The Breast Blog: Not An April Fools Joke
I'm not the only one yelling FIRE.
Have you heard of something called, "The Body Burden"? No? Me neither. Until the last month or so.
What, you may wonder is this latest catch phrase and how, pray tell does it impact you?
Rest assured that the Body Burden is not a new name for your overweight 'hunk of burning love'. Nor is it a new chain of stores specializing in gadgets designed to remove the weight of the world from your shoulders.
The Body Burden is our life time collection of toxic residue that gets into and accumulates in our bodies.
Geez, I hate it when that happens.
So here's a little story from Lake County California's on-line edition of Record-bee.com, written by Douglas Fischer -- ANG Newspapers. It appeared in my inbox on March 31.
No one can prove the link. But it's there.
It's there for Susan Liroff, diagnosed with breast cancer, who spent the 1950s on Long Island where DDT saw liberal application and the 1970s as a veterinary technician in California, bathing pets in malathion and other since-banned pesticides.
It was there for Rose Mendez, who staked a claim as one of Los Angeles' promising young architects and won a 1997 contest to redesign San Francisco's Union Square. Non-Hodgkins lymphoma snuffed that promise in 2002, killing her at age 32.
It's there for any parent watching their 3-year-old succumb to the early signs of autism.
Something in our environment is killing us.
For 50 years, society has pumped the global environment full of synthetic chemicals, reaping benefits never before imagined. And over those 50 years our bodies, almost without exception worldwide, have become repositories for those industrial and consumer chemicals.
This is our chemical "body burden." A few years ago scientists could not even see it. Now researchers are finding some of these compounds impair our health.
Scientists can draw precious few lines connecting toxic load to specific ailment. Simply because we detect a pollutant in our blood does not mean it causes harm, many toxicologists say.
More profoundly, the ability to link body burden to harm remains just beyond the limits of science, for now. Exposures are fuzzy. We move from place to place. There are far too many variables. Epidemiology -- the study of the incidence and prevalence of disease -- has considerable limits.
But these chemicals do take a toll, researchers suspect. They're in our environment, in our kids. They will not kill us today or tomorrow or perhaps ever, but they threaten us with insidious, almost impossible-to-detect debilities and frustrations -- a child robbed of a few IQ points, a couple struggling to conceive.
Infants begin life with detectable levels of PCBs and DDT in their veins. Fire retardants lace mothers' breast milk. Everybody's blood is laced with a chemical once used to make Scotchgard.
As is the blood of polar bears in the Arctic and cormorants in Japan.
As exposures have risen, so, too, have a string of ailments:
Breast cancer incidence rates have climbed 90 percent since 1950. Non-Hodgkins lymphoma, a cancer tied to a weakened immune system, has seen a 250 percent jump in incidence rates.
Sperm counts appear down -- by some indications a man born in the 1970s has three-quarters the sperm as a man born in the 1950s. Eight percent of all couples of reproductive age in the U.S. are infertile, according to the U.S. Department of Health and Human Services.
And fertility problems seem to be increasing.
Between 1982 and 1995, the number of women in their prime childbearing years to report some difficulty conceiving increased 42 percent, according to one study.
During those 13 years, Swedish researchers tracking fire retardants in breast milk saw a sevenfold leap from .5 parts-per-billion to 3.5 parts-per-billion.
One does not cause the other. But the parallel trends sound a klaxon for our health.
"We're all confident environmental exposures of some sort do cause cancer," said Dr. Sheila Zahm, deputy director of the National Cancer Institute's division of cancer epidemiology and genetics. "But it's very difficult at these very low levels to know what is going on.
"We don't have good answers."
To be sure, diet, exercise and other lifestyle choices remain by far the biggest culprit for most afflictions. In the United States, three-quarters of all new cancers can be traced to smoking, diet and obesity alone.
For instance, during the same 50-year period that saw breast cancer rates rise 90 percent, lung cancer in women jumped 685 percent -- largely because women started smoking in large numbers in the 60s and 70s.
Also worth noting: Our environment by most markers remains considerably cleaner than 30 years ago. We're living longer. PCBs, DDT and other dangerously bioaccumulative, persistent pollutants have been banned since the 70s. Suspected carcinogens are tightly regulated. Big killers -- tuberculosis, pneumonia, childhood mortality -- are, with few exceptions, problems for Third World economies.
But some of those with cancer -- 2 percent, 5 percent, no one truly knows -- had their ailment foisted upon them, triggered, according to the National Cancer Institute, by the soup of environmental toxins in which we live.
Only in the past 10 years, in fact, have scientists come to understand how exquisitely small amounts of some pollutants mimic our body's hormones, setting off cascades of largely unknown, and likely unwanted, downstream effects.
"Even things like a reduction in one's ability to process information or reductions in intelligence these are subtle changes," said Tom McDonald, staff toxicologist at California's Office of Environmental Health Hazard Assessment.
"We're not talking about retardation. We're talking about someone getting (an IQ score of) 160 instead of 170."
The Centers for Disease Control and Prevention set out in the late 1990s to catalog the nation's environmental chemical burden. The first report, in 2001, surveyed thousands of Americans for 27 different compounds. The second, released in 2003, upped the catalog to 116. The third, to be released this spring, will track 148.
But the CDC will never know for sure. Some 82,000 chemicals are in commerce today, with nearly 1,000 new ones added annually. Not all make it to our bodies. But some will. Not all prove poisonous. But some do.
We have metals, nicotine and benzene in our blood. Phthalates, used to make our plastics soft and dissolve fragrances in our shampoos and lotions, filter through our kidneys. Polychlorinated biphenyls, or PCBs, settle in our fat. Pesticides, both organophosphate and organochlorine, cling to house dust, even though the latter was banned in the United States in the 1970s. Fire retardants and pest repellents and plastic all can be found in blood, urine and breast milk.
Toxicologists insist the dose makes the poison. And for the average American, these exist in minute amounts, a few dozen parts per billion or less -- a chocolate bar split among the 750,000 residents of San Francisco.
But that does not mean they do no harm.
"As studies have gotten better, we're finding effects at lower and lower levels," said Don Wigle, a semi-retired epidemiologist with Environment Canada and author of the textbook "Child Health and the Environment."
"It's not going away."
And not all of us are average.
For reasons unexplained, studies consistently show about 5 percent of all subjects have extremely high blood concentrations of environmental toxins -- in some cases, particularly for PBDEs, near concentrations known to cause defects in laboratory animals.
Which means 15 million Americans live near a threshold that gives scientists pause, McDonald said. "The comparison is very close. ... It doesn't mean we're finding effects in people, but it is a cause for concern."
A Berkeley family tested by the Oakland Tribune supports this point.
The family was picked because they lived as chemically clean a life as possible, yet lab tests found PCBs, phthalates, mercury, lead and cadmium in each member. The surprise was the family's level for a class of fire retardants common in plastic appliances, foam cushions and carpet backing.
The parents were well above what scientists consider "normal" for the United States. But their kids, for reasons no one fully understands, had levels as high or higher than found in workers handling the stuff for a living.
Forty years ago, Wigle emerged with his Ph.D. and set to work in a world where lead exposure was simply an assumed price to pay for civilized society.
Doctors find signs of acute brain damage at a blood lead level of 80 ppb. But at the time in the United States, 60 ppb marked the CDC's health threshold. Physicians, Wigle said, would basically shrug at a child with 40 ppb in their body. The nation's average, after all, was 14 ppb for children younger than 5, and lab researchers considered 10 ppb the minimum exposure.
Today 10 ppb is the government's threshold. Scientists suspect no safe level of exposure exists, particularly for children.
In the hunt to define our body burdens' toll, scientists often fail to see the damage until once a compound is removed. Lead is such an example.
In 1975 the California Air Resources Board ordered lead out of gasoline -- not amid concern of lead exposure, but because catalytic converters necessary to curb smog in Los Angeles wouldn't work with the octane booster.
1980 the CDC could start drawing links. During the four years starting with 1976, lead levels dropped 40 percent in gasoline, 40 percent in air and 40 percent in the blood of every population cross-section the agency could track.
The information single-handedly spiked a 1981 proposal by the U.S. EPA to increase the amount of lead allowed in leaded gasoline. "It's hard to put a price on how valuable those data are," Wigle said.
Since then, researchers tracking cognitive ability, memory, sensory function and motor skills in children have found dysfunction at progressively lower lead levels. They've found a link between lead and preterm delivery, low birth weight and fetal growth retardation.
But the main effect is on the brain, with exposure tied to impaired development and to aggressive, destructive and delinquent behavior.
Today the average U.S. level is 2 ppb.
But the damage from high lead levels haunts us still. Many scientists suspect the exposure fried four to five points off the IQ scores of every kid growing up across the nation at that time.
"You're shifting the whole curve to the left," Wigle said. "You're drastically reducing the proportion of very bright kids and drastically increasing the proportion of kids with learning disabilities."
For lead, the evidence is clear. For newer compounds, the data remain far too sketchy to prove -- or disprove -- similar conclusions. "There's not a lot of studies done," Wigle added. "We don't have 40 to 50 years of experiments observing what happens to humans."
Rick Becker hears this all the time. He doesn't believe it.
Our body burden, he -- and many others -- say, hovers below the level where those chemicals do harm.
Becker holds a Ph.D. in toxicology and pharmacology. He spent the 1990s assessing the exposure risk of pesticides, hazardous waste and other chemicals for the California Environmental Protection Agency. Today, he's a senior toxicologist with the American Chemistry Council, representing every major chemical manufacturer in the country.
The central tenet of modern toxicology holds that the dose makes the poison. The amount ingested, in other words, has great say in whether a substance is a killer.
Ethanol is one example, Becker notes. Toxic at high levels, we all consume tiny amounts every day in fruits, vegetables and grains with no effect.
Aspirin is another. Swallow a full bottle, and someone will be calling 911 on your behalf.
But break a pill in half, then in half again and again and again, and Becker will be able to detect aspirin in your blood. But the dose has no effect.
"You have a similar principle with reproductive toxicity," Becker said. "The idea that ultra-low doses cause harm is a hypothesis. But that hypothesis generally has been shown not to hold up."
Take perfluorinated compounds -- the stuff behind GoreTex, Scotchgard and Teflon. They're uncomfortably long-lasting, with a half-life -- the time needed for the body to purge half its total exposure -- of between four and eight years in humans. At high levels, they cause liver damage. The U.S. EPA sees potential for carcinogenity in the chemistry but hasn't made a definitive decision yet.
Studies suggest we all have trace amounts in our bodies, with an average of 30 ppb for PFOS, one such compound.
If that posed a problem, toxicologists reason, we'd surely see it in chemical workers at 3M's plants -- where blood levels average 2,000 ppb. But years of tracking data find their health no different than ours, said the company's chief medical officer.
"The low levels in the general population really do not represent a health issue," Dr. Larry Zobel, 3M's medical director said. "Those levels are not associated with health effects."
That's the danger, say Zobel, Becker and other epidemiologists and toxicologists studying environmental toxins. "We can detect these compounds in microscopic amounts. But we don't yet know what it means.
"If you can't measure it, it's a non-detect and you're not worried," said David Savitz, a professor at the University of North Carolina and president-elect of the Society for Pediatric and Perinatal Epidemiology.
"There's a little bit of danger, if you will, of the information itself. You could argue that by being aware of it, what could it do, other than help people to worry?"
Or would you make a different choice?
In a modest office off the University of California, Berkeley campus, Professor William Nazaroff pulls a piece of paper with a simple graph from among a sheaf of papers.
The graph shows what happens when you mix a few capfuls of Pine-Sol with water and start cleaning.
In a ventilated chamber -- akin to a room with an open window -- Nazaroff mixed a bit of vaporized cleaner with a modest bit of ozone -- what blows through a typical urban house on a summer day.
The result, due to a bit of reactive chemistry, was particles. An invisible cloud of hundreds upon thousands of microscopic particles still being generated four hours after the release.
That in itself is alarming. Tiny particles lodge in the lungs and are considered a key contributor to asthma. But these weren't just any particles.
They were carcinogens.
Nazaroff is one of a relatively few scientists studying the chemistry and physics of indoor air.
He looks at the ways such everyday items as carpets and air fresheners and cleaners like Pine-Sol interact, producing problematic compounds nobody expected. Given that Americans spend 90 percent of their time indoors on average, his findings are eye-popping.
Take Pine-Sol. The original formula -- not, for whatever reason, the lemon-scented version -- consists of 15 percent to 20 percent terpene. A relatively harmless hydrocarbon, terpenes are everywhere, from hand lotion to dry cleaners to air fresheners, even plants. That pine-fresh scent from Pine-Sol? The whiff of citrus from Formula 409? What you smell are terpenes.
But mix those benign cleaners with highly reactive ozone -- from car pollution, from an ozone-generating air cleaner, from just living in a city -- and that pine-fresh scent becomes far more malevolent: formaldehyde, carbonyls and other reactive and unstable compounds.
"You don't have to be in Livermore on a Spare the Air Day," he said. "You're going to get ozone combining with these terpenes, and you're going to get all these secondary compounds."
Oakland-based Clorox, maker of Pine-Sol and Formula 409, notes that plant-based cleaners such as Pine-Sol have been around for 150 years or more. They've played a key role improving hygiene and human health.
So if you splash some in a bucket of water, mop your floor, then open the windows to let it dry, does the potential for chemical reaction outweigh the benefits of a clean floor?
"Pine-Sol has never been shown to be an irritant," said spokeswoman Mary O'Connell. "We're not disputing there's potential for reaction, but what it means is really unclear."
The problem doesn't sit on Clorox's doorstep alone, Nazaroff added. It's the whole industry.
What amazes him is not the dearth of hard facts about how these chemicals interact. It's that so many believe they can improve their environment by adding an odor, or lighting a candle or -- even worse, he says -- using an air cleaner that deliberately introduces ozone.
"You start with a biologically innocent compound, and you expose it to ozone, and you get a carcinogen," he said. "There's a lot of downside risk from reactive chemistry, as our investigations have begun to explore."
In some ways, Nazaroff's puzzlement gets to the center of the issue. We live in a rich culture, with pans that don't stick, jackets that shed water, sprays that disinfect toilets, traps that kill ants.
We have lotions to moisturize chapped skin and colognes to make us smell good. Our grandparents would never recognize today's tiny, fuel-efficient car engines. We enjoy first-rate medical care.
But we also carry a legacy -- a tiny bit of the chemicals that make it all possible. It's in our parents, us and our children. And no one yet knows what it means.
"We should not be arrogant or ignorant," said Wigle, the Environment Canada epidemiologist. "Arrogant in the sense that we think we know a lot about the significance of these contaminants, or ignorant in not admitting what we don't know.
"And there's a lot we don't know."