Commentary: 25 Years of Endocrine Disruptor Research – Great Strides, But Still a Long Way to Go

written by Laura N. Vandenberg, PhD
Assistant Professor and Graduate Program Director of Environmental Health Sciences, University of Massachusetts Amherst School of Public Health and Health Sciences

Laura Vandenberg (Credit: umass.edu)

Reprinted with permission from Environmental Health News

Cancer. Diabetes. Autism. Infertility. ADHD. Asthma. As the rates of these diseases increase over time, the public and researchers alike have focused on the role the environment might play in their cause and progression. Scientists in the field of environmental health sciences are not satisfied just to know that the environment contributes to human disease – they want to know how.

This week [ScienceSeptember 18-20], researchers, public health advocates, government officials, and industry spokespersons will meet at National Institutes of Health (NIH) to celebrate 25 years of scientific research on one aspect of environmental health: endocrine disrupting chemicals (EDCs). These are compounds that alter the way hormones act in the body, often by mimicking or blocking their actions. Just a few examples of widely used consumer products that contain EDCs are plastics, electronics, flooring, some personal care products, and furniture treated with some flame retardants.

Unprecedented Alliance of Scientists, Health Professionals, & Advocates Agree Toxic Chemicals Are Hurting Brain Development

written by Ted Schettler, MD, MPH
Science Director

An unprecedented alliance of leading scientists, health professionals, and children’s health advocates has come together to publish a consensus statement concluding that scientific evidence supports a causal link between exposures to toxic chemicals in food, air and everyday products and children’s risks for neurodevelopmental disorders. The alliance, known as Project TENDR, is calling for immediate action to significantly reduce exposures to toxic chemicals to protect brain development for today’s and tomorrow’s children.

Neurodevelopmental disorders include intellectual disability, autism spectrum disorder, attention deficits, hyperactivity, other maladaptive behaviors, and learning disabilities.  Project TENDR’s consensus statement is available on the Project TENDR website.

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.

Making the Bottom Line Healthier for All: The Economic Argument for Reducing Exposures

written by Elise Miller, MEd
Director

What does it cost us to have more people than ever suffering from chronic illnesses? Last week a highly respected health economist in Europe, along with a number of scientists specializing in endocrine disrupting chemicals (EDCs), released a groundbreaking report indicating that the EU is spending at least $175 billion (US) a year on chronic diseases related to EDC exposures. This was the first analysis of its kind to focus on the costs of neurological effects, obesity and diabetes (related to the disruption of metabolic function), and male reproductive disorders.

And this is of course not just a European concern. Over the past decade or two, leaders in environmental health have provided various estimates on the environmentally attributable fraction of costs for various health endpoints, such as ADHD, childhood cancers, and asthma, in the US. All of these analyses, even the most conservative ones, have indicated that society would save billions of dollars every year in health care costs and lost wages if we reduced exposures to certain chemical contaminants. As the director of the National Institute of Environmental Health Sciences noted in response to the EU report, “If you applied these [health care] numbers to the US, they would be applicable, and in some cases higher.”

Lizzie Grossman made this point even clearer in her breaking article: “To put $175 billion in perspective, it is more than the combined proposed 2016 budgets for the US Department of Education, Department of Health and Human Services, National Park Service, and Environmental Protection Agency combined.”

Another way of thinking about this is even if the estimated health care costs related to exposures to EDCs were only about half of that, say $90 billion, we could quintuple the budgets for Head Start and Child Care and Development Fund in the US with those savings alone. That would mean a lot more kids could get a far better start in life—and of course, a lot fewer adults would be suffering from preventable diseases.

On the federal level, the politics are so mired and convoluted that a bill to protect citizens more effectively from exposures to the tens of thousands of untested chemicals that are on the market has yet to pass Congress. The latest draft of the measure to reform the Toxics Substances Control Act (TSCA), circulated to lawmakers earlier this week, continues to have some serious flaws according to many colleagues. This means that it’s not at all clear how the Senate hearing on this version will go next week.

But there is good news on the market front. On Monday, it was announced that Ashley Furniture, the largest furniture retailer in the US, has agreed to stop using toxic flame retardants (which are EDCs) in their products. This is of course a huge win for consumers and shows that leading companies can move away from using chemicals that impact human health without harming their bottom line—and perhaps even increasing it. Plus, health will improve more broadly because people won’t be exposed to flame retardants—in turn, reducing health care costs across society. And that brings us back to the seminal report I mentioned at the beginning on health costs in the EU linked to EDCs.

The economic argument for minimizing exposures to toxic chemicals is a powerful one because it is grounded in evidence-based science. Naysayers can continue to try to make the case that these exposures are not really harmful to health and that removing them would undermine the economy. But it’s clear that companies like Ashley Furniture aren’t going to wait for politics to catch up with the science to do the right thing. Here’s to more companies and decision-makers in every sector of society realizing that a healthy bottom line can in fact be healthier for all.

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.

Top 10 Selections: December 2013

For this Top 10 list from the last quarter of 2013, CHE selected several items in which we perceived clusters of news stories – patterns and connections that we share with our partners and other readers. We offer both the media version and the scientific report when available to make this information most accessible and meaningful to both scientists and the general public. Full journal articles may require purchase or subscription. Comments are invited.

1. New California chemical flame retardant rules adopted
   The flame retardant story has been ongoing—and in our Top 10 before.  The spotlight directed on this issue by the Chicago Tribune in 2012 precipitated this sweeping change in policy in California. New flammability standards for furniture and other products will allow manufacturers to stop using chemical flame retardants—a big win for public health.
2. Progress on reducing harm from mercury exposures
   Two news items indicate that awareness of mercury’s toxic effects is becoming more mainstream, with real benefits for people worldwide. This is another big win for health.
   1. New global treaty cuts mercury emissions and releases, sets up controls on products, mines and industrial plants: The Minamata Convention on Mercury—a global, legally binding treaty—was agreed to by governments in January and formally adopted as international law in early October.
   2. Women’s mercury levels dropping: Mercury levels in women of childbearing age dropped by a third in the past decade, a survey by the US Environmental Protection Agency has found. See the report: Trends in Blood Mercury Concentrations and Fish Consumption Among U.S. Women of Childbearing Age: NHANES, 1999-2010.
3. Fracking sites tied to hormone disruptors
   Surface and ground water samples taken from hydraulic fracking sites in a drilling-dense area of Colorado showed higher levels of estrogenic, anti-estrogenic, androgenic and anti-androgenic activity than reference sites with limited drilling. This research is provocative, suggesting that natural gas drilling operations may result in elevated endocrine-disrupting chemical activity in surface and ground water. See also a response to this study: Oil industry group disputes fracking health study findings.
4. Oceans in trouble
   Two stories describe deep problems in our oceans, with serious impacts on human and ecological health.
   1. How plastic in the ocean is contaminating your seafood: fish ingest and absorb into their tissue a “slew of synthetic and organic pollutants.” See the ocean study: Ingested plastic transfers hazardous chemicals to fish and induces hepatic stress and a related story that describes a similar issue in fresh water: Scientists turn their gaze toward tiny threats to Great Lakes.
   2. Oceans face ‘deadly trio’ of threats, study says: The world’s oceans are under greater threat than previously believed from a “deadly trio” of global warming, declining oxygen levels and acidification, an international study said on Thursday. See the report: Big Threats: The Main Factors Destroying Ocean Health and a related article: Sea change: food for millions at risk.
5. Glimmers of hope regarding climate change
   Related to the issue of ocean warming and acidification and much more, a couple of positive developments in response to climate change:
   1. China recognizes the importance of climate change: US academics and think tanks applaude the latest move by California and China to strengthen low carbon development to fight climate change.
   2. US lays out strict limits on coal funding abroad: The United States said in late October it plans to use its leverage within global development banks to limit financing for coal-fired power plants abroad, part of Washington’s international strategy to combat climate change.

   However, see more sobering articles: Greenhouse gas concentrations in atmosphere reach new record, The projected timing of climate departure from recent variability and Diseases on the move because of climate change.

6. World’s largest cancer database launched
   The online resource, called CanSAR, was developed by a team at the Institute of Cancer Research in London, and contains 1.7 billion experimental results relating to genes, clinical trials and pharmacological data. The environmental health story here is that environmental exposure data, and thus prevention, is not on the radar for this project. With recent reports highlighting the role of environmental exposures in cancer from the President’s Cancer Panel and the Breast Cancer Fund, we wonder how much more useful this database could have been—and could still be—if it cast prevention in a starring role.
7. Early life exposures and mental health
   With children being diagnosed and medicated at young ages for various mental health issues, identifying potential causes and working toward prevention is all too rarely prioritized. The research here brings to light links between environmental exposures and several mental health outcomes.
   1. Smoking in pregnancy linked to child depression: Children whose mothers smoked during pregnancy have altered brain growth, which may put them at greater risk of anxiety and depression. See the study: Prenatal tobacco exposure and brain morphology: a prospective study in young children.
   2. Air pollution and psychological distress during pregnancy:  Maternal psychological distress combined with exposure to air pollution during pregnancy has an adverse impact on the child’s behavioral development, according to researchers at the Columbia Center for Children’s Environmental Health. See the study:Prenatal exposure to air pollution, maternal psychological distress, and child behavior.
   3. Transmitting stress response patterns across generations: Offspring born to stressed mothers show stress-induced changes at birth, with altered behavior and gender-related differences that continue into adulthood. See the study: Prereproductive stress to female rats alters corticotropin releasing factor type 1 expression in ova and behavior and brain corticotropin releasing factor type 1 expression in offspring.
   4. Pregnant mother’s stress affects baby’s gut and brain: Pregnant women may pass on the effects of stress to their fetus by way of bacterial changes in their vagina, suggests a study in mice. It may affect how well their baby’s brain is equipped to deal with stress in adulthood.
8. CDC’s Camp Lejeune study links birth defects to marine base’s drinking water
   The study concludes that babies born to mothers who drank the tap water while pregnant were four times more likely as other women to have such serious birth defects as spina bifida. Babies whose mothers were exposed also had a slightly elevated risk of such childhood cancers as leukemia, according to the results. This study is just the most recent unfolding of a story that involves the US military and its provisions, or lack of them, for military service members and their families as well as its environmental stewardship and transparency in addressing problems. See the study: Evaluation of exposure to contaminated drinking water and specific birth defects and childhood cancers at Marine Corps Base Camp Lejeune, North Carolina: a case-control study.
9. Controversy around science review and publication
   Two stories from within the scientific community and one about media reporting on science show weaknesses or distortions within the process of designing, publishing and reporting research studies—studies that we all rely on to guide policy and inform decisions. If we can’t rely on the integrity of the science published, then we are further handicapped in effectively addressing the toughest public health concerns of our times.
   1. GMO study retracted—censorship or caution? A French study in 2012 led by Gilles-Eric Séralini found animals fed Monsanto’s Roundup Ready corn had increased mortality and more tumors than a control group. Amid heavy industry criticism, the journal that published the research has retracted the study from its archives. This article looks at the controversy: “Basically what Dr. Séralini did was he did the same feeding study that Monsanto did and published in the same journal eight years prior, and in that study, they used the same number of rats, and the same strain of rats, and came to a conclusion there was no problem. So all of a sudden, eight years later, when somebody does that same experiment, only runs it for two years rather than just 90 days, and their data suggests there are problems, that all of a sudden the number of rats is too small?”
   2. Nobel winner declares boycott of top science journals:  Randy Schekman, a US biologist who won the Nobel Prize in physiology or medicine this year, says pressure to publish in “luxury” journals encourages researchers to cut corners and pursue trendy fields of science instead of doing more important work. Further, some journals favor more sensational stories, further distorting the types of research being conducted.
   3. US science reporters becoming an endangered species: At a time when conversations should be revolving around climate change, energy, natural resources and sustainable development, space for environmental reporting and coverage in the United States seems to be shrinking.
10. Progressive actions from the FDA
    The US Food and Drug Administration, often spotlighted in the media recently for allowing drugs on the market that have proven unsafe, took three notable actions this quarter to safeguard public health and safety.
    1. FDA issues proposed rule to determine safety and effectiveness of antibacterial soaps: The FDA issued a proposed rule to require manufacturers of antibacterial hand soaps and body washes to demonstrate that their products are safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections.
    2. Phasing out certain antibiotic use in farm animals: The FDA is implementing a voluntary plan with industry to phase out the use of certain antibiotics for enhanced food production. Why is this important? See this article, for example: When antibiotics stop working, here’s what else we’ll lose. A caveat is that the FDA plan is not as strong as the situation calls for: The FDA’s not-really-such-good-news .
    3. FDA takes step to further reduce trans fats in processed foods : FDA announced its preliminary determination that partially hydrogenated oils, the primary dietary source of artificial trans fat in processed foods, are not “generally recognized as safe” for use in food. See also an interview with Dennis Keefe, PhD, Director of the Office of Food Additive Safety at the FDA, about the evidence underlying this decision and the implications for clinicians: Removing trans fats from foods: the FDA’s view.

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.
   

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.

Get a Grip on Toxic Chemicals

Reps. Doyle and Murphy are well positioned to help protect us

Maureen Swanson
CHE Partner and Director of the Healthy Children Project for the Learning Disabilities Association of America

This letter was originally published in the Pittsburgh Post-Gazette. It’s republished here with the author’s permission.

Imagine all the chemicals used in televisions, computers, upholstery, car seats, building materials, even children’s pajamas. Imagine that some of these chemicals migrate from products into dust and dirt, and build up in our bodies. They are found in the cord blood of newborns and in breast milk. Imagine that these chemicals are similar in structure to the notorious PCBs – carcinogens banned from use in the late 1970s.

Now wouldn’t you also imagine that these chemicals were tested and found to be safe to human health before they were allowed into our products and homes?

Unfortunately, that is not the case.

Polybrominated diphyenyl ethers are flame retardant chemicals that persist in the environment and build up in the food chain and in people. Laboratory studies link exposure to PBDEs with lowered IQ and attention problems. This summer, a study of pregnant women found that those with higher levels of PBDEs had reduced levels of thyroid hormone, which is essential to a baby’s brain development.

But despite growing scientific evidence linking toxic chemical exposures to serious disease and disability, our government does not require that PBDEs – or any of the other 80,000 chemicals on the market – be tested for effects on human health.

That could be about to change, and two Pittsburgh members of Congress are in key positions to help make it happen.

Fueling the fire? How flame retardants might be doing more harm than good

Sarah Dunagan
Staff Scientist, Silent Spring Institute

The history of flame retardants stretches back at least as far as 450 B.C. when, as noted by Herodotus, the Egyptians soaked wood in alum. But it wasn’t until World War II, and the subsequent flush of highly flammable petroleum-based products into the market, that the flame retardants so popular today came into widespread use. The addition of these chemicals to our couches, TVs, and computers has soared in recent decades in response to flammability standards developed in the 1970s. Of course, we all want to protect ourselves and our families from fires. But the very regulations intended to protect us have unintentionally exposed us to chemicals that may be doing more harm than good. 

Mounting research suggests that flame retardants may cause neurological and reproductive harm, thyroid disruption, and cancer. What is the latest evidence from animal and human studies? Are some people disproportionately exposed? Do less toxic alternatives exist? How can the emerging research inform chemicals policy reform? We explored these questions on a teleconference hosted by the CHE-Fertility Working Group and the Women’s Health and Environment Initiative (WHEI) on April 15.