I Wish I Were Far From the Madding Crowd

August 24, 2010

First report released on global economic burden of cancer

First Global Economic Cost of Cancer Report released by American Cancer Society and LIVESTRONG®

Press release

Also reported on the Global Fight Against Cancer Blog, “American Cancer Society and LIVESTRONG® Release First-of-its-kind Study ‘Global Economic Cost of Cancer’

Link to report summary

This was also reported on by the Associated Press, “Report: Cancer is the world’s costliest disease.”  Costs, not including direct medical costs, are estimated at $895 billion.

LIVESTRONG® also sponsored a report by The Economist Intelligence Unit, which presents the results of research and analysis on the health
and economic burden of cancer, global expenditures for cancer control and the funding gap relating to achieving a global expenditure standard for treatment and care.  (It’s not clear what the relationship between these two reports is.)

The Economist/LIVESTRONG® report on the global burden of cancer

LIVESTRONG® Summary

Full report: “Breakaway: The global burden of cancer—challenges and opportunities” (PDF, 73 pp.)

The primary collaborators on this project were Nancy Beaulieu and David E. Bloom of the Harvard School of Public Health, Lakshmi Reddy Bloom of Data For Decisions LLC and Richard M. Stein of the Economist Intelligence Unit.

The American Cancer Society reports that in 2009 the National Institutes of Health estimated the total cost of cancer as $228.1 billion.  That included direct medical costs and indirect costs due to loss of productivity due to illness and premature death.

The recent global report did not include direct medical costs.

Other resources

World Health Organization’s International Agency for Research on Cancer (IARC)

August 6, 2010

A chemical pot pourri

This is a real hodge-podge of items.

Bisphenol A

The Environmental Working Group (EWG) recently announced the findings of a study that found BPA in a large percentage of paper receipts it had collected.  http://ewg.org/BPA_Found_In_Receipts

Chemicals in cosmetics

Another resource EWG maintains is the Skin Deep cosmetic safety database.

http://www.cosmeticsdatabase.com/

Speaking of cosmetics, Annie Leonard (“The Story of Stuff”) has come out with “The Story of Cosmetics”, a look at chemicals in cosmetics and personal care products.  The Story of Stuff blog looks at the cosmetics industry’s reaction.

Learning and developmental disabilities and other diseases and conditions

The Collaborative on Health and the Environment (CHE) covers a wide range of topics, from learning and developmental disabilities to the CHE Toxicant and Disease Database, a searchable database that summarizes links between chemical contaminants and approximately 180 human diseases or conditions, to the Metabolic Syndrome Discussion Group.

BP (not just oil spills)

The CHE site also includes news items like:

6 Aug Thousands sign on for $10 billion BP suit. The revelation that BP’s Texas City refinery emitted toxic benzene for more than a month has ignited a furor in the port community that has suffered its share of deadly industrial accidents and toxic spills. Houston Chronicle.

Yes, before the BP oil spill there was the BP Texas City refinery explosion.  The U.S. Chemical Safety Board conducted an investigation.  I believe that they are looking into whether these incidents show that BP fostered a culture of cutting corners.

Chemicals and depression?

Was reading Peter Kramer’s Against Depression, where he argued that depression is a true illness.  (At least that’s what I’m getting out of it.)  He makes a couple of points that struck me.  One, on p. 156 he states that there is a connection between diabetes and depression.  Unfortunately, he doesn’t cite a source for that.  And if true, it’s not clear which caused which.  That is, does having diabetes make it more likely that you would be depressed?  Or does depression in some way connected to the development of diabetes.  Or could diabetes and depression be caused by the same agent?  (Or some combination of the above.)

He also talks about how long-term stress can result in increased levels of corticotropin and that such stress can lead to depression and illness.  Of course, corticotropin is but one element of the neuroendocrine system.  And with many of these things, there are feedback loops that get out of whack if enough recovery time is not available.  That’s actually why some scientists have proposed that a chronic lack of sleep can cause obesity over the long haul.  The International Agency for Research on Cancer and NIOSH are looking at whether “shift work” (along with a number of chemicals) can be considered carcinogenic.

Leptin: An example of what we didn’t know

Leptin, the appetite hormone, was not discovered until 1994 (though its effects had been observed much earlier).  (Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM (December 1994). “Positional cloning of the mouse obese gene and its human homologue”. Nature 372 (6505): 425–32. doi:10.1038/372425a0. PMID 7984236.) I mention that because chemical industry apologists seem to ignore the fact that we’ve learned a lot about the human body in the last 15-20 years.  And the more we learn, the more we discover how chemicals can mess up our systems.

Regarding leptin, I found the following using the National Library of Medicine’s MedlinePlus service.

A National Cancer Institute fact sheet on physical activity and cancer states that “increasing physical activity may influence insulin and leptin levels and influence breast cancer prognosis.”

An EPA report, “A Decade of Children’s Environmental Health Research:  Highlights from EPA’s Science to Achieve Results Program,” cites an EPA-funded study that found that “autistic children showed higher levels of leptin (a hormone that affects the regulation of body weight, metabolism, and reproductive function, and influences the immune system) in their blood when compared to typically developing children (Ashwood et al. 2007; R829388C002).”

Citation: Ashwood P., Kwong C., Hansen R., Hertz-Picciotto I., Croen L., Krakowiak P., Walker W., Pessah I.N., and Van de Water J. 2007. “Brief report: Plasma leptin levels are elevated in autism: association with early onset phenotype?” J. Autism Dev. Disord. Advanced online publication (DOI 10.1007/s10803-006-0353-1).  Abstract

So our bodies are these incredibly complex systems.  Some chemical companies would have you believe that the stuff they make, even the synthetic chemicals that human beings have never been exposed to before, have absolutely NO effect on our health.

Truth is, despite the Environmental Defense Fund saying that we’re not guinea pigs, we all are.  (See previous post: “Tired of being a guinea pig?“)

“Would you like BPA with those fries?”

May 11, 2010

President’s Cancer Panel recommendations for individuals

I had difficulty copying these from the 7+ MB report (my Adobe Acrobat kept crashing).  Then I discovered that Acrobat Reader 9 lets you save a PDF as text!

Full report URL – http://deainfo.nci.nih.gov/advisory/pcp/pcp08-09rpt/PCP_Report_08-09_508.pdf

Note: I added the links below—they were not in the original report (and they may or may not be sanctioned by the Panel or the U.S. government).

President’s Cancer Panel – What Individuals Can Do: Recommendations

Much remains to be learned about the effects of environmental exposures on cancer risk. Based on what is known, however, there is much that government and industry can do now to address environmental cancer risk. The Panel’s recommendations in this regard are detailed above. At the same time, individuals can take important steps in their own lives to reduce their exposure to environmental elements that increase risk for cancer and other diseases. And collectively, individual small actions can drastically reduce the number and levels of environmental contaminants.

CHILDREN

1. It is vitally important to recognize that children are far more susceptible to damage from environmental carcinogens and endocrine-disrupting compounds than adults. To the extent possible, parents and child care providers should choose foods, house and garden products, play spaces, toys, medicines, and medical tests that will minimize children’s exposure to toxics.
Ideally, both mothers and fathers should avoid exposure to endocrine-disrupting chemicals and known or suspected carcinogens prior to a child’s conception and throughout pregnancy and early life, when risk of damage is greatest.

CHEMICAL EXPOSURES

2. Individuals and families have many opportunities to reduce or eliminate chemical exposures. For example:

  • Family exposure to numerous occupational chemicals can be reduced by removing shoes before entering the home and washing work clothes separately from the other family laundry.
  • Filtering home tap or well water can decrease exposure to numerous known or suspected carcinogens and endocrine-disrupting chemicals. Unless the home water source is known to be contaminated, it is preferable to use filtered tap water instead of commercially bottled water.
  • Storing and carrying water in stainless steel, glass, or BPA– and phthalate-free containers will reduce exposure to endocrine-disrupting and other chemicals that may leach into water from plastics. This action also will decrease the need for plastic bottles, the manufacture of which produces toxic by-products, and reduce the need to dispose of and recycle plastic bottles. Similarly, microwaving food and beverages in ceramic or glass instead of plastic containers will reduce exposure to endocrine-disrupting chemicals that may leach into food when containers are heated.
  • Exposure to pesticides can be decreased by choosing, to the extent possible, food grown without pesticides or chemical fertilizers and washing conventionally grown produce to remove residues. Similarly, exposure to antibiotics, growth hormones, and toxic run-off from livestock feed lots can be minimized by eating free-range meat raised without these medications if it is available. Avoiding or minimizing consumption of processed, charred, and well-done meats will reduce exposure to carcinogenic heterocyclic amines and polyaromatic hydrocarbons.
  • Individuals can consult information sources such as the Household Products Database to help them make informed decisions about the products they buy and use.
  • Properly disposing of pharmaceuticals, household chemicals, paints, and other materials will minimize drinking water and soil contamination. Individuals also can choose products made with non-toxic substances or environmentally safe chemicals. Similarly, reducing or ceasing landscaping pesticide and fertilizer use will help keep these chemicals from contaminating drinking water supplies.
  • Turning off lights and electrical devices when not in use reduces exposure to petroleum combustion by-products because doing so reduces the need for electricity, much of which is generated using fossil fuels. Driving a fuel-efficient car, biking or walking when possible, or using public transportation also cuts the amount of toxic auto exhaust in the air.
  • Individuals can reduce or eliminate exposure to secondhand tobacco smoke in the home, auto, and public places. Most counseling and medications to help smokers quit are covered by health insurance or available at little or no cost.

RADIATION

3. Adults and children can reduce their exposure to electromagnetic energy by wearing a headset when using a cell phone, texting instead of calling, and keeping calls brief.

4. It is advisable to periodically check home radon levels. Home buyers should conduct a radon test in any home they are considering purchasing.

5. To reduce exposure to radiation from medical sources, patients should discuss with their health care providers the need for medical tests or procedures that involve radiation exposure. Key considerations include personal history of radiation exposure, the expected benefit of the test,
and alternative ways of obtaining the same information. In addition, to help limit cumulative medical radiation exposure, individuals can create a record of all imaging or nuclear medicine tests received and, if known, the estimated radiation dose for each test.

6. Adults and children can avoid overexposure to ultraviolet light by wearing protective clothing and sunscreens when outdoors and avoiding exposure when the sunlight is most intense.

SELF-ADVOCACY

7. Each person can become an active voice in his or her community. To a greater extent than many realize, individuals have the power to affect public policy by letting policymakers know that they strongly support environmental cancer research and measures that will reduce or remove from the environment toxics that are known or suspected carcinogens or endocrine-disrupting chemicals. Individuals also can influence industry by selecting non-toxic products and, where these do not exist, communicating with manufacturers and trade organizations about their desire for safer products.

May 10, 2010

President’s Cancer Panel report on “Reducing Environmental Cancer Risk”

Nicholas Kristof blogged about the President’s Cancer Panel (PCP) issuing its Annual Report for 2008-2009 entitled “Reducing Environmental Cancer Risk, What We Can Do Now,” in “New Alarm Bells About Chemicals and Cancer“.  While his blog is very informative, the report itself can be found at Annual Report for 2008-2009 (the URL for the PCP reports page is http://deainfo.nci.nih.gov/advisory/pcp/pcp.htm).

The Panel looked at Sources and Types of Environmental Contaminants, including Exposure to Contaminants from Industrial and Manufacturing Sources, Exposure to Contaminants from Agricultural Sources, Environmental Exposures Related to Modern Lifestyles, Exposure to Hazards from Medical Sources, Exposure to Contaminants and Other Hazards from Military Sources, and Exposure to Environmental Hazards from Natural Sources.

The text of the letter accompanying the report:

Though overall cancer incidence and mortality have continued to decline in recent years, the disease continues to devastate the lives of far too many Americans. In 2009 alone, approximately 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. With the growing body of evidence linking environmental exposures to cancer, the public is becoming increasingly aware of the unacceptable burden of cancer resulting from environmental and occupational exposures that could have been prevented through appropriate national action. The Administration’s commitment to the cancer community and recent focus on critically needed reform of the Toxic Substances Control Act is praiseworthy. However, our Nation still has much work ahead to identify the many existing but unrecognized environmental carcinogens and eliminate those that are known from our workplaces, schools, and homes.

To jumpstart this national effort, the President’s Cancer Panel (the Panel) dedicated its 2008–2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. In addition, key regulatory, political, industrial, and cultural barriers to understanding and reducing environmental and occupational carcinogenic exposures were identified. The attached report presents the Panel’s recommendations to mitigate or eliminate these barriers.

The Panel was particularly concerned to find that the true burden of environmentally induced cancer has been grossly underestimated. With nearly 80,000 chemicals on the market in the United States, many of which are used by millions of Americans in their daily lives and are un- or understudied and largely unregulated, exposure to potential environmental carcinogens is widespread. One such ubiquitous chemical, bisphenol A (BPA), is still found in many consumer products and remains unregulated in the United States, despite the growing link between BPA and several diseases, including various cancers.

While BPA has received considerable media coverage, the public remains unaware of many common environmental carcinogens such as naturally occurring radon and manufacturing and combustion by-products such as formaldehyde and benzene. Most also are unaware that children are far more vulnerable to environmental toxins and radiation than adults. Efforts to inform the public of such harmful exposures and how to prevent them must be increased. All levels of government, from federal to local, must work to protect every American from needless disease through rigorous regulation of environmental pollutants.

Environmental exposures that increase the national cancer burden do not represent a new front in the ongoing war on cancer. However, the grievous harm from this group of carcinogens has not been addressed adequately by the National Cancer Program. The American people—even before they are born—are bombarded continually with myriad combinations of these dangerous exposures. The Panel urges you most strongly to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase health care costs, cripple our Nation’s productivity, and devastate American lives.

What the Panel recommends people do….

April 2, 2010

Metabolic syndrome and exposure to persistent organic pollutants

Take a spoonful of sugar, add a pinch of chemicals that accumulate in fatty tissue, and voila, metabolic syndrome! So while Dr. Lustig may be on to something, it looks like fructose might not be the only thing to blame for the obesity epidemic.

The reason why persistent organic pollutants (POPs) are a problem is that they can bioaccumulate in fatty tissue.  (If fructose causes metabolic syndrome as Dr. Lustig says, and metabolic syndrome results in increased obesity, which in turn means more fatty tissue, and more fatty tissue can absorb more POPs, we would seem to have started a rather vicious cycle.)

The Editor’s Summary explains why the findings of this study are especially important (emphasis added).

The authors conclude that exposure to POPs through a diet high in fatty fish is capable of inducing insulin resistance and impairing both lipid and glucose metabolism. Furthermore, they found that n-3 polyunsaturated fatty acids failed to counteract the harmful metabolic effects of dietary POP exposure. This finding is important because the presence of n-3-polyunsaturated fatty acids in fish oil has been reported to have a wide range of beneficial effects, including protection against high-fat diet–induced insulin resistance. The authors conclude that there is a need to continue efforts to limit human exposure to dietary POPs even in foods containing protective factors such as polyunsaturated fatty acids.

Persistent Organic Pollutant Exposure Leads to Insulin Resistance Syndrome, Jérôme Ruzzin et al. Environmental Health Perspectives, 118(4) Apr 2010.

Related EHP news item:

Chew on This: Persistent Organic Pollutants May Promote Insulin Resistance Syndrome

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