The Ecological Paradigm of Health: An Interview with Dr. Ted Schettler

Yes! Magazine’s Fall 2012 issue features an interview with Dr. Ted Schettler, CHE’s science director:

Talking with Dr. Ted Schettler is probably unlike any conversation you have had with your physician. Raise the topic of breast cancer or diabetes or dementia, and Schettler starts talking about income disparities, industrial farming, and campaign finance reform.

The Harvard-educated physician, frustrated by the limitations of science in combating disease, believes that finding answers to the most persistent medical challenges of our time—conditions that now threaten to overwhelm our health care system—depends on understanding the human body as a system nested within a series of other, larger systems: one’s family and community, environment, culture, and socioeconomic class, all of which affect each other.

Continue reading on the Yes! Magazine website.

Paternal Age, de Novo Mutations and Autism Risk

Ted Schettler, MD, MPH
Science Director

A recent study of paternal age, de novo DNA mutations, and autism risk in Iceland, published in the journal Nature, has received considerable attention. The authors of the study found more de novo DNA mutations in children with autism and those mutations were largely traced to fathers rather than mothers. Increasing numbers of mutations were also associated with increasing paternal age. The authors wondered if recent increases in autism were largely attributable to the increasing age of fathers.

The New Yorker said, “What was surprising was how that news, which one of the study’s lead authors described as “sort of a little bit of our side story,” obscured the implications of the paper’s main findings—namely, that the genetic health of the species is now facing a serious threat.” Read more.  Important as this is, most reports have failed to comment on another observation in the paper.  The authors said this:

“There has been a recent transition of Icelanders from a rural agricultural to an urban industrial way of life, which engendered a rapid and sequential drop in the average age of fathers at conception from 34.9 years in 1900 to 27.9 years in 1980, followed by an equally swift climb back to 33.0 years in 2011, primarily owing to the effect of higher education and the increased use of contraception. On the basis of the fitted linear model, whereas individuals born in 1900 carried on average 73.7 de novo mutations, those born in 1980 carried on average only 59.7 such mutations (a decrease of 19.1%), and the mutational load of individuals born in 2011 has increased by 17.2% to 69.9. Demographic change of this kind and magnitude is not unique to Iceland, and it raises the question of whether the reported increase in ASD diagnosis lately is at least partially due to an increase in the average age of fathers at conception.”

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Science Pick: More Evidence of Declining Sperm Quality.

Karin Gunther Russ, MS, RN
Coordinator of the Fertility and Reproductive Health Working Group

The role that environment plays in male fertility has been debated over the years.  A landmark study by Dr. Carlsen et al in 1992 demonstrated an approximately 50% decline in sperm counts in Danish military recruits over a 50 year period. Dr. Jorgensen and colleagues published a study this summer showing sperm counts in Danish men have increased somewhat in recent years, but are still significantly lower than sperm counts in a population of infertile men in Denmark studied in the 1940s. This new study again gives reason for concern about trends in male fertility. Looking at data from Israeli sperm banks, the authors found the average sperm concentration dropped from ~106 million spermatozoa/ml to ~68 million/ ml over the study period. The authors state: “The rapid deterioration of sperm quality among fertile semen donors is alarming and may lead to cessation of sperm donation programs.”

Haimov-Kochman R, Har-Nir R, Ein-Mor E, Ben-Shoshan V, Greenfield C, Eldar I, Bdolah Y, Hurwitz A. Is the quality of donated semen deteriorating? Findings from a 15 year longitudinal analysis of weekly sperm samples. Israel Medical Association Journal. 2012. Jun;14(6):372-7.

From the abstract: Studies suggest that global semen quality is declining, but the debate remains open owing to geographic variation. This study evaluates temporal trends of sperm parameters—namely concentration, motility and total motile sperm count—in sperm donated during the period 1995-2009 in Israel. Despite the lowering of criteria for sperm parameters satisfactory for donation that were implemented in 2004, 38% of applicants for sperm donation are now rejected based on semen quality.

Geonotic Diseases: a New Taxonomy

Carolyn Raffensperger
Executive Director of the Science and Environmental Health Network

This excerpt is reprinted with permission of the author. The full post can be found on the SEHN blog.

Premises:

1. There are taxonomies of human health and disease. Taxonomies are conceptual frameworks that organize our thinking by grouping things that share characteristics. One taxonomy of disease is based on the system of the body that is diseased: the endocrine system, the cardiovascular system, the nervous system. Within those systems there can be various disorders such as birth defects, cancer, or poisoning. Another taxonomy is the kind of disease: infectious disease, injuries, or chronic disease, as examples. Within the category of those diseases there can be further subdivisions. Within the domain of infectious diseases there are those known as zoonotic diseases. These are diseases that cross between species and are often carried by a vector such as mosquitoes or ticks.

2. Epidemiology specializes in two kinds of disease,  infectious and chronic. Frequently epidemiologists studying infectious disease investigate causes because there is usually a direct cause and a single effect with infectious diseases. Chronic disease specialists often study effects because many chronic diseases have multi-factorial causes making it harder to study causes.

3. Since the rise of industrialization the disease pattern has changed from primarily infectious disease to primarily chronic disease. Small pox and polio have been replaced by cardiovascular disease, diabetes and asthma.

3. When it focuses on effects, rather than causes of chronic disease, the medical professions emphasize treatment of disease, rather than prevention of disease.

4. The causes of chronic diseases are often complex, ecological (both biological and geological) and result from cumulative impacts of multiple stressors.

Continue reading on the SEHN blog.

Science Pick: Lead Is Still the Problem

Ted Schettler, MD, MPH
Science Director

Sheila Kaplan and Corbin Hiar show that lead contamination of drinking water is a problem that has not yet been solved. Here’s what can happen when a systems problem is attacked piecemeal….. missing the danger, new tactics, and passing the buck. Ultimately, a failure to protect public health.

Millions of Americans may be drinking water that is contaminated with dangerous doses of lead. The Environmental Protection Agency (EPA) knows it; state governments know it; local utilities know it. The only people who usually don’t know it are those who are actually drinking the toxic water. Read the full article on the Investigative Reporting Workshop website.

U.S. House Passes Camp Lejeune Compensation Bill

Dick Clapp
CHE Partner and  member of the ATSDR Camp Lejeune Community Assistance Panel

This post is reprinted with permission of the author. The original post is on The Pump Handle.

After years of diligent and effective advocacy by former Marines and family members, the House voted on July 31, 2012 in favor of the Honoring America’s Veterans and Caring for Camp Lejeune Families Act (H.R. 1627). The House version was amended by the Senate and passed earlier in July and the final version now goes on to President Obama for signing into law. The first section of the bill is named after Janey Ensminger, the nine year-old daughter of former Marine Jerry Ensminger, who was conceived and born at Camp Lejeune and lived there until she was diagnosed with leukemia, which subsequently took her life. She was exposed to contaminated drinking water, as were hundreds of thousands of others who lived or worked on the base.

The Act, among other things, provides that the Department of Veterans Affairs will give hospital care and medical services to those veterans and families exposed during the years 1957 to 1987 for a variety of conditions that may have been caused by chemicals such as TCE, PCE, benzene and vinyl chloride in Camp Lejeune drinking water. The House members who spoke in favor of the bill noted that the health studies establishing the link between the water and various diseases are still underway, but the process of setting up medical and hospital care should not wait until those studies are completed. The details of this portion of the Act are still to be worked out by the VA and the affected parties.

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