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.

CHE’s Top 10 Environmental Health Stories from Mid 2012

The Collaborative on Health and the Environment initiates a quarterly Top 10 series with this offering of journal articles, news stories, policy recommendations and actions from the last few months.

Given that we all are inundated with dozens of stories—often compelling new science and ideas—every week, if not every day, discerning which ones seem most significant and influential is challenging. This is why we decided to start this service—to help us all figure out which ones seem particularly important to track over time.

Though choosing a “Top 10” is more of an art than a science, we selected these items because we consider them “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. We have also listed some that reflect a high level of energy and activity in a particular arena. Though the science may still be relatively new or controversial, the level of focus suggests it is worthy of our attention.

We realize articles in addition to the ones we selected could arguably be included. We also may have missed some new publication or story that, in retrospect, will appear to be seminal. We invite comments and look forward to a rich conversation around this.

Finally, we have chosen to focus on stories instead of issues. There are many additional issues of great importance than we could have captured in this brief analysis, but these are the stories we believe are currently making an impact on environmental health thinking and conversations, both for professionals and for the general public.

CHE intends to publish our next quarterly Top 10 in mid January 2013.

Now for this first Top 10, in no particular order:

1. Chicago Tribune series on flame retardants
   CHE selected this story series because the depth of the investigative reporting was impressive, the conversation as a result of the series was far-reaching (Watchdog Update: Pressure grows for limits on flame retardants), and the repercussions have been significant:
   1. California is reconsidering its 37-year-old regulation on flammability in sofas, easy chairs and baby products in homes (Key agency moves to scrap rules that made toxic flame retardant common in U.S. furniture);
   2. Bipartisan support has emerged for national restrictions on flame retardants (see Changes in chemical safety law getting bipartisan support and Legislators urge ACC to expel firms);
   3. The EPA has promised to look at banning harmful flame retardants (EPA vows investigation of flame retardants, which Tribune investigated and EPA identifies substitutes for toxic flame retardant chemical); and
   4. The Senate passed the Safe Chemicals Act out of committee (Historic vote: oversight of EPA authorities and actions to control exposures to toxic chemicals). Similar bills have been introduced many times over the last dozen years or more, but this is the first time it passed out of committee. While there is no stated connection between the Tribune series and the Senate vote, the news series appeared to elevate general national conversation around chemical regulation, and all of the individuals who testified as part of the Senate hearing specifically mentioned flame retardants in their testimony.
2. Endocrine-disrupting chemicals and public health protection: a statement of principles from the Endocrine Society
   This position statement from a major medical society guides research and regulation of chemicals that disrupt endocrine function and interfere with the function of other biological systems in the human body. In the paper, the Endocrine Society proposes a simplified definition of an endocrine-disrupting chemical (EDC) as an exogenous chemical or mixture of chemicals that interferes with any aspect of hormone action. The position statement also lays out recommendations for more protective regulation of EDCs including addressing low-dose effects of EDCs.
   Also see
   1. Experts say protocols for identifying endocrine-disrupting chemicals inadequate
   2. Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic dose responses
   3. International Workshop: Low Dose Effects and Non-Monotonic Dose Responses for Endocrine Active Chemicals: Science to Practice, held in Berlin September 11 – 13, 2012
3. Fracking
   Heightened attention has been given to scientific studies and news stories in the US and in Europe regarding health and safety concerns around hydraulic fracturing, commonly known as fracking. Of particular concern is the negative repercussions fracking can have on the quality of our drinking and irrigation water, for air and soils, for human health and regarding earthquakes and climate change. See, for example:
   1. Impacts of gas drilling on human and animal health
   2. Polluted water fuels a battle for answers
   3. Nurses promote healthier energy choices
   4. There goes paradise
   5. ‘Fracking’ could get UK approval
   6. Fracking: boom or doom
   7. Fracking poses risk to water systems, research suggests
   8. Unconventional natural gas development and infant health: evidence from Pennsylvania
   9. The fracking of Rachel Carson
   10. Three studies from the European Commission on environmental impacts and risks of energy resources.

   CHE applauds this ongoing discussion, the continued investigation of adverse effects, and the spotlight on public health and safety.

4. Environmental Justice, led by a series published by Environmental Health news (EHN)
   As Marla Cone, editor-in-chief of Environmental Health News, stated in an interview about the series, the reporters were instructed “to give their stories a strong sense of place and a compelling voice of the people—but also to be well grounded in the science.” As a result, this series is not only piercing and thought-provoking, documenting “the triple whammy of race, poverty and environment converging nationwide to create communities near pollution sources where nobody else wants to live”, but also prescient. Published two months before the Chevron refinery explosion in Richmond, California, the first article quotes a resident of North Richmond: “People still wonder when the next big accident is going to happen.” It happened on August 6th. The community was not taken by surprise, and there are many, many similar communities throughout the country wondering when, how and how much they will be impacted by neighboring factories, refineries, waste dumps, transmission lines and other toxic sites. A related article, Slow and underfunded, EPA program falls short in toxic site cleanups, also addresses many of the same core problems, as applied to brownfields. These quotes from this article sum up CHE’s reason for this selection: “The shortcomings are due to limited funds, a lack of federal oversight, seemingly endless waits for approvals and dense bureaucratic processes that make it difficult for poor and sparsely populated neighborhoods to compete against larger and middle-class communities that have the means to figure them out, an investigation by six nonprofit newsrooms has found… As a result, poor Americans are both more likely to live with polluted sites and less likely to be able to attract a means to turn them around, despite the existence of the brownfields program.”
5. Studies of transgenerational effects of chemical or nutritional exposures in laboratory animals, in all likelihood acting through heritable epigenetic mechanisms. This is a relatively new field of research that is gaining a lot of traction. The science is still evolving, with many studies needing to be replicated and consensus reached regarding the methodology. However, several recent studies show apparent passing of traits and effects down one or more generation without DNA mutation, such as through heritable DNA methylation changes. Although further research is necessary to confirm these effects in animals, to determine the real-world implications in humans, and to better understand the mechanisms involved, these epigenetic effects provide greater reason for reducing or eliminating toxic environmental exposures in our lives.
   1. High-fat or ethinyl-oestradiol intake during pregnancy increases mammary cancer risk in several generations of offspring
   2. Epigenetic transgenerational inheritance of altered stress responses
   3. Environmentally induced epigenetic transgenerational inheritance of ovarian disease
   4. Transgenerational actions of environmental compounds on reproductive disease and identification of epigenetic biomarkers of ancestral exposures
   5. Gestational exposure to bisphenol A produces transgenerational changes in behaviors and gene expression
   6. Dioxin (TCDD) induces epigenetic transgenerational inheritance of adult onset disease and sperm epimutations
6. Father’s health and exposures contribute to a child’s health and development
   The idea that the effects of a father’s exposures before or close to the time of conception can affect the health of the child is building evidence, as in this article: Father’s occupation can affect health of newborn. It’s been accepted for decades that the mother’s exposures, health status and environment can affect fetal growth and development, but the idea that a father’s exposures before and around the time of conception may alter the baby’s health and development is much more recent. This study found a correlation between the father’s occupation and birth defects. While not designed to determine a causal relationship, this is a step toward identifying the contributions of the father’s exposures to fetal health. Also see
   1. The study referenced in the article: Paternal occupation and birth defects: findings from the National Birth Defects Prevention Study
   2. Why fathers really matter
   3. Rate of de novo mutations and the importance of father’s age to disease risk and a CHE commentary on this study: Paternal age, de novo mutations and autism risk
7. American Thyroid Association (ATA) issues policy statement on minimizing radiation exposure from medical, dental diagnostics‎
   While some risks of diagnostic medical radiation exposures have been acknowledged for decades, there has generally been an assumption that the benefits of diagnostic exposures outweigh the risks. New thinking is challenging that assumption. The American Thyroid Association’s policy statement formalizes concern that has been growing about the cumulative risks of exposures and about the increasing use of alternate technologies such as computed tomography, in this case as related to the thyroid gland. “Increased radiation exposure among both children and adults is of primary concern to the ATA because the thyroid gland is among the most susceptible sites of radiation-induced cancer,” said Dr. Elizabeth Pearce, a member of the Board of Directors of the American Thyroid Association. See also the statement: Policy Statement on Thyroid Shielding During Diagnostic Medical and Dental Radiology and Medical radiation soars, with risks often overlooked.
8. CDC updates guidelines for children’s lead exposure
   This change from the Centers for Disease Control and Prevention (CDC) follows several years of advocacy from environmental health researchers. It  is at least the fourth time the CDC has lowered the acceptable blood-lead level since 1975 in response to new evidence that ever-lower exposures continue to harm health and development. The acknowledgement that exposures considerably lower than the previous acceptable level—10 micrograms per deciliter (µg/dL)—cause cognitive impairment and other adverse health outcomes will help alert parents and health professionals that screening and corrective action are necessary. The CDC has now set the reference level at 5 µg/dL and will re-evaluate it every four years. See also New health issues tied to low-level lead exposure, describing evidence that even very low levels of exposure to lead are associated with kidney damage and hypertension in adults and hearing impairment, reduced growth and delayed onset of puberty in children.
9. ACOG District IX Clinicians’ Guide
   This clinician’s guide is the first document produced by an American Congress of Obstetricians and Gynecologists (ACOG) regional office recommending that physicians screen patients for environmental exposures, provide anticipatory guidance on risk reduction, and become involved in health policy. CHE views having a major medical society regional office, especially a society focused on pregnant women and infant development, formally recommend environmental health screenings is a tremendous step forward.
10.  Preventing dementia: two new lines of research
    Combined, these new approaches represent a sea change from past years that there was nothing individuals could do to prevent dementia.
    1. Exercise and dementia: four new studies
       Quite a number of recent studies show that exercise can affect cognitive function late in life. From first assuming that there was no way to prevent dementia, we came to think that exercising your brain will keep it fit. Now evidence shows that exercising your body may also keep your brain fit. This is a breakthrough for improving quality of life for seniors and their families.
    2. Insulin resistance and Alzheimer’s disease
       See, for example, Can Alzheimer disease be a form of type 3 diabetes?, Link between metabolic disorders and Alzheimer’s disease examined, Link between brain insulin resistance, neuronal stress in worsening Alzheimer’s disease and a collection of journal articles from the Journal of Alzheimer’s Disease, plus a study showing a link between glucose control and dementia (but not necessarily Alzheimer’s): Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia. All these studies add to the conversations about Alzheimer’s and dementia an understanding of the role of food, nutrition and insulin in cognitive well being. If insulin resistance does play a role in Alzheimer’s, further possibilities for preventive action and treatment may be possible, since insulin resistance can be influenced by nutrition, obesity, environmental chemical exposures, exercise and more.

Science Pick: Traits Can Be Inherited, with No DNA

Elise Miller
Director

An article from Stone Hearth News is titled “Traits can be inherited, with no DNA: Columbia University Medical Center research.”

This article struck me because of its possible implications for new areas of environmental health research beyond epigenetics. The study focused on “viral-silencing agents” that can be passed down to progeny circumventing the DNA process of inheriting traits that has long dominated the science of hereditary genetics. These agents, known as viRNAs, are able to turn off a virus’ capacity to take over a cell and thereby boost the immune systems of subsequent generations. If these agents can also be influenced by exposures to environmental contaminants, such as endocrine disrupting chemicals, then this could explain why some traits, apparently not associated with the genome, could be inherited. This may mean that the important research being undertaken on gene-environment interactions may now need to include studies that focus on RNA-environment interactions.

Review of Autism Society National Conference in Dallas: Excerpt

The following is excerpted from a review by CHE Partner Leigh Attaway Wilcox of the 2010 Autism Society National Conference. It is reprinted with her permission. The full review is on the Dallas Moms blog.

On July 8, 2010, CHE’s Learning and Developmental Disability Initiative, with the support of the John Merck Fund, cosponsored the 2nd annual Science That Makes a Difference Annual Symposium at the Autism Society of America National Conference.

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The “Science Symposium” was potentially the most powerful and meaningful part of the conference, in my opinion. Six very well-respected and knowledgeable experts shared their take on “Environmental Exposures and Child Development: The Latest on Environmental Health Sciences, Developmental Disabilities and Public Health Policy.” While waiting for the first session to begin, I was encouraged that Sharon Lewis and Lee Grossman were both in the audience. Sadly, they both left before the first speaker began. I had secretly hoped that in hearing the blatant scientific proof that our environment is greatly affecting our youngest, and most vulnerable generation, that Ms. Lewis would feel compelled to share concerns with President Obama…that I might even have the opportunity to dialog with her about the topic. However, since she was not there throughout the day, I don’t know if she has heard what these speakers had to say…or what many of the other speakers addressing the topic of our toxic environment have to say…I can only hope that she has heard and will continue to learn from these experts in the coming months.

My dream would be to have President Obama hear directly from these speakers! After hearing them, one cannot walk away without strong determination to take action and make necessary changes; that is what our country – our global society – truly needs.

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To kick off the Science Symposium, Dr. Ted Schettler gave a general overview of our Environmental Health entitled “In Harm’s Way.” Dr. Schettler’s speech was not geared directly at ASD, but moreso at our general and overall health as a global community.

Getting the Questions Right

Elise Miller, MEd
Director

With epigenetics on the cover of Time magazine this week, public awareness of the links between our genes, our environment and our health has never been so widespread. Throughout history, breakthroughs in understanding have been largely shaped and guided by the questions we choose to ask. After World War II, the questions most researchers as well as policymakers in the U.S. were asking focused on how to build infrastructures to catalyze the growth of large-scale industrial processes and products – from pesticides to plastics to pharmaceuticals. The underlying assumption was that we could improve on nature without necessarily understanding or abiding by the natural principles that have allowed life to be nourished and sustained for the previous tens of thousands of years.

In just the last generation, however, new and pressing questions have begun to emerge. For example, why – with the vast availability of food products, abundance of sophisticated technologies, and myriad advances in medicine – are more and more people facing chronic diseases and other health problems in the U.S. as well as experiencing a lower quality of life? Why – if being successful means driving bigger cars and having bigger houses – would we be seeing glaciers melting at unprecedented rates and millions of new climate refugees?

Clearly, we can no longer delude ourselves that ‘improving on nature’ is predicated on disregarding it – and instead, ask how can we work within the systems and imitate the processes that have made this planet life-sustaining to date?

Fortunately, there are more and more researchers and others who are asking just that, and perhaps none more energetically than those in the increasingly robust field of green chemistry. Just a couple weeks ago, Paul Anastas, PhD, who is considered by some ‘the father of green chemistry’, was finally appointed Assistant Administrator of the Office of Research and Development at the EPA. For some years now, he and other colleagues – including many of you – have suggested that a number of the major problems we see today, such as the adverse health consequences of toxic exposures and climate change, are in large part due to not asking the right questions in the first place (or perhaps, as some would argue, there were simply too few people in power asking those essential questions). By contrast, those in green chemistry are urging us to ask a set of principled questions before creating new products and technologies, so that, ultimately, the trajectory of our choices can be as biologically and ecologically benign as possible. 

This month CHE is hosting or co-sponsoring three national/international calls that are intended to help us ask better questions so that our pursuits can be more in keeping with the natural systems in which we have evolved and in which future generations will live. The first is a CHE Café Call with Elizabeth Grossman, author of the recently published book Chasing Molecules, which describes how green chemistry has the potential to not only lead to safer products and materials, but reduce the health impacts of climate change. The next is a CHE Partner call on the potential health impacts of chemicals that can disrupt thyroid dysfunction and how chemical policy reform can help address these concerns. And the third call will be co-sponsored with SeaTrust and IGI and feature two colleagues working at the intersection of climate change and health and attended the recent Copenhagen climate change talks. For more information on these calls and how to register, please view the left-hand column on CHE’s home webpage.

I truly look forward to collaborating with you in the New Year in order to hone our capacity to get the questions right as we work towards a healthier tomorrow.