Your Health the Week of June 1st

written by Nancy Hepp, MS
Research and Communications Specialist

Childhood Leukemia

Two studies this week connect childhood leukemia with the environment. Childhood leukemia and residential proximity to industrial and urban sites, from Environmental Research, shows an association between living near certain industries or urban areas and an increased risk of childhood leukemia. Industries working with glass and mineral fibers, organic solvents, galvanization and processing of metals, and surface treatment of metals were identified with the greatest increases in risk. The other study, from JAMA Pediatrics, found that breastfeeding a child for six months or more could prevent 14% or more of cases of childhood leukemia.

Top 10: 1st Quarter 2015

This quarter’s selections include a discussion of the role of bad luck in cancer, the continuing saga of federal chemical policy reform, the costs of hormone-disrupting chemicals, a couple of success stories, and plenty of research on the impacts of several common toxics on health. Find out more about many of the Top 10 topics in the new A Story of Health illustrated multimedia eBook developed by CHE and other partners. Through the lives of fictional characters and their families we investigate the multiple environmental factors that influence asthma, developmental disabilities and cancer. Each story features the latest scientific research about disease origin and prevention, key concepts on environmental health, and links to a wide range of additional resources and hundreds of scientific papers.

1. The “bad luck” of cancer
   A study and its media reporting caused quite a stir among scientists and advocates, with conversation continuing for weeks.
   1. The study: The bad luck of cancer
   2. An initial media report: Most cancer types ‘just bad luck’
   3. Reiterated a few days later in the New York Times: Cancer’s random assault
   4. Response from Silent Spring Institute: Is cancer just bad luck? We don’t think so.
   5. Response from CHE: Cancer, Stem Cells, and Bad Luck
   6. Response from the International Agency for Research on Cancer: Most types of cancer not due to “bad luck”: IARC responds to scientific article claiming that environmental and lifestyle factors account for less than one third of cancers
   7. Reply by Science Magazine: Backlash greets ‘bad luck’ cancer study and coverage
   8. Response from Medscape: Why the ‘cancer due to bad luck’ story needs revision
   9. Response from Natural Resources Defense Council: No, cancer is not mostly bad luck—the role of environmental factors
2. Chemical policy legislation introduced
   Two new bills have been introduced in Congress to update and reform the Toxic Substances Control Act of 1976. Substantial conversation and analysis has ensued, including these items:
   1. Udall introduces bill to reauthorize Toxic Substances Control Act
   2. 697 – Frank R. Lautenberg Chemical Safety for the 21st Century Act introduced by Senator Tom Udall
   3. 725 – A bill to amend the Toxic Substances Control Act, and for other purposes Introduced by Senator Barbara Boxer
   4. Safer Chemicals’ Igrejas discusses competing Senate TSCA reform bills
   5. Eight key questions on chemical safety reform (Environmental Working Group)
   6. How best to strengthen chemical regulations (New York Times)
   7. Reducing Our Exposure to Toxic Chemicals: Stronger State Health Protections at Risk in Efforts to Reform Federal Chemical Law (Center for Effective Government)
   8. The bizarre way the US regulates chemicals—letting them on the market first, then maybe studying them (Washington Post)
3. Environmental contributors to autoimmune diseases
   While research into the role of environmental contributors to autoimmune diseases is not new, the specifics of contributors and their effects is difficult to pinpoint. We applaud these new discoveries:
   1. Mercury in seafood may raise risk of autoimmune diseases in women: study: To explore risk factors for autoimmune disorders, the study authors focused on government data that looked at women between the ages of 16 and 49 between 1999 and 2004. The study: Mercury exposure and antinuclear antibodies among females of reproductive age in the United States: NHANES.
   2. Environmental estrogen bisphenol A and autoimmunity: Here, we review the role of a specific environmental factor, bisphenol A (BPA), in the pathogenesis of autoimmune diseases. BPA belongs to the group of environmental estrogens that have been identified as risk factors involved in the development of autoimmune diseases.
   3. World Trade Center workers at increased risk of developing autoimmune diseases: A new study has found a strong link between prolonged work at the World Trade Center (WTC) site following the terrorist attacks of September 11, 2001 and the development of various autoimmune diseases including arthritis and lupus. The study: Nested case-control study of selected systemic autoimmune diseases in World Trade Center rescue/recovery workers.
   4. Maternal intake of fatty acids and their food sources during lactation and the risk of preclinical and clinical type 1 diabetes in the offspring: Maternal consumption of red meat, especially processed meat, during lactation may increase the risk of type 1 diabetes.
4. Chemical exposure linked to billions in health care costs
   Exposure to hormone-disrupting chemicals is likely leading to an increased risk of serious health problems costing at least $175 billion (US) per year in Europe alone, according to a study. The four reports, plus two CHE calls, from the study:
   1. Estimating burden and disease costs of exposure to endocrine-disrupting chemicals in the European Union
   2. Male reproductive disorders, diseases, and costs of exposure to endocrine-disrupting chemicals in the European Union
   3. Obesity, diabetes, and associated costs of exposure to endocrine-disrupting chemicals in the European Union
   4. Neurobehavioral deficits, diseases and associated costs of exposure to endocrine disrupting chemicals in the European Union
   5. March 24th call: A High Price to Pay: Burden of Disease and Costs of Endocrine Disrupting Chemicals in the European Union
   6. April 28th call: A High Price to Pay: Obesity, Diabetes, and Associated Costs of Exposure to Endocrine Disrupting Chemicals in the European Union
5. Concerns about glyphosate and other herbicides
   Gyphosate, known by trade names Roundup, Accord, Rodeo and Touchdown, was under fire this quarter by the International Agency for Research on Cancer (IARC) and several new studies. IARC also classified several other herbicides as to their carcinogenicity.
   1. International Agency for Research on Cancer: carcinogenicity of several herbicides: A monograph published by the International Agency for Research on Cancer (IARC) has branded the herbicide glyphosate as “probably carcinogenic to humans.” The insecticides malathion and diazinon received the same classification (Group 2A) while the tetrachlorvinphos and parathion were classified as “possibly carcinogenic to humans” (Group 2B) based on convincing evidence that these agents cause cancer in laboratory animals. The preliminary report: Carcinogenicity of tetrachlorvinphos, parathion, malathion, diazinon, and glyphosate.
   2. Glyphosate, pathways to modern diseases III: manganese, neurological diseases, and associated pathologies: A recent study on cows fed genetically modified Roundup®-Ready feed revealed a severe depletion of serum manganese (Mn). Glyphosate, the active ingredient in Roundup®, has also been shown to severely deplete Mn levels in plants. Here, we investigate the impact of Mn on physiology, and its association with gut dysbiosis as well as neuropathologies such as autism, Alzheimer’s disease, depression, anxiety syndrome, Parkinson’s disease, and prion diseases.
   3. Study links widely used pesticides to antibiotic resistance: A study published by mBio has linked glyphosate and two other widely-used herbicides — 2,4-D and dicamba — to one of the most pressing public health crises of our time: antibiotic resistance. The study: Sublethal exposure to commercial formulations of the herbicides dicamba, 2,4-dichlorophenoxyacetic acid, and glyphosate cause changes in antibiotic susceptibility in Escherichia coli and Salmonella enterica serovar Typhimurium.
   4. Drinking well water and occupational exposure to herbicides is associated with chronic kidney disease, in Padavi-Sripura, Sri Lanka: The current study strongly favors the hypothesis that CKDu epidemic among farmers in dry zone of Sri Lanka is associated with, history of drinking water from a well that was abandoned. In addition, it is associated with spraying glyphosate and other pesticides in paddy fields.
6. Nation’s biggest furniture retailer drops flame retardants
   Ashley Furniture, the nation’s largest furniture retailer, is purging flame retardants from its product lines, the strongest evidence yet that the toxic, ineffective chemicals are on the way out of household couches and chairs. This is a success for public health.
7. Developmental origins of health and disease: a paradigm for understanding disease cause and prevention
   The evidence in support of the developmental origins of the health and disease paradigm is sufficiently robust and repeatable across species, including humans, to suggest a need for greater emphasis in the clinical area. As a result of these data, obesity, diabetes, cardiovascular morbidity, and neuropsychiatric diseases can all be considered pediatric diseases. Understanding the origins of disease is the first step in prevention.
8. Effects of arsenic
   From blood pressure and heart disease to gestational diabetes, hypothyroidism, chickenpox, early childhood growth, infant mortality and neurobehavioral effects, arsenic is much under investigation. Because arsenic exposure is widespread and often natural in origin, these effects are quite concerning.
   1. Blood pressure and heart disease:
      1. Blood pressure changes in relation to arsenic exposure in a US pregnancy cohort: In our US cohort of pregnant women, arsenic exposure was associated with greater increases in blood pressure over the course of pregnancy. These findings may have important implications as even modest increases in blood pressure impact cardiovascular disease risk.
      2. Blood pressure, left ventricular geometry, and systolic function in children exposed to inorganic arsenic: Early-life exposure to inorganic arsenic was significantly associated with higher blood pressure and left ventricular mass and with lower ejection fraction in our study population of Mexican children.
      3. Association between lifetime exposure to inorganic arsenic in drinking water and coronary heart disease in Colorado residents: Lifetime exposure to low-level inorganic arsenic in drinking water was associated with increased risk for CHD in this population.
   2. Diabetes
      1. A nested case-control study indicating heavy metal residues in meconium associate with maternal gestational diabetes mellitus risk: The present work implies that exposure to some of the selected metals (noticeably arsenic) may contribute to maternal gestational diabetes mellitus risk during pregnancy.
      2. Arsenic exposure, arsenic metabolism, and incident diabetes in the Strong Heart Study: Arsenic metabolism, particularly lower monomethylarsonate percentage, was prospectively associated with increased incidence of diabetes.
   3. Hypothyroidism
      1. Association of hypothyroidism with low-level arsenic exposure in rural West Texas: The prevalence of hypothyroidism was significantly higher in Hispanics or non-Hispanic whites of this rural cohort than the national prevalence. Measures should be taken to reduce arsenic in drinking water in order to prevent hypothyroidism in rural areas.
   4. Varicella zoster virus, cause of chicken pox and shingles
      1. Arsenic exposure and prevalence of the varicella zoster virus in the United States: NHANES (2003-2004 and 2009-2010): In this cross-sectional analysis urinary arsenic was inversely associated with VZV immunoglobulin G seroprevalence in the US population. This finding is in accordance with clinical observations of zoster virus reactivation from high doses of arsenic.
   5. Pregnancy/infant outcomes
      1. Association of arsenic with adverse pregnancy outcomes — infant mortality: a systematic review and meta-analysis: Arsenic is associated with adverse pregnancy outcomes and infant mortality. The interpretation of the causal association is hampered by methodological challenges and limited studies on dose-response.
      2. Association between maternal urinary arsenic species and infant cord blood leptin levels in a New Hampshire pregnancy cohort: These results suggest in utero exposure to low levels of arsenic influences cord blood leptin concentration and presents a potential mechanism by which arsenic may impact early childhood growth.
   6. Neurobehavioral outcomes
      1. Neurobehavioral effects of arsenic exposure among secondary school children in the Kandal Province, Cambodia: Arsenic-exposed school children from the Kandal Province of Cambodia with a median hair As level of 0.93 µg/g among those from the highly contaminated study site, showed clear evidence of neurobehavioral effects.
9. BPA and neurodevelopment
   1. BPA exposure linked to autism spectrum disorder, study reports: A newly published study is the first to report an association between bisphenol A (BPA), a common plasticizer used in a variety of consumer food and beverage containers, with autism spectrum disorder (ASD) in children. The study: Bisphenol A exposure in children with autism spectrum disorders.
   2. Bisphenol A exposure and behavioral problems among inner city children at 7-9 years of age: These results suggest BPA exposure may affect childhood behavioral outcomes in a sex-specific manner and differently depending on timing of exposure.
   3. Autistic features associated with prenatal exposure to endocrine disruptors: Exposure during pregnancy to a combination of fire retardant chemicals and phthalate chemicals, which are present in the average home, may contribute to autistic-like behaviors in offspring, according to a new Canadian study.
10. Cleaner air linked to bigger, stronger lungs in Southern California children
    Cleaner air has for the first time been linked to bigger and stronger lungs among school-age children, according to findings from a two-decade study in Southern California. This is another success story. The study: Association of improved air quality with lung development in children.

Top 10 Selections: 4th quarter 2014

We present CHE’s picks of the most important environmental health stories from the last quarter of 2014.

1. Air pollution and autism
   A growing body of evidence implicates air toxics as potential contributors to autism spectrum disorders, with four studies published in rapid succession this quarter:
   1. Environmental chemical exposures and autism spectrum disorders: a review of the epidemiological evidence.
   2. University of Pittsburgh study correlates autism with air pollution: Preliminary results from the study show that children with autism spectrum disorders were more likely to have been exposed to higher levels of certain air toxics during their mothers’ pregnancies and their first two years of life compared with children without the condition. The study: The association of national air toxics assessment exposures and the risk of childhood autism spectrum disorder: a case control study.
   3. Air pollution exposure in pregnancy linked to autism in study: Women who are exposed to high levels of air pollution during their third trimester of pregnancy may be twice as likely to have an autistic child. The study: Autism spectrum disorder and particulate matter air pollution before, during, and after pregnancy: a nested case–control analysis within the Nurses’ Health Study II cohort.
   4. Fourth study finds traffic pollution may cause autism: The more traffic pollution a pregnant woman is exposed to — especially during her third trimester — the greater chance her child will develop autism. The study: In utero exposure to toxic air pollutants and risk of childhood autism.
2. Phthalates’ effects on health
   A proposed rule by the Consumer Product Safety Commission was mandated by the Consumer Product Safety Improvement Act of 2008 and is now open for public comment: Prohibition of children’s toys and child care articles containing specified phthalates. Research continues to bring fuller understanding of the potential for harm from several phthalates:
   1. Prenatal exposure to household chemical linked to reduced IQ, study says: Children who were exposed in utero to high levels of phthalates went on to have lower IQ levels than their peers who were exposed to lower levels, a new study from the Mailman School of Public Health at Columbia University found. The study: Persistent associations between maternal prenatal exposure to phthalates on child IQ at age 7 years.
   2. A birth cohort study to investigate the association between prenatal phthalate and bisphenol A exposures and fetal markers of metabolic dysfunction: Associations between maternal exposure to chemicals and markers of metabolic function appear potentially to be sex specific.
   3. Plastics chemical linked to changes in boys’ genitals: Boys exposed in the womb to high levels of a chemical found in vinyl products are born with slightly altered genital development, according to research published today. The study of nearly 200 Swedish babies is the first to link the chemical di-isononyl phthalate (DiNP) to changes in the development of the human male reproductive tract. The study: Prenatal phthalate exposures and anogenital distance in Swedish boys.
   4. How household plastics could ruin your sex life: Phthalates are being linked to, among other things, a decrease in libido in women. The study: Environmental exposure to di-2-ethylhexyl phthalate is associated with low interest in sexual activity in premenopausal women.
3. Sugar and other sweeteners
   The impact of sugar and other sweeteners on health has been getting more attention lately. In addition to the launch of SugarScience, a new website touted as an authoritative source for evidence-based, scientific information about sugar and its impact on health, the nation’s first soda tax passed in Berkeley, California. Proponents of the tax say it will curb the consumption of sodas, energy drinks and sweetened teas which are contributing to the country’s obesity epidemic and Type 2 diabetes. Meanwhile, research is uncovering health effects of sugar and other sweeteners that go beyond obesity and diabetes:
   1. This is your teenager’s brain on soda: Researchers at the University of Southern California recently published a study showing a connection between sugar consumption and memory problems. The study: Effects of sucrose and high fructose corn syrup consumption on spatial memory function and hippocampal neuroinflammation in adolescent rats.
   2. Intake of energy-dense foods, fast foods, sugary drinks, and breast cancer risk in African American and European American women.
   3. Soda and cell aging: associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the National Health and Nutrition Examination Surveys.
4. Climate change
   The biggest climate story this quarter was that the US and China announced important new actions to reduce carbon pollution. The Climate Change 2014: Synthesis Report from the Intergovernmental Panel on Climate Change also reiterated that the situation requires immediate and substantial action or the Earth will face “further warming and long-lasting changes in all components of the climate system, increasing the likelihood of severe, pervasive and irreversible impacts for people and ecosystems.” While the connection to human health is not always mentioned in reports on climate change, the health impacts are substantial. For example, in Chemically mediated behavior of recruiting corals and fishes: a tipping point that may limit reef recovery, there’s an understated repercussion of the loss of reefs: devastating impacts on sources of food, and especially protein, for much of the world’s human population. Other stories highlighting other aspects of climate change include these:
   1. From bar fights to wars, climate change will make us more violent: The hotter it gets, the more likely we are to kill each other. Murder rates go up in heat waves; in some countries, civil war is also more likely. In training exercises in hot weather, police are more likely to pull out a gun and fire. The paper: Climate and conflict.
   2. Climate change affects national security: After close examination of the science, the Military Advisory Board, a group of 16 retired flag-level officers, conclude that, “The national security risks of projected climate change are as serious as any challenges we have faced.”
5. NY health and environmental chiefs: no to fracking
   New York Governor Andrew Cuomo’s administration has moved to prohibit fracking in the state, citing unresolved health issues and dubious economic benefits of the widely used gas-drilling technique. This is the first US state to take such a stand. The report from the New York State Department of Health: A Public Health Review of High Volume Hydraulic Fracturing for Shale Gas Development and another recent report: Warning Signs: Toxic Air Pollution Identified at Oil and Gas Sites.
6. BPA and its replacements
   While more research mounts on health concerns from exposure to BPA, the Food and Drug Administration maintains that “the available information continues to support the safety of BPA for the currently approved uses in food containers and packaging”, as reported in Bisphenol A is safe for approved uses in food containers, packaging, FDA says. In a conflicting decision, a California court upheld the state scientists’ finding that BPA is known to cause reproductive health problems: Court upholds BPA health warning. Recent research on BPA and replacements include these studies:
   1. Kids exposed to BPA before birth at risk of wheeze: study: Young kids who were exposed to Bisphenol A before birth are more likely than others to have a wheeze before age five, according to a new study that found no connection to BPA exposure after birth.The study: Bisphenol A exposure and the development of wheeze and lung function in children through age 5 years.
   2. Prenatal bisphenol A exposure and maternally reported behavior in boys and girls: These results suggest that prenatal exposure to BPA may be related to increased behavior problems in school age boys, but not girls.
   3. The leaching of BPA into skin from cash receipts is enhanced by using sanitizers: Touching cash register receipts while using sanitizers can dramatically increase your body’s absorption of BPA, researchers report. The study: Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA).
   4. BPA exposure by infants may increase later risk of food intolerance: This research involving rats suggests that early life exposure at a dose significantly below the current human safety limit set by the FDA affects developing immune systems, predisposing offspring to food intolerance in adulthood. The study: Food intolerance at adulthood after perinatal exposure to the endocrine disruptor bisphenol A.
   5. That takeout coffee cup may be messing with your hormones: A new study suggests that whole classes of BPA-free plastics — including the kind in styrofoam — release estrogenic chemicals. The study: Estrogenic chemicals often leach from BPA-free plastic products that are replacements for BPA-containing polycarbonate products.
7. New study charts the fate of chemicals affecting health and the environment
   In a new study, Rolf Halden, PhD, a researcher at Arizona State University’s Biodesign Institute, examines the trajectory of chemicals appearing as emergent threats to human or environmental health. His research offers a highly instructive analysis of how long it takes chemicals of concern to become recognized and acted on — and why. The review: Epistemology of contaminants of emerging concern and literature meta-analysis.
8. 16 major companies and agencies say no to chemical flame retardants
   The Center for Environmental Health, which helped encourage a rewrite of California’s regulations regarding safety standards in furniture manufacturing, announced in mid December that 16 major furniture manufacturers have now “sworn off” chemical flame retardants. This is a prime example of how environmental health science can be effectively translated into regulations that better protect health. The CEH press release including the list: Major producers eliminating flame retardant chemicals as major buyers are demanding flame retardant-free furniture.
9. National Institutes of Health ends longitudinal children’s study
   The US National Institutes of Health has cancelled its plan for an ambitious, multi-decade study of environmental influences on children’s health known as the National Children’s Study, agency director Francis Collins announced on December 12th. The study was originally approved by a bipartisan Congress in 2000 but was fraught with scientific and political challenges over the last 14 years. See also an analysis: How the US government botched its multibillion-dollar plan to beat childhood disease.
10. Theo Colborn: Honoring the work of an environmental health giant
    Theo Colborn, PhD, passed away on December 14th at age 87, leaving an extraordinary legacy of careful and determined environmental health research and advocacy. She was particularly recognized for her seminal work on endocrine disrupting chemicals and fracking.
    1. A brief biography by Elizabeth Grossman.
    2. Theo’s CV.
    3. Comments and stories from those who knew Theo.
    4. Remembering the genius who got BPA out of your water bottles, and so much more, one of many media reports on Theo’s death.

Another Cry for Primary Prevention

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.

Prospective Evidence: BPA, Phthalates, and Type 2 Diabetes

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

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.
3. Research and controversy around BPA
   1. Bisphenol A (BPA) pharmacokinetics with daily oral bolus or continuous exposure via silastic capsules in pregnant rhesus monkeys: relevance for human exposures: This research addresses the ongoing controversy in BPA research about using silastic capsules versus oral bolus. This study suggests that oral bolus exposure is not an appropriate human exposure model. Differences in pharmacokinetics of dBPA were evident between pre-pregnancy, early and late pregnancy, likely reflecting changes in maternal, fetal and placental physiology.
   2. FDA finding on BPA: The FDA’s publication, Toxicity evaluation of bisphenol A administered by gavage to Sprague-Dawley rats from gestation day 6 through postnatal day 90 generated a great deal of comment. See opposing views of the review: BPA is A-OK, says FDA and Scientists condemn new FDA study saying BPA is safe: “it borders on scientific misconduct.” Also compare FDA’s finding to news from France: RAC proposes to strengthen the classification of bisphenol A.
4. The Elk River chemical spill in West Virginia
   This event and its repercussions kept water quality, chemical contamination, testing and regulation in Americans’ minds for weeks. Most notably it highlighted the failures of the Toxic Substances Control Act (TSCA) and need for chemical policy reform. Though there were dozens of news articles and analyses, one example of the reach and possible impact of this story is Data deficit on Elk River chemicals shows need for TSCA reform, legislators say. “Members of a House subcommittee pointed to the lack of toxicity and other data on chemicals that recently contaminated drinking water for hundreds of thousands of West Virginia residents as illustrating a key reason the Toxic Substances Control Act needs to be revised.”
5. Inheriting fear
   New research demonstrates that fear can be passed on from one generation of laboratory animals to the next. Epigenetic changes are most likely responsible, and this provocative study is bringing new challenges to how scientists think about behavior and evolutionary change.
   1. See the study: Parental olfactory experience influences behavior and neural structure in subsequent generations.
   2. See also similar research regarding “inherited” stress: Is stress contagious? Study shows babies can catch it from their mothers and the study: Stress contagion: physiological covariation between mothers and infants.
6. Fracking and health
   As more research and news regarding fracking emerges, the concerns and controversies about fracking’s potential impact on human health continue to deepen. In this last quarter, a few important new studies and reports were published:
   1. 4 states confirm water pollution from drilling: “In at least four states that have nurtured the nation’s energy boom, hundreds of complaints have been made about well-water contamination from oil or gas drilling, and pollution was confirmed in a number of them, according to a review that casts doubt on industry suggestions that such problems rarely happen.”
   2. Study shows fracking is bad for babies: researchers found that proximity to fracking increased the likelihood of low birth weight by more than half, from about 5.6 percent to more than 9 percent. The chances of a low Apgar score, a summary measure of the health of newborn children, roughly doubled, to more than 5 percent. See the study: Birth outcomes and maternal residential proximity to natural gas development in rural Colorado but also State questions study linking fracking to birth defects.
   3. Ohio earthquakes linked to fracking: “Ohio authorities shut down a hydraulic fracturing natural gas operation in Mahoning County on Monday after two earthquakes were felt in the area.”
   4. Report: Big Oil, Bad Air: Fracking the Eagle Ford Shale of South Texas: “an eight-month investigation found Texas regulators are largely ignoring air pollution problems caused by fracking the Eagle Ford Shale.” See also Planning for fracking on the Barnett shale: urban air pollution, improving health based regulation, and the role of local governments: “Using the community experience on the Barnett Shale as a case study, this article focuses on the legal and regulatory framework governing air emissions and proposes changes to the current regulatory structure.”
7. The Textbook of Children’s Environmental Health
   This textbook edited by Philip Landrigan, MD, MSc, and Ruth Etzel, MD, PhD, provides one of the most comprehensive overviews of the research and clinical applications to date and the scientific basis in clear and accessible language for why promoting children’s environmental health now is essential for a healthy, thriving society in the future. As the first course textbook of its kind, it could be used as the basis for the possible inclusion of questions on environmental health as part of the medical board certification process.
8. In many neighborhoods, the main obstacle to good health is poverty
   For decades, activists and scholars around the country have emphasized that focusing solely on changing individual behaviors is not enough to change the broader patterns of inequities in health. Researchers who study disparities have found that social and economic factors, such as employment, education, and social networks, also strongly influence whether people have the resources to protect their health. In racially segregated neighborhoods such as the one discussed in this article, with its crumbling infrastructure and history of institutional neglect, the main obstacle to good health is poverty. Though this is not news, we chose to include this piece because it highlights not just the problem, but shifts the conversation toward a more ecological model of health and includes possible solutions and some emerging evidence to bolster them as well.
9. Study questions fat and heart disease link
   “A large and exhaustive new analysis by a team of international scientists found no evidence that eating saturated fat increased heart attacks and other cardiac events.” This negates several decades of nutritional guidance and reopens a crucial conversation about what are the fundamentals of a healthy diet. See the study: Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis.
10. Climate risks as conclusive as smoking and lung cancer link – scientists
    In an unusual policy intervention, one of the world’s largest scientific bodies said evidence that the world is warming is as conclusive as the link between smoking and lung cancer. There has been much hyping from climate deniers of the uncertainty around climate science and predictions. This statement provides context for non-scientists. See the statement: What We Know and also the newest report from the Intergovernmental Panel on Climate Change: Climate Change 2014: Impacts, Adaptation, and Vulnerability.

You Are What Your Great-Grandmother Ate? Transmission of Obesity Across Generations

Sarah Howard
Coordinator of CHE’s Diabetes-Obesity Spectrum Working Group

Two important studies have been published this month on chemical exposures that cause obesity in subsequent generations of rodents, long after the exposure ends. Until now, no prior studies on transgenerational obesogen exposures had been published. The results are alarming.

In the first study, pregnant mice (F0 generation) were exposed to low doses of the known obesogen tributyltin (TBT) and bred for 3 generations (up to the F3 generation). Thus, the F0 generation was exposed directly, the F1 generation exposed in the womb, the F2 generationsl could have been primordially exposed as germ cells in the developing fetus, and the F3 generation was not exposed directly (changes in the F3 generation are considered truly transgenerational). The TBT exposure had obesity-promoting effects on fat deposition on the F1 through the F3 generation, including increasing the number of fat cells, fat cell size, fatty tissue weights, and fatty livers (similar to non-alcoholic fatty liver disease (NAFLD) in humans). Interestingly, TBT exposure reprogrammed stem cells to develop into fat cells instead of bone cells.

The study, entitled “Transgenerational inheritance of increased fat depot size, stem cell reprogramming, and hepatic steatosis elicited by prenatal obesogen tributyltin in mice”, was written by Raquel Chamorro-García, Margaret Sahu, Rachelle J. Abbey, Jhyme Laude, Nhieu Pham, and Bruce Blumberg, of the University of California, Irvine.

CHE’s Top 10 Environmental Health Stories, October through December 2012

For our second quarterly Top 10 list, we again selected news articles, journal articles, policy decisions and events that we consider “game-changers” in one way or another: they all have had a significant impact, or are likely to have a significant impact on thinking and action in the field; they’ve changed the conversation on a topic or expanded the scope of the conversation to a new audience or awareness; and/or they are likely to be pivotal in defining a new trend.

These were selected from several dozen candidates for this list:

1. Workshop ‘Low Dose Effects and Non-Monotonic Dose Responses for Endocrine Active Chemicals’
   This groundbreaking international meeting in September moved the conversation about low-dose effects from endocrine disrupting chemicals significantly forward in re-examining the ways in which chemicals are tested for endocrine disrupting properties and how risk to human health is managed.
   See also a report from the World Health Organization: Endocrine disrupters and child health; movement from the EPA: EPA responds to scientists’ concerns, initiates new effort for low-dose, hormone-like chemicals and an article in Nature magazine: Toxicology: the learning curve.
   

BPA Exposures in the Human Fetus

Ted Schettler, MD, MPH
Science Director

Nahar MS, Liao C, Kannan K, Dolinoy DC. (2012), Fetal liver bisphenol A concentrations and biotransformation gene expression reveal variable exposure and altered capacity for metabolism in humans. Journal of Biochemical and Molecular Toxicology. doi: 10.1002/jbt.21459

This recently published study shows that the developing fetus is generally exposed to much higher levels of free (unconjugated) BPA than to conjugated BPA. In 78% of the samples, the ratio of free to conjugated BPA was greater than one with a mean of 6.91. (the authors undertook a number of efforts to avoid sample contamination, as described in their paper).

Previous studies have shown free BPA in amniotic fluid.

This adds to the growing evidence that the fetus is regularly exposed to free (active) BPA; that the chemical is not rapidly inactivated and excreted as in adults. Efforts to control BPA exposure in infants and children do nothing to protect the fetus…The fetus can only be protected by reducing/eliminating exposures in adults.

Animal studies show that fetal and perinatal exposures to BPA alter the development of the mammary gland and prostate, making them more likely to develop cancer later in life. Over 93% of Americans have measureable levels of BPA/BPA metabolites in their urine….i.e. exposures are ubiquitous. Based on the animal data, we continue to expose virtually the entire human population to a chemical that increases the risk of breast and prostate cancer. When will this stop?

FDA to Consumers: We’re still thinking about it. Sorry you’re still eating it.

This essay is reprinted with permission from the author, Gina Solomon, a CHE partner and senior scientist at the Natural Resources Defense Council. You can read the original post on Switchboard, NRDC’s blog.

FDA is kicking the BPA-lined can further down the road in an announcement today that the Agency plans to keep studying this issue while consumers continue to be exposed. Specifically, the Agency’s response to NRDC’s petition is: “FDA has determined, as a matter of science and regulatory policy, that the best course of action at this time is to continue our review and study of emerging data on BPA.”

The FDA response to NRDC comes as a result of a petition NRDC filed years ago asking the Agency to ban BPA for food-contact uses, and a resulting lawsuit when FDA failed to offer any response at all. The FDA was legally required to respond to the petition, and did so today with another punt.