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Another Cry for Primary Prevention April 9, 2014

Posted by Nancy Hepp in Newsletter introductions.
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Elise Miller, MEd
CHE Director

How many of us have sat with loved ones in the throes of cancer? No doubt way too many. My cousin just passed away two days ago from lung cancer, having never smoked in her life. She joins several other family members and close friends who have died of one form of cancer or another in the last few years. Unfortunately, all of you likely have similar stories to share, and not just about older people in your lives, but about those younger and younger—including those who exercise regularly and have healthy diets.

One would think this untenable situation would catapult our society into action—it would move us to do whatever it takes to implement primary prevention strategies, not just look for cures. But instead the President’s Cancer Panel report on environmental contributors to cancer sits on the proverbial shelf collecting dust. As do other seminal reports that provide clear analyses of the science linking chemical contaminants and other chronic diseases and disorders as well as how to address these issues—such as Endocrine Society’s statement on endocrine disrupting chemicals, the joint opinion issued by the American College of Obstetricians and Gynecologists (ACOG) and the American Society of Reproductive Medicine (ASRM) on environmental chemicals and reproductive health, and the National Academy of Sciences “Science and Decisions” report which offers concrete recommendations to contend with the inadequacies of current risk assessment practices—to name just a few.

Not only are we slow to respond collectively to the knowledge we already have regarding human health, we also regularly learn that some advances in our field, such as removing bisphenol A (BPA) from water bottles or taking triclosan out of cosmetics, turn out not to be lasting victories for public health. Instead, the synthetic chemicals used as replacements are found to have potential human health impacts as well—usually after the new product is already out in the marketplace [see Avon plans to remove triclosan from products, but what will replace it?, The Guardian].

I could of course go on and on, but my point here is not to plunge us all into despair with a litany of multiple and interrelated woes that can undermine our health. Instead, when anyone close to us dies of a disease that might have been preventable, I think it’s useful to pause and reflect on the reality in which we live. And for me, that time of reflection then serves as a springboard for my renewed commitment to voicing the truth—whether that is about the mounting environmental health science linking certain exposures to chronic disease and disability, the need for chemical policy reform, the promise of green chemistry, the interplay of the social and environmental determinants of health, or the exceptional persistence of communities fighting for their rights to clean water, air and food. The comforting news is that my voice is not alone, but is inspired and amplified by the concerted efforts of colleagues like you.

As we experience the often devastating effects of chronic disease and disabilities on those near and far, may our collective cry for primary prevention finally be heard. Thank you for all that you do to move us towards this goal.

Prospective Evidence: BPA, Phthalates, and Type 2 Diabetes April 8, 2014

Posted by Nancy Hepp in science pick.
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Sarah Howard
Coordinator of CHE’s Diabetes and Obesity Spectrum Working Group

The first prospective study on diabetes in relation to BPA or phthalates has just been published (ahead of print), in Environmental Health Perspectives. The results suggest that BPA and phthalate exposures may be associated with the risk of type 2 diabetes among middle-aged women, but not older women. The association between BPA and phthalates in younger but not older women may be due to menopausal status (although chance cannot be ruled out).

The study analyzed levels of BPA and eight phthalates in two urine samples over 1-3 years from U.S. women in the Nurses’ Health Study I (average age 66) and II (average age 46). The younger women had higher levels of BPA and phthalates than the older women, yet these differences did not explain the findings.

Because experimental data suggests that BPA interferes with the function of the insulin-producing pancreatic beta cells by activating estrogen receptors, the authors hypothesized that any associations between BPA and diabetes would be stronger in pre-menopausal women than post-menopausal women. Indeed, the association between BPA and diabetes shows a clear linear trend in pre-menopausal women, but there is no association in post-menopausal women. And, the association between BPA and diabetes was stronger in women who developed diabetes at a younger age (under 55). These interesting findings should be examined in other cohorts.

Sun Q, Cornelis MC, Townsend MK, Tobias DK, Eliassen AH, Franke AA, Hauser R, Hu FB. 2014. Association of Urinary Concentrations of Bisphenol A and Phthalate Metabolites with Risk of Type 2 Diabetes: A Prospective Investigation in the Nurses’ Health Study (NHS) and NHSII Cohorts. Environ.Health Perspect. http://ehp.niehs.nih.gov/1307201/

Top 10: 1st Quarter 2014 April 3, 2014

Posted by Nancy Hepp in science pick.
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CHE offers this selection of research, news and announcements that were of special significance during the first quarter of 2014. Items include research that made a noteworthy contribution to the field, news and announcements that took a conversation to a new level and/or new audience and some welcome action. As before, we offer both the scientific report and media reporting on it, when available, to meet the needs of our various audiences.

  1. Tobacco use.
    Three items relating to tobacco use are of particular note this quarter:

    1. Historic smoking report marks 50th anniversary
      Those of us old enough to remember the Virginia Slims commercials from the 1970s will appreciate the irony of employing their slogan regarding changing the culture of smoking: “You’ve come a long way.” As described in this news article, “fifty years ago, ashtrays seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins. More than 42 percent of US adults smoked, and there was a good chance your doctor was among them. The change of culture around smoking in public is one of the biggest public health success stories, done largely without heavy regulation.” This sea change in tobacco’s acceptance provides both hope and lessons for current campaigns. See a related article: Eight million lives saved since US alarm on smoking 50 years ago, the JAMA themed issue: 50 Years of Tobacco Control, and The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General, 2014.
    2. Health effects of “thirdhand smoke”
      A growing body of research on harmful effects of smoke and ash residue shows that this is a health concern: Cigarette smoke toxins deposited on surfaces: implications for human health, Thirdhand smoke causes DNA damage in human cells, plus older but relevant Third-hand smoke exposure and health hazards in children and The impact of second-hand tobacco smoke exposure on pregnancy outcomes, infant health, and the threat of third-hand smoke exposure to our environment and to our children.
    3. Policy shifts in smoking
      CVS drugstores to stop selling cigarettes over health issues: “Drugstore chain CVS will stop selling cigarettes this year after corporate leaders decided that offering tobacco products is antithetical to the company’s goal of improving customer health. This decision came with an expected economic loss to the company.” A large review bolsters the case for such policy shifts: Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis.
  2. Chlorinated persistent organic pollutants, obesity, and type 2 diabetes
    Not only does this article review the extensive evidence linking these conditions, it also explains puzzling findings in the field related to high vs low dose exposures and nonmonotonic dose-response curves, found in not only laboratory but also in epidemiological studies. It addresses the perplexing role of POPs in adipose tissue– perhaps a safer place to store them than in organs– but also causing harmful inflammatory effects in fatty tissue. It reviews the role of POPs as potential obesogens, as well as their potential interaction with gut microbiota, mitochondrial dysfunction, and other mechanisms. It outlines how future research may address some of the remaining questions in the field.



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