Please check the CHE-WA website to stay abreast of the latest postings, news and events: http://washington.chenw.org.
To join the Collaborative on Health and the Environment (CHE) and CHE-Washington, please complete the form at http://www.healthandenvironment.org/roles/register?&phase=registerform. Be sure to mark that you want to join the Washington State Regional Group at the bottom of the application.
November 1, 2006
6:30 - 8:30 p.m.
Seattle, Washington
at Miller Community Center, 330 19th East
The evening features presentations on the Pollution in People body burden study, discussion and a fun dinner gathering, with Patricia Dawson, MD, study subject, breast cancer surgeon; and and WPSR Board of Sponsors member Erika Schreder, Washington Toxics Coalition staff scientist and report author. Presented by Washington Physicians for Social Responsibility. Please RSVP to the contact person below.
Contact: 206-354-2170 or nancyd@wpsr.org
November 5, 2006 (Bellevue, 2:00 - 5:00 p.m. at North Bellevue Community Center)
or November 6, 2006 (Seattle, 6:00 - 9:00 p.m. at Swedish Medical Center)
Lotion, deodorant, shampoo, makeup ... we use these products every day. But did you know that many cosmetics contain chemicals linked to cancer and birth defects? And did you know these chemicals end up in the waterways and wildlife of the Puget Sound region? Most people don't. That's why we're inviting you to a free community forum about cosmetics, your health, and the environment this November. Come find out about ingredients used in cosmetics and personal care products, their cumulative effects on our health and environment, and what consumers can do to protect themselves, their families and the environment. Refreshments will be served. And free samples from natural products companies.
Website: http://www.toxicfreelegacy.org/safecosmetics/forums_Nov06.html
Contact: Margaret Shield at 206-632-1545 x123 or fill out the web form at http://www.actionstudio.org/public/page_view_all.cfm?option=begin&pageid=7390
Abstracts: by November 6, 2006
Conference: March 29 - 31, 2007
Washington, DC
at the Howard University School of Law
It has been more than 25 years since the Warren County protest that arguably gave birth to the environmental justice movement in this country. It has been twenty years since the United Church of Christ published Toxic Waste and Race in the United States, a nationwide study that further documented the association between hazardous waste facilities and the racial composition of the communities hosting such facilities. It has been ten years since the United Church of Christ, the National Association for the Advancement of Colored People and the Center for Policy Alternatives published Toxic Waste and Race Revisited, a study that found that the associations documented in Toxic Waste and Race were just as active as they were in the original study. The National Small Town Alliance, the Howard University School of Law, and the United States Department of Energy are teaming with others to review the environmental justice movement and to determine the State of Environmental Justice in America. This effort will team with communities, scholars, researchers and others to issue a comprehensive report and conduct this conference.
Call for papers: The conference planners are inviting individuals to submit a short abstract of no more than 250 words that describes the current state of environmental justice in one of the areas listed below, preferably placing your discussion in the context of changes that have occurred in the selected area since Warren County. For a list of suggested topics, please contact ejinamerica2007@yahoo.com. Abstracts are due November 6, 2006.
Contact: Michelle Hudson, hudsonmi@saic.com
November 8 - 9, 2006
University Place, Washington
at the Pierce County Environmental Services Building
The Puget Sound Partnership meets regularly in its quest to develop an aggressive 15-year plan to solve Puget Sound's most vexing problems. The Partnership is holding a series of general public forums and specific scientific forums throughout the summer and fall.
Website: http://www.pugetsoundpartnership.org/
Contact: Martha Neuman, 206-625-0230 or mneuman@sharedsalmonstrategy.org
November 18, 2006 (Olympia) or November 19, 2006 (Seattle)
9:30 a.m. - 4:30 p.m.
Olympia and Seattle, Washington
Olympia: at the Unitarian Universalist Congregation Building, 220 E. End St. NW
Seattle: the location is TBD
This is a postelection gathering to plan for the new year and discuss common ways we will benefit from fixing our broken democracy. United on this issue, we can more easily achieve our various goals as citizens and citizen-based organizations. Those attending will discuss how we can fix democracy and speed our progress on these issues: 1) corporate power over government and corruption of democracy; 2) more effective tools for change; 3) basic assumptions and focus of activism; and 4) common bonds and strengths.
Website: http://www.SoundDemocracy.org
Contact: 360-236-9684 or JacquiAfd@comcast.net
CHE-Washington welcomes these new members:
For a searchable database of organizations with which CHE-WA members are affiliated, please visit http://washington.chenw.org/members.html.
The Association of State and Territorial Health Officials (ASTHO) is the national nonprofit organization representing the state and territorial public health agencies of the United States, the U.S. Territories, and the District of Columbia. ASTHO's members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy, and to assuring excellence in state-based public health practice.
ASTHO is seeking to fill an Analyst, Environmental Health Policy position in Washington, DC. The policy analyst reports to and assists the Director, Environmental Health Policy, principally with project deliverables for federally funded environmental health-tracking projects. This project focuses on the collection, integration, analysis, interpretation, and communication of data about environmental hazards, exposures to environmental hazards, and human health effects potentially related to environmental hazards. The policy analyst will spend considerable time working on a risk communications project and will assist and support other ASTHO environmental health projects as necessary. Specific duties and the application contact are listed at http://www.astho.org/index.php?template=employment.php (Search for "analyst" in "District of Columbia".) A bachelor's degree and experience are required. The salary is in the high $30's to low $40's with excellent benefits.
The National Environmental Education & Training Foundation (NEETF) is seeking an Associate, Health & Environment. The goal of the Health & Environment Program is to improve public health by advancing environmental health literacy. The program includes projects involving partnerships with health professional organizations, public health groups and federal agencies to provide environmental education to physicians, nurses and other primary healthcare providers. Candidates should hold a bachelor's degree and possess two years of project management experience, exhibit excellent oral and written communication skills, possess a high level of professionalism and ability to function effectively in a team environment, as well as other skills. To apply, please send a resume and cover letter to health@neetf.org. For more information about NEETF, please visit http://www.neetf.org/health.
by Peggy Andersen, Associated Press, Seattle Post-Intelligencer
October 31, 2006
http://seattlepi.nwsource.com/local/6420ap_wa_epa_regional_director.html
SEATTLE -- The region's new Environmental Protection Agency administrator, a former Dow Chemical executive, was greeted by about two dozen protesters in her first day on the job. Activists raised concerns Monday about Elin Miller's 1996-2004 stint at Dow and her subsequent work with Arysta LifeScience of Tokyo, a pesticide maker. Miller also served as chief deputy of California's Department of Pesticide Regulation and in 1995 was named to head California's Department of Conservation, which oversees oil and gas production.
"EPA has a responsibility to protect the community and an appointment like this reflects their unwillingness" to do so, said Jeri Sundvall-Williams, executive director of the Environmental Justice Action Group, in a news release from activist groups. It's a case "of the fox guarding the henhouse," she said. "We know the public and EPA are not always going to agree on everything. We want people to know they're being heard," agency spokesman Mark MacIntyre said in response.
Environmentalists are also concerned about some reshuffling in the office of civil rights and environmental justice for the EPA's Region X, which covers Washington, Oregon, Idaho and Alaska. That office traditionally handles such issues as cleanup of industrial sites in poor neighborhoods where residents are concerned about exposure. "They're closing the office and scattering the staff to different programs.... It's an entirely different level of commitment," said B.J. Cummings of the Duwamish River Cleanup Coalition in Seattle. "Duwamish River neighborhoods suffer from Superfund sites, air emissions and industrial waste that the rest of Seattle is largely spared," Cummings said . "It's no coincidence that these communities are our poorest and represent the largest Latino population in the city. They need more protection, not less."
MacIntyre said two in the office who focused on environmental justice are being moved to the office of ecosystems, tribal and community affairs. The third staffer, assigned to civil rights, will remain in the office of management programs, where the three-member unit had been based. "That's the best fit for that job. People in that unit are already working on service to communities, working with farmworkers on pesticides and other issues," MacIntyre said. "We understand what people are saying ... but we feel pretty strongly that the way we're going to be organizing the office of environmental justice will make the effort stronger, not weaker," MacIntyre said.
by Martin Mittelstaedt, Toronto Globe and Mail
October 31, 2006
http://www.theglobeandmail.com/servlet/story/RTGAM.20061031.wxmultiple31/BNStory/specialScienceandHealth/home
It has long been thought that multiple sclerosis isn't an equal-opportunity disease when it comes to afflicting women and men. In recent decades, far more women have been getting the ailment, with most experts believing that multiple sclerosis in Canada afflicts about twice as many females as males. But a team of researchers combing over Canadian data on those with multiple sclerosis has made a startling discovery: Women with the disease have inexplicably started to outnumber men by a ratio of more than 3 to 1. And what is more, the researchers have found that the gender ratio, rather than being stable as has been commonly thought, has been rising in an almost uninterrupted fashion for at least 50 years, jumping from about 1.9 women for every man for those born in the 1930s, to 3.2 women for every man for those born around 1980.
The rise over this long period has been so pronounced that it has made multiple sclerosis an overwhelmingly female-dominated disease, even though it wasn't originally. Until the 1940s most doctors believed there was no difference in the incident rate based on gender, and it was only in the 1950s and 1960s that physicians began to notice that the disease was more common in women. A paper on the new findings is appearing in the November edition of the journal Lancet Neurology and the researchers who conducted the study of the Canadian multiple sclerosis data are speculating that something new has arisen in the environment in the past half-century to make women far more likely to develop the disease, a factor that inexplicably doesn't seem to affect men.
If multiple sclerosis rates are rising because of an environmentally induced cause among women, the discovery of what this might be would be highly significant because it suggests a possible avenue for preventing the often disabling disease. "What is going on here is something presumably that is preventable," said George Ebers, a professor in the department of clinical neurology at the University of Oxford in the United Kingdom and lead author of the study. "We just need to find out what it is in the environment because it has to be environmental. Your genes don't change over two generations, three generations."
Scientists do not know what causes multiple sclerosis, although the disease is more prevalent in wealthy countries. Canada has one of the highest rates in the world, as do many nations in Northern Europe, which has led to speculation the cause may have something to do with vitamin D. Levels of the vitamin fall off in northern countries during the winter months because sunlight isn't intense enough to allow people to make it in their skin.
For those with multiple sclerosis, the research confirms what has often been the subject of anecdotal observations. Marla Zaichick, who was diagnosed with the illness 10 years ago and is part of an organization called Women against MS, says the gender difference is readily apparent in groups of people with the disease. "You definitely see it," said Ms. Zaichick, who lives in Mississauga. "Yes, you do see men," but women are "just so much more predominant." For Ms. Zaichick, who has a sister with MS and a brother who doesn't have it, one of the worries about the greater odds of women getting the disease is that she has a 10-year-old daughter, Ariel, and is concerned that she may be at higher risk. The paper said "the factors causing the increasing number of women with multiple sclerosis can only be speculated on, but given the short duration over which this is occurring, genetic change can be excluded."
Among the possible factors that could be causing the trend, the paper cited the changing role of women in the work force, dietary habits, changes in the timing of childbearing years, the falling age at which girls have their first period, and changes in outdoor activity levels. If there is a connection to vitamin D, it could be through less time spent outdoors and an increase in time spent indoors at work. Prof. Ebers said a link to vitamin D is "certainly very plausible." Prof. Ebers said previous research on half-siblings has found that mothers seem to be the ones influencing whether their children get MS, suggesting that something is increasing the risk of the disease during fetal life.
The rise in the sex ratio began before women started using oral contraceptives and before woman began smoking in great numbers. About 1,000 new cases of the disease will be diagnosed this year in Canada, and an estimated 55,000 to 75,000 people are currently living with it. Lifetime medical costs per person with the disease are estimated at about $1.6-million. Most cases are diagnosed between the ages of 15 to 40, making it a disease with large potential economic impact because it generally strikes people in the prime of their adult years.
The disease attacks the protective myelin covering of the central nervous system causing symptoms such as extreme fatigue, loss of balance, speech problems and even complete paralysis. Multiple sclerosis is considered an autoimmune disease, but it is not known why the body's immune system begins to malfunction and attacks myelin. Previous research has made some odd discoveries about multiple sclerosis, such as a recent finding that those born in the Northern Hemisphere in May are more likely to develop it than those born in November, who had the lowest risk. This finding also suggests a role for vitamin D -- but in mothers -- because their May-born children would have less of the nutrient during fetal development, most of which took place in fall and winter.
By looking at a Canadian databank that has detailed information on about 27,000 people with the disease, Prof. Ebers and the other researchers calculated sex ratios starting with those born in 1931 up to 1980, or people who would have a relatively recent diagnosis. There were about 19,500 women and 7,600 men in the database. Because of the large number of people whose information is in the database, one of the most extensive in the world, the results of the research are considered statistically significant and not due to chance.
by Elizabeth Weise, USA TODAY
October 31, 2006
http://www.usatoday.com/news/health/2006-10-30-ecoli-bottomstrip_x.htm
The first rule of public health is one most of us learn in kindergarten: Don't eat poop. But that's what the people were eating who were struck down with E. coli in the late summer outbreak tied to bagged spinach, California health officials now say. There was deadly E. coli O157:H7 in water samples taken on the Salinas Valley ranch where the spinach was grown, in wild pigs that rampaged through the fields, in cattle and calves that grazed nearby, and on cow manure in adjacent pastures, says Kevin Reilly, deputy director of prevention services for the California Department of Health Services. "It's not unusual or unexpected that we'd find O157:H7 in the environment where those species exist," Reilly says. Three people died and more than 200 others were sickened in the outbreak that spread to 26 states.
Because E. coli lives in the gut of warm-blooded animals (though it likes cattle and deer best), it gets transferred between them via what the squeamish call "fecal contact." People have been experiencing such contact for as long as there's been farming. Before the advent of modern agriculture, all fields were fertilized with manure, and wild animals were abundant. But today the pathogenic reality of agriculture is different -- and deadly. "The microbial world has changed, but people haven't quite caught up with it," says Douglas Powell, a professor of pathobiology at Kansas State University in Manhattan. It's certainly caught up with us. There have been 20 reported outbreaks of E. coli O157:H7 in lettuce or leafy greens since 1995. And Monday, the Centers for Disease Control and Prevention said it is tracking a salmonella outbreak, possibly linked to produce, which has sickened at least 172 people in 18 states.
Troubling trends
Several trends have converged to create a perfect storm of dangerous produce:
These trends are causing scientists to rethink their assumptions about how bad bugs get into our food. And if conventional wisdom about the transmission of food-borne illnesses is wrong, getting rid of them is going to be a whole lot harder, says Jack Guzewich, an epidemiologist at the FDA's Center for Food Safety and Applied Nutrition.
A call for action
Companies are going to have to start talking not just about how natural and wholesome their food is, but exactly what they are doing to protect customers from microbial illnesses, says Powell. A newly assembled group of produce buyers is calling on three of the major produce industry associations to come up with new, enforceable food safety standards. The buyers represent some of the biggest food retailers, including Safeway, Costco and Denny's restaurants. They sent a letter to the Produce Marketing Association, United Fresh Produce Association and Western Growers Association last Thursday. They set a Dec. 15 deadline for putting together safety protocols for lettuce and leafy greens and a Feb. 15 deadline for melons, tomatoes and green onions. "We believe the power to change the industry is in the hands of the buyers," says Tim York, president of Markon Cooperative and leader of the ad hoc group.
by Angela Epstein, UK Daily Mail
October 31, 2006
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=413581&in_page_id=1774&in_a_source=
She's just a teenager and lives in the country -- but Bethan already has 17 different gender-bending chemicals in her blood. As our disturbing tests reveal, many adults have TWICE that...and it's common household products that are to blame: They seem innocuous but many everyday household products -- from face creams to computers and even carpets -- contain chemicals that could seriously damage our health. Several studies have recently linked gender-bending chemicals to genital malformation, infertility and cancer. Last week a study for the World Wildlife Fund (WWF) suggested that they could account for the rise in breast cancer -- over the past 30 years the number of cases has risen by 81 per cent.
These chemicals are known as hormone disruptors or EDCs (endocrine disrupting chemicals). They upset the delicate hormonal development of an embryo, fooling targeted cells into behaving differently. Or they act as a blocker, preventing natural hormones such as the male sex hormone testosterone from functioning properly. Both men and women can be affected by exposure to such chemicals, both inside the womb and later in life. The worry is that some chemicals can bio-accumulate (build up in body fat). There may only be a small amount in the environment, but they accumulate through the food chain. They get into our water supply, are ingested by fish and are passed on to humans. With each step in the chain more chemicals are passed on. We are, therefore, potentially exposed to a huge amount.
EDCs also settle in fatty tissue such as breast tissue, which could explain the rise in breast cancer, says Dr Andreas Kortenkamp, director of the Centre of Toxicology at London University's School of Pharmacy, who produced the latest study for the WWF. 'It is well-known that natural hormones play a role in the development of breast cancer,' says Dr Kortenkamp. 'This raises the question whether chemicals that mimic hormonal activity could be a cause, too.' He says that, in isolation, many EDCs may not pose a dramatic health risk. 'The concern is that there are so many of them in circulation in our environment and no one yet knows the long-term effect of this cocktail of chemicals.' The WWF is pushing for a precautionary approach and is campaigning for strong EU chemicals regulation.
In the meantime, experts suggest we limit our exposure. Some of the more worrying chemicals are:
The only way to assess your individual exposure is by having a special blood test, which will reveal if you have any of these gender-bending chemicals. Here three people have their levels checked. Professor Richard Sharpe, of the Medical Research Council's Human Reproductive Unit, comments on the results. Although there is no set guideline as to what is a 'dangerous' level, Professor Sharpe explains: 'The problem is we don't know their long-term effect so you don't really want any in your system.'
Bethan Jones, 14, lives on a farm in Welshpool, Wales, with her parents Enid, 53, and Arwel, 46, and her brother Alwyn, 11.
Chemical Test Results
OCPs: 2
PCBs: 11
Flame retardants: 3
Phthlates: 1
TOTAL: 17
Bethan says: I have always been a bit of a tomboy. I love playing football and doing sport and I don't bother with make-up. So I was shocked when I heard about a study which said that girls with high levels of PCBs in their blood preferred masculine-type games. Eleven types were found in my blood. I've been told this is lower than the adult testers, but then I'm half their age and it's not the same as not having any there at all. It was weird to think these chemicals could influence the way I play. I don't understand how all these chemicals could get into my bloodstream. I live a healthy outdoor life. I'm always helping on my parents' farm and my mum cooks great home-made meals every night. We eat lots of meat such as lamb and beef, with vegetables from our farm or local markets.
My mum stopped using a microwave because she was worried about the possible effects on our health. She also stopped using nonstick pans, and instead of air fresheners we keep the windows open as much as we can. Our farmhouse is quite old and the furnishings are very old-fashioned so I was surprised to find I had flame retardants in my blood. The only toiletries I use are shampoo, conditioner and soap -- nothing fancy, but it's scary to think that the phthlates could have come from such ordinary products. Dad does use some kind of chemical spray on some of the fields but I'm never nearby when he does. Anyway, the pesticides found in my blood have been banned for many years -- which shows how long they stay in the environment. The fact that I had two pesticides in my blood when I noticed that one of the other testers Matt, who doesn't live on a farm, has three, suggests that living nearby has nothing to do with it. It seems these things are everywhere. It's horrible to think that some of these chemicals could affect my health or the health of any children I have in the future. It's a long way off, but it is a worry just the same.
Expert's verdict
Bethan's results really brings home the effects of exposure to environmental chemicals. She's a young, growing girl but already has many chemicals in her blood. Bethan is almost 30 years younger than Beth, yet had an equal number of phthlates. Phthlates can be risky for the developing foetus -- they can get into breast milk and could be passed on to any children that Bethan may have. Bethan should try to limit her exposure now. And especially when the time comes for her to plan a family. We don't know what role they will play in her future.
Beth Williams, 42, an ecology lecturer, lives in Stourport, Worcestershire, with her partner Andrew Sharkey, 43, an operations director and their children Shamus, 15, and Connie, 13.
Chemical Test Results
OCPS (pesticides): 2
PCBs: 22
Flame retardants: 3
Pthalates: 1
PFCs: 2
TOTAL: 30
Beth says: In my late 20s I was diagnosed with cancer in the soft fatty tissue of my right leg. I had liposarcoma, which is extremely rare. Although I was successfully treated with surgery and radiotherapy, it did make me think about what could have triggered the disease. I then found out that there is a potential connection between liposarcoma and pesticides -- the chemical residues can build up in fatty tissues. I realised that ordinary fruit and vegetables could have put my health at risk -- which is why for several years we have grown our own fruit and vegetables organically. That's why I couldn't believe that my blood contained two types of OCPs -- or pesticides. I imagine that some of the chemicals come from food packaging. I lead a busy life, juggling family and work life and we can eat ready-made or takeaway meals four times a week.
I also sit in front of a computer -- which exposes me to brominated flame retardants in the dust coming from the machine -- for a few hours every day. I'd never thought about this but now I'm terribly worried. I was also surprised by the presence of flame retardants. We live in an old Victorian terrace with few modern appliances and around 50 per cent of the house is tiled.
Even more alarming was the discovery of a phthalate in my blood -- I already knew that these had gender-bending properties and I deliberately don't use many cosmetics, so where did this come from? The results of the blood tests shocked me. They made me realise how exposed we are on a daily basis to potentially hazardous chemicals. As a result, I'm now going to make some changes to my routine. If I needed to buy a new sofa I'd get one second-hand because the level of flame retardants would be much lower. I use chemical-free shampoos. But I still have no control over the gender-bending chemicals in the environment.
I'm particularly worried about the link between these chemicals and breast cancer. I have several friends in their 40s fighting the disease. As a child I don't remember any of my mother's friends having the disease at that age. We are clearly doing something very wrong to ourselves, to our bodies and the environment.
Expert's verdict
OCPs and PCBs were banned many years ago so the fact they're in Beth's blood now is a potent illustration of how persistent these chemicals can be. They accumulate in fat in the food chain -- such as in milk and animal products -- and build up over the years. That is a major worry for all of us, including Beth. I am surprised that only one phthalate was found since they are absolutely everywhere. The greatest threat they pose is to a developing foetus, so thankfully Beth isn't at the stage in life where she is planning to have a family. Some of the other chemicals in Beth's blood may be connected to breast cancer, so Beth should carry out regular self-examinations.
Matt Farrow, 32, a website manager, lives in Goldaming, Surrey with his partner, Jackie Drennan, 32 and their 12-week-old daughter, Molly.
Chemical Test Results
OCPs: 3
PCBs: 23
Flame retardants: 6
TOTAL: 32
Matt says: I've always strived to live a really healthy life. I don't smoke and I like to exercise regularly: I go running, use the gym, and cycle to work. I'm a vegetarian and even with a new baby in the house, we always make sure that we eat freshly-cooked meals every evening. We also try to use environmentally-friendly household products such as Ecover as well as hypoallergenic soaps and shampoos. So I was really angry when I received the results of my blood testing. It seems that despite my efforts to live a blameless life my body is still exposed to and absorbs potentially hazardous chemicals.
I seem to have a lot of flame retardants -- I wonder if they come from the new mattress and sofa that I bought this year. It has certainly made me think twice about buying any new furnishings for the house. I do sit in front of a computer for long periods of time -- up to 12 hours a day -- so maybe that has caused my exposure. I was also surprised by the PCBs since I believe they often get into the body through contaminated fish -- and I'm a vegetarian. I eat a lot of fruit and vegetables, only around 50 per cent of which are organic. But this is now going to have to change as there were pesticides in my blood, too.
It took us six months to conceive our first child. Looking back, I wonder if chemicals could have played a part? Now that I am a father I worry how much this could compromise my baby's health in the future. She is being breast fed at the moment but some chemicals can get into breast milk. At some point she will go onto formula milk, yet Bisphenol A has been found in babies' bottles. She is at such a vulnerable stage of her life. While we do everything we can to limit her exposure it seems this chemicals are everywhere.
Expert's verdict
Matt can't directly transfer chemicals from his body to his daughter's in the same way as a breast-feeding mother. But his partner could have similar results and that is worrying. Chemicals found in Matt's blood might have caused DNA damage to sperm -- he mentioned that it took six months to conceive. He also has a high level of PCBs which -- because of the rising rates of testicular cancer and their potential link to chemicals -- means he should regularly check himself. It is the unknown of the effect of any of these chemicals in any amount in our blood that is troubling so even though Matt's results seem better than the those of the others, he may not be safe.
by Kim Rahn, Korea Times
October 30, 2006
http://times.hankooki.com/lpage/nation/200610/kt2006103018275111960.htm
The more mercury pregnant women are exposed to, the greater chance they have of giving premature birth to babies, according to a study. Research on 85 pregnant women conducted by Ha Eun-hee, a professor of Ewha Womans University's preventive medicine department, showed that women with high levels of mercury in cord blood are three to five times more likely to give premature birth, which is to deliver a child in less than 37 weeks of pregnancy. Ha announced the study results on Friday during a meeting of the Korean Society for Preventive Medicine.
According to the study, the 50 percent of the 85 people with the highest levels of mercury had a 3.1 times greater chance of having a premature delivery than the lower 50 percent. The upper 25 percent had a 5.3 times more of a chance than the lower 75 percent. "Mercury in cord blood, which connects the mother and the fetus, is critical to the child, as it directly flows to the fetus," Ha said.
The study disclosed two main reasons for the mercury concentration -- dental treatment with amalgam and fish consumption. Pregnant women who had treatments with amalgam during the pregnancy had an average of 5.15 micrograms of mercury per 1 liter of blood, 1.3 times more than the 3.98 micrograms in women who hadn't had the treatment. The mercury level increased in proportion to the frequency of treatment. Women undergoing the amalgam treatment fewer than three times had an average 4.8 micrograms of mercury in their blood, while those having undergone the treatment three to six times had 5.04 micrograms, and seven times or more 5.2 micrograms. Also, a woman who never had fish during pregnancy had 4.6 micrograms of mercury per 1 liter of blood, while the mercury level of women who consumed fish more than four times per week had an average mercury level of 8.3 micrograms. "The nation should prepare education programs for pregnant women, advising them not to undergo dental treatments with amalgam," Ha said.
Professor Yi Seung-muk at Seoul National University's graduate school of public health said a great deal of mercury in the air above the Korean Peninsula is from China's industrial areas. Yi's team measured mercury levels in the air and followed the path of wind to China. "We obtained Chinese institutes' data about the industrial locations emitting mercury and compared them with our data, which correlated with the Chinese data," Yi said. It was the first South Korean research about mercury pollution from China, although international academic circles have presented studies about the issue. It is said that half of the world's mercury pollutants in the air come from the country with the largest populace.
"Mercury is contained not only in the air, but also in fish. Korea and Japan, which are near China and consume large amounts of fish, have a greater chance of being exposed to mercury than other countries," Yi said. The research was announced at a meeting of the Korean Society for Atmospheric Environment on Friday. Yi will soon present the amount and ratio of pollutants carried to Korea.
by Manny Fernandez, New York Times
October 29, 2006
http://www.nytimes.com/2006/10/29/nyregion/29asthma.html?pagewanted=1&_r=1&adxnnl=0&adxnnlx=1162272533-6LE2dBFj0vJkha5UVWFbqA
In New York City, air pollution levels have typically been monitored by inanimate objects, at more than a dozen locations around town. But in the South Bronx, from 2002 to 2005, air pollution monitors went mobile. They went to the playground, to the gritty sidewalks, even to the movies. A group of schoolchildren carried the monitors everywhere they went. The instruments, attached to the backpacks of children with asthma, allowed researchers at New York University to measure the pollution the children were exposed to, morning to night.
The South Bronx is home to miles of expressways, more than a dozen waste-transfer stations, a sewage-treatment plant and truck traffic from some of the busiest wholesale produce, meat and fish markets in the world. It is also home to some of the highest asthma hospitalization rates for children in the city.
The N.Y.U. study found that the students were exposed to high levels of air pollutants in their neighborhoods and that children in the South Bronx were twice as likely to attend a school near a highway as were children in other parts of the city. The findings paint a bleak picture of the air quality in one of the poorest sections of the city and have focused renewed attention from community groups and elected officials on curbing pollution from truck exhaust. "The levels did surprise me," said José E. Serrano, the Bronx representative whose district includes the South Bronx. "They are really telling us that this is a very serious problem." Mr. Serrano, who is a Democrat and who helped secure federal money for the study, and the researchers held a news conference this month about the findings.
Ten children from each of four public schools in the South Bronx -- P.S. 154, M.S. 302, M.S. 201 and Community School 152 -- took part in the study. They were given wheeled black and dark blue backpacks outfitted with a battery-powered pump and an air filter, along with other instruments. "You rolled it, so it wasn't really that heavy," said Derrick Reliford, one of the students. The children, who were volunteers ages 10 to 12, each took part in the study for a month. They reported to researchers stationed at the schools twice a day and kept diaries on their asthma symptoms and daily activities. Their lung function was tested, and the filters from their backpacks were regularly changed and analyzed. A van parked near the schools served as an air-monitoring lab.
Derrick, 14, took part in the study in 2002, when he was a student at Public School 154 on East 135th Street. The school is across the street from the Major Deegan Expressway. His great-grandmother Evelyn Reliford, 70, said she never thought much about the air pollution in the Mott Haven neighborhood. "I didn't really worry about it until they took the study," said Mrs. Reliford.
Airborne particles like dust, soot and smoke that are less than 2.5 micrometers in diameter are small enough to lodge themselves deep in the lungs. Studies have linked pollution of this sort to respiratory problems, decreased lung function, nonfatal heart attacks and aggravated asthma, according to the United States Environmental Protection Agency. E.P.A. officials said these fine particles, a significant portion of which are produced by diesel engine emissions, lead to 15,000 premature deaths a year nationwide.
In the South Bronx study, of the 69 days for which measurements were taken over the three-year period, average daily exposure to fine-particle pollution for a group of 10 children exceeded the E.P.A.'s new standard on 18 days. The standard will be 35 micrograms per cubic meter in December. "I think it's an indicator that these kids are being exposed to very high fine-particle concentrations on a fairly regular basis," said George Thurston, associate professor of environmental medicine at the N.Y.U. School of Medicine, who was one of the study's principal researchers.
Walter Mugdan, director of environmental planning and protection for the E.P.A. region that includes New York, said he had not seen the detailed study, which was financed in large part by an E.P.A. grant. He cautioned that there were differences between the methods used by the agency and by researchers to gather data on air pollution. Bronx County is one of 10 counties in the state that exceed current federal air quality standards for fine-particle pollution. "We know that this is an area that has air quality that isn't satisfactory," he said.
Four Bronx organizations that supported the study -- including the Point, a Hunts Point community group -- have asked pro bono lawyers to look into their legal options to get the E.P.A. and the state to improve air quality in the South Bronx. "Hopefully, this will ring the alarm bells a little louder," said Kellie N. Terry-Sepulveda, executive managing director of the Point. New York State must submit a plan to the E.P.A. by April 2008 detailing how it will bring its fine-particle pollution levels into compliance. States that fail to submit or implement their plans risk losing federal highway money. All states must bring their levels of fine-particle pollution into compliance by 2010, though they can ask for an exemption seeking more time, E.P.A. officials said.
The State Department of Environmental Conservation said in a statement that the state plan is under development and will be released for public comment late next year. Fine-particle pollution levels are expected to decrease as a result of city, state and federal measures already in place, the statement said. Gov. George E. Pataki signed a bill in August that requires that all diesel vehicles owned by the state or working on state projects use low-sulfur diesel fuel and be retrofitted with the best available technology to reduce emissions.
Dr. Thurston said the findings of the study, which will be published in a scientific journal next year, showed that only 5 to 10 percent of the fine particle pollution was soot from diesel exhaust, but it was that portion that seemed to be having the worst effect on the children's asthma. He said their symptoms, like wheezing, doubled on days when pollution from truck traffic was highest. The study also examined the proximity of expressways to schools. Four expressways -- the Cross Bronx, Major Deegan, Bruckner and Sheridan -- and the Bronx River Parkway run through or around the South Bronx. About one-fifth of all students from prekindergarten to eighth grade in the area go to schools located within 500 feet, or about two blocks, of major highways, the study showed. The research was conducted by the Institute for Civil Infrastructure Systems at the university's Wagner Graduate School of Public Service.
Asthma, which causes wheezing, coughing and shortness of breath, is the most common chronic disease among children. In the Bronx, the borough with the highest percentage of children, the asthma hospitalization rate for boys and girls under 14 is 9.3 per 1,000 children. Of the 10 neighborhood areas in the city with the highest rates, five are in the Bronx. The highest is East Harlem, according to state health data. At the Children's Hospital at Montefiore Medical Center, the Bronx, there were 7,000 admissions last year; of those, 1,200 were asthma related. "It's definitely a crisis," Dr. Deepa Rastogi, director of the hospital's Asthma Center, said of the borough's asthma rates. Dr. Rastogi and other Bronx asthma experts said air pollution was only one of the factors contributing to the problem. Asthma attacks can be triggered by secondhand smoke, dust mites, pets and mold, in addition to outdoor air pollution.
Dr. A. Hal Strelnick, a professor of family and social medicine at the Albert Einstein College of Medicine in the Bronx, said the borough's high rates stemmed from a high concentration of traffic in a densely populated area; poorly maintained housing in impoverished neighborhoods; a lack of access to medical care; and a large population of blacks and Hispanics, two groups with high rates of asthma. He said his own asthma research and the N.Y.U. study showed that the old saying that we all breathe the same air may not necessarily be true in the South Bronx. "We think it's the same air, but it's not really the same air," Dr. Strelnick said.
by Jonathan Bor, Baltimore Sun
October 27, 2006
http://www.baltimoresun.com/news/local/bal-te.md.cough27oct27,0,548505.story
With cough and cold season fast approaching, Baltimore's health commissioner and a group of leading pediatricians warned parents yesterday not to give children 5 years old and younger the over-the-counter medications designed to relieve those ailments. The remedies do no good and might cause harm, they said. Health Commissioner Dr. Joshua Sharfstein said the deaths of four Baltimore children in the past six years have been tied to the medications, which parents often consider so benign that they exceed the recommended dosage. One child died this year; all were under age 4.
But doctors are not simply concerned about excessive dosing. Dr. Janet Serwint, a Johns Hopkins pediatrician, said side effects such as suppressed breathing and elevated heart rate and blood pressure can occur even at standard doses. "I'm aware of cases of children who have had reactions or side effects and have been dosed correctly," Serwint said. Sharfstein said he has sent a letter containing the warning to the Food and Drug Administration, asking the federal agency to take appropriate action. In signing the letter, Sharfstein and Serwint were joined by the pediatric directors of eight city hospitals, including Hopkins and the University of Maryland Medical Center, and the president of the Maryland chapter of the American Academy of Pediatrics. "The bottom line is that there is no evidence that the products are effective, and we know they've harmed children," Sharfstein said.
The FDA has not issued warnings or taken regulatory action against giving the medicines to young children. Last year, however, it warned against abuse of dextromethorphan, a cough suppressant found in many preparations, saying the drug can cause death and injuries that include brain damage, seizures, loss of consciousness and irregular heartbeat. In issuing the warning, however, the agency was responding to the deaths of five teenagers who had taken excessive doses to get high. It called the thrill-seeking behavior "a disturbing new trend," but added that the medication can be "safely used in cough suppressant medicines."
This year, an industry group, the Consumer Healthcare Products Association, defended the use of the medicines at recommended doses. The group was responding to a warning by the American College of Chest Physicians not to give the remedies to children 14 and under. "Cough is very common in children," Dr. Richard S. Irwin of the University of Massachusetts Medical School said in a statement from the college on treating cough. "However, cough-and-cold medicines are not useful in children and can actually be harmful." The Maryland Poison Center tallied 900 cases of children overdosing on cough-and-cold preparations in 2004, Sharfstein said.
"It's understandable that parents are trying to make their children feel better, but experts we worked with are very concerned that [parents] are risking more harm than warranted, given the absence of any evidence of benefit," Sharfstein said. According to Serwint, several studies have established that children on the medications do not fare better than those taking placebos. She said parents can help their children by suctioning nasal secretions, keeping children hydrated with liquids and using cool-mist humidifiers. Children who are miserable with fever can safely receive acetaminophen or ibuprofen at recommended doses, Serwint said.
Dr. Daniel Levy, who heads the Maryland pediatrics association chapter, said he believes that cough-and-cold medications can prolong symptoms by drying up mucus that is part of the body's immune response. Though Sharfstein and the doctors did not list brand names, they said the drugs typically include combinations of antihistamines, cough suppressants and decongestants. They are marketed under a variety of names and make varying claims but are very similar in their ingredients, Serwint said.
Cough suppressants, which act on the central nervous system, can suppress a child's breathing, Serwint said. "Decongestants can cause blood vessels to get smaller and constrict, and can lead to side effects of increasing heart rate and blood pressure," she said. Antihistamines "make patients very sleepy but sometimes make people jittery." In some cases, antihistamines and decongestants cause young children to have visions of bugs or spiders crawling on them, she said. The sensation, a type of hallucination, goes away when the drugs leave the child's system.
In an article published in 2001, Serwint and three co-authors detailed case studies of three children who were admitted to Hopkins with side effects of the medications. One of the children died. The child, a 9-month-old boy who had coughed for six days but did not have a cold, turned blue and struggled to breathe, and died at a hospital despite 20 minutes of advanced life support. "After review of the autopsy findings and tests, the medical examiner determined the cause of death as mixed drug intoxication secondary to the ingestion of these drugs," said the authors, writing in the journal Pediatrics. The child had received numerous doses of cough-and-cold preparations. An autopsy found the presence of a decongestant, antihistamine and cough suppressant -- along with acetaminophen.
Though the FDA has not taken action, Sharfstein said awareness of the drugs' side effects has grown in recent years. When he trained as a pediatrician in the 1990s, Sharfstein said, he was taught that the medications are ineffective. "But there's a big discrepancy between the scientific evidence on these products and what parents actually do," Sharfstein said.
by Jessica Marshall and Peter Aldhous, New Scientist
October 27, 2006
http://www.newscientist.com/channel/health/mg19225755.100
They are supposed to be grassroots organisations representing the interests of people with serious diseases. But Drummond Rennie, professor of medicine at the University of California, San Francisco, and deputy editor of the Journal of the American Medical Association, believes that some patient groups are perilously close to becoming extensions of pharmaceutical companies' marketing departments. "There's a crisis here," he contends. Rather than grassroots, the word Rennie uses to describe such organisations is "astroturf". Originating in the black arts of politics and public relations, astroturfing is the practice of disguising an orchestrated campaign as a spontaneous upwelling of public opinion.
Other health specialists don't go as far, but they are still uneasy about the financial relationships between drug firms and prominent patient groups. "I think there are grounds to be concerned," says Joel Lexchin, who studies pharmaceutical policy at York University in Toronto, Canada. He and others point to instances in which representatives of patient groups, sometimes in close contact with corporate public relations teams, have spoken favourably about drugs at meetings or press conferences.
It is easy to see the appeal for pharmaceutical companies. Patient groups provide people with information about available treatments for a particular disease and offer support to those affected by it. They campaign for treatments to be financed by publicly funded health insurance programmes, and some patient representatives are members of advisory committees that consider drugs for approval. Firms would clearly have much to gain by filtering their marketing messages through such organisations, which tend to engender more trust than do multinational companies.
Self-policing
Patient groups rely largely on public donations for support, and must adhere to the financial and lobbying restrictions that apply to all public charities. However, when it comes to the type of information the groups provide, they are largely self-policing. Many groups were founded by patients or their family members, and they range from small, volunteer-run organisations to large operations with executive staff.
So is the charge of astroturfing fair? How much money are patient groups typically taking from pharmaceutical and medical device firms, and does this affect their behaviour? To investigate, New Scientist conducted the largest survey to date of industry donations to patient groups based in the US -- the biggest single market for drugs and medical devices. As well as taking a random sample, we identified groups associated with conditions for which companies have been accused of "disease-mongering" -- encouraging an expansion of the boundaries of an illness in order to boost sales of a treatment for it (see "How the groups were selected", below). Though these allegations are unproven, we decided it was important to investigate whether any patient groups have received unusually large proportions of their funding from industry.
In each case, we tried to determine the percentage of a group's total funding that came from the pharmaceutical and medical device industry in the most recent year for which figures were available. This was not always easy, as US non-profit organisations are not required by law to disclose their donors' identities. Tax returns and annual reports provided some of the information, but in most cases, obtaining a figure required the group concerned to provide it voluntarily.
The extent of industry funding varied widely (see chart on the article web page). In some cases the cash amounts were enormous -- more than $23 million in the case of the American Heart Association, the largest organisation studied, although this accounted for just 4 per cent of its total funding. Small proportions of funding may not be cause for concern, Lexchin says, unless they go toward activities like creating biased treatment information. "It depends how the money is used." Lexchin also believes there is a need for greater transparency about where such donations are coming from, so patients can evaluate for themselves the information the groups are providing.
In total, seven groups received 20 per cent or more of their funding from pharmaceutical and medical device companies, including all four linked to the conditions over which accusations of disease-mongering have been made. One of these groups, the Depression and Bipolar Support Alliance, said it received more than half of its 2005 funding from industry. The group did not provide an exact percentage, but combined information from its annual report and tax return reveals that 77 per cent of its revenue for 2005 came from 15 major donors, 12 of which are drug or device companies. Only one other organisation, the Colorectal Cancer Coalition, or C3, received a greater proportion of its revenue from drug and device firms. This group, part of our random sample, is only in its second year of existence. Director of operations Judi Sohn says C3 is working to diversify the organisation's funding sources to make its finances more stable.
So are companies specifically targeting those groups which offer the greatest potential for marketing their products? In general, groups in our survey that received more than 20 per cent of their funding from industry did seem to be associated with conditions that affect a significant number of people, for which a specific therapy exists and which require long-term treatment, therefore creating the potential for substantial profit. The Restless Legs Syndrome (RLS) Foundation, for instance, received more than $450,000 of its $1.4 million revenue in 2005 from GlaxoSmithKline (GSK) and nearly $178,000 from Boehringer Ingelheim. GSK's drug Requip was approved for the syndrome in 2005, while Boehringer Ingelheim has a drug pending FDA approval. Both drugs are intended to control the symptoms of RLS over long periods. While these symptoms can seriously disturb sleep, critics claim that their prevalence has been exaggerated by GSK and in media reports.
The extent of industry funding of the RLS Foundation is "pretty incredible", says one such critic, Steve Woloshin of Dartmouth Medical School in Hanover, New Hampshire. However, both the RLS Foundation and GSK reject accusations of disease-mongering. GSK is clear that Requip is indicated for moderate to severe RLS only, says company spokeswoman Holly Russell. "The main sense we get from patients is an enormous sense of relief," she adds. "Show me the scientific article that says that people who don't have the condition or people that have very mild RLS are flocking to take drugs," says Georgianna Bell, executive director of the RLS Foundation.
By contrast, groups in our survey that received no industry funding seemed to be for diseases that drug companies have little opportunity to profit by. For example, the people supported by Faces, the National Craniofacial Association, are typically treated with surgery, while the Ehlers-Danlos National Foundation is for people with a disorder of the body's connective tissue for which there is no specific treatment. The Amyotrophic Lateral Sclerosis Association received just 0.6 per cent of its $16 million budget for 2005 from pharmaceutical companies. This neurodegenerative disease is typically fatal within four years of diagnosis, and there is only one drug approved by the US Food and Drug Administration to treat it. Aventis, which manufactures the drug, provided $10,000 to the association.
The timing of donations also suggests a link to marketing interests, though donations to individual groups can vary from year to year for various reasons. Pfizer, for example, was a major donor to the RLS Foundation in 2003 and 2004. In July 2004 the firm announced that it had ceased developing its candidate RLS drug, and the following year donations to the patient group ceased. Meanwhile, concerns about the safety of psychiatric drugs in children, which reached new heights in 2004, have hit the Child and Adolescent Bipolar Foundation hard. Its donations from industry fell from about 40 per cent of its total revenue in 2004 to 20 per cent in 2006. "Pharmaceutical companies are not as willing to support us because of increased scrutiny around psychiatric treatments in children," says Susan Resko, the foundation's executive director. As a consequence, she has had to lay off more than half of her staff.
It should come as no surprise that a company would donate where its commercial interests lie, but is this a problem? Some groups argue that the funding allows them to expand their operations and serve more patients than they would be able to otherwise. "Should I say no to company donations and not benefit all the people that we serve?" asks Virginia Ladd, president of the American Autoimmune Related Diseases Association. Ladd claims the organisation could not raise enough money for national campaigns if it had to rely on individual donations alone.
Every group in our survey that received a high proportion of funding from industry denied that it biased their mission. Companies have no input into how the money is used, they said, and some added that they had turned down funding that they felt came with strings attached. Most of the organisations also stressed that they do not endorse specific drugs or therapies, and that any treatment information posted on their website is approved by a medical advisory board. "We're extremely conscious of our ties with any of our funders," says Catherine Rice, executive director of the International Essential Tremor Foundation. "It's got to be an arm's length away."
Critics claim, however, that dependence on industry funding can unintentionally compromise an organisation's objectivity. "I think it's naive to think that you aren't being influenced," says Douglas Ball of Kuwait University, who has studied patient groups in many countries, including the US. Lexchin agrees: "Psychologists talk about the 'gift relationship'. The patient organisations are getting something and feel the need to repay that gift. Whether they are conscious of it or not is really irrelevant."
Sharon Batt of Dalhousie University in Halifax, Canada, has just begun to study patient group behaviour and funding after years working in breast cancer advocacy, where she noticed a general pattern. Organisations that accept pharmaceutical funding "tend to advocate for faster review and availability of drugs, greater insurance coverage, and they tend to see 'direct-to-consumer' advertising as a benefit to patients", she claims. Groups that maintain financial independence, on the other hand, "emphasise safety over speed and are critical of direct-to-consumer advertising", she says (see "Virtuous but poor", below).
Information on the websites of some groups in our survey raises further questions. For example, the treatment section of the Depression and Bipolar Support Alliance's site was developed with an "educational grant" from Neuronetics, a company which gave at least $10,000 and possibly as much as $150,000 to the alliance in 2005. One page describes transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS) which both aim to treat mood disorders by stimulating neural activity. Neuronetics makes equipment for TMS, which has not yet been approved as a treatment. Nevertheless, the site provides web links and telephone numbers for Neuronetics and Cyberonics, a VNS equipment maker that donated between $150,000 and $500,000 to the alliance in 2005. The AMD Alliance International, which is for people with a common cause of sight loss called age-related macular degeneration, did not provide information on its industry funding. A note posted on the organisation's website in June "loudly applauded" the US approval of Lucentis as a "ground-breaking treatment". International rights for marketing Lucentis are held by Novartis Ophthalmics, the alliance's "founding global sponsor".
Whether or not such examples represent inappropriate corporate influence, critics argue that such groups should be more transparent about where their funding comes from -- especially since they are a vital source of information and people will expect them to be impartial. "Groups should publicise how much money they've gotten from which companies and what it is used for," Lexchin says. Ball's team recently examined the websites of 69 national and international patient groups, and concluded that they gave insufficient financial information to evaluate whether a conflict of interest existed. Annual reports, which were provided on 37 sites, were often inconsistent with information found elsewhere, while only seven itemised donations from pharmaceutical firms and none chose to list the total proportion of industry funding. "Basically, it's a muddle, which these organisations haven't thought about coherently," says co-author Andrew Herxheimer of the UK Cochrane Centre in Oxford.
Some patient groups don't provide information on their funding as a matter of policy. The public relations consultant for the Neuropathy Association told New Scientist that the information was "proprietary", and wouldn't discuss the group's guidelines on receiving donations, while the director of the National Spasmodic Dysphonia Association called the subject "a sensitive topic for our board", and declined to provide figures. Families for Depression Awareness similarly declined to answer our queries.
Complete disclosure of industry funding by patient groups is almost unheard of, but the massive American Heart Association, which boasts an annual revenue of more than $650 million, is leading the way. This month, it will begin posting an itemised list of pharmaceutical and medical device company donations on its website. Until now, most patient groups have been shielded from public scrutiny of their finances. "There is a tendency not to want to criticise the motives of the patient groups, because a lot of them are made up of people who are pretty seriously sick," says Batt, herself a breast cancer survivor. She argues that such organisations need to put their house in order and accept the need for greater transparency. Only then, claim the critics, will patients be able to make informed judgements about which groups they can really trust.
How the groups were selected
We selected 20 US patient groups operating on a national level with annual revenues of more than $100,000, plus five with revenues exceeding $10 million, pulling them at random from the GuideStar database, which provides information on US non-profit organisations. In addition, we identified four further groups, again with annual revenues exceeding $100,000, associated with bipolar disorder, restless legs syndrome and attention deficit hyperactivity disorder. These conditions were highlighted in April by the journal PLoS Medicine as being susceptible to "disease-mongering" by the pharmaceutical industry.
Virtuous but poor
Just two groups identified in New Scientist's survey -- the National Women's Health Network (NWHN) and Breast Cancer Action -- refuse to accept donations from pharmaceutical or medical device companies. "We want women to know that when they come to us, they are getting independent information," says Amy Allina, the network's programme director. "We think of ourselves as virtuous, but poor." The NWHN was a prominent advocate of one of the clinical trials in the Women's Health Initiative, the largest-ever study of post-menopausal women, which investigated the use of hormone replacement therapy (HRT). The trial was halted in 2002 after finding that HRT increased women's risk of heart attack, stroke and breast cancer. "We have been very active critics of the ways drug companies have promoted HRT," says Allina. On its website, the NWHN stresses that women who choose to have HRT should take the lowest dose possible for the shortest time.
The same basic information is also posted on the website of an organisation not included in our survey, the Society for Women's Health Research (SWHR), but its position on HRT seems more ambiguous. The society's president and chief executive officer, Phyllis Greenberger, told The Washington Post in September 2005 that she believed the risks of the treatment had been exaggerated, and described her own experience with HRT over more than 10 years. "I feel better, I have no side effects and in my case I see no downside," she told the newspaper. SWHR does accept funding from the drug industry -- including from Wyeth, a manufacturer of the hormones used in HRT.
by Lidia Wasowicz, United Press International
October 27, 2006
http://www.upi.com/ConsumerHealthDaily/view.php?StoryID=20061026-041131-4041r
SAN FRANCISCO -- Despite a flurry of new studies, neither those who champion nor those who challenge the notion that childhood immunizations are to blame for a surge in autism diagnoses in America's children are ceding their case. Each side offers science that has certain limits, which are promptly criticized by the other. The complaints run the gamut: conflicts of interest that preclude objective conclusions, study sizes too small to provide definitive answers, lack of the required replication of results, faulty or manipulated methodology. Neither side is free of vested interests. Many parents have filed claims or lawsuits. Many scientists have ties to vaccine makers or sell their expertise in court cases.
Fearing an erosion in a strategy that has clearly benefited public health by stamping out such scourges as polio and rubella, the medical establishment is deeply protective of the vaccine program and committed at all cost to the notion of "herd immunity." In pushing for universal immunization as the key to disease prevention, the plan also pushes the wrong buttons with some families who resent having to expose their children to a perceived danger for the sake of others.
When it comes to credibility, each side sees the other as having a checkered past. Parent groups and their supporters get criticized for flip-flopping -- from the measles-mumps-rubella vaccine to the mercury-based preservative thimerosal once commonly used and still found in some children's shots to immunizations in general -- in laying blame not just for autism but also for learning disabilities, behavioral problems, other neurodevelopmental disturbances and even diseases like asthma and diabetes. It may turn out all of these factors had a role in autism's ascent, those who view thimerosal with a suspicious eye respond.
Mainstream medicine, in turn, gets faulted for backing a seizure-associated whole-cell pertussis vaccine for years before switching to a safer version. Health risks linked to the live polio and original rotavirus immunizations -- including life-threatening bowel obstructions in as many as 99 infants and death in two -- also tested public confidence in governmental guarantees of safety.
Doctors see the changes they have made in these areas as proof of their willingness to admit their mistake and act to correct it when a problem emerges. "If one were to do a search of the Cochrane database, which is the international consortium that evaluates the quality of medical research, there is nothing to suggest that thimerosal (in vaccines) has any role in any medical condition," said Dr. Steven Kmucha. He is an otolaryngologist, allergist and sleep specialist, governor for the San Francisco Bay Area of the American Academy of Otolaryngology Board of Governors and expert consultant to the Medical Board of California who has served on the medical school faculty at Yale and Stanford universities and chaired a variety of committees on environment and public health. "In fact, the literature available from around the world nearly unanimously suggests no harmful effect despite lots of speculation and chatter in the non-medical press," he added.
That "speculation and chatter" are getting louder and blunter. Among disclosures that let sparks fly, the Los Angeles Times in early 2005 published the contents of a 1991 Merck and Co. Inc. memo it had obtained in which a scientist who once worked for the drug giant calculated 6-month-old infants who received all their vaccinations on time could be exposed to a dose of ethylmercury (the kind present in shots) as much as 87 times higher than the Environmental Protection Agency's safety guideline for maximum consumption of methylmercury (the kind found in polluted fish). A few months later the debate heated up a few more degrees with allegations by a member of an American political dynasty that health authorities failed to act even after incriminating evidence against thimerosal was brought to their attention. The contention came from environmental lawyer Robert F. Kennedy Jr. In running publicity-generating interference for parents who hold vaccines responsible for their children's developmental differences, Kennedy wrote a hair-raising article that alleged government officials, scientists and vaccine makers had tried to keep from the public evidence of thimerosal as a toxic trigger of neurological damage.
Most mainstream research on the issue comes from flawed and manipulated population studies, Kennedy contended in an article replete with allegations of secret meetings of federal health officials, physicians and pharmaceutical company executives, hidden agendas, concealed data and "lost" documents. The piece reiterated some material covered in the best-selling book, "Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy" (St. Martin's Press, 2005), in which author David Kirby, while portraying both sides of the vaccine controversy, paints the parents' plight with a more sympathetic brush.
Kennedy's "Deadly Immunity," published June 16, 2005, in Rolling Stone magazine and online at salon.com, was cheered as an enlightening exposé and jeered as a titillating tirade, along the thimerosal party lines. Central to the story was a review of immunization data of 124,170 children provided by more than half a dozen large health maintenance organizations to the Centers for Disease Control and Prevention's Vaccine Safety Datalink. That's a storehouse of some 7 million medical records the agency uses to monitor adverse reactions to inoculations.
The original evaluation, launched in the aftermath of the discovery of unexpectedly high levels of mercury exposure in some infants, suggested children getting thimerosal-containing shots faced a greater likelihood of developing neurodevelopmental disorders than did those with zero exposure. The results were discussed at an invitation-only meeting in June 2000 at a Georgia retreat center, detailed in Kennedy's article, Kirby's book and a transcript thimerosal opponents posted on the Internet. Subsequently, the CDC put the study through several more generations of information inclusion, exclusion and analysis that led to a final finding of no increased risk. Critics made much of what they deemed research tampering and result fixing.
On the other hand, the investigator involved in both studies, Dr. Thomas Verstraeten, defended what he called typical progression of scientific inquiry leading toward the ultimate conclusion; when new data are entered, it's natural for the final outcome to change. In this case, he said, the earlier version failed to account for such key factors as low birth weight, which can boost the odds of developmental delays. Lost in all the hubbub was the wiggle room in the final version of the study, which not only declined to categorically discount the possibility of an association between thimerosal and neurodevelopmental problems but also urged further exploration of the issue -- a task the CDC has undertaken, Verstraeten said in a subsequent response to the critics. In the study, Verstraeten, who, skeptics like to point out, by then had left the CDC for a job with British vaccine maker GlaxoSmithKline, and his coauthors concluded: "No consistent significant associations were found between (thimerosal-containing vaccines) and neurodevelopmental outcomes. Conflicting results were found at different HMOs for certain outcomes. For resolving the conflicting findings, studies with uniform neurodevelopmental assessments of children with a range of cumulative thimerosal exposures are needed."
The CDC, which had judged the early raw material and interpretation inadequate for making a credible call, has stood by the much-publicized later results -- as has the prestigious Institute of Medicine of the National Academy of Sciences. But even such notable endorsements have failed to stem the tide of skepticism. In a move seen by thimerosal critics as significant, former American Academy of Pediatrics official Neal Halsey wrote a letter critical of Verstraeten's study to the journal that published it. Halsey suggested an independent review of the data and evaluation of vaccine safety and noted public confidence in vaccines could be enhanced if the same agency that recommends inoculations did not also assess their safety, as the CDC then did.
That double-duty -- denounced by some as a serious conflict of interest -- was broken up when the government entity separated its national immunization program, which promotes inoculation, from its vaccine safety branch, which monitors the potential risks of the shots. The decision to split the office was announced Feb. 18, 2005 -- a day after a panel of medical experts recommended the CDC ease outside investigators' access to its highly guarded vaccine database, a step the agency had resisted on the premise it would compromise the privacy of patients whose medical histories are contained therein.
(Note: In this multi-part installment, based on dozens of reports, conferences and interviews, Ped Med is keeping on eye on autism, taking a backward glance at its history and surrounding controversies, facing facts revealed by research and looking forward to treatment enhancements and expansions.)
from the Washington State Department of Health
October 26, 2006
http://www.doh.wa.gov/Publicat/2006_news/06-172.htm
submitted to this bulletin by Marnie Boardman
OLYMPIA -- Fish are an important part of a healthy diet, but some types should be eaten in moderation. A new assessment by the Department of Health confirmed that most Puget Sound salmon are low in contaminants; however, Chinook and some others species of fish have higher levels of mercury and PCBs. The health department recently completed a study of toxics in Puget Sound fish using data from the Puget Sound Assessment and Monitoring Program. The department also sampled fish found in markets across the state. Overall, many fish are low in contaminants, but meal limits are recommended for some.
"Many fish from Puget Sound remain a smart choice for the dinner table; however, this news is another sign that Puget Sound is sick and we must take action now," said Governor Chris Gregoire. "The Puget Sound Partnership is tackling this challenge head on." The main contaminants of concern are polychlorinated biphenyls (PCBs) and mercury. These contaminants move through the food chain into fish, marine mammals and humans. Mercury and PCBs can cause behavior and learning deficits in children exposed in the womb, so meal limits of certain fish are especially important for women of child-bearing age and young children. Consumers should limit Chinook salmon to one meal per week and resident Chinook (blackmouth) to two meals per month. Consumption advice for flatfish (e.g. English sole, flounder, and sanddab) and rockfish is organized by Fish and Wildlife’s recreational marine areas with more specific advice provided for some urban areas.
"Fish, particularly salmon, are good to eat -- including those from Puget Sound," said Secretary of Health Mary Selecky. "The high protein and beneficial omega-3 fatty acids make fish a healthy choice. However, some fish accumulate more toxics than others so we want people to be smart and choose wisely." The Healthy Fish Eating Guide, created by the department, includes a list of fish low in toxics as well as those that should be eaten less frequently. It’s a reference that will help people make sure that fish remains part of a healthy diet. The guide (http://www.doh.wa.gov./fish) shows many fish commonly available in markets that can be eaten two times a week in accordance with recommendations from the American Heart Association.
PCBs, mercury and other long-lasting chemicals are found worldwide. While this study shows these toxics in Puget Sound fish, chemicals in the environment remain a broader problem. The health department and the Department of Ecology are working on strategies to reduce chemicals like PCBs and mercury in the environment. Banned since 1977, PCBs were an insulating fluid in electrical transformers. Mercury occurs naturally but also comes from coal-fired electric plants and improper disposal of fluorescent bulbs, thermometers, thermostats and electrical switches.
from BBC News
October 26, 2006
http://news.bbc.co.uk/2/hi/health/6086824.stm
The extra risk is likely to be caused by health problems that make it difficult for these couples to conceive in the first place, scientists believe. Fertility treatments, such as IVF, may contribute too, an American Society for Reproductive Medicine meeting heard. But the experts stressed the overall risk was still relatively low. They said couples should be counselled about the risks and encouraged to improve their health before undergoing fertility treatment.
Professor Mary Croughan, who led the University of California research on 4,000 women and their children aged up to six years, explained those with fertility problems were also more likely to have other health problems, such as heart disease and diabetes, and were more at risk of pregnancy and labour complications. She said: "What has caused them to be unable to conceive goes on to cause problems. It is as if a brick wall has stopped you becoming pregnant. Treatment allows you to climb over the wall, but it is still there and it goes on to cause problems."
Raised risk
Her team found the risk of five conditions -- autism, mental retardation, cerebral palsy, seizures and cancer -- was 2.7 times higher among the children born to 2,000 women who experienced fertility problems than among those born to the 2,000 women who did not have difficult conceiving. For autism alone, the risk was four times higher. Moderate developmental problems such as attention deficit hyperactivity disorder, learning disabilities or serious sight or hearing disorders were also 40% more common in the children born to the couples who struggled to start a family.
Stuart Lavery, a spokesman for the British Fertility Society, questioned how valid the findings were because of the wide range of fertility problems and treatments the women had. "There is no doubt that people who have difficulties with their fertility have difficulties conceiving and carrying pregnancies, although it has not been shown that it is the infertility that is causing the problems," he added.
Clare Brown of Infertility Network UK said continued work was needed to ensure treatment was safe for couples and potential children. At the same conference, doctors heard how Britain should consider paying women thousands of pounds to donate their eggs. US clinics often pay women up to $10,000 (£5,200) per IVF cycle. In comparison, British clinics can offer £250 plus travel and childcare expenses. A spokesman for The Human Fertilisation and Embryology Authority said it had no plans to review the £250 cap, set last year.
by Janet Pelley, Environmental Science & Technology
October 24, 2006
http://pubs.acs.org/subscribe/journals/esthag-w/2006/oct/science/jp_triclosan.html
Triclosan, widely used in soaps and toothpastes for its ability to kill bacteria, has been found to hasten the transformation of tadpoles into adult frogs. The new research, published online September 29 in Aquatic Toxicology, is the first to show that triclosan can act as an endocrine disrupter at concentrations found in North American streams. Although sewage treatment plants remove most of the triclosan washed down the drain, the chemical makes its way into U.S. streams at readily detectable levels. More than 55% of streams examined in 2002 had a median concentration of 0.14 parts per billion (ppb).
Previous studies have shown that triclosan, which has a similar chemical structure to polybrominated diphenyl ethers and PCBs, bioaccumulates in fish and is present in human breast milk, according to Caren Helbing, who is a molecular biologist at the University of Victoria (Canada) and a coauthor of the study. Intrigued by triclosan's structural similarity to thyroid hormones, which orchestrate growth and development in wildlife and humans, Helbing and her colleagues set out to determine whether triclosan could interfere with thyroid-hormone activity in frogs.
When the team exposed young bullfrog tadpoles -- which do not yet produce thyroid hormones -- to triclosan alone, they did not observe any significant changes. However, when the tadpoles were exposed to triclosan and thyroid hormones together, the scientists documented a mosaic of impacts. The triclosan effects included significant weight loss and accelerated hind-limb development. Helbing and co-workers also detected elevated activity in the brain of genes linked with uncontrolled cell growth, and decreased gene activity in the tail fin. The data suggest that triclosan, at concentrations as low as 0.15 ppb, is capable of perturbing a fundamental hormone signaling mechanism that is nearly identical in frogs and humans, she says.
"This experimental design is very clever because [Helbing] looked at both the presence and absence of thyroid hormone," says Tom Zoeller, an endocrinologist at the University of Massachusetts, Amherst. If Helbing had merely exposed the tadpoles to triclosan alone, she would have missed adverse effects on the thyroid system, he says. But because she added thyroid hormone along with triclosan, she could see that the triclosan made the thyroid hormone much more potent than it would have been under normal circumstances. These results hint that triclosan does not mimic thyroid hormones but instead speeds up their impact, says Cathy Propper, an endocrinologist at Northern Arizona University. Although the mechanism is unknown, triclosan may be making protein receptors in the cell more sensitive to thyroid hormones, Zoeller speculates. Because thyroid-hormone signaling is essential for the development of the human brain and body, the new study raises red flags for human health, Zoeller says.
Current screening programs for endocrine disrupters, such as the protocols being considered by the U.S. EPA, might miss the effects observed by Helbing and her team, Zoeller says. Tests of contaminants might not be conducted in the presence of natural hormones, or animals might be tested at a stage of life when the targeted responses aren't sensitive to thyroid hormones, he says. Triclosan producers declined to comment on this study for this story.
"The insidiousness of these compounds in the environment is that they don't necessarily have a direct impact but can be inappropriately sensitizing or desensitizing animals to their own endocrine environment," Propper says. The question to ask, she continues, is: "Do the antimicrobial gains you get from using triclosan outweigh both the risks to wildlife and the potential human health risks associated with it?"
by Andrew Bridges, Associated Press, North County [California] Times
October 24, 2006
http://www.nctimes.com/articles/2006/10/25/health/17_37_1410_21_06.txt
WASHINGTON (AP) -- Federal health officials won't put new restrictions on the use of a mercury-based preservative in vaccines and other medicines, denying a petition that sought the limits because of health concerns. A group called the Coalition for Mercury-free Drugs petitioned the Food and Drug Administration in 2004 seeking the restrictions on thimerosal, citing concerns that the preservative is linked to autism. In a reply dated Sept. 26 but made public only Tuesday, the FDA rejected the petition. "Only a small number of licensed and approved products still contain thimerosal, and the available evidence supports FDA's conclusion that all currently licensed vaccines and other pharmaceutical drug products containing thimerosal are safe," Dr. Jeffrey Shuren, the FDA's assistant commissioner for policy, wrote in denying the petition.
"We're not accepting that answer," said Dr. Mark Geier, one of the petitioners. The group now plans to seek a court order that would force the FDA to withdraw thimerosal from all vaccines and medicines unless the agency can show the preservative is safe, Geier said. Thimerosal, about 50 percent mercury by weight, has been used since the 1930s to kill microbes in vaccines. There have been suspicions that thimerosal causes autism. However, studies that tracked thousands of children consistently have found no association between the brain disorder and the mercury-based preservative. Critics contend the studies are flawed.
Since 2001, all vaccines given to children 6 and younger have been either thimerosal-free or contained only trace amounts of the preservative. Thimerosal has been phased out of some, but not all, adult vaccines as well. Most doses of the flu vaccine still contain thimerosal, though manufacturers produce versions free of the preservative for use in children. The FDA said it was in discussions with those manufacturers to increase the supply of thimerosal-free flu vaccine. There also are minute amounts of mercury, as thimerosal or phenylmercuric acetate, in roughly 45 eye ointments, nasal sprays and nasal solutions, the FDA said. Various antivenoms for black widow and snake bites also contain thimerosal.
by Maffini MV, Rubin BS, Sonnenschein C, and Soto AM, Molecular and Cellular Endocrinology
July 25, 2006
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16781053&itool=pubmed_DocSum
submitted to this bulletin by Chemical Sensitivity Network
Epidemiological studies have reported that during the last 60 years the quantity and quality of human sperm has decreased and the incidence of male genital tract defects, testicular, prostate and breast cancer has increased. During the same time period, developmental, reproductive and endocrine effects have also been documented in wildlife species. The last six decades have witnessed a massive introduction of hormonally active synthetic chemicals into the environment leading some to postulate that the diverse outcomes documented in human and wildlife populations might be the result of extemporaneous exposure to xenoestrogens during development. The estrogen-mimic bisphenol-A (BPA) is used as a model agent for endocrine disruption. BPA is used in the manufacture of polycarbonate plastics and epoxy resins from which food and beverage containers and dental materials are made. Perinatal exposure to environmentally relevant BPA doses results in morphological and functional alterations of the male and female genital tract and mammary glands that may predispose the tissue to earlier onset of disease, reduced fertility and mammary and prostate cancer.