All eyes on China

Byoliveridley

First it was the melamine. Then this weekend, there was that horrible story about deaths in Panama linked to the use of diethylene glycol in cough syrup. Now, pigs are dying mysteriously.

Epidemic Is Killing Pigs in Southeastern China – New York Times

Hong Kong television broadcasts and newspapers were full of lurid accounts today of pigs staggering around with blood pouring from their bodies in Gaoyao and neighboring Yunfu, both in Guangdong Province. The Apple Daily newspaper said that as many as 80 percent of the pigs in the area had died, that panicky farmers were selling ailing animals at deep discounts and that pig carcasses were floating in a river.

Lovely. China has exploded out of the gate with its development and incredible growth. But its infrastructure, bureaucracy, attitudes, government accountability and transparency are obviously way behind. The whole world faces the consequences of this lag. But my guess is that it is the rural Chinese and the ones who have been “left behind” that suffer the most, something to keep in mind I guess as people rush to blame China for yet another safety issue. We have the option of being more careful, the rural Chinese don’t.

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Common chemicals are linked to breast cancer

Byoliveridley

The LA Times features a study arising from the Silent Spring institute.

Common chemicals are linked to breast cancer – Los Angeles Times

More than 200 chemicals — many found in urban air and everyday consumer products — cause breast cancer in animal tests, according to a compilation of scientific reports published today.

Writing in a publication of the American Cancer Society, researchers concluded that reducing exposure to the compounds could prevent many women from developing the disease.

The research team from five institutions analyzed a growing body of evidence linking environmental contaminants to breast cancer, the leading killer of U.S. women in their late 30s to early 50s.

Experts say that family history and genes are responsible for a small percentage of breast cancer cases but that environmental or lifestyle factors such as diet are probably involved in the vast majority.

“Overall, exposure to mammary gland carcinogens is widespread,” the researchers wrote in a special supplement to the journal Cancer. “These compounds are widely detected in human tissues and in environments, such as homes, where women spend time.”

The scientists said data were too incomplete to estimate how many breast cancer cases might be linked to chemical exposures.

The resources to come out of this study include two databases, one that summarizes animal mechanistic studies, and one that summarizes human epidemiological studies. It’s a good start and I hope these databases are continually expanded. The study was essentially a big lit review and data organization project.

There are two major issues with the way carcinogenicity is studied. Firstly, animals other than humans are dosed at high levels to test for possible cancer outcomes. This leaves most researchers vulnerable to the charge that these high dose studies do not translate well to humans because the dose-response relationship at ambient levels is not well studied. So, the obvious criticism is that just because cancer endpoints were seen at high levels does not mean that the same thing will happen at low levels. This cuts both ways, though. We’re seeing with bisphenol A that low doses can cause more harm than intermediate doses. Another issue is the additivity of the interactions. Does 1 “dose” of PAH + 1 “dose” of PCB = 2 “doses” of PAH? We’re exposed to a whole host of chemicals all our lives, who knows which ones add, which ones subtract, which ones multiply, etc.

Of course, as with most diseases, some macro variables dominate. For instance, the US has seen 8-9% decline in breast cancer incidence recently due to a decreased use of hormone replacement therapy. So, as with all diseases, taking care of some of these big ticket items is very important. One discouraging story I read today reported on a four percentage point decline in mammograms (70 to 66%) in women age 40 and older. Why? decreased access to health insurance and dropping the ball on promotion.

The depressing fact of the matter is that the boring basics of good preventative healthcare, screening, good lifestyle and diet are the most important factors, and if we take care of these factors, we will make most health issues easier to deal with.

Is Chronic Occupational Pain a Class Issue?

Byoliveridley

Americans in households making less than $30,000 a year spend nearly 20% of their lives in moderate to severe pain, compared with less than 8% of people in households earning above $100,000

Millions of Americans in Chronic Pain – TIME

Based on a study published in the Lancet (much moolah required to read, funny that the authors of an article on the class/money based nature of pain would publish in a journal that requires all kinds of money to read, heard of PLOS?), one would have to say yes. People in low paying service jobs don’t have the luxury of mid afternoon yoga, or that once a week massage, or being able to take a “mental health” day, or any such luck. Also, the work is physically demanding, long hours of standing, heavy lifting, and repetitive motions the body was not designed for.

Krueger notes that the type of pain people reported typically fell on either side of the rich-poor divide. “Those with higher incomes welcome pain almost by choice, usually through exercise,” he says. “At lower incomes, pain comes as the result of work.” Indeed, Krueger and Stone found that blue-collar workers felt more pain, from physical labor or repetitive motion, while on the job

It is very sad, but a lot of this pain is avoidable. Next time you go to the grocery store, notice that the people at the check out counter stand all the time. Why? What about their job requires continuous standing? I’ve been to other countries, Germany for instance, where they are provided with high chairs that help them move the items from the conveyor through the scanner to the bagging area with much less effort. How many chairs have you seen in a grocery store lately?

Why can’t this very simple system be implemented? It would provide much relief. Three major issues:

  1. Lack of bargaining power: Unions are a dirty word. Last I heard, the unionization rate in the states was 12%. No one speaks for the cashier. It is considered a low paying, low skill occupation where people can be replaced easily and without “pain”. So, you’re on your own, ask for a chair, and you’ll be seated in one very soon (at home, your ass fired and tired).
  2. Money: And this is linked to point 1. Implementation of any programs designed to make workers’ lives a little easier costs money up front. Since workers are expendable and have no voice, it’s easiest to steal from them and deny them basic comforts.
  3. The American notion of individualism: You deserve what you get based on how hard you work and how intelligent you are. Grocery store cashiers must be lazy and dumb to be where they are. they “deserve it”

I don’t see it changing at all. But next time you walk into a grocery store and find a rather sullen clerk, it’s not that she’s lazy or has a bad attitude, she may just be in a lot of pain.

Happy Sunday!

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Flame Retardants and Hyperthyroidism in Cats

Byoliveridley

Caveat Emptor: They found a correlation, not a causative mechanism. But Polybrominated Diphenyl Ethers (PBDEs, yum!) have structures that can mimic endocrine hormones. Because hormones signal at very low doses and continuously, our whole toxicological risk testing structure of looking for acute effects at high doses and trying to extrapolate those effects to low doses is flawed for endocrine disrupting compounds. We are finally beginning to see some new research, especially with other toxics such as Bisphenol A, which test for chronic conditions and subtle gene and hormonal signalling effects at low doses. After all, small changes in hormone regulation especially at childbirth and a young age can have very serious effects later on in life.

Inside Bay Area – NEW: Flame retardants linked to thyroid disease in cats

A mysterious epidemic of thyroid disease in cats may be linked to flame retardants common in carpets, foam furniture and mattresses, according to U.S. Environmental Protection Agency researchers, who suggest that scientists have underestimated the damaging health risk the chemicals pose to humans.

The research, published Wednesday in the journal Environmental Science and Technology, does not prove these compounds, known as PBDEs, caused the rash of hyperthyroidism in the nation’s household cats over the past 30 years.

Rather, it lays out a hypothesis, showing that cats are heavily contaminated by these compounds, which leach from household products and are found everywhere, particularly household dust. Cats, meticulous cleaners, ingest PBDE-contaminated dust daily.

The case of fire retardants is especially difficult because they save many lives, so manufacturers can always point to that fact and resist change. The logical fallacy, however is as follows:

  1. Fire retardants save lives (therefore good)
  2. PBDEs are fire retardants
  3. Therefore, PBDEs are good!!

The search for a safer fire retardant needs to continue, and will not happen unless the old ones are under pressure of being phased out.

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Feds punt on Bisphenol A

Byoliveridley

By studiously ignoring all the subtle hormone disruption effects of bisphenol A and concentrating on easily observable neurological effects, the CERHR essentially does the industry’s bidding.

Some risk linked to plastic chemical – Los Angeles Times

A federal panel of scientists concluded Wednesday that an estrogen-like compound in plastic could be posing some risk to the brain development of babies and children.

Bisphenol A, or BPA, is found in low levels in virtually every human body. A component of polycarbonate plastic, it can leach from baby bottles and other hard plastic beverage containers, food can linings and other consumer products.

Culminating months of scientific debate, the decision by the 12 advisors of the Center for the Evaluation of Risks to Human Reproduction — part of the National Institutes of Health — is the first official, government action related to the chemical. Their recommendation will be reviewed for a federal report that could lead to regulations restricting one of the most used chemicals.

The scientists ranked their concerns about BPA, concluding they had “some concern” about neurological and behavioral effects in fetuses, infants and children, but “minimal” or “negligible” concern about reproductive effects. The findings put the panel roughly in the middle — between the chemical industry, which has long said there is no evidence of danger to humans, and the environmental activists and scientists who say it is probably harming people.

For a detailed look at how bisphenol research has been corrupted by industry sponsored “focused counter research” – where the goal is to show no effects and the experiment is tiled to ensure this goal, read this excellent article in the The Public Library of Science Biology Open Source Journal. Note, because it is Open Access, you can actually read it without selling a kidney! Some highlights…

The moment we published something on bisphenol A, the chemical industry went out and hired a number of corporate laboratories to replicate our research. What was stunning about what they did,” vom Saal says with a mix of outrage and bemused disbelief, “was they hired people who had no idea how to do the work. Each of the members of these groups came to me and said, ‘We don’t know how to do this, will you teach us?’”

More…

The HCRA report, commissioned before Schwartz’s tenure, concluded that “the weight of the evidence for low-dose effects is very weak” [15]. Industry groups hailed the report as a comprehensive review by independent experts and quickly disseminated its findings. Yet the “comprehensive” report reviewed just 19 of 47 studies available in April 2002, and when it was published more than two years later, three panelists asked not to be listed as authors.

What the hell, just read the whole article, especially the bit about the Harvard Center for Risk Analysis and its well documented industry shillness.

The key to understanding bisphenol research is to realize that it is a hormone disruptor that works at low doses. At high doses, normal toxicological testing doses that is, it floods the hormone receptors and slows down the receptor pathways. So, the usual technique of testing in rats and mice at high doses and extrapolating will not work.

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South Asians: Watch your Heart

Byoliveridley

Seems like us South Asians die earlier from heart attacks.

ScienceDaily: South Asians Have Higher Levels Of Heart Attack Risk Factors At Younger Ages

Deaths related to cardiovascular disease occur 5 to 10 years earlier in South Asian countries than in Western countries, according to background information in the article. This has raised the possibility that South Asians exhibit a special susceptibility for acute myocardial infarction (AMI; heart attack) that is not explained by traditional risk factors.

But why?

The prevalence of protective risk factors (leisure time physical activity, regular alcohol intake, and daily intake of fruits and vegetables) were markedly lower in South Asian study participants compared with those from other countries.

Um, it is mainly behavioral, not genetic according to the authors, and hence can be mitigated by lifestyle changes.

Well, I guess it is time to take a personal stock as of 1-18-2007:

  • Weight – Well, I am in the lower end of the healthy BMI.
  • Exercise – 4-5 days of 45 minutes – 1 hour per day, pretty good.
  • Food – Well, mostly good, especially if the candy can be avoided. I need to eat more vegetables, but I eat a lot of high fibre, and whole wheat food, probably not enough protein, mostly vegetarian.
  • Alcohol (1-2 drinks is apparently a heart protector) – Amen, I am a religious one drink a day partaker, more on weekends :-;
  • Smoking – Well, gave that up a while back, now to quit that occasional “party” smoke.
  • Stress – Well, not so good, this is probably the area I would need to work on the most.
  • Hypertension – Well, I am borderline on my blood pressure readings 🙁 Need to work on that.
  • Cholesterol – Still waiting for results on my physical.

On the whole, I seem to be in decent shape. It’s good to take stock once in a while.

AARP – Selling to you AND advocating for you at the same time

Byoliveridley

Am I just slow on the uptake? How can you simultaneously be an advocate for someone, and also sell them something very expensive and important? If at some point in time, these two tasks conflict, will AARP drop out of the healthcare industry to ensure that its role as advocate does not get compromised? I think not, the conflict of interest simply boggles the mind. How can you write a whole article about this issue and not have CONFLICT OF INTEREST flashing in big bold letters!!

For example, if it is proven that single payer, universal healthcare was the most effective way to ensure that people 50-64 (before they hit medicare, which used to work very much like single payer healthcare without drug coverage until a really complex and crazy drug insurance was written on top of it) were insured and healthy, how would this affect the AARP? They are now in the business of selling you the health insurance that would be rendered less necessary by said policy, what would the AARP do? Somehow, I don’t see them saying “Yeah, we’ll close our multimillion dollar profit making business because it is the right thing to do”.

This is ridiculous!

AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby – New York Times

AARP, the lobby for older Americans, announced Monday that it would become a major participant in the nation’s health insurance market, offering a health maintenance organization to Medicare recipients and several other products to people 50 to 64 years old.

The products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account.

When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage.

William D. Novelli, the chief executive of AARP, said, “In launching these initiatives, we are driven by our mission to create a healthier America.”

The group also said it would use its leverage to reshape the health insurance market. The organization has 38 million members, and Mr. Novelli said it hoped to have 50 million by 2011.

The new Medicare product will be marketed with UnitedHealth Group. Policies for people under 65 will carry the AARP name and will be marketed with Aetna.