Dementia Decline: Another Consideration

written by Ted Schettler, MD, MPH
Science Director

Today, a study in The Lancet reported that that the prevalence of dementia in the UK in 2011 was significantly lower than would have been expected based on the estimated prevalence in 1991. An accompanying editorial said, “A powerful message from these data is that what we as individuals and services do matters in terms of dementia. The CFAS data point to substantial added value from existing healthy lifestyle messages. They suggest that lifestyle changes—eg, in diet, exercise, and smoking—might reduce the risk of dementia and promote more general health and wellbeing.”

Many news outlets picked it up. See, for example, the BBC’s report. The story was also discussed on the News Hour with the lead, “Researchers See Decline in Dementia, Offering Optimism for Power of Lifestyle.”

A healthy lifestyle is of course important, but what has not been mentioned in any report that I’ve seen is the potential role of declining lead levels in the UK population.

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Top 10: July 2013

For the second quarter of 2013, we collectively selected ten topics from several dozen candidate news articles, journal articles, policy decisions and reports that have had a significant impact or are likely to have a significant impact on thinking and action in the field of environmental health. We consider these selections to be the biggest contributors toward new insights, toward changing the conversation or expanding the scope of the conversation on a topic to a new audience or awareness, or toward defining a new trend. Comments are welcome.

The selections, in no particular order:

  1. Chemical policy reform
    A significant development in federal chemicals policy reform occurred in late May when  Senator Frank Lautenberg (D-NJ) and David Vitter (R-LA) introduced a new, bipartisan bill called the Chemical Safety Improvement Act (CSIA). The introduction of the CSIA took many by surprise. Senator Lautenberg, who had been a champion for chemical policy reform for many years, passed away about a week later. CHE has compiled a selection of responses to this bill as well as links to other relevant sites for additional information: Chemical Policy Reform.
  2. Autism: New insights
    Several new studies have provided further understanding of environmental and genetic contributors to autism spectrum disorders. We list what we view as some of the most significant of these studies:

    1. Autism study finds link to environment, even in womb: A new study of twins suggests that environmental factors, including conditions in the womb, may be at least as important as genes in causing autism. See the study abstract: Genetic heritability and shared environmental factors among twin pairs with autism and related studies: Quantitative trait loci for interhemispheric commissure development and social behaviors in the BTBR T+ tf/J mouse model of autism and Methylomic analysis of monozygotic twins discordant for autism spectrum disorder and related behavioural traits.
    2. Study links autism with antidepressant use during pregnancy. See the study abstract: Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study.
    3. Epilepsy drug in pregnancy tied to autism risk: Women who take the epilepsy drug valproate during pregnancy are three times more likely to have a child with an autism spectrum disorder, suggests new research based on close to 700,000 babies born in Denmark. See the study abstract: Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism.
    4. US kids born in polluted areas more likely to have autism. See the study abstract: Perinatal air pollutant exposures and autism spectrum disorder in the Children of Nurses’ Health Study II participants.
  3. EHN special report: ‘chemicals of high concern’ found in thousands of children’s products
    An Environmental Health News analysis of thousands of reports from America’s largest companies shows that toys and other children’s products contain low levels of dozens of industrial chemicals. See the database: Children’s Safe Product Act Reports.
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A Boon for Reproductive Health

written by Elise Miller, MEd
CHE Director

For those concerned about environmental impacts on reproductive health, the stars have aligned. Last month, the University of California, San Francisco’s Program on Reproductive Health and the Environment (PRHE) honored three exceptional leaders: Teresa Woodruff, PhD, the new president of The Endocrine Society; Linda Giudice, MD, PhD, president of the American Society for Reproductive Medicine; and Jeanne Conry, MD, PhD, president of the American Congress of Obstetricians and Gynecologists. Not only do these highly gifted women head major professional societies which represent tens of thousands of researchers and health professionals around the world, they are deeply committed to expanding the scientific literature on links between environmental contaminants and reproductive health and to highlighting the need for stronger chemical policy reform.

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Responses to RCOG Statement on Dealing with Chemicals during Pregnancy

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

Recently, the Royal College of Obstetricians and Gynaecologists published the Scientific Impact Paper No. 37 entitled “Chemical Exposures During Pregnancy: Dealing with Potential, but Unproven, Risks to Child Health.” The paper describes environmental hazards to which pregnant women are routinely exposed, and offers guidance on reducing exposures to harmful chemicals. As the accompanying press release explains “The paper recommends that the best approach for pregnant women is a ‘safety first’ approach, which is to assume there is risk present even when it may be minimal or eventually unfounded.”

Public and scientific response to the paper has been quite varied, with some calling the recommendations extreme and likely to cause undue anxiety in expectant mothers. Others have hailed the recommendations as long overdue. On the CHE Fertility and Reproductive Health working group listserv, a vibrant discussion of the paper took place. Please see the official comments from leading CHE partners below. What are your thoughts on the recommendations for pregnant women?

“It is wise to begin with a precautionary principle, to caution women that it is in the best interest of their health and the health of their families to be aware and cautious of exposures to a variety of chemicals in the environment.”

Jeanne A. Conry, MD, PhD, FACOG
The American Congress of Obstetricians and Gynecologists

Linda Giudice, MD, PhD, MSc
American Society for Reproductive Medicine

Read the full letter from ACOG and ASRM.

The status quo for a long time has been for health care providers, in the face of uncertainty, to say very little to their patients about potentially harmful exposures during pregnancy. This unfortunately has created a culture where all kinds of exposures have been assumed safe. This report at the very least acknowledges that women should not be so reassured, and should take precautionary steps until we know more.

Alexandra Scranton
Director of Science and Research
Women’s Voices for the Earth

Read the full WVE response.