the observed secular trend toward earlier male sexual maturity. For the first time to our knowledge, this work reveal a significant and positive association between pyrethroids exposure and gonadotropins levels in 463 Chinese boys, in which a 10% increase in 3-PBA (a common urinary metabolite of pyrethroids) is associated with more than 2% increase in both LH and FSH. Boys with increased urinary levels of 3-PBA have a significantly increased risk of earlier pubertal development, in which the odds of being in an advanced testicular volume and genitalia stage are increase by 113% and 268%, respectively.

Because it is difficult to test the direct causality of environmental risk factors in humans, we further sought to identify in animals how pyrethroids alter the timing of puberty. Postnatal exposure to a widely used pyrethroid pesticide, cypermethrin, can accelerate pubertal timing and induce circulating levels of gonadotropins and testosterone in male mice. Our findings reveal the activation of voltage-gated calcium channels pathway in pituitary gonadotropes and testicular Leydig cells as a newly discovered mechanism of pyrethroid-induced early pubertal development in the male.

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Environmental Pyrethroids May Be Associated With Behavioral Problems in Children

MedicalResearch.com Interview with:
Professor Jean-Francois Viel
Department of Epidemiology and Public Health
University Hospital
Rennes, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention.

Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled).

Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament).

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Thyroid Hormone Disruptors Found In Household Cats and Dust

MedicalResearch.com Interview with:

Jana Weiss PhD Department of Environmental Science and Analytical Chemistry Stockholm University

Dr. Jana Weiss

Jana Weiss PhD
Department of Environmental Science and Analytical Chemistry
Stockholm University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In an earlier publication, we could see an association between elevated concentrations of brominated flame retardants (BFR) in the blood of cats with developed Feline hyperthyroidism, compared to healthy cats (Norrgran et al 2015, ES&T 49:5107-5014). To establish the exposure pathway we now took paired samples from healthy cats and dust from their households. We also analysed the cats food to include another major exposure pathway. In total 17 families participated. They lived in houses in the countryside or in apartments in the city. All families had kids under 12 years of age living at home, thus representing a household with typical child products. The dust was sampled from the living room, the child’s room and from the adult’s bedrooms. We could not see any difference in the composition of compounds between the rooms, but we saw that levels were in general higher in the living room compared to the other two rooms. This was expected as many products being treated with BFRs can be found in the living room.

We could see that higher levels of some  brominated flame retardants in the dust were correlated to elevated levels in the cat’s blood. Therefore, this hypothesized exposure pathways is now statistically established. We could also confirm cat food to be the major exposure pathway for naturally brominated compounds coming from the marine food web, such as6-OH-BDE47, a known thyroid hormone disruptor. Continue reading

Smokers Who Switch Completely To E-Cigs Reduce Their Exposure to Toxins

MedicalResearch.com Interview with:
Dr Lion Shahab
MA (Oxon) MSc MSc PhD CPsychol AFBPsS PGCLTHE
Senior Lecturer in Health Psychology
Department of Behavioural Science and Health
University College London
London 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To date most studies on e-cigs have either looked at the product itself, i.e. analysed vapour/aerosol or e-liquid, or investigated its effects on animal and cell models. Only very few studies have looked at actual body-level exposure in users of e-cigarettes to evaluate their safety, and this study is the first to explore this in long-term real-life users of e-cigs.

We find that compared with people who continue to smoke conventional cigarettes, those who switch over completely to using e-cigarettes long-term (1.5 years) dramatically reduce their exposure to cancer-causing chemicals to levels observed in users of nicotine replacement products like nicotine patch or gum (which are known to be safe when used long-term).

Our results also suggest that while e-cigarettes are not only safer, the amount of nicotine they provide is not noticeably different to conventional cigarettes. This can help people to stop smoking altogether by dealing with their cravings in a safer way.

MedicalResearch.com: What should readers take away from your report?

Response: The public has been receiving very mixed signals about the safety of e-cigarettes, with some reports claiming to show that they are as harmful as smoking. These reports have been based on studies that bear little relationship to exposure of e-cigarette users in the real world.

We report the first study that has actually measured the intake of potentially harmful chemicals in e-cigarette users, and compared this with people using licensed nicotine products (e.g. nicotine patches), and cigarettes. This study should reassure smokers who are thinking of switching to an e-cigarette that if they manage to cut out cigarettes altogether, they should see a large benefit in terms of their health.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The next step would be would be to follow smokers over a longer period of time who switch over to using e-cigarettes and measure potential harm and risks not only in relation to cancer but also lung function and cardiovascular health.

MedicalResearch.com: Is there anything else you would like to add?

Response: None of the other authors have received funding from an e-cigarette company or any organisation acting for one.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Shahab L, Goniewicz ML, Blount BC, Brown J, McNeill A, Alwis KU, et al. Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study. Ann Intern Med. [Epub ahead of print 7 February 2017] doi: 10.7326/M16-1107

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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