Mental Health: A Heightened Recognition of the Role of Toxic Chemicals

written by Elise Miller, EdM

For the first time the American Psychological Association’s (APA) Monitor on Psychology magazine featured a cover story (Oct 2015) on the impact toxic chemicals can have on the developing brain. It makes sense that if chemical exposures can undermine children’s learning capacities, then they might be implicated in mental health problems as well. However, there has been scant research in or recognition of the latter in mainstream psychology. image from the APA articleThe publication of this article suggests that this sector may now be starting to take these concerns more seriously.

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Diseases, Vectors, Specific Chemicals or Life Phases: What’s Your Pleasure?

written by Elise Miller, EdM

When many of us think of air pollution, images often come to mind of smoke stacks and diesel trucks spewing dirty fumes or thick brown smog enveloping cities. We think of people coughing or wearing masks on their faces to breathe, kids being rushed to emergency rooms for asthma attacks. These respiratory and lung conditions are of course part of our global reality today—and sadly so.

But I was truly struck by the plethora of new studies published during the last quarter implicating air pollution in a litany of other health outcomes. These conditions, not often associated with exposures to air particulates and other toxic airborne matter, include diabetes, autoimmune diseases, various forms of cancer, mental health, brain function, and birth defects. Nancy Hepp, CHE’s Research and Communications Specialist, compiled a long list of relevant studies (below) that appeared in journals and other media outlets from April through June 2015 highlighting these concerns.

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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.

Top 10: October 2013

For the third quarter of 2013, CHE has selected stories and studies that come from a wide range of environmental health topics. Comments are welcome.

  1. Drug-resistant ‘superbugs’ deemed urgent threats: US report
    “For organism after organism, we’re seeing this steady increase in resistance rates,” Dr. Thomas Frieden, director of the CDC, said in a telephone interview. “We don’t have new drugs about to come out of the pipeline. If and when we get new drugs, unless we do a better job of protecting them, we’ll lose those, also.” This is not a new issue, but it’s gaining substantially greater press.
    [See the CDC report: Antibiotic Resistance Threats in the United States, 2013]
  2. Journal editors trade blows over toxicology
    Leading toxicologists and endocrinologists have been trading barbs in the pages of respected journals over ‘endocrine disrupters’—chemicals, such as bisphenol A (BPA), that affect the endocrine system and have been linked to developmental problems in humans.
    [See the editorials: Scientifically unfounded precaution drives European Commission’s recommendations on EDC regulation, while defying common sense, well-established science and risk assessment principles; Policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich et al.; Transparency and translation of science in a modern world and Science and policy on endocrine disrupters must not be mixed: a reply to a “common sense” intervention by toxicology journal editors plus The 2013 Berlaymont Declaration on Endocrine Disrupters and analyses and commentary: Eight questions for toxicologists against proposals for new EU chemicals laws; EDCs: negotiating the precautionary principle and Special report: scientists critical of EU chemical policy have industry ties]
  3. Air pollution responsible for more than 2 million deaths worldwide each year, experts estimate
    Co-author of the study, Jason West, from the University of North Carolina, said: “Our estimates make outdoor air pollution among the most important environmental risk factors for health. Many of these deaths are estimated to occur in East Asia and South Asia, where population is high and air pollution is severe.”
    [See the study: Global premature mortality due to anthropogenic outdoor air pollution and the contribution of past climate change]
  4. American Academy of Pediatrics demands FCC protect children from cell phone & wireless radiation
    The American Academy of Pediatrics submitted a letter to the Federal Communications Commission (FCC) urging “the FCC to adopt radiation standards” that 1) protect children’s health and well-being from radiation emitted by cell phones and other wireless devices; 2) reflect how people actually use their cell phones; and 3) provide sufficient information that enables consumers to make informed decisions when they purchase mobile phones. CHE considers this noteworthy because of AAP’s stature.
  5. New findings about arsenic: These items reveal several new concerning health effects from arsenic, an interaction between arsenic and estrogen, and a promising treatment for arsenic-contaminated soil.
    1. Contaminant found in most US rice causes genetic damage: A study has shown the first direct link between rice consumption and arsenic-induced genetic damage. [See the study: High arsenic in rice is associated with elevated genotoxic effects in humans and a related announcement: FDA explores impact of arsenic in rice]
    2. Drinking arsenic-laced water is like smoking for decades, study finds: The researchers found that people drinking water with dangerous levels of arsenic had decreased lung capacities. The effect appeared even when the researchers controlled for people’s ages, genders, smoking habits and other traits that affect lung capacity. The more arsenic the researchers found in the volunteers’ bodies, the smaller the volunteers’ lung capacity. [See the study: Arsenic exposure and impaired lung function: findings from a large population-based prospective cohort study]
    3. Arsenic immunotoxicity: a review: Overall, the data show that chronic exposure to arsenic has the potential to impair vital immune responses which could lead to increased risk of infections and chronic diseases, including various cancers.
    4. The arsenic in our drinking water: Long famed for its homicidal toxicity at high doses, a number of studies suggest that arsenic is an astonishingly versatile poison, able to do damage even at low doses. Chronic low-dose exposure has been implicated not only in respiratory problems in children and adults, but in cardiovascular disease, diabetes and cancers of the skin, bladder and lung.
    5. Low arsenic levels linked with heart disease: Exposure to even low levels of arsenic in drinking water and food may increase the risk of developing, and dying from, heart disease, a new study suggests. [See the study: Association between exposure to low to moderate arsenic levels and incident cardiovascular disease: a prospective cohort study]
    6. Researchers find cancer risks double when two carcinogens present at ‘safe’ levels: New research conducted by Texas Tech University scientists has found that low doses of both chemicals together [arsenic and estrogen]—even at levels low enough to be considered “safe” for humans if they were on their own—can cause cancer in prostate cells. [See the study: Chronic exposure to arsenic, estrogen, and their combination causes increased growth and transformation in human prostate epithelial cells potentially by hypermethylation-mediated silencing of MLH1]
    7. Friendly bacteria to detox arsenic: A new study has identified bacterial strains capable of oxidising toxic arsenic into a less toxic form, offering a feasible and affordable solution to the problem of arsenic in soil and water. [See the study: Arsenic-tolerant, arsenite-oxidising bacterial strains in the contaminated soils of West Bengal, India]
  6. Milestone study probes cancer origin
    The international team of researchers was looking for the causes of certain mutations as part of the largest-ever analysis of cancer genomes. The well-known ones such as UV damage and smoking mutate the DNA, increasing the odds of cancer. But each also leaves behind a unique hallmark—a piece of “genetic graffiti”—that shows if smoking or UV radiation has mutated the DNA. Researchers, led by the Wellcome Trust Sanger Institute in the UK, hunted for more examples of “graffiti” in 7,042 samples taken from the 30 most common cancers. The ability to identify the specific cause of a mutation could change cancer litigation and policy profoundly.
    [See also Towards incorporating epigenetic mechanisms into carcinogen identification and evaluation]
  7. New findings on brain development and mental health: This selection of studies provide new insights on environmental contributors to mental health: food, lead, tobacco use and antibiotic use.
    1. Early ‘junk food’ exposure risks kids’ mental health
      Along with the myriad negative effects on physical health, “junk food” during pregnancy and in early childhood is linked to a significantly increased risk for poor mental health, including anxiety and depression, in very young children, new research shows. [See the study: Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study]
    2. Study links high lead levels to anxiety, alcohol problems: Childhood lead exposure in the South Australian city of Port Pirie has been linked to psychological illness and substance abuse problems in adulthood. [See the study: Prospective associations between childhood low-level lead exposure and adult mental health problems: the Port Pirie cohort study and more about the Birth to Now Study]
    3. Anxiety in your head could come from your gut: Scientists think there may be a link between what’s in your gut and what’s in your head, suggesting that bacteria may play a role in disorders such as anxiety, schizophrenia and autism. The foods and drugs that we use influence our gut bacteria, and so this is in part an environmental health issue.
    4. 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]
  8. Fukushima water leaks: new source of health concerns?
    The radioactive water leak from Japan’s Fukushima nuclear plant—which was upgraded this week from level 1 to level 3, indicating the leak is a “serious incident”—has some wondering whether the contaminated water could be a source of concern for human health. Fukushima is a nuclear power catastrophe that refuses to be resolved, which could have broad implications throughout the industry and the world.
    [See also Oceanic plume of radioactivity predicted to reach US by 2014 and the related study: Multi-decadal projections of surface and interior pathways of the Fukushima Cesium-137 radioactive plume and Pollution, Fukushima radiation tracked by environmental websites]
  9. Report: environmental chemicals are a pregnancy risk
    From mercury to pesticides, Americans are exposed daily to environmental chemicals that could harm reproductive health, the nation’s largest groups of obstetricians and fertility specialists said Monday. Having the American Congress of Obstetricians and Gynecologists publish an opinion of this nature raises the level of awareness and conversation around this issue.
    [See the ACOG Committee Opinion: Exposure to Toxic Environmental Agents]
  10. Wal-Mart announces phase-out of hazardous chemicals
    Prodded by health and environmental advocates, Wal-Mart announced Thursday that it will require suppliers to disclose and eventually phase out 10 hazardous chemicals from the fragrances, cosmetics, household cleaners and personal care products at its stores. Because Wal-Mart, by virtue of its market share, can shift industry-wide behavior of suppliers, this announcement could be a game-changer.
    [See responses from advocacy groups on the Safe Markets site]

Mental Health and Environment

Elise Miller, MEd

According to the National Institute of Mental Health, one in five children under the age of 18 have or have had a serious debilitating mental illness—that is even more than the proportion of children under 18 who have been diagnosed with a learning, developmental or behavioral disorder (which the CDC indicates in one in six). In this light, I was gratified to attend a meeting of the Northern California Association of Child and Adolescent Psychiatrists last month that focused on not only social stressors, but on toxic chemicals. In fact, this may have been the first time chemical contaminants appeared on the primary agenda at any meeting of a psychiatric association across the country. Given the scientific literature associating a number of chemicals—including pesticides, bisphenol A, flame retardants, lead and mercury found in products used or ingested every day—with learning and developmental disabilities, it would make sense that at least some of these chemicals could also play a role in mental illness (see: Scientific and policy statements on environmental agents associated with neurodevelopmental disorders by Steven G. Gilbert, et al). After all, if a chemical can disrupt the neurological system, the result could range from ADHD to depression depending on a number of other factors for that individual.

But why should a psychiatrist or psychotherapist care about possible chemical exposures? Well, if these health professionals understand that certain contaminants might hinder a person’s mental health, then it may be that a patient’s suffering could be alleviated by reducing their exposures to certain chemicals. No amount of prescriptions for psychopharmaceuticals nor talk therapy is going to ultimately help if the environment in which a person lives, works, studies or plays is contaminated and thereby contributes to a mental health diagnosis.

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What Do World Health Day, CHE’s Healthy Aging Initiative, and Bruce Springsteen All Have in Common?

In recognition of CHE’s 10th anniversary, colleagues who have been particularly instrumental to shaping CHE this past decade will be invited to write an introduction. This month’s introduction is by Maria Valenti, who serves as the national coordinator for CHE’s Healthy Aging and the Environment Initiative.

They are all about aging well.

April 7th was World Health Day, an annual observation to mark the founding of the World Health organization (WHO) in 1948. The theme this year is “Good health adds years to life.” According to a statement issued by the United Nation Secretary General Ban Ki-moon, this theme “conveys an important message: promoting health throughout life improves one’s chances of remaining healthy and productive in one’s later years.”

This statement could have been lifted from the pages of the report Environmental Threats to Healthy Aging co-authored in 2008 by Drs. Ted Schettler and Jill Stein, myself, and Ben Rohrer. CHE’s relatively new Healthy Aging and the Environment Initiative was founded on this same premise, a life-course approach to health, which recognizes that the path to healthy aging is paved with healthy pregnancies, childhoods and mid-lives.

It is ever more important to consider the health of those who are aging as the number of this population swells dramatically, nearly doubling in the US over the next two decades. Soon, worldwide, for the first time in history, there will be more people aged 65 or over than children under 5.  

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Your Brain on My Mind

Elise Miller, MEd, Director

A virtual flood of new studies on cognitive function influenced by air pollution, second-hand smoke, nutrition and other environmental factors has been published in the last couple weeks. One notable study on autism by researchers at UCSF and Stanford suggests that environmental conditions may contribute as much to autism as genetic heritability (Read more). Given that autism has long been considered almost exclusively “genetic”, this research will likely have a profound impact on how scientists, health professionals and parents think about how autism may occur in some individuals and not in others and why the numbers of those diagnosed with autism is significantly increasing.

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