Category Archives: Environmental Exposures

The last 50 years of smoking: cigarettes and what we know about them has changed

Diet, Habits, & Other Behaviors, Environmental Exposures, Prevention
Anna E. Mazzucco, Ph.D.

The U.S. Surgeon General just released an annual report on the negative health effects of smoking.  But this one marks the 50th anniversary of the very first report on smoking in 1964.  We’ve learned a lot about smoking in 50 years, and unfortunately most of the news is bad.

Many health problems in addition to Lung Cancer

While many people know that smoking comes with serious health risks, such as lung cancer and chronic obstructive pulmonary disease (COPD), the 50th anniversary report warns about less widely known risks. For example, smoking increases the risk of:

  • ectopic pregnancy (this type of pregnancy kills the fetus and the mother can also die or become infertile as a result)
  • birth defects
  • diabetes
  • heart disease
  • stroke
  • rheumatoid arthritis
  • difficulty getting or maintaining an erection (erectile dysfunction or ED).

Smoking also increases your chances of developing cancers. A United Kingdom study involving over 100, 000 women found a significant link between smoking and breast cancer. Over a 7-year period, about 2% of women who ever smoked developed cancer compared to about 1.6% of women who never smoked. This means that smoking causes about 4 in 1000 breast cancers. Even though that number seems small (less than half a percent), it is statistically significant. Starting smoking at a younger age, smoking 15 or more daily cigarettes, and smoking for at least 10 years increase the chances of developing breast cancer. If you smoke, you should talk to your doctor about ways to quit. Quitting decreases the chances of developing breast cancer, but it may take about 20 years to see the full benefits. To read more, click here.

Whether you’re a cancer patient, cancer survivor, or have no known health conditions, smoking puts you at greater risk of dying. Exposure to tobacco smoke while in the womb and smoking in the teenage years have both been shown to cause long-term problems regarding brain development.

 20 Million people have died from smoking since 1964

Although smoking has decreased over the 50 years—from 52% to 25% of adult men, and from 35% to 19% of adult women—the decline has slowed over the last two decades. However, among adults who never completed high school or who have a GED diploma, almost 1 in 2 are smokers.[end Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2011. Morbidity and Mortality Weekly Report. 2012; 61(44):889–94 [accessed 2014 Feb 10]  The report estimates that half a million Americans die from smoking every year, and this number has not changed in a decade. Smoking costs the U.S. economy about $100 billion per year, including direct medical costs and the indirect cost of lost productivity from employee sick time due to smoking-related illness.

The Surgeon General cautions that current efforts to reduce smoking are not getting as much support as they need.  While many states have received substantial funds from settlements with tobacco companies which were intended for tobacco control programs, this funding is frequently been spent elsewhere.  In 2013, Alaska was the only state to fund their tobacco control programs at the level recommended by the Centers for Disease Control and Prevention (CDC).

 What more should be done to reduce smoking?

In 2009, the FDA was given much more authority to regulate tobacco products, and in 2010, it made it illegal to sell tobacco products to anyone under 18, banned free samples of cigarettes, and prohibited cigarette brands from sponsoring music and other cultural events. While making public spaces smoke-free and increasing the price of cigarettes and other tobacco products has helped, we need to do more.  Most experts agree that effective tobacco control programs require a combination approach: public health campaigns supplemented by laws that limit where you can smoke, make cigarettes harder to buy, and ensure that programs to help people quit smoking are covered by all health plans.  Under the Affordable Care Act, Medicare, Medicaid and employer-sponsored insurance plans are required to cover medications to help with quitting.  Unfortunately, it is still unclear exactly what will be covered through the state insurance exchanges, even though they are subsidized through the federal government.

Of course, the ideal strategy is to prevent a person from starting to smoke, since tobacco is very addictive.  The Surgeon General’s report says more advertising campaigns targeting young people with anti-smoking messages are needed, since 87% of adult smokers had their first cigarette by age 18.  A study published in 2014 revealed that the nicotine dose from cigarettes increased 15% between 1999 and 2011, making them more addictive without any warning to consumers.[end Land T et al.  Recent Increases in Efficiency in Cigarette Nicotine Delivery: Implications for Tobacco Control.  Nicotine and Tobacco Research. 2014.]  That is only one example of a long history of misleading information from tobacco companies, which is why anti-tobacco ads are so important.  For example, the Surgeon General’s report details how “low-tar” cigarettes, advertised by tobacco companies as safer, were later found to be just as harmful.   In addition, other changes in cigarette design and content have also had unexpected health effects, such as increasing rates of one of the two most common types of smoking-related lung cancer, adenocarcinoma.

Once a person starts to smoke, all doctors and health experts agree: quitting smoking is one of the best things you can do for your health and the health of your loved ones, no matter how long you’ve been smoking.  Studies show that the health benefits of quitting kick in soon after you stop.   Twenty minutes after your last cigarette your high blood pressure will drop; within 3 months your lung function will improve; one year later your risk of heart disease will fall to half of what it was when you were smoking; and five years after your last cigarette your risk of several cancers will drop by half as well.[end S. A. Kenfield, M. J. Stampfer, B. A. Rosner, G. A. Colditz. Smoking and Smoking Cessation in Relation to Mortality in Women. JAMA: The Journal of the American Medical Association, 2008; 299 (17): 2037-2047.],[end Centers for Disease Control and Prevention. 2010 Surgeon General’s Report—How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. 2010.]  For information on how to quit, see this article.  If you are considering taking medication to help with quitting, check out this article.  And if you are thinking of using e-cigarettes to cut back on regular cigarettes, you should know that there are many unanswered questions about the risks of e-cigarettes and almost no research to support their use in smoking cessation. For more on e-cigarettes, read here.  Many e-cigarette brands are owned by tobacco companies which have been caught lying to the American public about the risks of their products repeatedly.

 

Phthalates and Children’s Products

Environmental Exposures, Other Cancers, Prevention
Paul Brown, Keris Krenn Hrubec, Dana Casciotti, PhD, Brandel France de Bravo, MPH, Stephanie Fox-Rawlings, PhD, Cancer Prevention & Treatment Fund

Phthalates are synthetic chemicals found in every home, in plastic toys, personal care products such as shampoos and lotions, vinyl floors, and shower curtains. They are also found in some medical products, such as saline bags, feeding tubes and catheters. They are used to make plastic flexible and to add fragrances to soap and other personal products.  Unfortunately, these chemicals don’t stay inside the products. Based on recent research on ants, scientists have concluded that the high levels of phthalates in the bodies of insects around the world are the result of phthalates in the air.[1] Because phthalates are released into the air and dust around us, they are found in human urine, blood, and breast milk.[2] Levels are highest in women and children ages 6 to 11. Young children may have higher levels of phthalates in their bodies because their hands find their way into their mouths more frequently: they touch objects made with phthalates and surfaces covered with phthalate dust, and then their hands touch their mouths.

Phthalates are called “endocrine disruptors” because they affect the body’s hormones by mimicking them or blocking them. They interfere with the body’s natural levels of estrogen, testosterone, and other hormones, which is why they are called “disruptors.” Endocrine disruptors are hard to study for several reasons: 1) we are exposed to very small quantities from many different sources every day, 2) researchers have proved that, unlike other chemicals, these appear to have more serious effects at lower levels than at higher levels.[3] Usually, we assume that the higher the dose or exposure, the greater the harm, but endocrine disruptors play by different rules. The director of the National Institute of Environmental Health Sciences, Linda Birnbaum, says that chemical manufacturers are asking “old questions” when they test for safety even though “science has moved on.”[4]

Hormones can increase the risk of some cancers, whether those hormones are natural or synthetic. Too much or too little of a hormone can be harmful. Is a child who is exposed to phthalates more likely to develop cancer as an adult?  No one knows for sure but animals exposed to phthalates are more likely to develop liver cancer, kidney cancer, and male reproductive organ damage.[5]

Phthalates are believed to also affect girls’ hormones, but the health impact is not yet known. Studies also show associations between children’s exposure to phthalates and the risk of asthma, allergies and bronchial obstruction.[6][7][8]

Researchers at Mount Sinai also found a link between obesity and phthalates.[9] They found that among overweight girls ages 6 to 8, the higher the concentration of certain phthalates (including low molecular weight phthalates) in their urine, the higher their body mass index (BMI).  BMI takes height and weight into account when determining if someone is overweight. A study among Danish children ages 4 to 9 found that the higher the concentration of phthalates (all of them), the shorter the child. This was true for girls and boys.[10] More research is needed to determine the impact of phthalates on height and BMI.

Even short-term exposure has now been linked to developmental deficits.[11] Researchers found that children in intensive care units were exposed to the phthalate DEHP through plastic tubing and catheters. The children had 18 times (!)  as much DEHP in their blood compared to children who had not spent time in the ICU. Four years later, the children who had been exposed to DEHP had more problems with attention and motor coordination. The researchers found that the DEHP caused these problems regardless of medical complications or treatments.

Prenatal Exposure to Phthalates

Childhood exposure to phthalates begins in the womb. Several studies that have tested phthalate levels in women in their third trimester of pregnancy have found health effects in the infants, toddlers, and older children of the mothers with the highest levels. There are many different types of phthalates. Most studies look at several types, and the effects tend to vary by type.  A 2011 study found that six-month-old boys whose mothers had the highest phthalate levels scored lower on brain and motor development tests.[12] The same effect was not true for female infants.

Research indicates that boys exposed to phthalates while in the womb may be more likely to develop smaller genitals and incomplete descent of the testicles.[13] Boys who are born with undescended testicles are 2-8 times more likely to develop testicular cancer later on than men born with both testicles descended[14] (their risk is lessened if they get corrective surgery before age 13.[15]). Studies by Harvard researchers have shown phthalates may alter human sperm DNA and semen quality.[16][17][18][19]

Columbia University researchers discovered that three-year olds with high prenatal exposure to two types of phthalates were more likely to have motor delays.[20] They also reported that three phthalates were linked to certain behavior problems in three-year olds, such as social withdrawal.  One phthalate in the study was linked to lower mental development in girls.

Other studies have also linked increased prenatal phthalate exposure to behavior problems. Researchers in Taiwan found an association with aggressive and disobedient behaviors in eight-year-olds of both sexes.[21][22] Similarly, researchers from Icahn School of Medicine at Mount Sinai found that higher levels of exposure to phthalates during gestation were associated with aggression, rule-breaking, and conduct problems for males only.[23]

Researchers at Mount Sinai School of Medicine studied the impact of prenatal exposure to “low molecular weight” phthalates—the kind often found in personal care products and the coatings of some medications—on the social behavior of children ages 7 to 9. Children who were exposed to higher levels of these phthalates, which include DEP and DBP, had worse scores for social learning, communication, and awareness.  This means they were less able to interpret social cues, use language to communicate, and engage in social interactions.[24]

What Is Being Done to Limit Children’s Exposure?

As of February, 2009, children’s toys and child care products sold in the U.S (such as teething rings and plastic books) cannot contain certain phthalates.  The ban on those phthalates is the result of a law passed in 2008, the Consumer Product Safety Improvement Act.  The law permanently bans certain kinds of phthalates (BBP, DBP and DEHP) from toys and child care products, and temporarily bans other phthalates (DIDP, DINP and DnOP) until a scientific board (the Chronic Hazard Advisory Panel) determines for the Consumer Product Safety Commission (CPSC) whether or not they are safe. In 2014 the Chronic Hazard Advisory Panel determined that stricter regulations were appropriate.[25] It stated that the permeant bans should remain on BBP, DBP and DEHP, and that DINP should be added to this list. Furthermore, because a large component of exposure to these chemicals comes from food and other products, it recommended increased regulation. The panel was less concerned about DIDP and DnOP, but recommended additional study. Finally, the panel recommended permanently banning DIBP, DPENP, DHEXP, and DCHP, and putting an interim ban on DIOP.

A few months before the 2008 bill passed, major retailers such as Wal-Mart, Target, and Babies “R” Us promised to remove or severely restrict children’s products containing phthalates by the end of 2008.[26] That provided added incentives for major companies making teething rings and other soft plastic products to stop using phthalates.

The ban in the U.S.followed similar bans in other countries.  In 2006, the European Union banned the use of 6 phthalates in toys that may be placed in the mouth by children younger than 3 years old.[27] The banned phthalates are DINP, DEHP, DBP, DIDP, DNOP, and BBzP.  Fourteen other countries, including Japan, Argentina, and Mexico, had also banned phthalates from children’s toys prior to the U.S.

Phthalate Exposure Continues

A 2014 study looking at data over a ten-year period (2001– 2010) found that exposures to some phthalates have declined while others have increased. Americans’ exposure to three substances permanently banned in toys and children’s products—DEHP, DBP and BBP—has declined. But exposure to other phthalates such as DiNP and DiBP, as measured in urine, has increased. The higher  levels of DiBP and other phthalates “suggest that manufacturers may be using them as substitutes for other phthalates even though the US EPA has expressed concern about their use.”[28] It is surprising that DiNP exposure has gone up since it was banned on an interim basis from children’s toys and children’s products.  Additionally, in 2013, California declared DiNP a carcinogen.[29]

Even with the ban on phthalates in children’s toys, children, and adults, too, continue to be exposed because these chemicals are in many products, including food packaging, pharmaceuticals, medical devices and tubing, soap, lotions, and shampoos.[30] Johnson & Johnson recently reformulated its baby shampoo to remove harmful chemicals,[31] and Proctor & Gamble has promised to eliminate the phthalate DEP from fragrances used in its products by the end of 2014.[32] DEP is used in personal care products  and “reductions in DEP exposures have been the most pronounced,” according to the 2014 study.[33] Ten years ago, more than a thousand companies pledged to remove “chemicals of concern from personal care products,” however, it is unclear how many have done so. The U.S. Food and Drug Administration (FDA) regulates many of these products, including baby shampoo and baby lotion.  If the FDA does not decide to ban phthalates from these products, legislation would be required to do so.

The U.S. Environmental Protection Agency (EPA) developed an “action plan” in 2010 for eight phthalates “because of their toxicity and the evidence of pervasive human and environmental exposure.” [34] The phthalates are being studied for health effects and for alternatives. The EPA developed two new rules for these chemicals. However, the rules were delayed and then withdrawn in 2013.[35] In 2014, seven of these phthalates were included in the Toxic Substances Control Act work plan, because of their potential for harm and the frequency of exposure.[36] The eighth phthalate (DnPP) was not included because it is no longer being used in new products. The chemicals on the work plan are to be assessed for additional study or regulation, but it is unclear when that assessment will occur.

While other government agencies are concerned about phthalates in specific products, the EPA’s job is to focus on the chemicals for use in any kind of product and establish safety standards for each phthalate.  A challenge for the EPA is to set safety standards that make sense given that people may be exposed to several phthalates from many different sources. Teenage girls, for instance, have been found to use up to 17 personal care products a day.[37] Setting safety standards for phthalates individually or for individual products without considering their interactions and cumulative effects could underestimate the real-world risks of phthalates to the health of children and adults.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

References

  1. Rudel RA, Brody JG, Spengler JD, Vallarino J, Geno PW, Sun G, Yau A (2001). Identification of selected hormonally active agents and animal mammary carcinogens in commercial and residential air and dust samples. Journal of Air and Waste Management Association 51(4):499-513.
  2. Kato K, Silva MJ, Reidy JA, Hurtz D, Malek NA, Needham LL, Nakazawa H, Barr DB, Calafat AM (2003). Mono(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-oxhexyl) phthalate as biomarkers for human exposure assessment to di-(2-ethylhexyl) phthalate. Environmental Health Perspectives 112: 327-330.
  3. Vandenberg et al. (2012). Hormones and Endocrine Disrupting Chemicals: Low-dose Effects and Nonmonotonic Dose Responses. Endocrine Reviews.  First published ahead of print March 14, 2012 as doi:10.1210/er.2011-1050.
  4. Cone, Marla and Environmental Health News. Low Doses of Hormone-Like Chemicals May Have Big Effects. Scientific American.march 15, 2012. http://www.scientificamerican.com/article.cfm?id=low-doses-hormone-like-chemicals-may-have-big-effects.
  5. Vastag, B., (2001). CDC Unveils First Report on Toxins in People, JAMA 285(14): 1827-1828.
  6. Jaakkola JJ, Knight TL (2008 July). The Role of exposure to phthalates from polyvinyl chloride products in the development of asthma and allergies: a systematic review and meta-analysis. Environ Health Perspect, 116(7): 845-53.
  7. Kanazawa A, Kishi R (2009 May). Potential risk of indoor semivolatile organic compounds indoors to human health. Nippon Eiseigaku Zasshi, 64(3): 672-82.
  8. Hsu NY, Lee CC, Wang JY, et al. (2012). Predicted risk of childhood allergy, asthma, and reported symptoms using measured phthalate exposure in dust and urine. Indoor Air. 22(3): 189-99.
  9. Teitelbaum SL, Mervish N, L Moshier E, Vangeepuram N, Galvez MP, Calafat AM, Silva MJ, L Brenner B, Wolff MS. (2012, January).Associations between phthalate metabolite urinary concentrations and body size measures in New York City children. Environmental Research 112:186-193.
  10. Boas M, Frederiksen H, Feldt-Rasmussen U, Skakkebaek NE, Hegedus L, Hilsted L, et al. (2010). Childhood exposure to phthalates: associations with thyroid function, insulin-like growth factor I, and growth. Environmental Health Perspectives 118:1458-1464.
  11. Verstraete S, Vanhorebeek I, Covaci A, Güiza F, Malarvannan G, Jorens PG, Van den Berghe G. (2016). Circulating phthalates during critical illness in children are associated with long-term attention deficit: a study of a development and a validation cohort. Intensive Care Med 42(3):379-92.
  12. Yeni Kim Y, Eun-Hee Ha, Eui-Jung Kim, et al. (2011). Prenatal Exposure to Phthalates and Infant Development at Six Months: Prospective Mothers and Children’s Environmental Health (MOCEH) Study, Environmental Health Perspectives. 119(10): 1495-500.
  13. Main KM, Skakkebaek NE, Virtanen HE, Toppari J (2010). Genital anomalies in boys and the environment. Best Pract Res Clin Endocrinol Metab.Apr;24(2):279-89.
  14. Toppari J, Kaleva M. Maldescendus testis. Horm Res 1999;51:261-9.
  15. Pettersson A et al. (2007) Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine 356:1835-41.
  16. Duty, S. M., M. J. Silva, et al., (2003). Phthalate exposure and human semen parameters. Epidemiology 14(3): 269-77.
  17. Duty, S. M., N. P. Singh, et al., (2003). The relationship between environmental exposures to phthalates and DNA damage in human sperm using the neutral comet assay. Environ Health Perspect 111(9): 1164-9.
  18. Duty, S. M., A. M. Calafat, et al., (2004). The relationship between environmental exposure to phthalates and computer-aided sperm analysis motion parameters. J Androl 25(2): 293-302.
  19. Duty, S. M., A. M. Calafat, et al., (2005). Phthalate exposure and reproductive hormones in adult men. Hum Reprod 20(3): 604-10.
  20. Whyatt RM, Liu X, Rauh, VA, Calafat AM, Just AC, Hoepner L, Diaz D, et al. (2012). Maternal prenatal urinary phthalate metabolite concentrations and child mental, psychomotor and behavioral development at age three years.  Environmental Health Perspectives 120(2):290-5.
  21. Lien YJ, Ku HY, Su PH, Chen SJ, Chen HY, Liao PC, Chen WJ, & Want SL (2015). Prenatal Exposure to Phthalate Esters and Behavioral Syndromes in Children at 8 Years of Age: Taiwan Maternal and Infant Cohort Study. Environ Health Perspect 123(1): 95–100.
  22. Prenatal Phthalate Exposures and Neurobehavioral Development Scores in Boys and Girls at 6–10 Years of Age. Environ Health Perspect 122(5): 521–528.
  23. Kobrosly RW, Evans S, Miodovnik A, Barrett ES, Thurston SW, Calafat AM, & Swan SH (2014).
  24. Miodovnik A, Engel SM, Zhu C, et al. (2011). Endocrine disruptors and childhood social impairment.  Neurotoxicology Mar;32(2):261-7.
  25. CPSC. Chronic Hazard Advisory Panel on Phthalates and Phthalate Alternatives. 2014. http://www.cpsc.gov/PageFiles/169902/CHAP-REPORT-With-Appendices.pdf
  26. Pereira, J. and Stecklow, S. (2008, May). Wal-Mart Raises Bar on Toy-Safety Standards, The Wall Street Journal.
  27. Sathyanarayana S, Swan SH et al., (2008, February). Baby Care Products: Possible Sources of Infant Phthalate Exposure, Pediatrics, Vol. 121, No. 2.
  28. Zota AR, Calafat AM, & Woodruff TJ (Advance on-line publication January 15, 2014) Temporal Trends in Phthalate Exposures: Findings from the National Health and Nutrition Examination Survey, 2001-2010.
  29. Lee SM, (January 15, 2014). Banned chemicals replaced by worrisome ones, UCSF study shows. SFgate.com (San Francisco Chronicle).
  30. U.S. Food and Drug Administration (2008). Phthalates and Cosmetic Products. Retrieved November 4, 2009 at http://www.fda.gov/Cosmetics/ProductandIngredientSafety/SelectedCosmeticIngredients/ucm128250.htm
  31. Thomas K (January 17, 2014). The ‘No More Tears’ Shampoo, Now With No Formaldehyde. The New York Times. http://www.nytimes.com/2014/01/18/business/johnson-johnson-takes-first-step-in-removal-of-questionable-chemicals-from-products.html.
  32. Prcoter & Gamble Web site: What are Phthalates?  Accessed January 22, 2014. http://www.pg.com/en_US/sustainability/safety/ingredients/phthalates.shtml.
  33. Zota AR, Calafat AM, & Woodruff TJ (Advance on-line publication January 15, 2014) Temporal Trends in Phthalate Exposures: Findings from the National Health and Nutrition Examination Survey, 2001-2010.
  34. EPA. Phthalates Action Plan Summary. http://www.epa.gov/assessing-and-managing-chemicals-under-tsca/phthalates.
  35. Sheppard Kate (September 6, 2013). EPA Quietly Withdraws Two Proposed Chemical Safety Rules. Huffington Post. http://www.huffingtonpost.com/2013/09/06/epa-chemical-safety_n_3882262.html.
  36. EPA. TSCA Work Plan for Chemical Assessments: 2014 Update. https://www.epa.gov/sites/production/files/2015-01/documents/tsca_work_plan_chemicals_2014_update-final.pdf
  37. Environmental Working Group. 2008. Sutton R. Adolescent exposures to cosmetic chemicals of concern. http://www.ewg.org/research/teen-girls-body-burden-hormone-altering-cosmetics-chemicals.

Are E-Cigarettes Safer Than Regular Cigarettes?

Diet, Habits, & Other Behaviors, Environmental Exposures, Lung Cancer, Prevention, Uncategorized
Brandel France De Bravo, MPH, Sarah Miller, Jessica Becker, and Laura Gottschalk, PhD, Cancer Prevention & Treatment Fund

Electronic cigarettes, or e-cigarettes, are being marketed as the “safe” new alternative to conventional cigarettes. But are e-cigarettes safe?  What does the FDA think about them?  Are e-cigarettes going to reverse the decline in smoking—giving new life to an old habit—or can they help people quit smoking? Here is what you need to know before picking up an e-cigarette.

What Are E-Cigarettes?

Electronic cigarettes (e-cigarettes) are battery operated devices that used to be shaped like cigarettes but are now sometimes shaped to look like a flash drive, toy, or candy. They contain nicotine, which is an addictive drug that is naturally found in tobacco.  Nicotine is what makes regular cigarettes addictive and e-cigarettes also allow nicotine to be inhaled, but they work by heating a liquid cartridge containing nicotine, flavors, and other chemicals into a vapor. Because e-cigarettes heat a liquid instead of tobacco, what is released is considered smokeless.[1]

Are E-Cigarettes Safer Than Traditional Cigarettes?

The key difference between traditional cigarettes and e-cigarettes is that e-cigarettes don’t contain tobacco.  But, it isn’t just the tobacco in cigarettes that causes cancer. Traditional cigarettes contain a laundry list of chemicals that are proven harmful, and e-cigarettes have some of these same chemicals.

Since 2009, FDA has pointed out that e-cigarettes contain “detectable levels of known carcinogens and toxic chemicals to which users could be exposed.”[2] For example, in e-cigarette cartridges marketed as “tobacco-free,” the FDA detected a toxic compound found in antifreeze, tobacco-specific compounds that have been shown to cause cancer in humans, and other toxic tobacco-specific impurities.[3] Another study looked at 42 of these liquid cartridges and determined that they contained formaldehyde,  a chemical known to cause cancer in humans.[4] Formaldehyde was found in several of the cartridges at levels much higher than the maximum EPA recommends for humans.

The body’s reaction to many of the chemicals in traditional cigarette smoke causes long-lasting inflammation, which in turn leads to chronic diseases like bronchitis, emphysema, and heart disease.[5f] Since e-cigarettes also contain many of the same toxic chemicals, there is no reason to believe that they will significantly reduce the risks for these diseases.

There are no long-term studies to back up claims that the vapor from e-cigarettes is less harmful than conventional smoke. Cancer takes years to develop, and e-cigarettes were only very recently introduced to the United States. It is almost impossible to determine if a product increases a person’s risk of cancer or not until the product has been around for at least 15-20 years. Despite positive reviews from e-cigarette users who enjoy being able to smoke them where regular cigarettes are prohibited, very little is known about their safety and long-term health effects.

Can E-Cigarettes Be Used to Cut down or Quit Smoking Regular Cigarettes?

If a company makes a claim that its product can be used to treat a disease or addiction, like nicotine addiction, it must provide studies to the FDA showing that its product is safe and effective for that use. On the basis of those studies, the FDA approves or doesn’t approve the product. So far, there are no large, high-quality studies looking at whether e-cigarettes can be used to cut down or quit smoking long-term. Most of the studies have been either very short term (6 months or less) or the participants were not randomly assigned to different methods to quit smoking, including e-cigarettes. Many of the studies are based on self-reported use of e-cigarettes. For example, a study done in four countries found that e-cigarette users were no more likely to quit than regular smokers even though 85% of them said they were using them to quit.[6] Another year-long study, this one in the U.S., had similar findings.[7] People may believe they are smoking e-cigarettes to help them quit,  but 6-12 months after being first interviewed, nearly all of them are still smoking regular cigarettes.

Until there are results from well-conducted studies, the FDA has not approved e-cigarettes for use in quitting smoking.[8]

Teenagers, Children, and E-Cigarettes

The percentage of teenagers who have tried e-cigarettes has almost quadrupled in just four years, from 5% in 2011 to 19% in 2015.  Three million U.S. students in middle school and high school tried e-cigarettes in 2015, according to the National Youth Tobacco Survey.  And, 1 in 5 middle schoolers who said they had tried e-cigarettes also said they had never smoked conventional cigarettes.[9]

E-cigarette use by young people is worrisome for a number of reasons:

1) The younger people are when they begin smoking, the more likely it is they will develop the habit: nearly 9 out of 10 smokers started before they were 18.[10]

2) Nicotine and other chemicals found in e-cigarettes might harm brain development in younger people.[11]

3) E-cigarettes may introduce many more young people to smoking who might otherwise never have tried it, and once they are addicted to nicotine, some may decide to get their “fix” from regular cigarettes. Whether e-cigarettes end up being a “gateway” to regular cigarettes or not, young people who use them risk becoming addicted to nicotine and exposing their lungs to harmful chemicals.

The sharp rise in young e-cigarette users highlights the need to stop manufacturers from targeting teenagers with candy-like flavors and advertising campaigns.

Even children who are too young to smoke have been harmed by e-cigarettes. The liquid used in e-cigarettes is highly concentrated, so absorbing it through the skin or swallowing it is far more likely to require an emergency room visit than eating or swallowing regular cigarettes. In 2012, less than 50 kids under the age of six were reported to poison control hotlines per month because of e-cigarettes. In 2015, that number had skyrocketed to about 200 children a month, almost half of which were under the age of two![12]

How Are E-Cigarettes Regulated?

The FDA was given the power to regulate the manufacturing, labeling, distribution and marketing of all tobacco products in 2009 when President Obama signed into law the Family Smoking Prevention and Tobacco Control Act and in 2010 a court ruled that the FDA could regulate e-cigarettes as tobacco products.[13]

It wasn’t until 2016 that the FDA finally announced a rule to regulate e-cigarettes.[14] Under the final rule, the FDA plans to ban the sale of e-cigarettes to anyone under the age of 18.  The rule also requires all makers of e-cigarettes sold after February 15, 2007 to go through a “premarket review.” This is the process that the FDA uses to determine whether potentially risky products are safe. However, companies are allowed to have anywhere from 18 months to two years to prepare their applications. And it will take another year for the FDA to actually approve these applications. So don’t expect e-cigarettes currently on the market to be officially allowed to be sold by the FDA for another couple of years.

In the meantime, individual states have always had the power to pass laws restricting the sale and use of e-cigarettes. For example, in May 2013, the California state senate proposed a law making all e-cigarettes subject to the same regulations and restrictions as traditional cigarettes and tobacco products.  However, that did not become law.

The Bottom Line

E-cigarettes have not been around long enough to determine if they are harmful to users in the long run.  Unfortunately, many people, including teenagers, are under the impression that e-cigarettes are safe or that they are effective in helping people quit smoking regular cigarettes.  Neither of these assumptions has yet been proven. Studies by the FDA show that e-cigarettes contain some of the same toxic chemicals as regular cigarettes, even though they don’t have tobacco.  The big three tobacco companies—Lorillard, Reynolds American, and Altria Group—all have their own e-cigarette brands, so it’s not surprising that e-cigarettes are being marketed and advertised much the way regular cigarettes used to be.  Here are the 7 Ways E-Cigarette Companies Are Copying Big Tobacco’s Playbook.

Unless you want to be a guinea pig, hold off on e-cigarettes until more safety information is available.  And if you need help quitting or reducing the number of cigarettes you are smoking, check out the smokefree.gov website.

Related Content:

Quitting smoking: women and men may do it differently
Third-hand smoke
Smoking cessation products

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff. 

References

  1. Richard J. O’Connor Non-cigarette tobacco products: What have we learned and where are we headed? Tob Control. Author manuscript; available in PMC 2013 July 19. Published in final edited form as: Tob Control. 2012 March; 21(2): 181–190. doi: 10.1136/tobaccocontrol-2011-050281.
  2. “Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA.” FDA News & Events. FDA, 22 July 2009. http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm173146.htm.
  3. “Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA.” FDA News & Events. FDA, 22 July 2009. Web. 09 Aug. 2013. http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm173146.htm.
  4. Varlet et al. (2015) Toxicity of refill liquids for electronic cigarettes. International Journal for Environmental Research and Public Health. 12:4796-4815.
  5. Stoller, JK & Juvelekian, G; Chronic Obstructive Pulmonary Disease; 2010 Cleveland Clinic Center for Continuing Education. https://my.clevelandclinic.org/departments/respiratory/depts/chronic-obstructive-pulmonary-disease.
  6. Adkison SE, O’Connor RJ, Bansal-Travers M, et al. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013;44(3):207-215.
  7. Grana RA, Popova L, Ling PM. A Longitudinal Analysis of Electronic Cigarette Use and Smoking Cessation. JAMA Internal Medicine, published online March 24, 2014
  8. “Electronic Cigarettes” FDA News & Events. FDA, 25 July 2013. http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm
  9. Singh T, Arrazola RA, Corey CG, et al. Tobacco Use Among Middle and High School Students – United States, 2011-2015. CDC Morbidity and Mortality Weekly Report. April 15, 2016. 65(14);361-367.
  10. Centers for Disease Control and Prevention. Fact sheets: Youth and tobacco use.  http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/.
  11. US Department of Health and Human Services. Preventing tobacco use among youth and young adults. Atlanta, GA: US Department of Health and Human Services, CDC; 2012. http://www.cdc.gov/tobacco/data_statistics/sgr/2012/index.htm.
  12. Kamboj A, Spiller HA, Casavant MJ, et al. Pediatric Exposure to E-Cigarettes, Nicotine, and Tobacco Products in the United States. Pediatrics. May 2016. In Press.
  13. “Regulation of E-Cigarettes and Other Tobacco Products.” FDA News & Events. FDA, April 25, 2011. http://www.fda.gov/newsevents/publichealthfocus/ucm252360.htm.
  14. Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products. 21 CFR Parts 1100, 1140, and 1143 (2016).
  15. Vaping Could Up Risks for Asthma, COPD and Other Lung Diseases. Dec 16, 2019. (HealthDay) Newshttps://consumer.healthday.com/cancer-information-5/electronic-cigarettes-970/vaping-could-up-risks-for-asthma-copd-and-other-lung-diseases-753003.html

Phthalates Q&A

Environmental Exposures, Other Cancers
By Paul Brown & Stephanie Fox-Rawlings, PhD
Updated 2016

Phthalates are synthetic chemicals found in everyday plastic products, including toys, children’s care products, medical tubes and saline or blood bags, and food packaging. They are used to make plastic flexible.  They are also used in many personal care products that smell good, such as shampoo and creams, as well as air fresheners. The use of some phthalates is being restricted in some products; however, they are still very common. Phthalates can leach out of the plastic to cause health problems, especially for young children.

Q: Animals exposed to phthalates are more likely to develop serious diseases and health problems, such as liver cancer, kidney cancer, and male reproductive organ damage1, but have any studies shown that phthalates cause health problems in humans?

A: Yes, studies by Harvard researchers have shown that phthalates may damage human sperm DNA, reduce sperm numbers, and reduce its mobility2, and another study from several major medical centers has found that phthalates may cause genital changes for boys.3 Mount Sinai researchers found that girls exposed to more phthalates were more likely to be overweight.[end Wolff MS. (2012, January).Associations between phthalate metabolite urinary concentrations and body size measures in New York City children. Environmental Research 112:186-193] Other studies have shown that being exposed to phthalates increases the chance of developing asthma, allergies and bronchial obstruction.4

Q: Can phthalate exposure affect a child’s behavior?

A: Yes, prenatal exposure to phthalates and/or as a young child increases the chances of cognitive and behavior problems.5 Higher levels of phthalates have been associated with attention and memory problems, increased aggression and law-breaking behaviors, as well as poor social skills.

Q: Have scientists representing the European Union concluded that phthalates are safe?

A: No, in 2006, the European Union banned the use of 6 phthalates in toys that may be placed in the mouth by children younger than 3.6 The banned phthalates are DINP, DEHP, DBP, DIDP, DNOP, and BBzP. More recently the European Union banned the use of DEHP, BBP, DBP and BiBP in electronic equipment starting in 2019. The chemicals cause environmental and health hazards during recycling or disposal.7

Q: How are phthalates regulated in the US?

A: As of February 2009, U.S. law bans children’s toys and child care products related to sleep or feeding that contain the phthalates BBP, DBP, or DEHP. Toys or items that can be placed in a child’s mouth cannot contain DIDP, DINP, or DnOP.8 In 2014, the Chronic Hazard Advisory Panel recommended banning DIBP, DPENP, DHEXP, DCHP, and DIOP.9 The Consumer Protection and Safety Commission (CPSC) followed with a proposed a rule to ban DIBP, DPENP, DHEXP, and DCHP in children’s toys and care products.10 However a final rule (and thus the ban) has not been published. The Environmental Protection Agency (EPA) has planned to assess seven phthalates under the Toxic Substances Control Act, which could limit their use in all kinds of products.11 These are DBP, DIBP, BBP, DEHP, DnOP, DINP, and DIDP. However, it is unclear when assessment will occur.

Q: If phthalates are banned, will the toy industry start using unsafe alternatives?

A:  No, federal legislation requires that alternatives to the banned phthalates are not hazardous under the Federal Hazardous Substance Act.8 Manufactures are also required to sufficiently test their product to insure it will not cause injury through normal use or predictable misuse.

Q: Should the Consumer Product Safety Commission (CPSC) establish federal regulations for phthalates that preempt state laws?

A: That would be a bad idea because some States have better laws than the federal government. The CPSC is a small agency that has a hard time keeping up with reports of unsafe products that are sold in the U.S. In 2015, CPSC recalled more than 600 distinct products, including 52 for children and babies.11 The states of California and Washington have passed strong laws to protect adults and children from unsafe products, and it would be inappropriate for federal laws to interfere. California has listed six phthalates (DBP, DEHP, BBP, DINP, DIDP, and DNHP) on their Prop 65 lists of chemicals known to cause cancer, birth defects or reproductive harm.12 In Washington state, the definition of “children’s product” is broader that that used by the CPSC. Therefore, there are some children’s products that cannot be sold in the state of Washington but are not banned by the CPSC. Examples include children’s cosmetics or clothing that are not packaged as toys.13

For more information, contact Dr. Diana Zuckerman or Paul Brown at (202) 223-4000 or by e-mail at dz@center4research.org and pb@center4research.org

Home sweet home? Flame retardants in your home can harm you

Environmental Exposures
By Abigail Fredenburg, PhD, Caitlin Kennedy, PhD, Anna Mazzucco, PhD
Updated 2016

Could your couch increase your chances of getting cancer? Possibly. Studies show that every day we are exposed to chemicals that were intended to protect us from household fires but are hazardous to our health.14 15 Toxic flame retardants are used in upholstered furniture such as couches, chairs, and mattresses, as well as in drapery and carpets. They are even in our televisions and plastic-cased electronics. Flame retardants have also been found in foam in baby products such as baby carriers, high chairs, strollers, and nursing pillows.16

Who invited cancer-causing chemicals into our homes?

At one time, It made sense to require flame retardants that would prevent or slow the spread of fire, but we now know those same chemicals can cause cancer. They also can affect children’s growth and brain development.

Dr. Linda Birnbaum, the director of the National Institute of Environmental Health Services, explains that new research used 3-D imaging to demonstrate how synthetic flame retardants “interfere with the body’s natural hormones.”17 When chemicals affect adult hormone levels, they can be very harmful, such as reducing fertility or harming a developing fetus.

Other research shows how this can affect children’s learning. University of Cincinnati’s Dr. Aimin Chen and colleagues studied pregnant women and their children to determine the effect of prenatal exposure on learning and behavior. The researchers measured the amount of common flame retardants in 301 pregnant women at 16 weeks of pregnancy and tested their children during their first 5 years of life. Pregnant women with higher levels of flame retardants had children who tended to have more learning problems at ages 2, 3, 4, and 5 years, and the children also were more likely to be hyperactive.18

Another important way that young children are exposed to flame retardant chemicals is through their crib mattresses. The volatile organic compounds (VOCs) in crib mattresses come from the foam stuffing, usually made of polyurethane or polyester. Studies from the last ten years suggest that exposure to these chemicals increases the risk of asthma and lung infections in young children.19 20 A study from 2014 revealed that infants may be at greater risk from the chemicals in crib mattresses than adults for several reasons: their small size means there is less distance between a baby’s body and the mattress, and babies generate more body heat while sleeping which causes more chemicals to be released into the air that they breathe. Also, babies sleep more hours a day than adults do, lengthening the time they are exposed to the mattress chemicals.21

These findings have important implications for children’s health and are why previous flame retardants, such as brominated “Tris,”were banned from use in children’s pajamas in the late 1970s and chemicals called PentaBDE and OctaBDE were phased out of commercial products, beginning in 2004.22 23 Despite these laws, we are still exposed to these and even more harmful chemicals. Why? Because banned chemicals are replaced by new chemicals that we don’t yet know much about. As shown in recent studies, these new chemicals can also be dangerous, and in some cases may be more dangerous. Researchers found higher-than-expected levels of one such chemical, organophosphate esters, in the outdoor air in 5 sites around the U.S. Great Lakes. This new chemical was found in amounts 100 to 1,000 times higher than older PBDE’s.24

Even after flame retardants are phased out, we keep getting exposed when we use old furniture passed on to family members, or sold at garage sales. Because there is no standard process to safely dispose of furniture containing flame retardants, these chemicals remain in our environment via discarded furniture, dust, and air.2 Flame retardant chemicals can even be measured in tree bark. Research shows the highest levels are in densely populated areas, such as Toronto, Canada, but high levels are also found in remote regions of Indonesia and Nepal.25

Researchers at Duke University led a national study to identify flame retardant chemicals in the polyurethane foam used in couches. TDCPP was the most commonly detected flame retardant, often used to replace PentaBDE and OctaBDE in couches manufactured after their 2004 phase out. TDCPPcan cause cancer and is very similar to the Tris that was banned decades ago. Of the 102 couches tested, researchers detected toxic flame retardants in 85% of them.26

In a second study conducted by the Silent Spring Institute, dust samples were collected from 16 homes in California. House dust is the primary way Americans are exposed to toxic flame retardants, by inhaling and ingesting them.1 Researchers found Tris in 75% of the homes despite its ban from children’s pajamas more than 30 years ago and its listing in California as a chemical known to cause cancer.

California has a higher furniture flammability standard than other states, known as Technical Bulletin 117 (TB117). Because of its large size, it is often easier for companies to follow California’s standards for all their products, not just those sold in California. Manufacturers also make their products comply with TB117 to protect themselves against law suits.27 But, as a result, they are risking consumers’ health by exposing Americans to higher levels of flame retardants in their homes than they would otherwise be.28

In general, California’s stricter standards (on organic foods and on air quality, for instance) have paved the way for protections across the country, but in the case of flame retardants, their standards have been harmful.

We all depend on government regulators to keep us as safe as possible, by making our homes, cars, airplanes, foods, and medicines as safe as possible. Unfortunately, current standards for flame retardant furniture are not based on solid research.29 Fortunately, California has responded to criticisms of their standards by adopting new guidelines in November 2013 based on the latest research. The new guidelines require upholstery and fabric covers to be smolder proof, a new test that simulates fires from a lit cigarette. The changes are meant to more accurately reflect the situations that usually lead to fires in homes, and make it possible for manufacturers to use lower amounts of less toxic chemicals. As a consequence, manufacturers will use different, and presumably safer, flame retardants for products sold in California and across the country. The changes went into effect in January 2015.30 31

Since many of us can’t buy all new furniture to help reduce exposure to these toxic chemicals, we need to try to keep our homes as dust free as possible. Remember, as these flame retardants are released or shed from upholstered furniture and other household products, they accumulate in house dust. Vacuum regularly, use a wet-mop, and wash your hands frequently. Have young children who spend a lot of time on the floor wash their hands regularly, too.

If you are thinking of buying a new mattress or furniture, the Green Science Policy Institute provides a reference guide for furniture made without added flame retardants.32 There are now also many “green” furniture companies that use all natural and non-toxic materials like wool and organic cotton that are not only better for you and your family, but also for the environment. In 2015, Ikea, Wal-Mart Stores Inc., Ashley Furniture industries Inc. and Macy’s Inc. stated they would ban flame retardants from all their furniture, although it is not clear when the bans would be in place.33 34 Keep in mind that not all furniture comes with a tag outlining what it is made from. You may want to check online to find out more before you buy furniture that could expose yourself and your loved one to chemicals for years to come.

The bottom line is that reducing dust in your home, maintaining or replacing old furniture and making careful decisions about new purchases are important steps for keeping a healthy home!

Children and Cell Phones: Is Phone Radiation Risky for Kids?

Brain Cancer, Environmental Exposures, Prevention, , , , ,
Hannah Kalvin

Children use cell phones to watch TV, play games, make phone calls, and send text
messages.  Many older kids and teens have their own cell phones, which they are attached to kid texting24/7. But are there risks to such frequent use by children, and if so is that different than the risks for adults?

Cell phones emit a type of radiation that is known as Radio Frequency-Electromagnetic Radiation (RF-EMR), also referred to as microwave radiation. There have been concerns from the scientific community about whether or not cell phones are safe. Cancer is a particular concern, but since cancers take 10-20 years to develop and children’s frequent cell phone use is a relatively recent development, there are more questions than answers.  To read more about whether we should be worried about cell phone radiation in general, read our article here.

There are several studies of the impact of cell phone radiation on children. Here are some of the conclusions so far:

  • A 2010 study of cell phone radiation noted that, “in general and on average, children suffer a higher exposure of their brain regions than adults.”  This is because children have proportionally smaller heads and brains, yet receive the same levels of cell phone radiation as adults.35 The American Academy of Pediatrics agrees, saying that “when used by children, the average RF energy deposition is two times higher in the brain and 10 times higher in the bone marrow of the skull, compared with mobile phone use by adults.”36
  • Another study found that people who begin using cell phones (and cordless landline phones) before the age of 20 are at an even higher risk of developing brain tumors than people who begin using these wireless phones as adults.37,38 This is because of the closer proximity of the source of radiation to the brain of kids (they have thinner tissues and bones than adults).
  • Research also suggests that cell phone exposure could affect children’s behavior.39 The children in the study who were hyperactive or had emotional or behavioral problems, including trouble getting along with other kids, were much more likely to have mothers who used cell phones during pregnancy. After accounting for other factors that could affect behavior, the children of these mothers were 80% more likely to have behavioral problems than children whose mothers rarely or didn’t use cell phones. However, this is difficult to study because mothers who use cell phones frequently during pregnancy or after the baby is born, may pay less attention to their children, resulting in the children’s bad behavior. More research is needed to understand the link between mother’s cell phone use and children’s behavior.
  • Children that used cell phones more were more likely to have ADHD. Although the link to ADHD was only for children who also had high levels of lead in their blood, when researchers adjusted for blood lead level, they still found that ADHD was more likely for children who made more phone calls and spent a longer amount of time on the phone.40 This study was conducted in Korea, so it would be important to do similar research on children living in other countries.
  • A 2014 article reviewing studies on children and their cell phone use found that the younger the child, the greater the risk of brain cancer and brain tumors. The same article also points to studies concluding that cell phones are associated with an increased risk of breast cancer (due to adolescents putting cell phones in their bras), parotid (salivary) gland tumors, and sperm damage for adolescents and adults.41

Reactions To Research About Cell Phone Radiation

In 2012, the American Academy of Pediatrics wrote a letter to the Federal Communications Commission, which sets the standards for cell phone radiation in the United States, and recommended that they reevaluate these standards since this had not been done since 1996. Their reasoning is that “children, however, are not little adults and are disproportionately impacted by all environmental exposures, including cell phone radiation.”2 But, as of 2015, the FCC still says that there is no evidence between wireless device use and health problems and continues to uphold the regulations from 1996.42 Other countries have taken a different approach. As of 2014, Turkey, Belgium, Australia, and France have warned about the dangers of children’s cell phone usage.7

 

Conclusions

Scientists disagree on whether cell phone radiation can cause cancer or other health problems.  Since so many children and adults use cell phones so frequently, that makes it difficult to do a study comparing high and low cell phone usage.  And since brain tumors and other cancers usually do not develop until several decades after the initial exposure, it could be years before we know how risky cell phones are and under what circumstances.7

By the time we find out, many people will have been harmed if cell phones are found to be dangerous. Here are some precautionary tips on how to protect your children from the health issues that could be connected to cell phone radiation.43

  1. Turn airplane mode on when giving a child a technology device or when a cell phone is near a pregnant abdomen, to prevent exposure to radiation.
  2. Turn off wireless networks and devices to decrease your family’s radiation exposure whenever you aren’t actively using them. As an easy first step, turn your Wi-Fi router off at bedtime.
  3. Decrease use of phones or wifi where wireless coverage is difficult, in order to avoid an increase in radiation exposure.
    The warning about RF exposure found on an iPhone 5s.
    The warning about RF exposure found on an iPhone 5s.
  4. Use the speaker phone or a plug in earpiece when you use a cell phone. To protect children from radiation, they should not use cell phones except in emergency and should use the speaker phone.
  5. Increase the distance between you and your cell phone whenever it is on, to reduce your exposure to radiation emitted. For example, do not use a cell phone while a child is on your lap, and do not carry your cell phone in your baby carrier, crib, or pockets. When the phone is on, tell your kids to put it in a backpack as far from their body as possible (such as an outside pocket) or on the desk or other furniture at home, instead of holding it or carrying it in a pocket.
  6. Read the fine print: All device manufacturers advise that cell phones should be at least 5 millimeters, or about ¼ of an inch away from your body or brain. With the iPhone 6 and the iPhone 6s, the company advises users to keep the cell phone at least 10 millimeters, or about half an inch, away from your body or brain. See the safe distance for your phone. For iPhone 5 and iPhone 6, this is located under: Settings -> General -> About -> Legal -> RF Exposure.
  7. Share this info with your friends, family, and schools so that they can make these simple changes as well.

 

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.

Agent Orange and Serious Diseases including Multiple Myeloma

Environmental Exposures, Other Cancers
Nicholas J. Jury, PhD and Diana Zuckerman, PhD
2015

It has taken many years to determine how Agent Orange exposure during the Vietnam War has harmed the health of those who were exposed. One of the reasons is that it can take decades for cancer to develop after a dangerous exposure.  Agent Orange was used extensively by the United States military during the Vietnam War to clear vegetation to make it easier to see enemy soldiers. Agent Orange was contaminated with dioxin, making it more dangerous to humans. Nearly 1.5 million veterans were exposed to Agent Orange during the war 44  when approximately, 20 million gallons of Agent Orange were sprayed over Vietnam during Operation Ranch Hand. 45,46

Although more research is still needed to learn more about the risks of Agent Orange, by 2012, the Institute of Medicine had concluded that individuals exposed to Agent Orange are more likely to develop these types of cancers and serious diseases 47:

Cancers:

  • Chronic B-cell leukemia
  • Chronic lymphocytic leukemia
  • Hodgkin disease
  • Non-Hodgkin lymphoma
  • Prostate cancer
  • Respiratory cancers (bronchus, larynx, lung, and trachea)
  • Soft tissue sarcoma

Serious diseases:

  • Early-onset peripheral neuropathy
  • High blood pressure
  • Ischemic heart disease
  • Parkinson disease
  • Stroke
  • Type 2 diabetes

The report also stated that some of the children being born to those exposed had spinal cord birth defects. 48

New research indicates Agent Orange also increases the chances of developing a type of cancer of the bone marrow called multiple myeloma.

Veterans who have been exposed to Agent Orange or other herbicides during military service are eligible to receive Veterans Administration health care benefits and compensation for respiratory cancers without having to prove the connection between their disease and exposure.  49

Does Agent Orange cause Multiple Myeloma?

Bone marrow is crucial for making new blood cells. Multiple myeloma causes blood cells to accumulate in the bone marrow and interfere with the process of making new blood cells. 50  Patients who develop multiple myeloma are usually diagnosed first with a condition called monoclonal gammopathy of undetermined significance (MGUS). 51, 52  Patients who have MGUS tend to develop multiple myeloma, and this risk increases over time. 53  More than 26,000 people are expected to be diagnosed with multiple myeloma this year, and less than half are predicted to survive. 54

In its 2012 report, the Institute of Medicine stated that there was insufficient evidence to conclude that exposure to Agent Orange can cause multiple myeloma. 55  However, a study published in a cancer journal in 2015 reported that veterans who were exposed to Agent Orange were 2.4 times more likely to develop MGUS than the veterans who were not exposed to it. 56  The study was based on 958 veterans who served in the United States Air Force during Operation Ranch Hand. This study provides compelling evidence that Agent Orange exposure can increase the risk of multiple myeloma.

Tanning beds: safe alternative to sun?

Diet, Habits, & Other Behaviors, Environmental Exposures, Prevention, Skin Cancer
By Heidi Mallis, B.A and Diana Zuckerman, PhD
Updated 2015

For many years, tanning beds were advertised as a safe alternative to a natural suntan, but in fact, there was no evidence that was true.  No U.S. government agency evaluated sun lamps, tanning beds, or tanning booths to make sure they were safe.  As a result, nearly 30 million people in the U.S. were using tanning beds each year57, 2.3 million of whom were adolescents.58

Research evidence was growing about the risks of tanning beds.  According to the American Academy of Dermatology and the World Health Organization, indoor tanning increases a person’s chances of developing melanoma by 59 percent, and the risk goes up with each use.59

Finally, in 2014 the U.S. Food and Drug Administration (FDA) announced that all sun lamps and UV lamps intended for use in sun lamp products must come with warnings include the following:

  • This product is contraindicated for persons under the age of 18 years;
  • This product must not be used if skin lesions or open wounds are present;
  • This product should not be used on people who have had skin cancer or a family history of skin cancer
  • People repeatedly exposed to UV radiation should be regularly evaluated for skin cancer3

As evidence grew of the link between tanning beds and skin cancer, especially for men and women in their 20s, more than 60% of states passed some kind of legislation restricting the use of tanning salons by children under 18 and two states, California and Vermont, have passed complete bans of indoor tanning for minors.60

What does this mean for you?

Tanning beds expose the user to a lot of artificial UV radiation in a short period of time. Just one 8-20 minute session exposes a person to more UV radiation than an entire afternoon spent in natural sunlight. In fact, doses of UV radiation emitted by high pressure sunlamp products may be up to 10 to 15 times higher than that of the midday sun, which is more intense than UV radiation found in nature.

A study conducted by Dr. S. Elizabeth Whitmore and Dr. Warwick Morison of Johns Hopkins University School of Medicine found that ten tanning sessions in two weeks produced evidence of a suppressed immune system among participants. This means that the body is less capable of fighting off infectious agents.61 Tanning bed use is also associated with faster skin aging because the UV radiation destroys skin fibers and damages elasticity. Characteristics of skin aging include wrinkles, dark spots, and a leathery texture.62

The International Agency for Research on Cancer lists tanning beds in its highest cancer risk category, “carcinogenic to humans.” This means that there is enough evidence to conclude that tanning beds can cause cancer in humans. Prior to 2009, the agency, which is part of the World Health Organization (WHO), previously classified tanning beds as “probably carcinogenic.” The change came after an analysis of more than 20 epidemiological studies indicating that people who begin using tanning devices before age 30 are 75% more likely to develop cutaneous melanoma, the most serious type of skin cancer63

Skin cancer is the most common form of cancer, with more than one million cases diagnosed each year in the U.S. There are three types of skin cancer: squamous cell, basal cell, and melanoma. Squamous cell carcinomas typically occur on surfaces exposed to the most sunlight, such as the ears or face. This type of skin cancer can spread quickly to other organs in the body. Basal cell carcinomas account for 8 out of 10 skin cancers. They grow very slowly and rarely spread to other parts of the body (as a result, they are highly treatable). Melanomas are the third and most dangerous type of skin cancer. They are less common than basal and squamous cell carcinomas but much more serious.64 Melanomas usually present as a change to an existing mole or an entirely new mole that is black or has a blue-black area. Their diameter is typically larger than that of a pencil eraser. If caught early, melanomas are often completely curable. However, they are much more likely to spread to other parts of the body if not found early.65

Risk factors for all three types of skin cancer include:

  • Lifetime exposure to UV radiation (from natural or artificial sources)
  • Family history of skin cancer
  • Geographic location (people who live close to the equator as well as in the mountains are exposed to higher levels of UV radiation)
  • Fair skin that freckles or burns easily
  • Severe sunburns as a child
  • Radiation therapy

Here are a few ways to lower your risk and avoid wrinkles and other skin damage:

  • Avoid direct sun exposure during midday hours (from 10 am-4 pm),
  • Use sunscreen with a sun protection factor (SPF) of at least 15
  • Regularly check your skin for any new moles, sores, or scaly patches (and visit a dermatologist if you notice the lesion changing form or color), and
  • Avoid using a tanning bed or booth (especially if you are a child, teenager, or young adult).66

Keeping track of moles and other changes to your skin are an easy way to improve your skin health. However, the U.S. Preventive Services Task Force suggests that if you are not at an increased risk of developing skin cancer, there is no need for yearly skin checks by a dermatologist.67

Continue to monitor any existing or new moles and contact your doctor if you detect any significant changes in size, shape, or color.

 

Are Pesticides, Roundup, and Cancer in Children Connected?

Diet, Habits, & Other Behaviors, Environmental Exposures,
By Prianka Waghray and Avni Patel
2022

In murder mysteries, rat poison and pesticides intentionally added to food are sometimes used to kill.  Scientists have also warned they can cause birth defects.  However, more recent research shows that relatively low levels of pesticides and indoor bug sprays can cause cancer and other serious medical problems in children, and possibly adults.

A study published in 2020 found that children exposed to pesticides are more likely to develop cancer later in life. The study highlights an urgent need to prevent and child’s exposure to pesticides 1. Although it was already known that many chemicals used in pesticides, such as certain organophosphates, can cause cancer, the study aimed to find out how much exposure is likely to cause cancer in children.

The evidence about the risks of various chemicals has been growing. There is some evidence that high level of exposures to pesticides, especially among farm workers, may increase the chances of developing lung cancer, but more research is needed on which pesticides are most likely to cause harm 2. In 2019, a University of  Washington study showed that the use of a widely used weed killer called Roundup increases the chances of contracting non-Hodgkin lymphoma by 21% 3.  Children are especially vulnerable to even small amounts of insecticides and pesticides that are meant to kill rodents or insects, even in tick and flea sprays used on pets, because children are smaller than adults and their bodies and brains are still developing.  Roundup, which has been banned in 41 countries as of 2021 due to health concerns, as well as other weed killers are currently being investigated by scientists to learn more about the risks for adults and children. 4.

Even before the latest study, the American Academy of Pediatrics (AAP), which is the nonprofit organization for pediatricians, warned that children can be harmed by pesticides in their daily life.5. The AAP concludes that exposure to pesticides early in life can result in childhood cancers, behavioral problems, and lower scores on tests to measure thinking, reasoning, and remembering. They recommend that parents reduce their children’s exposure to pesticides as much as possible, by controlling bugs and other pests using non-chemical methods whenever possible, and by reducing the amount of pesticides in what children eat and drink.

Several studies have found, for instance, that children exposed to organophosphates, which are common in household insecticides, in their early years tend to have lower IQ and more likely to show the behaviors typical of autism and attention deficit and hyperactivity disorders.6

Several cancer-causing organophosphates have been banned from household pesticides. Unfortunately, they have been replaced with other organophosphates that have not yet been studied. Whether or not these chemicals cause cancer, they can be dangerous and children should not be exposed to them.8

Young children are more likely to be exposed to more pesticides and insecticides than adults because they are closer to the ground and often put whatever they find there, along with their own fingers, in their mouths. When bug spray or other pesticides are used in the home, chemical residues can linger in the air, on the floor or carpet where children crawl and play, and on toys.68 Children breathe in more pesticide than adults, too, because they are down low where the chemicals accumulate. Lawn and garden weed killers can be tracked in the house by pets or people, and left in carpets and rugs.

How can we reduce children’s exposure to pesticides?

The good news is that parents can reduce their children’s exposure to these chemicals. The easiest way is to stop using them in your home and garden. It is also safer to use roach motels, ant baits, and mouse traps instead of chemical sprays. You can weed the yard by hand instead of using weed killers (at least while your children are young).

What about the fruits and vegetables that you buy?  Be sure to wash, scrub, and peel fruits and vegetables if you don’t buy organic produce. Although washing and peeling fruits and vegetables doesn’t get rid of the pesticides that have been absorbed into the growing vegetable or fruit, it is still better than nothing. However, if you can afford to buy them, organic fruits and vegetables have the least amount of pesticide on and inside the fruit or vegetable.69

One way to reduce the use of bug sprays and other chemicals in the home is to not leave out food overnight that can attract bugs or rodents. Discourage rats by covering garbage cans.

If you must use pesticides, use the ones that are less toxic. If you aren’t sure how a product kills pests, look at the label. According to the EPA, pesticides with “warning” on the label are more dangerous to humans than the ones that say “caution.” Products with labels that say “danger” are the most harmful.70 71 Besides using the lowest risk products, be careful where you store pesticides, so that children can’t reach them and the chemicals won’t contaminate foods or medicines.

Is buying organic really better for you?

Researchers at Stanford University have concluded that organic fruits and vegetables are not more nutritious than other produce. However, they also found that children who eat organic produce have significantly lower levels of pesticides in their bodies than children who eat regular produce.72,73,74

Unfortunately, organic fruits and vegetables are not always available, and they are often more expensive. One way to eat organic less expensively is to limit your organic purchases to the fruits and vegetables on the Environmental Working Group’s (EWG) Dirty Dozen list.75 These are the 12 fruits and vegetables that tend to have the highest amount of pesticide residues. The list is constantly being updated based on recent test results so check it regularly (http://www.ewg.org/foodnews/). There is also a Clean 15 list, which lists 15 foods that have the least amount of pesticides and, therefore, are safe even when they are not organic. By following these lists, you can feed your children more safely without breaking the bank.

As of Feburary 2022, the Dirty Dozen consists of the following foods:

  1. Strawberries
  2. Dirty dozen; peachesSpinach
  3. Kale, collard, and mustard greens
  4. Nectarines
  5. Apples
  6. Grapes
  7. Cherries
  8. Peaches
  9. Pears
  10. Bell and hot peppers
  11. Celery
  12. Tomatoes

The Clean 15 list consists of the following foods, where it is not necessary to buy organic:

  1. Avocados
  2. Sweet Corn
  3. Pineapples
  4. Onionsclean 15; red onions
  5. Papaya
  6. Sweet Peas (frozen)
  7. Eggplant
  8. Asparagus
  9. Broccoli
  10. Cabbage
  11. Kiwi
  12. Cauliflower
  13. Mushrooms
  14. Honeydew Melon
  15. Cantaloupe

THE BOTTOM LINE

Even small amounts of pesticides are very harmful for children. They may cause behavior problems, harm children’s thinking and memory, and increase their risk of childhood cancers.  These chemicals can also harm adults, especially after years of exposure.  To help prevent these problems, limit your use of bug sprays, weed killers, and other pesticides and herbicides and buy organic fruits and vegetables that would otherwise have a lot of pesticide residue.

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff. 

 

Can cell phones harm our health?

Brain Cancer, Environmental Exposures
By Diana Zuckerman, PhD, Brandel France de Bravo, MPH, Dana Casciotti, PhD, Megan Cole, MPH, Krista Brooks, BS, Hannah Kalvin

You’ve probably heard about news stories claiming that “cell phones are dangerous” and others claiming that “cell phones have been proven safe.” It’s hard to know what to believe-especially when we’ve grown so dependent upon these convenient communication devices.

Should We Be Worried?

Have you ever read the fine print in your cell phone manual? All manuals say not to hold cellphonethe phone next to your ear, but how many of us actually talk on cell phones while holding them an inch away?

There have been concerns, from both scientists and the media, that cell phone usage is linked to tumor development. The extensive use of cell phones is a relatively recent phenomenon, and since cancers usually take at least 10-20 years to develop, it will be years before research is likely to conclude whether cell phones cause cancer or not.  In addition, the long-term risks of cell phone use may be much higher for children than adults.

International organizations have been researching this issue. The International Agency for Research on Cancer (IARC), which is part of the World Health Organization (WHO), brought together scientists, including those with financial ties to cell phone companies, to review all relevant data on radiation from wireless handheld devices such as cell phones. This type of radiation is known as Radio Frequency-Electromagnetic Radiation (RF-EMR), also referred to as microwave radiation.  The IARC concluded that the evidence suggests this radiation is “possibly carcinogenic to humans,” and that there wasn’t enough research evidence to conclude that cell phones are dangerous or that they are safe.76

This resulted in the IARC creating the Interphone Project, an international effort (that did not include the United States) to investigate the risk of tumors from cell phones. After the 10-year project was finished in February 2012, scientists found that due to biases present in the study, no strong conclusions could be made.77

The Centers for Disease Control and Prevention, or CDC, called for caution in cell phone use because of “the unresolved cancer question” in 2014. However, the CDC removed this statement from their website soon after.78 Critics assume it was removed because of political pressure from cell phone companies. Currently, the CDC says that more research is needed on this topic since “there is no scientific evidence that provides a definite answer.”79

What Does Research Tell Us About Cell Phones, Tumors And Other Health Issues?

In 2007, a published review of 18 studies of cell phones and brain tumors, concluded that studies of individuals using cell phones for more than 10 years “give a consistent pattern of an increased risk for acoustic neuroma and glioma,” with the risk being highest for a tumor on the same side of the head that the phone is used.80 Gliomas are the most common cancerous brain tumor, and most gliomas are malignant (and usually fatal). Acoustic neuromas are benign tumors of the acoustic nerve that can cause deafness.  In 2012, the same authors reviewed even more studies and also conducted a meta-analysis that combined the results of all the studies. These analyses confirmed the 2007 conclusions about the increase in acoustic neuromas and gliomas.81 However, a study conducted in 2013 found that while long-term cell phone use was associated with acoustic neuromas, it did not predict gliomas.82 In contrast, a study of 1,339 cell phone users, published in 2014, found that the heaviest cell phone users had an increased chance of developing gliomas.  These heaviest users, who had a total of over 900 hours of cell phone usage, were found to have spent an average of 54 minutes on the phone per day.83 Although the results of studies on the effects of cell phones are inconsistent, probably related to how the time spent on cell phones is increasing over time, there is a trend toward showing that cell phone usage is associated with brain tumors.

A 2015 study in Germany also identified a connection between cell phone radiation and tumor growth. Researchers found that in comparison to a known cancer-causing agent, weak cell phone signals were more likely to promote tumor growth. Although this study was carried out in mice, it implies that cell phone radiation may negatively affect human health more than previously thought and that limits for cell phone radiation need to be lower.84

Scientists in countries around the world have published their own results on other health problems that appear to be a result of increasing cell phone usage. the following health problems connected to cell phone radiation:

  • salivary gland tumors85,86
  • dizziness and migraines87
  • less sleep and poor sleep quality88
  • increases and decreases in production of specific proteins in human cells89
  • decreased sperm count and quality90,91,92
  • skin irritation, especially on the face (this is a condition known as electrohypersensitivity)93,94
  • behavioral problems and increased chance of cancer tumor development in children. You can read more about this here.

Meanwhile, cell phone companies continue to insist that the evidence shows that their cell phones are safe. Cell phone companies tend to draw conclusions based on the studies they funded themselves, and those studies have always found cell phones are safe.   In addition, many of those studies were conducted years ago, when cell phone usage was much lower for the average person than it is today.

Controversies On Cell Phone Research Results

Underlying the controversy about cell phone radiation is the belief by most physicists that cell phone radiation could not possibly cause cancer.  Although epidemiological research seems to suggest otherwise, that is undermined by other factors: cancer takes a very long time to develop, cell phone technology and frequency of usage has changed dramatically, and any link between cancer and cell phones could possibly be caused by unknown exposures or traits.  Additionally, there is potential for biases and errors in the collection of data in these studies, which could result in inaccurate conclusions. For example, many researchers questioned the Interphone study because they thought that risk was underestimated. Research is needed to determine the true effect of cell phones on different cancers.

Different Types Of Studies: How Can Researchers Get To The Bottom Of This?

There is a consensus among researchers that retrospective studies present problems and that prospective studies are needed. Retrospective studies are ones that look back in time to study or measure risk, such as whether past cell phone use makes a person more likely to develop cancer or other health problems. But people may not remember their past behaviors accurately and researchers have no way to verify the information.  Unless they use phone records, retrospective studies are also subject to “recall bias,” which means people with a disease might remember the past differently than people without a disease. In the case of cell phones, people with brain tumors may exaggerate their past cell phone use in an attempt to find an explanation for the inexplicable.  An analysis published in 2015 shows that information used for many retrospective studies may not be reliable because numerous brain tumor cases are not reported to the Swedish Cancer Register, the database that has commonly been used to try to disprove any connection between cell phones and tumors.95

Prospective studies are ones that follow people over time and monitor the health problems that arise in the different groups during the study period.  A prospective study of cell phone users would have to compare the health of infrequent users (controls) to heavy users (cases) but it is becoming increasingly difficult to find people who never use cell phones. In addition, any study started now would take at least 10 years to have useful information about the development of cancer; by that time, millions of people would have been harmed if cell phone radiation is dangerous.

Wireless technologies are proliferating daily, and different countries have different limits on radiation from wireless devices, which is why more and better designed research is urgently needed to determine safe levels of exposure.  And yet, as noted above, it is increasingly difficult to design and conduct studies that will answer key questions anytime soon.

Precautions You Can Take

Scientists recognize that most people are not going to stop using cell phones. Since many studies suggest that there may be risks, experts recommend that cell phone users take some precautions:

  • Limit the number of calls you make.
  • Limit the length of your calls.
  • Use hands-free devices (wired cell phone headsets or wireless ones like Bluetooth).
  • If you are not using a hands-free device, put the cell on “speaker phone” or hold the phone away from your ear.
  • When speaking on your cell phone, alternate sides.
  • Avoid carrying your phone in your pocket, on your belt, or anywhere close to your body since cell phones emit radiation even when they are not in use
  • Limit your cell phone use in rural areas or in any place where reception is poor. More radiation is emitted when you are farther from a cell phone tower.
  • Text message instead of talking (never while driving!).
  • Check out how much radiation your phone emits by looking at its SAR (specific absorption rate), which is a measure of the amount of radiation absorbed by your body. When buying a new phone, try to select one with a lower SAR. A list of cell phones with the lowest SARs can be found here. But remember, these SARs are based on a six foot tall, 200 pound man with an 11 pound head, and the levels are higher for smaller people.

In summary, although not enough time has passed for research to agree on the exact impact of cell phones on brain tumors and other health risks, the evidence so far suggests that we should be cautious.  While hands-free driving laws are resulting in greater use of ear pieces in cars, more and more people are opting not to pay for land lines and are relying exclusively on their cell phone.  As a result, adults and children are holding cell phones to theirs ears for hours each day.

Should we be concerned?  Remember that most published studies evaluated relatively infrequent cell phone usage and that research is inadequate to draw conclusions regarding safety. The health impact of the long-term and frequent use of cell phones that is typical today could be substantially worse.  And, if there is a cancer risk, we won’t see the effects of cell phone use on cancer rates for another 10-20 years.  That is why it is important that researchers who do not have financial ties to cell phone companies continue long-term studies with more appropriate measures of high, medium, and low cell phone usage.  In the meantime, you can play it safe and limit your cell phone use.