Another Victory for Cleaner Air

written by Ted Schetter, MD, MPH
Science Director for CHE and the Science and Environmental Health Network

Ted Schettler, MD, MPHThis month the US Court of Appeals in Washington, DC, upheld EPA’s 2012 decision to tighten air quality standards for fine particulate air pollution (PM 2.5) by lowering the annual average limit from 15 to 12 microgm/m3.[1] The EPA selected the new standard because it is slightly below the lowest long-term average concentration known to cause adverse health effects, including damage to the lungs and cardiovascular system and premature death in people with heart and lung disease.[2] The National Association of Manufacturers, the US Chamber of Commerce, and other industry groups had challenged the scientific basis of this decision, also objecting to EPA’s plan to eliminate the use of spatial averaging in determining compliance and to require near-road monitoring in certain heavily populated urban areas. The court’s affirmation of each of EPA’s decisions was timely since each year the Asthma and Allergy Foundation of America declares May to be “National Asthma and Allergy Awareness Month.”

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Type 1 Diabetes Incidence Skyrocketing in China

written by Sarah Howard
Coordinator, Diabetes-Obesity Spectrum Working Group

Sarah HowardYou may have seen the news, published in JAMA, that type 1 diabetes prevalence in US children increased by 21.1% between 2001 and 2009 (Dabelea et al. 2014).

You may not have seen the news from the other side of the world, that type 1 diabetes incidence increased by 14.2% per year in Shanghai’s children. At this rate, the incidence of type 1 will double in just four years in Shanghai (between 2016 and 2020), and prevalence will sextuple by 2025 (Zhao et al 2014).

What might explain an increasing incidence that is this rapid and this large? The first thing that comes to my mind is pollution. Indeed, air pollution exposure has been linked to type 1 diabetes incidence in children from Los Angeles (Hathout et al. 2006). However, most environmental chemical exposures have not been well studied in type 1 diabetes—or even studied at all (Howard and Lee 2012). The extremely rapid increase of type 1 diabetes incidence in China—in an area where type 1 has traditionally been rare—deserves our full attention. Pollution as a potential cause or contributor to this increase should not be ignored.

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Science, Civility, and…”Politics”?

Steve Heilig, MPH
CHE Director of Public Health & Education
Director of Public Health & Education at the San Francisco Medical Society

Steve HeiligCHE’s motto is “Science and Civility”—it’s right there on top of our home page. Just below that comes our mission: “… to strengthen the science dialogue on environmental factors impacting human health and to facilitate collaborative, multifactorial, prevention-oriented efforts to address environmental health concerns.”

Fair enough and we think important, for, as our founding chairman and public health icon Dr. Philip Lee notes in his welcome letter, “Compelling scientific evidence increasingly indicates that the proliferation of chemicals in our air, water, soil, food, homes, schools, and workplaces can be an important factor in many human diseases and health conditions.” This is even more true than it was in 2002 when CHE was founded—thanks to the diligent work of many researchers, of course.

But further in his letter, Phil concludes that one goal shared by CHE partners is “better policies and preventive efforts.” It can even be logically argued that this latter aim is the ultimate aim of CHE-like activities. But we also know all too well that “pure” science does not automatically—or even often—lead to healthier, science-based policy.

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Risk Tolerance and the Search for Meaning

written by Michael Lerner, PhD
Vice-Chair of CHE

Reposted with permission from Michael Lerner’s blog.

Each year I come to Europe for the month of May. Work brings me here. Delight keeps me coming back, as well as curiosity about the human condition. Take personal and social risk tolerances in different cultures as an example.

Everywhere in Europe I see young people smoking cigarettes. I see people on bicycles without helmets. In Amsterdam (I was there last year, not this year), cyclists overwhelm the number of cars. They bicycle (or ride scooters and motorcycles) without helmets in the tens of thousands every day. They carry young children without helmets in bicycle baskets without a second thought.In the United States, most of would not think of smoking. Few of us would ride a bicycle without a helmet. To ride a motorcycle without a helmet seems like the height of irresponsibility. And carrying a child with no helmet in a bicycle basket on a long daily commute in heavy city traffic? We would shake our heads in disbelief.

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New Insights into Chronic Stress, Obesity, and Metabolic Syndrome: Further Support for an Ecological Model of Health and an Integrated Approach to Care

Ted Schettler MD, MPH
CHE Science Director


In laboratory animal studies a combination of chronic stress and a high-fat, high-sugar diet causes more abdominal fat to accumulate than that diet alone. This effect seems to be mediated, at least in part, by a substance called Neuropeptide Y (NPY) released from sympathetic nerves supplying adipose tissue in response to certain kinds of stress. A new study reports the same phenomenon in chronically stressed women.[1]

Scientists at UC San Francisco studied a group of 61 disease-free women, about half of whom were chronically stressed caring for a spouse or parent with dementia, while the others were relatively stress-free. They found that the stressed women who ate larger amounts of high-fat, high-sugar food were more prone to abdominal obesity and insulin resistance than the low-stress women who ate the same amount of unhealthy food. As in the animal studies, these effects were also associated with NPY levels, which were significantly higher in the group of stressed women. According to lead author Kirstin Aschbacher, “This study suggests that two women who eat the same thing could have different metabolic responses based on their level of stress. There appears to be a stress pathway that works through diet.”

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