Chemical exposure despite organic diet and plastic-free food containers

While water bottles may tout BPA-free labels and personal care products declare phthalates not among their ingredients, these assurances may not be enough. According to a study published February 27 in the Nature Journal of Exposure Science and Environmental Epidemiology, we may be exposed to these chemicals in our diet, even if our diet is organic and we prepare, cook, and store foods in non-plastic containers. Children may be most vulnerable.

“Current information we give families may not be enough to reduce exposures,” said Dr. Sheela Sathyanarayana, lead author on the study and an environmental health pediatrician in the UW School of Public Health and at Seattle Children’s Research Institute. She is a physician at Harborview Medical Center’s Pediatric Environmental Health Specialty Unit, and a UW assistant professor of pediatrics.

Phthalates and bisphenol A, better known as BPA, are synthetic endocrine-disrupting chemicals. Previous studies have linked prenatal exposure to phthalates to abnormalities in the male reproductive system. Associations have also been shown between fetal exposure to BPA and hyperactivity, anxiety, and depression in girls.

The researchers compared the chemical exposures of 10 families, half of whom were given written instructions on how to reduce phthalate and BPA exposures. They received handouts prepared by the national Pediatric Environmental Health Specialty Units, a network of experts on environmentally related health effects in children. The other families received a five-day catered diet of local, fresh, organic food that was not prepared, cooked or stored in plastic containers.

When the researchers tested the participants’ urinary concentrations of metabolites for phthalates and BPA, they got surprising results. The researchers expected the levels of the metabolities to decrease in those adults and children eating the catered diet.

Instead, the opposite happened. The urinary concentration for phthalates were 100-fold higher than the those levels found in the majority of the general population. The comparison comes from a study conducted by the National Health and Nutrition Examination Survey. This is a program of studies managed by the Centers for Disease Control and Prevention and designed to assess the health and nutritional status of adults and children in the United States.

The concentrations were also much higher for children as compared to the adults. The researchers then tested the phthalate concentrations in the food ingredients used in the dietary intervention. Dairy products—butter, cream, milk, and cheese—had concentrations above 440 nanograms/gram. Ground cinnamon and cayenne pepper had concentrations above 700 ng/g, and ground coriander had concentrations of 21,400 ng/g.

“We were extremely surprised to see these results. We expected the concentrations to decrease significantly for the kids and parents in the catered diet group. Chemical contamination of foods can lead to concentrations higher than deemed safe by the US EPA,” said Dr. Sheela Sathyanarayana.

Using the study results, the researchers estimated that the average child aged three to six years old was exposed to 183 milligrams per kilogram of their body weight per day. The U.S. Environmental Protection Agency’s recommended limit is 20 mg/kg/day.

“It’s difficult to control your exposure to these chemicals, even when you try,” said Sathyanarayana. “We have very little control over what’s in our food, including contaminants. Families can focus on buying fresh fruits and vegetables, foods that are not canned and are low in fat, but it may take new federal regulations to reduce exposures to these chemicals.”

BPA May Affect the Developing Brain

Environmental exposure to bisphenol A (BPA), a widespread chemical found in plastics and resins, may suppress a gene vital to nerve cell function and to the development of the central nervous system, according to a study led by researchers at Duke Medicine.

The researchers published their findings - which were observed in cortical neurons of mice, rats and humans - in the journal Proceedings of the National Academy of Sciences on Feb. 25, 2013.

"Our study found that BPA may impair the development of the central nervous system, and raises the question as to whether exposure could predispose animals and humans to neurodevelopmental disorders," said lead author Wolfgang Liedtke, M.D., PhD, associate professor of medicine/neurology and neurobiology at Duke.

BPA, a molecule that mimics estrogen and interferes with the body's endocrine system, can be found in a wide variety of manufactured products, including thermal printer paper, some plastic water bottles and the lining of metal cans. The chemical can be ingested if it seeps into the contents of food and beverage containers.

Research in animals has raised concerns that exposure to BPA may cause health problems such as behavioral issues, endocrine and reproductive disorders, obesity, cancer and immune system disorders. Some studies suggest that infants and young children may be the most vulnerable to the effects of BPA, which led the U.S. Food and Drug Administration to ban the use of the chemical in baby bottles and cups in July 2012.

While BPA has been shown to affect the developing nervous system, little is understood as to how this occurs. The research team developed a series of experiments in rodent and human nerve cells to learn how BPA induces changes that disrupt gene regulation.

During early development of neurons, high levels of chloride are present in the cells. These levels drop as neurons mature, thanks to a chloride transporter protein called KCC2, which churns chloride ions out of the cells. If the level of chloride within neurons remains elevated, it can damage neural circuits and compromise a developing nerve cell's ability to migrate to its proper position in the brain.

Exposing neurons to minute amounts of BPA alters the chloride levels inside the cells by somehow shutting down the Kcc2 gene, which makes the KCC2 protein, thereby delaying the removal of chloride from neurons.

MECP2, another protein important for normal brain function, was found to be a possible culprit behind this change. When exposed to BPA, MECP2 is more abundant and binds to the Kcc2 gene at a higher rate, which might help to shut it down. This could contribute to problems in the developing brain due to a delay in chloride being removed.

These findings raise the question of whether BPA could contribute to neurodevelopmental disorders such as Rett syndrome, a severe autism spectrum disorder that is only found in girls and is characterized by mutations in the gene that produces MECP2.

While both male and female neurons were affected by BPA in the studies, female neurons were more susceptible to the chemical's toxicity. Further research will dig deeper into the sex-specific effects of BPA exposure and whether certain sex hormone receptors are involved in BPA's effect on KCC2.

"Our findings improve our understanding of how environmental exposure to BPA can affect the regulation of the Kcc2 gene. However, we expect future studies to focus on what targets aside from Kcc2 are affected by BPA," Liedtke said. "This is a chapter in an ongoing story."

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Study finds higher levels of several toxic metals in children with autism

photo: imagerymajestic

In a recently published study in the journal Biological Trace Element Research, Arizona State University researchers report that children with autism had higher levels of several toxic metals in their blood and urine compared to typical children. The study involved 55 children with autism ages 5–16 years compared to 44 controls of similar age and gender.

The autism group had significantly higher levels of lead in their red blood cells (+41 percent) and significantly higher urinary levels of lead (+74 percent), thallium (+77 percent), tin (+115 percent), and tungsten (+44 percent). Lead, thallium, tin, and tungsten are toxic metals that can impair brain development and function, and also interfere with the normal functioning of other body organs and systems.

A statistical analysis was conducted to determine if the levels of toxic metals were associated with autism severity, using three different scales of autism severity. It was found that 38-47 percent of the variation of autism severity was associated with the level of several toxic metals, with cadmium and mercury being the most strongly associated.

In the paper about the study, the authors state “We hypothesize that reducing early exposure to toxic metals may help ameliorate symptoms of autism, and treatment to remove toxic metals may reduce symptoms of autism; these hypotheses need further exploration, as there is a growing body of research to support it.”

The study was led by James Adams, a President’s Professor in the School for Engineering of Matter, Transport and Energy, one of ASU’s Ira A. Fulton Schools of Engineering. He directs the ASU Autism/Asperger’s Research Program.

Adams previously published a study on the use of DMSA, an FDA-approved medication for removing toxic metals. The open-label study found that DMSA was generally safe and effective at removing some toxic metals. It also found that DMSA therapy improved some symptoms of autism. The biggest improvement was for children with the highest levels of toxic metals in their urine.

Overall, children with autism have higher average levels of several toxic metals, and levels of several toxic metals are strongly associated with variations in the severity of autism for all three of the autism severity scales investigated.

The study was funded by the Autism Research Institute and the Legacy Foundation.

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Childhood blood lead levels rise and fall with exposure to airborne dust in urban areas

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A new nine-year study of more than 367,000 children in Detroit supports the idea that a mysterious seasonal fluctuation in blood lead levels — observed in urban areas throughout the United States and elsewhere in the northern hemisphere — results from resuspended dust contaminated with lead.

The scientists, who report in the journal Environmental Science & Technology (ES&T), say the results have implications for government efforts to control childhood exposure to lead, which can have serious health consequences.

Shawn P. McElmurry and colleagues point out that average blood lead levels in the U.S. and globally have declined following the elimination of lead from gasoline, paint, water pipes and solder used to seal canned goods. In addition to McElmurry, who is with Wayne State University in Detroit. Much of the current lead in major urban areas is from those "legacy" contaminants.

Modern human exposure takes the form of fine particles, deposited in the soil years ago, that are swept up into the air. Past research identified a seasonal trend in blood lead levels in children in multiple North American cities, including Washington, D.C., New York, Chicago and Milwaukee. Those levels increase, often by more than 10 percent, in July, August and September. Blood lead levels then decrease during winter and spring.

The scientists set out to test a hypothesis implicating contact with lead-contaminated dust while children are outdoors and engaged in warm-weather activities — at a time when wind, humidity and other meteorological factors increase the amounts of dust in the air. Their ES&T report describes research that strongly implicates airborne dust as the reason for the seasonal trends in blood lead levels. It shows a correlation between atmospheric soil levels in Detroit and blood lead levels in children.

"Our findings suggest that the federal government's continued emphasis on lead-based paint may be out-of-step (logically) with the evidence presented and an improvement in child health is likely achievable by focusing on the resuspension of soil lead as a source of exposure," the report states. "Given that current education has been found to be ineffective in reducing children's exposure to Pb, we recommend that attention be focused on primary prevention of lead-contaminated soils."

Fungal particles in the lungs offer clues to new asthma treatments

Hundreds of tiny fungal particles found in the lungs of asthma sufferers could offer new clues in the development of new treatments, according to a team of University scientists.

In the first large study of its type, published in the journal, BMC Infectious Diseases, a team of researchers from the School of Medicine have uncovered large numbers of fungi present in healthy lungs.

"Historically, the lungs were thought to be sterile," according to Dr Hugo van Woerden from Cardiff University’s Institute of Primary Care and Public Health, who led the research.

"Our analysis found that there are large numbers of fungi present in healthy human lungs. The study also demonstrates that asthma patients have a large number of fungi in their lungs and that the species of fungi are quite different to those present in the lungs of healthy individuals," he added.

By examining the mucus or sputum of patients with and without asthma, the team found some 136 different fungal species with 90 fungal species more common in asthma patients and 46 were more common in healthy individuals.

Having established the presence of fungi in the lungs of patients with asthma, the researchers now hope this could lead to new lines of research and eventually, better treatments for sufferers.

"Establishing the presence of fungi in the lungs of patients with asthma could potentially open up a new field of research which brings together molecular techniques for detecting fungi and developing treatments for asthma.

"In the future it is conceivable that individual patients may have their sputum tested for fungi and their treatment adjusted accordingly," he adds.

This is not the first time the Cardiff researchers have made the link between fungi and asthma. Their previous research found that by removing fungi from people’s homes, they could also help improve life for sufferers.

Cost of medication and stigma leading asthma sufferers to risk health

The high cost of medication, stigmatisation and poor acceptance of their condition are causing young adults to take a dangerous approach to managing their asthma, according to new research published today in the journal BMJ Open.

The overuse of short-acting bronchodilators ("quick-acting" inhalers, usually blue, which relieve acute asthma symptoms) is a marker of poor asthma control and is linked to increased risk of hospital admission and death from asthma.

Regular use of low dose anti-inflammatory corticosteroid inhalers (preventer inhalers, usually brown) are fundamental to successfully controlling asthma, and preventing asthma symptoms.

In this study, led by Queen Mary, University of London, researchers looked at why young adults (20yrs -32yrs) overuse short-acting bronchodilators. The researchers interviewed 21 young adults from the same urban general practice who were classed as either high users (12) or low users (nine) of short-acting bronchodilators as judged by their number of prescriptions. They found:

• Cost was seen as a major disincentive to obtaining preventive medication
• High-users were more likely to express anger or resentment at their condition
• High-users often reported poor control of their asthma symptoms
• Stigma was common, with inhalers described as something "to hide in a bag"

Chris Griffiths, Professor of Primary Care at Queen Mary, who led the research said: "Relying on short-acting bronchodilators – 'my blue (inhaler) takes a battering' as one patient put it – is not a safe way to manage asthma and individuals taking this approach are putting their lives and health at risk.

"Our findings suggest a number of possible strategies to support people to manage their condition better. Providing free asthma medication, particularly to those on low incomes, could help boost the numbers using preventive medication. Better education, particularly at the time of diagnosis, could help people accept and adapt to their illness, while reducing stigmatisation might mean people feel more comfortable about using their inhalers in public."

Emily Humphreys, Head of Policy and Public Affairs at Asthma UK, said: "Over-reliance on reliever asthma medicines instead of preventers puts people at greater risk of a potentially fatal asthma attack, so this study is really important in highlighting some of the reasons behind it.

"It's telling that young people felt the costs of prescriptions were such a major barrier to taking the right medicines at the right time and we're keen to see the introduction of free prescriptions for long-term conditions so that young people with asthma would no longer face the dilemma of which medicine to buy when they can only afford one.

"In the meantime it is absolutely crucial that healthcare professionals explain how medicines work, particularly when younger people are diagnosed with asthma, to ensure that they understand how to manage their condition."

Effects of human exposure to hormone-disrupting chemicals examined in landmark UN report

Many synthetic chemicals, untested for their disrupting effects on the hormone system, could have significant health implications according to the State of the Science of Endocrine Disrupting Chemicals, a new report by the United Nations Environment Programme (UNEP) and WHO.

The joint study calls for more research to understand fully the associations between endocrine disrupting chemicals (EDCs)—found in many household and industrial products—and specific diseases and disorders. The report notes that with more comprehensive assessments and better testing methods, potential disease risks could be reduced, with substantial savings to public health.

Some substances can alter the hormonal system

Human health depends on a well-functioning endocrine system to regulate the release of certain hormones that are essential for functions such as metabolism, growth and development, sleep and mood. Some substances known as endocrine disruptors can alter the function(s) of this hormonal system increasing the risk of adverse health effects. Some EDCs occur naturally, while synthetic varieties can be found in pesticides, electronics, personal care products and cosmetics. They can also be found as additives or contaminants in food.

The UN study, which is the most comprehensive report on EDCs to date, highlights some associations between exposure to EDCs and health problems including the potential for such chemicals to contribute to the development of non-descended testes in young males, breast cancer in women, prostate cancer in men, developmental effects on the nervous system in children, attention deficit /hyperactivity in children and thyroid cancer.

Human exposure can occur in a number of ways

EDCs can enter the environment mainly through industrial and urban discharges, agricultural run-off and the burning and release of waste. Human exposure can occur via the ingestion of food, dust and water, inhalation of gases and particles in the air, and skin contact.

“Chemical products are increasingly part of modern life and support many national economies, but the unsound management of chemicals challenges the achievement of key development goals, and sustainable development for all,” said UN Under Secretary-General and UNEP Executive Director Achim Steiner.

“Investing in new testing methods and research can enhance understanding of the costs of exposure to EDCs, and assist in reducing risks, maximizing benefits and spotlighting more intelligent options and alternatives that reflect a transition to a green economy,” added Mr Steiner.

More research is needed

In addition to chemical exposure, other environmental and non-genetic factors such as age and nutrition could be among the reasons for any observed increases in disease and disorders. But pinpointing exact causes and effects is extremely difficult due to wide gaps in knowledge.

“We urgently need more research to obtain a fuller picture of the health and environment impacts of endocrine disruptors,” said Dr Maria Neira, WHO’s Director for Public Health and Environment. “The latest science shows that communities across the globe are being exposed to EDCs, and their associated risks. WHO will work with partners to establish research priorities to investigate links to EDCs and human health impacts in order to mitigate the risks. We all have a responsibility to protect future generations."

The report also raises similar concerns on the impact of EDCs on wildlife. In Alaska in the United States, exposure to such chemicals may contribute to reproductive defects, infertility and antler malformation in some deer populations. Population declines in species of otters and sea lions may also be partially due to their exposure to diverse mixtures of PCBs, the insecticide DDT, other persistent organic pollutants, and metals such as mercury. Meanwhile, bans and restrictions on the use of EDCs have been associated with the recovery of wildlife populations and a reduction in health problems.

Recommendations

The study makes a number of recommendations to improve global knowledge of these chemicals, reduce potential disease risks, and cut related costs. These include:

• Testing: known EDCs are only the ‘tip of the iceberg’ and more comprehensive testing methods are required to identify other possible endocrine disruptors, their sources, and routes of exposure.
• Research: more scientific evidence is needed to identify the effects of mixtures of EDCs on humans and wildlife (mainly from industrial by-products) to which humans and wildlife are increasingly exposed.
• Reporting: many sources of EDCs are not known because of insufficient reporting and information on chemicals in products, materials and goods.
• Collaboration: more data sharing between scientists and between countries can fill gaps in data, primarily in developing countries and emerging economies.

“Research has made great strides in the last ten years showing endocrine disruption to be far more extensive and complicated than realized a decade ago,” said Professor Åke Bergman of Stockholm University and Chief Editor of the report. “As science continues to advance, it is time for both management of endocrine disrupting chemicals and further research on exposure and effects of these chemicals in wildlife and humans.”

One in 20 cases of pre-eclampsia may be linked to air pollution

One in every 20 cases of the serious condition of pregnancy, pre-eclampsia, may be linked to increased levels of the air pollutant ozone during the first three months, suggests a large study published in the online journal BMJ Open.

Mothers with asthma may be more vulnerable, the findings indicate.

Pre-eclampsia is characterised by raised blood pressure and the presence of protein in the urine during pregnancy. It can cause serious complications, if left untreated.

The authors base their findings on almost 121,000 singleton births in Greater Stockholm, Sweden, between 1998 and 2006; national data on the prevalence of asthma among the children’s mothers; and levels of the air pollutants ozone and vehicle exhaust (nitrogen oxide) in the Stockholm area.

There’s a growing body of evidence pointing to a link between air pollution and premature birth, say the authors, while pregnant women with asthma are more likely to have pregnancy complications, including underweight babies and pre-eclampsia.

In all, 4.4% of the pregnancies resulted in a premature birth and the prevalence of pre-eclampsia was 2.7%.

There was no association between exposure to levels of vehicle exhaust and complications of pregnancy, nor were any associations found for any air pollutants and babies that were underweight at birth.

But there did seem to be a link between exposure to ozone levels during the first three months of pregnancy and the risk of premature birth (delivery before 37 weeks) and pre-eclampsia, after adjusting for factors likely to influence the results and seasonal variations in air pollutants, although not spatial variations in exposure.

Each rose by 4% for every 10 ug/m3 rise in ambient ozone during this period, the analysis indicated.

Mothers with asthma were 25% more likely to have a child born prematurely and 10% more likely to have pre-eclampsia than mums without this condition.

Asthma is an inflammatory condition and ozone may therefore have worsened respiratory symptoms and systemic inflammation, so accounting for the larger increase in the risk of premature birth among the mums with asthma, suggest the authors.

But after taking account of the mother’s age, previous births, educational attainment, ethnicity, asthma, season and year of conception, the authors calculated that one in every 20 (5%) cases of pre-eclampsia were linked to ozone levels during early pregnancy.

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Study shows air pollution has a direct impact on heart attacks

Researchers at Rice University in Houston have found a direct correlation between out-of-hospital cardiac arrests and levels of air pollution and ozone. Their work has prompted more CPR training in at-risk communities.

Given that the American Lung Association has ranked Houston eighth in the United States for high-ozone days, statisticians Katherine Ensor and Loren Raunthe set out to see if there is a link between ambient ozone levels and cardiac arrest.

For the new study, the authors analyzed eight years’ worth of data drawn from Houston’s extensive network of air-quality monitors and more than 11,000 concurrent out-of-hospital cardiac arrests (OHCA) logged by Houston Emergency Medical Services (EMS).

They found a positive correlation between cardiac arrests and exposure to both fine particulate matter (airborne particles smaller than 2.5 micrograms) and ozone.

The researchers found that a daily average increase in particulate matter of 6 micrograms per day over two days raised the risk of OHCA by 4.6 percent, with particular impact on those with pre-existing (and not necessarily cardiac-related) health conditions. Increases in ozone level were similar, but on a shorter timescale: Each increase of 20 parts per billion over one to three hours also increased OHCA risk, with a peak of 4.4 percent. Peak-time risks from both pollutants rose as high as 4.6 percent. Relative risks were higher for men, African-Americans and people over 65.

For the study, OHCA events were defined as cases where EMS personnel performed chest compressions. Ensor and Raun noted the patients died in more than 90 percent of the cases, which occurred more during the hot summer months (55 percent of total cases).

The researchers also looked at the effects of nitrogen dioxide, sulfur dioxide and carbon monoxide levels, none of which were found to impact the occurrence of OHCA.

The work is expected to help Houston EMS fine-tune its deployment of personnel and equipment and provide early warnings to health officials and the public when weather and/or incidents warrant an alert for high ozone levels in specific areas, Ensor said.

Co-author David Persse, Houston Fire Department EMS physician director and a public-health authority for the city, said it’s long been thought by EMS workers that certain types of air pollution, including ozone, have significant negative effects on cardiac and respiratory health. “But this mathematically and scientifically validates what we know,” he said.

Houston is already acting upon the results.

“The city has targeted educational resources to at-risk communities, where they’re now doing intensive bystander CPR training,” Raun said. Early intervention is seen as critical, as the chance of survival for a person suffering cardiac arrest drops 10 percent for every minute he or she is left unattended. She said statistics show one life is saved for every 26 to 36 people who receive cardiopulmonary resuscitation from a bystander.

Houston’s effort is part of a range of interventions to mitigate the consequences of poor air quality days, though none are substitutes for the primary strategy of improving air quality, according to the city’s Health and Human Services Department.

Smoking bans linked with 'successive reductions' in preterm birth

• No decreasing trend was evident in the years or months before the bans 
• The study supports the notion that smoking bans have public health benefits from early life

It is well established that smoking during pregnancy impairs the growth of an unborn child and shortens gestation. Exposure to second-hand smoke has also been found to affect birth outcomes, yet little is known about the impact of recent smoke-free legislation on birth weight and preterm birth.

So a team of researchers, lead by Dr Tim Nawrot from Hasselt University, investigated whether recent smoking bans in Belgium were followed by changes in preterm delivery. In Belgium, smoke-free legislation was implemented in three phases (in public places and most workplaces in January 2006, in restaurants in January 2007, and in bars serving food in January 2010).

The researchers analysed 606,877 live, single-born babies delivered at 24-44 weeks of gestation in Flanders from 2002 to 2011. Preterm birth was defined as birth before 37 weeks.

They found reductions in the risk of preterm birth after the introduction of each phase of the smoking ban. No decreasing trend was evident in the years or months before the bans.

The results show a reduction in the risk of preterm births of 3.13% on 1 January 2007 (ban on smoking in restaurants), and a further reduction in the risk of 2.65% after 1 January 2010 (ban on smoking in bars serving food). These changes could not be explained by several other factors - both at the individual level, such as mother's age and socioeconomic status - and at the population level, such as changes in air pollution and influenza epidemics.

Given that even a mild reduction in gestational age has been linked in other studies to adverse health outcomes in early and later life, our study has important public health implications, say the authors.

"Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. It supports the notion that smoking bans have public health benefits even from early life. More and more countries in Europe are adopting stricter legislation on smoking in public places. These results underscore the public health benefit of smoking ban policies."

Losing hope of a good night's sleep is risk factor for suicide

When people lose hope that they will ever get another good night's sleep, they become at high risk for suicide, researchers report.

Insomnia and nightmares, which are often confused and may go hand-in-hand, are known risk factors for suicide but just how they contribute was unknown, said Dr. W. Vaughn McCall, Chair of the Medical College of Georgia Department of Psychiatry and Health Behavior at Georgia Regents University.

The new study reaffirms that link and adds the element of hopelessness about sleep that is independent of other types of hopelessness, such as those regarding personal relationships and careers, said McCall, corresponding author of the study in Journal of Clinical Sleep Medicine, the journal of the American Academy of Sleep Medicine.

"It turns out insomnia can lead to a very specific type of hopelessness and hopelessness by itself is a powerful predictor of suicide," he said. "It's fascinating because what it tells you is we have discovered a new predictor for suicidal thinking."

If the findings hold true in larger studies, they wave a red flag about suicide risk and point toward prevention that targets the negative thoughts with pharmaceuticals and psychological intervention.

The finding also is a reminder to physicians that depressed patients who report increased sleep problems should be asked if they are having suicidal thoughts, McCall said.

The scientists used psychometric testing to objectively assess the mental state of 50 depressed patients age 20-80 being treated as an inpatient, outpatient or in the Emergency Department. More than half had attempted suicide and most were taking an anti-depressant. Testing enabled the researchers to filter out other suicide risks such as depression itself and hone in on the relationship between insomnia and suicide risk, asking specific questions about dysfunctional beliefs about sleep such as: Do you think you will ever sleep again?

"It was this dysfunctional thinking, all these negative thoughts about sleep that was the mediating factor that explained why insomnia was linked to suicide," said McCall, who specializes in depression and sleep disorders.

He's seen insomnia patients spiral downward with increasingly negative and unrealistic thoughts about not sleeping, thinking, for example, that their immune system is being irrevocably damaged. McCall challenges such negatives from his patients and asks other doctors to consider doing the same: to disagree, strongly stating there is no scientific evidence for the thoughts but there is hope and help. "People have choices," he said.

Once insomnia has been diagnosed, some fairly rigid guidelines can help turn the exhausting and potentially deadly tide, including:

• Wake up at the same time every day no matter when you go to bed
• Not going to bed until you are sleepy
• Eliminating caffeine, known to stay in your system up to 15 hours
• Eliminating alcoholic beverages or tobacco products
• Complete cardiovascular exercise at least four hours before bedtime
• Allowing ample time to digest a meal before heading to bed.

The likelihood of being suicidal at least doubles with insomnia as a symptom, McCall noted.
"If you talk with depressed people, they really feel like they have failed at so many things. It goes something like, 'My marriage is a mess, I hate my job, I can't communicate with my kids, I can't even sleep.' There is a sense of failure and hopelessness that now runs from top to bottom and this is one more thing," McCall said.

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Study shows alcohol consumption is a leading preventable cause of cancer death in the US

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Researchers from the Boston University School of Medicine (BUSM) and Boston University School of Public Health (BUSPH) have shown that alcohol is a major contributor to cancer deaths and years of potential life lost. These findings, published in the April 2013 issue of the American Journal of Public Health, also show that reducing alcohol consumption is an important cancer prevention strategy as alcohol is a known carcinogen even when consumed in small quantities.

Previous studies consistently have shown that alcohol consumption is a significant risk factor for cancers of the mouth, throat, esophagus and liver. More recent research has shown that alcohol also increases the risk of cancers of the colon, rectum and female breast. While estimates have shown that alcohol accounts for about four percent of all cancer-related deaths worldwide, there is a lack of literature focusing on cancer-related deaths in the U.S.

Timothy Naimi, MD, MPH, from the Department of Medicine at BUSM and colleagues from the National Cancer Institute, the Alcohol Research Group, Public Health Institute and the Centre for Addiction and Mental Health, examined recent data from the U.S. on alcohol consumption and cancer mortality. They found that alcohol resulted in approximately 20,000 cancer deaths annually, accounting for about 3.5 percent of all cancer deaths in the U.S.

Breast cancer was the most common cause of alcohol-attributable cancer deaths in women, accounting for approximately 6,000 deaths annually, or about 15 percent of all breast cancer deaths. Cancers of the mouth, throat and esophagus were common causes of alcohol-attributable cancer mortality in men, resulting in a total of about 6,000 annual deaths.

The researchers also found that each alcohol-related cancer death accounted for an average of 18 years of potential life lost. In addition, although higher levels of alcohol consumption led to a higher cancer risk, average consumption of 1.5 drinks per day or less accounted for 30 percent of all alcohol-attributable cancer deaths.

"The relationship between alcohol and cancer is strong, but is not widely appreciated by the public and remains underemphasized even by physicians," said Naimi, who served as the paper's senior author. "Alcohol is a big preventable cancer risk factor that has been hiding in plain sight."

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Zinc Helps Against Infection by Tapping Brakes in Immune Response

New research suggests that zinc helps control infections by gently tapping the brakes on the immune response in a way that prevents out-of-control inflammation that can be damaging and even deadly.

Scientists determined in human cell culture and animal studies that a protein lures zinc into key cells that are first-responders against infection. The zinc then interacts with a process that is vital to the fight against infection and by doing so helps balance the immune response.

This study revealed for the first time that zinc homes in on this pathway and helps shut it down, effectively ensuring that the immune response does not spiral out of control. The team led by Ohio State University researchers also found that if there is not enough zinc available at the time of infection, the consequences include excessive inflammation.

In this research, zinc’s activity was studied in the context of sepsis, a devastating systemic response to infection that is a common cause of death in intensive-care unit patients. But scientists say these findings might also help explain why taking zinc tablets at the start of a common cold appears to help stem the effects of the illness.

“We do believe that to some extent, these findings are going to be applicable to other important areas of disease beyond sepsis,” said Daren Knoell, senior author of the study and a professor of pharmacy and internal medicine at Ohio State. “Without zinc on board to begin with, it could increase vulnerability to infection. But our work is focused on what happens once you get an infection – if you are deficient in zinc you are at a disadvantage because your defense system is amplified, and inappropriately so.

“The benefit to health is explicit: Zinc is beneficial because it stops the action of a protein, ultimately preventing excess inflammation.”

While this study and previous work linking zinc deficiency to inflammation might suggest that supplementation could help very sick ICU patients, it’s still too early to make that leap.

“I think the question is whom to give zinc to, if anybody at all. We predict that not everybody in the ICU with sepsis needs zinc, but I anticipate that a proportion of them would,” Knoell said. “Zinc is a critical element that we get from our diet, but we do not think we can give zinc and fix everything. Usually, if there is zinc deficiency, we would expect to see other nutrient deficiencies, too.”

Zinc deficiency affects about 2 billion people worldwide, including an estimated 40 percent of the elderly in the United States – who are also among the most likely Americans to end up in an ICU.

The research is published in the journal Cell Reports.

Knoell’s lab previously showed that zinc-deficient mice developed overwhelming inflammation in response to sepsis compared to mice on a normal diet. Zinc supplementation improved outcomes in the zinc-deficient mice.

Until now, the beneficial effects of zinc in combating infection have not been fully understood at the molecular level. This is because zinc has numerous complex jobs in the body and interacts with thousands of proteins to sustain human life. Of all the zinc contained in our bodies, only about 10 percent of it is readily accessible to help fight off an infection, said Knoell, also an investigator in Ohio State’s Davis Heart and Lung Research Institute.

“We believe that our findings help to narrow an important gap that has existed in our understanding of how this relatively simple metal helps us defend ourselves from infection,” he said.

In this work, Knoell and colleagues sought to zero in on zinc’s role in preventing the inflammation that had led to such poor outcomes in the zinc-deficient mice.

In experiments using human monocytes – cells involved in the first line of defense against an invading pathogen – the researchers examined what happens when the immune response is launched.

When a pathogen is recognized, a series of molecules wake up from dormancy to create a process that activates the innate immune response. A major part of this process involves the NF-κB pathway, named for a highly active protein that is known to play an important role in the immune response to infection. Once NF-κB is activated and enters the nucleus, a gene is expressed that produces a zinc transporter called ZIP8. The transporter then rapidly mobilizes to the cell’s wall, where it can then shuttle zinc from the bloodstream into the cell.

After cell entry, zinc is then directed to and binds to a different protein in the NF-κB pathway. When this happens, it halts any further activity in that process. The cumulative impact of this feedback loop is that it prevents excessive inflammation, which can be damaging to cells and the body.

“The immune system has to work under very strict balance, and this is a classic example of where more is not always better,” Knoell said. “We want a robust inflammatory response, which is part of our natural programming to defend us against a bug. But if that is unchecked, and there is too much inflammation, then it not only attacks the pathogen but can also cause much more collateral damage.”

The researchers knew from previously published experiments that if ZIP8 activation was prevented, zinc couldn’t come into the cell and the cells died. In the current study, collaborators who specialize in computational modeling of protein interactions helped identify the likely target of zinc once it enters the cell: specific binding sites on a protein called IKKB. When researchers allowed this protein to function unchecked in mice with zinc deficiency, the animals developed excessive inflammation in response to sepsis – confirmation that IKKB was zinc’s target to turn off the inflammatory pathway.

“There are certainly other zinc targets in the cell, but we found evidence that zinc is brought in by ZIP8 to turn the pathway off by interacting with this protein at a specific region,” Knoell said.

The recommended daily allowance for zinc ranges from 8 to 11 milligrams for most adults. Red meat and poultry provide the majority of zinc in the American diet, according to the National Institutes of Health. Other food sources include beans, nuts, some shellfish, whole grains, fortified cereals and dairy products. The nutrient is also available in supplement form. Knoell said it is possible but relatively uncommon to take in too much zinc to reach toxic levels.

His lab is continuing to study the NF-κB pathway, inflammation and zinc deficiency in other disease processes. And though zinc would be inexpensive and easy to take as a supplement, Knoell said many questions remain about whether zinc should be considered as an intervention for specific disorders.

“There might be therapeutic implications about giving supplemental zinc in a strategic manner to help improve some people with certain conditions. But also, could we learn from this so someday we can be more diagnostic about who it is that needs zinc? And if so, what dose and for how long?” he said.

Anxiety About Relationships May Lower Immunity, Increase Vulnerability to Illness

Photo: David Castillo Dominici

Concerns and anxieties about one’s close relationships appear to function as a chronic stressor that can compromise immunity, according to new research.

In the study, researchers asked married couples to complete questionnaires about their relationships and collected saliva and blood samples to test participants’ levels of a key stress-related hormone and numbers of certain immune cells.

The research focused on attachment anxiety. Those who are on the high end of the attachment anxiety spectrum are excessively concerned about being rejected, have a tendency to constantly seek reassurance that they are loved, and are more likely to interpret ambiguous events in a relationship as negative.

Married partners who were more anxiously attached produced higher levels of cortisol, a steroid hormone that is released in response to stress, and had fewer T cells – important components of the immune system’s defense against infection – than did participants who were less anxiously attached.

“Everyone has these types of concerns now and again in their relationships, but a high level of attachment anxiety refers to people who have these worries fairly constantly in most of their relationships,” said Lisa Jaremka, lead author of the study and a postdoctoral fellow in Ohio State University’s Institute for Behavioral Medicine Research (IBMR).

Though some scientists theorize that attachment anxiety can be traced to inconsistent care during one’s infancy, Jaremka noted that there is also research-based evidence that people with attachment anxiety can change.

“It’s not necessarily a permanent state of existence,” she said.

The study appears online and is scheduled for future print publication in the journal Psychological Science.

Jaremka and colleagues tested the health effects of attachment anxiety on 85 couples who had been married for an average of more than 12 years. Most participants were white, and their average age was 39 years.

The participants completed a questionnaire called The Experiences in Close Relationships scale. They also reported general anxiety symptoms and their sleep quality. Researchers collected saliva samples over three days and blood samples over two days.

Participants with higher attachment anxiety produced, on average, 11 percent more cortisol than did those with lower attachment anxiety. The more anxiously attached participants also had between 11 percent and 22 percent fewer T cells than did less anxiously attached partners. Four T-cell markers were analyzed in the study.

The combined findings make sense and are likely related, Jaremka said, because cortisol can have immunosuppressive effects – meaning it can inhibit production of these very same T cells. Previous research has suggested that reduced T-cell levels can impair the immune response to vaccines and that low levels of the cells are a hallmark of an aging immune system.

Attachment anxiety is considered a phenomenon related to childhood development, Jaremka explained. At a very young age, children learn whether or not their primary caregivers will respond when the children are in distress. If caregivers are responsive, children learn they can rely on other people. If care is inconsistent or neglectful, children can develop feelings of insecurity that might manifest as attachment anxiety later in life.

Though she knows of no research-based advice about how to shed these feelings of insecurity, Jaremka said it is clear that people can change.

“Most research that does exist in this area supports the idea that being in very caring, loving, close relationships might be a catalyst to change from being very anxious to not,” she said.

Photo: freedigitalphotos.net
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Maternal exposure to outdoor air pollution associated with low birth weights worldwide

Mothers who are exposed to particulate air pollution of the type emitted by vehicles, urban heating and coal power plants are significantly more likely to bear children of low birth weight.

The study, the largest of its kind ever performed, analyzed data collected from more than three million births in nine nations at 14 sites in North America, South America, Europe, Asia and Australia.

The researchers found that at sites worldwide, the higher the pollution rate, the greater the rate of low birth weight.

Low birth weight (a weight below 2500 grams or 5.5 pounds) is associated with serious health consequences, including increased risk of postnatal morbidity and mortality and chronic health problems in later life.

In the study, published on February 6th, 2013 in the journal Environmental Health Perspectives, the researchers assessed data collected from research centers in the International Collaboration on Air Pollution and Pregnancy Outcomes, an international research collaborative established in 2007 to study the effects of pollution on pregnancy outcomes. Most of the data assessed was collected during the mid-1990s to the late 2000s, and in some cases, earlier.

"What's significant is that these are air pollution levels to which practically everyone in the world is commonly exposed," said co-principal investigator Tracey J. Woodruff, PhD, MPH, professor of obstetrics and gynecology and reproductive sciences at UC San Francisco. "These microscopic particles, which are smaller than the width of a human hair, are in the air that we all breathe."

Woodruff noted that nations with tighter regulations on particulate air pollution have lower levels of these air pollutants. "In the United States, we have shown over the last several decades that the benefits to health and wellbeing from reducing air pollution are far greater than the costs," said Woodruff. "This is a lesson that all nations can learn from."

Particulate air pollution is measured in size (microns) and weight (micrograms per cubic meter). In the United States, federal regulations require that the yearly average concentration in the air to be no more than 12 µg/m3 of particles measuring less than 2.5 microns. In the European Union, the limit is 25 µg/m3, and regulatory agencies there are currently debating whether to lower it.

"This study comes at the right time to bring the issue to the attention of policy makers," said study co-author Mark Nieuwenhuijsen, PhD, of CREAL.

Nieuwenhuijsen observed that particulate air pollution in Beijing, China has recently been measured higher than 700 µg/m3.

"From the perspective of world health, levels like this are obviously completely unsustainable," he said.

Whether these pregnancy exposures can have effects later in life, currently is under investigation through an epidemiological follow-up of some of the children included in these studies.

Air pollution primes children for asthma-related cockroach allergy

Researchers at the Columbia Center for Children's Environmental Health untangle complex web of factors behind high rates of asthma in urban environment.

An allergic reaction to cockroaches is a major contributor to asthma in urban children, but new research suggests that the insects are just one part of a more complex story. Very early exposure to certain components of air pollution can increase the risk of developing a cockroach allergy by age 7 and children with a common mutation in a gene called GSTM may be especially vulnerable.

Researchers at the Columbia Center for Children's Environmental Health at the Mailman School of Public Health published the findings, the first on this interplay of risk factors, in the February 6 online edition of the Journal of Allergy and Clinical Immunology.

"Allergy to cockroach is one of the greatest risk factors for asthma in low-income urban communities," says lead author Matthew Perzanowski. PhD. "Our findings indicate a complex relationship between allergen and air pollution exposures early in life and a possible underlying genetic susceptibility. Combined, these findings suggest that exposures in the home environment as early as the prenatal period can lead to some children being at much greater risk for developing an allergy to cockroach, which, in turn, heightens their risk of developing asthma."

Dr. Perzanowski and his co-investigators looked at 349 mother-child pairs from the Center's Mothers & Newborns study of environmental exposures in Northern Manhattan and the Bronx. During the mother's pregnancy, exposure to cockroach allergen (protein in feces, saliva or other remnants of the insects) was measured by collecting dust from the kitchen and bed. Researchers also sampled air to measure the mother's exposure to polycyclic aromatic hydrocarbons, or PAH (combustion products that are harmful components of air pollution). Presence of the GSTM1 mutation was determined through blood samples. At ages 5 and 7, the children had blood tests to identify the presence of IgE antibodies—an immune marker of allergy.

The researchers found that 279 or 80% of homes tested positive for high levels of cockroach allergen. By age 7, 82 of 264 children tested, or 31%, had cockroach allergy. Presence of higher levels of cockroach allergen led cockroach allergy only in children whose mothers also had been exposed to higher levels of PAH during pregnancy. This result, the authors say, suggests that PAH enhances the immune response to cockroach allergen.

The combined impact of the two exposures was even greater among the 27% of children with a common mutation in the GSTM gene. This mutation is suspected to alter the ability of the body to detoxify PAHs.

The study suggests that minimizing exposure to PAH during pregnancy and to cockroach allergen during early childhood could be helpful in preventing cockroach allergies and asthma in urban children.

"Asthma among many urban populations in the United States continues to rise," says senior author Rachel Miller, MD. "Identifying these complex associations and acting upon them through better medical surveillance and more appropriate public policy may be very important in curtailing this alarming trend."

Mercury contamination in water can be detected with a mobile phone

Credit: J. M. García et al.

Chemists at the University of Burgos (Spain) have manufactured a sheet that changes color in the presence of water contaminated with mercury. The results can be seen with the naked eye but when photographing the membrane with a mobile phone the concentration of this extremely toxic metal can be quantified.

Mercury contamination is a problem that is particularly affecting developing countries. It poses a risk to public health since it accumulates in the brain and the kidneys causing long term neurological illnesses. It is emitted from industrial and mining waste, especially small-scale gold mining.

A team at the University of Burgos have now developed a technique for detecting the presence of this dangerous metal in water "in a cheap, quick and in situ way," as explained to SINC by José Miguel García, one of the authors of the study. Details have been published in the 'Analytical Methods' journal.

The method consists of placing the fine sheet created by the researchers in the water for five minutes. If it turns red, this signals the presence of mercury. "Changes can be seen by the naked eye and anyone, even if they have no previous knowledge, can find out whether a water source is contaminated with mercury above determined limits," outlines the lecturer García.

In addition, if we take a photograph of the sheet with a digital camera, like those in mobile phones or tablet computers, we can find out the concentration of the metal. We only need image treatment software (the team used the open access GIMP programme) to see the colour coordinates. The result is then compared with reference values.

The membrane contains a florescent organic compound called rhodamine, which acts as a mercury sensor. "Rhodamine is insoluble in water," says the researcher. "But we chemically fix it to a hydrophilic polymer structure in such a way that when put into water it swells and the sensory molecules are forced to remain in the aqueous medium and interact with mercury."

The exact composition of the sheet can be adjusted to the desired parameters. More specifically, the researchers have calibrated the sheet so that it changes colour when limits established by the Environmental Protection Agency (EPA) of the United States are exceeded: 2 ppb (parts per billion) of divalent mercury –Hg(II), one of the most reactive, in water destined for human consumption.

Having also developed a method for other elements like iron or cyanide, the researchers believe that the water drunk in Spain "is of excellent quality due to highly efficient controls." Therefore, the technique could be used there for detecting mercury in certain spills and for studying its presence in fish.

A global problem

A recent study by the United Nations Environment Programme (UNEP) demonstrates that a large part of human exposure to this toxic metal is due to consumption of contaminated fish.

Named the Global Mercury Assessment 2013, the report analysed for the first time the mercury released into the rivers and lakes around the whole world. The small-scale extraction of gold and the combustion of coal for electricity generation seem to be behind the increase in the emissions of developing countries.

As for the sea, in the last century the mercury quantity has doubled in the first hundred meters from the surface of the planet's oceans. Concentrations in deep water have also increased by up to 25%.

To stop the global contamination of this metal, in January more than 140 countries came together in Geneva and approved the start-up of the Minamata Convention, a new international binding regulation bearing the name of the Japanese city where hundreds of people died in the 1950's due to mercury poisoning.

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Geographic factors can cause allergies, asthma

Those living near the equator may find themselves sneezing and wheezing more than usual. And the reason may not be due to increasing pollen counts. According to a new study in the February issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), living in locations closest to the equator can put you at increased risk of developing allergy and asthma.

"UV-B rays exposure is higher for people living in areas closer to the equator," said Vicka Oktaria, MPH, lead study author. "This increase in UV-B may be linked to vitamin D, which is thought to modify the immune system. These modifications can lead to an elevated risk of developing allergy and asthma."

Previous studies have shown that latitude can reflect a variation in airborne allergens due to climate, housing and social and cultural differences. This study is one of the first using the individuals latitude location and UV-B exposure to examine the association with allergy and asthma.

"Allergies and asthma are serious diseases that can be life-threatening if not diagnosed and treated properly," said allergist Richard Weber, MD, ACAAI president. "Both conditions can be more than bothersome for people, no matter their geographic location, and can last year-round."

According to ACAAI, many people that have an allergy also experience asthma symptoms. In fact, an estimated 75 to 85 percent of asthmatics have an allergy.
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Scientists find modified tobacco can treat this deadly infection

Tobacco leaves

Sure breathing in that tobacco smoke may be bad for you, but apparently tobacco has some redeeming properties. Scientists have genetically modified tobacco plants to produce anti-bodies that treat rabies, a deadly infection contracted from an animal bite. The virus travels from the wound to the brain where it causes inflammation. The new antibody works by preventing the virus from attaching to nerve endings around the bite site and keeps the virus from traveling to the brain.

"Rabies continues to kill many thousands of people throughout the developing world every year and can also affect international travelers," said Leonard Both, M.Sc., a researcher involved in the work from the Hotung Molecular Immunology Unit at St. George's, University of London, in the United Kingdom. "An untreated rabies infection is nearly 100 percent fatal and is usually seen as a death sentence. Producing an inexpensive antibody in transgenic plants opens the prospect of adequate rabies prevention for low-income families in developing countries."


To make this advance, Both and colleagues "humanized" the sequences for the antibody so people could tolerate it. Then, the antibody was produced using transgenic tobacco plants as an inexpensive production platform. The antibody was purified from the plant leaves and characterized with regards to its protein and sugar composition. The antibody was also shown to be active in neutralizing a broad panel of rabies viruses.

Photo: freedigitalphotos.net

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Can An Air Purifier Really Ease Asthma Symptoms?

Asthma, an inflammatory disorder of the airways, has become a common respiratory condition affecting an astonishing 30 million people in North America. While the exact cause and cure of asthma is unknown, experts agree that effective asthma management involves controlling known environmental triggers that aggravate the airways. This is where an air purifier may play an effective role; by reducing exposure to airborne irritants that are known to affect respiratory health and indoor air quality.

 

An Air Purifier: Part of a Global Approach to Asthma Management

There are numerous factors that affect indoor air quality; therefore using an air purifier must be part of a global strategy to fight indoor pollutants. An air purifier will be most effective in environments where homeowners have first eliminated major sources of allergens and irritants. The prime offender in most homes is wall-to-wall carpeting. One study by the Canadian Mortgage and Housing Corporation found that a normal vacuuming, even with a High-Efficiency Particulate Air (HEPA) filter-equipped vacuum cleaner could not adequately reduce fine dust in a carpeted home. To make any substantial impact on indoor air quality homeowners had to vacuum four to five times successively. Other significant sources of indoor allergens include pets, dust mites in bedding and mattresses, pollen and mold. Another area of interest for health professionals is non-allergenic contaminants such as chemicals, odors and volatile organic compounds (VOCs). The Institute of Medicine (2000) suggests limiting exposure to these pollutants where practical.

Choosing An Air Purifier

An air purifier with a high-efficiency particulate air (HEPA) filter was traditionally recommended for the reduction of airborne irritants that worsen asthma symptoms. True HEPA filters are very effective at reducing fine airborne dust. They were first developed during the World War II era to prevent radioactive particles from escaping from government laboratories. These medical-grade HEPA filters remove 99.97% of particles 0.3 microns in diameter or larger. The disadvantage of a HEPA air purifier for asthma sufferers is that it is not designed to remove non-allergenic contaminants such as chemicals, odors and VOCs. With increasing evidence that other pollutants may also play a role in aggravating delicate airways, an air purifier with additional filtration capabilities may be a better investment. 

An AirPurifier with Activated Carbon Filtration
Some more advanced air purifier models for asthma air care incorporate other technologies such as activated carbon to adsorb airborne chemicals, gases, odors and VOC’s. Like HEPA, activated carbon filtration was also developed for the military, this time for use in gas masks. Activated carbon is a type of charcoal that has been treated with oxygen to open up millions of tiny pores and fissures into which pollutants are trapped. The surface area created by the activation process is so extensive, that the openings found in small handful of activate carbon could cover a football field. Granular carbon is considered the most effective for air filtration and a deeper bed of carbon will provide more surface area for chemicals, gases and odors to become trapped.

An AllerAir Air Purifier for Asthma Irritants and Triggers

Successful management of asthma involves the cooperative effort of the patient, their doctor and effective control of environmental triggers. An AllerAir air purifier is designed to remove the widest range of possible airway irritants producing cleaner, healthier indoor air. AllerAir air purifiers offer a powerful combination of HEPA filtration and deep-bed activated carbon filtration for cleaner indoor air over HEPA alone. To learn more about AllerAir air purifier models or specialty units for smoke odor, allergies or MCS contact an AllerAir air quality expert today at 1-888-852-8247 or connect via live chat, Facebook or Twitter.