Autism Spectrum Disorder and Particulate Matter Air Pollution before, during, and after Pregnancy
Women who are exposed to high levels of air pollution during their third trimester of pregnancy may be twice as likely to have an autistic child, researchers from the Harvard School of Public Health (HSPH) found.
Background: Autism spectrum disorder (ASD) is a developmental disorder with increasing prevalence worldwide, yet with unclear etiology.
Objective: To explore the association between maternal exposure to particulate matter (PM) air pollution and odds of ASD in her child.
Methods: We conducted a nested case-control study of participants in the Nurses’ Health Study II (NHS II), a prospective cohort of 116,430 US female nurses recruited in 1989, followed by biennial mailed questionnaires. Subjects were NHS II participants’ children born 1990-2002 with ASD (n=245), and children without ASD (n=1522) randomly selected using frequency matching for birth years. ASD was based on maternal report, which was validated against the Autism Diagnostic Interview-Revised in a subset. Monthly averages of PM with diameters ≤2.5 µm (PM2.5) and 2.5-10 µm (PM10-2.5) were predicted from a spatiotemporal model for the continental US and linked to residential addresses.
Results: PM2.5 exposure during pregnancy was associated with increased odds of ASD, with an adjusted odds ratio (OR) for ASD per interquartile range higher PM2.5 (4.42 µg/m3) of 1.57 (95% CI: 1.22, 2.03) among women with the same address before and after pregnancy (160 cases, 986 controls). Associations with PM2.5 exposure 9 months before or after the pregnancy were weaker in independent models and null when all three time periods were included, while the association with the 9 months of pregnancy remained (OR=1.63; 95% CI: 1.08-2.47). The association between ASD and PM2.5 was stronger for exposure during the third trimester (OR=1.42 per inter-quartile range increase in PM2.5, 95% CI: 1.09, 1.86) than other trimesters (ORs 1.06 and 1.00) when mutually adjusted. There was little association between PM10-2.5 and ASD.
Conclusions: Higher maternal exposure to PM2.5 during pregnancy, in particular the third trimester, was associated with greater odds of her child having ASD.
Sources and more information
Autism Spectrum Disorder and Particulate Matter Air Pollution before, during, and after Pregnancy: A Nested Case–Control Analysis within the Nurses’ Health Study II Cohort, Environ Health Perspectives DOI:10.1289/ehp.1408133, 18 December 2014. Full studyPDF.
Fertility, Motherhood and the Reality of the Biological Clock
A candid assessment of the pros and cons of delayed motherhood
Biology does not bend to feminist ideals and science does not work miracles. That is the message of this eye-opening discussion of the consequences of delayed motherhood. Part personal account, part manifesto, Tanya Selvaratnam recounts her emotional journey through multiple miscarriages after the age of 37. Her doctor told her she still “had time,” but Selvaratnam found little reliable and often conflicting information about a mature woman’s biological ability (or inability) to conceive.
Beyond her personal story, the author speaks to women in similar situations around the country, as well as fertility doctors, adoption counselors, reproductive health professionals, celebrities, feminists, journalists, and sociologists. Through in-depth reporting and her own experience, Tanya Selvaratnam urges more widespread education and open discussion about delayed motherhood in the hope that long-lasting solutions can take effect. The result is a book full of valuable information that will enable women to make smarter choices about their reproductive futures and to strike a more realistic balance between science, society and personal goals.
Strong evidence of decreased semen quality in men, higher miscarriages in women and increased risk of birth defects in children, due to chemicals released from fracking
Unconventional oil and gas (UOG) operations release large amounts of reproductive, immunological, and neurological toxicants, carcinogens as well as endocrine disrupting chemicals (EDCs) into the environment that may negatively affect human health. Studies show that humans can be harmed by these chemicals released from fracking ; there is strong evidence of decreased semen quality in men, higher miscarriages in women and increased risk of birth defects in children.
Unconventional oil and gas (UOG) operations have the potential to increase air and water pollution in communities located near UOG operations. Every stage of UOG operation from well construction to extraction, operations, transportation, and distribution can lead to air and water contamination. Hundreds of chemicals are associated with the process of unconventional oil and natural gas production. In this work, we review the scientific literature providing evidence that adult and early life exposure to chemicals associated with UOG operations can result in adverse reproductive health and developmental effects in humans. Volatile organic compounds (VOCs) [including benzene, toluene, ethyl benzene, and xylene (BTEX) and formaldehyde] and heavy metals (including arsenic, cadmium and lead) are just a few of the known contributors to reduced air and water quality that pose a threat to human developmental and reproductive health. The developing fetus is particularly sensitive to environmental factors, which include air and water pollution. Research shows that there are critical windows of vulnerability during prenatal and early postnatal development, during which chemical exposures can cause potentially permanent damage to the growing embryo and fetus. Many of the air and water pollutants found near UOG operation sites are recognized as being developmental and reproductive toxicants; therefore there is a compelling need to increase our knowledge of the potential health consequences for adults, infants, and children from these chemicals through rapid and thorough health research investigation.
Sources and more information
Developmental and reproductive effects of chemicals associated with unconventional oil and natural gas operations, degruyter, Reviews on Environmental Health. Volume 29, Issue 4, Pages 307–318, ISSN (Online) 2191-0308, ISSN (Print) 0048-7554, DOI: 10.1515/reveh-2014-0057, December 2014. Full text PDF link and download.
Fracking Chemicals Linked to Serious Reproductive, Developmental Health Risks, ceh, DECEMBER 5, 2014.
Miscarriage and stillbirth linked to fracking chemical exposure, theecologist, 15th December 2014.
Chemicals Released During Natural Gas Extraction May Harm Human Reproduction and Development, missouri.edu, Dec. 05, 2014.
Lots of useful information brought together all in one place
The Human Fertilisation and Embryology Authority is the UK’s independent regulator overseeing the use of gametes and embryos in fertility treatment and research. The HFEA has updated their free guide to fertility treatment which brings lots of useful information together all in one place.
The HFEA expertise and years of experience mean they can provide you with authoritative, independent information. “Getting started” is their free guide to fertility treatment which brings lots of useful information together all in one place. It gives you an overall view of:
how and when to seek treatment
initial considerations (eg, NHS or private treatment)
how to choose a clinic and what to expect
what to think about before starting treatment (including risks)
where to find support and advice.
If you’re exploring fertility treatment, the HFEA is the first place to go for reliable information. Making sure you have all the information you need means you can be confident that you’re making the right choices.
Free Yourself from Drug Reps – the No Ads Please campaign
Doctors who see medical representatives are more likely to prescribe more medication, more expensively and less according to accepted guidelines. The No Advertising Please campaign encourages doctors to avoid using drug representatives as their “educational” resource, by pledging to not see drug reps at their practice for one year.
Sources and more information
Help promote the No Advertising Please campaign ; Get involved.
Pesticide poisoning and depression in farm residents
Pesticide Exposure and Depression among Male Private Pesticide Applicators in the Agricultural Health Study
Background: Pesticide exposure may be positively associated with depression. Few previous studies have considered the episodic nature of depression or examined individual pesticides.
Objective: We evaluated associations between pesticide exposure and depression among male private pesticide applicators in the Agricultural Health Study.
Methods: We analyzed data for 10 pesticide classes and 50 specific pesticides used by 21,208 applicators enrolled in 1993–1997 who completed a follow-up telephone interview in 2005–2010. We divided applicators who reported a physician diagnosis of depression (n = 1,702; 8%) into those who reported a previous diagnosis of depression at enrollment but not follow-up (n = 474; 28%), at both enrollment and follow-up (n = 540; 32%), and at follow-up but not enrollment (n = 688; 40%) and used polytomous logistic regression to estimate odds ratios (ORs) and 95% CIs. We used inverse probability weighting to adjust for potential confounders and to account for the exclusion of 3,315 applicators with missing covariate data and 24,619 who did not complete the follow-up interview.
Results: After weighting for potential confounders, missing covariate data, and dropout, ever-use of two pesticide classes, fumigants and organochlorine insecticides, and seven individual pesticides—the fumigants aluminum phosphide and ethylene dibromide; the phenoxy herbicide (2,4,5-trichlorophenoxy)acetic acid (2,4,5-T); the organochlorine insecticide dieldrin; and the organophosphate insecticides diazinon, malathion, and parathion—were all positively associated with depression in each case group, with ORs between 1.1 and 1.9.
Conclusions: Our study supports a positive association between pesticide exposure and depression, including associations with several specific pesticides.
Depression and pesticide exposures among private pesticide applicators enrolled in the Agricultural Health Study
Background: We evaluated the relationship between diagnosed depression and pesticide exposure using information from private pesticide applicators enrolled in the Agricultural Health Study between 1993 and 1997 in Iowa and North Carolina.
Methods: There were 534 cases who self-reported a physician-diagnosed depression and 17,051 controls who reported never having been diagnosed with depression and did not feel depressed more than once a week in the past year. Lifetime pesticide exposure was categorized in three mutually exclusive groups: low (< 226 days, the reference group), intermediate (226-752 days), and high (> 752 days). Two additional measures represented acute high-intensity pesticide exposures: an unusually high pesticide exposure event (HPEE) and physician-diagnosed pesticide poisoning. Logistic regression analyses were performed relating pesticide exposure to depression.
Results: After adjusting for state, age, education, marital status, doctor visits, alcohol use, smoking, solvent exposure, not currently having crops or animals, and ever working a job off the farm, pesticide poisoning was more strongly associated with depression [odds ratio (OR) = 2.57; 95% confidence interval (CI), 1.74-3.79] than intermediate (OR = 1.07; 95% CI, 0.87-1.31) or high (OR = 1.11; 95% CI, 0.87-1.42) cumulative exposure or an HPEE (OR = 1.65; 95% CI, 1.33-2.05). In analysis of a subgroup without a history of acute poisoning, high cumulative exposure was significantly associated with depression (OR = 1.54; 95% CI, 1.16-2.04).
Conclusions: These findings suggest that both acute high-intensity and cumulative pesticide exposure may contribute to depression in pesticide applicators. Our study is unique in reporting that depression is also associated with chronic pesticide exposure in the absence of a physician-diagnosed poisoning.
A cohort study of pesticide poisoning and depression in Colorado farm residents
Purpose: Depressive symptoms have been associated with pesticide poisoning among farmers in cross-sectional studies, but no longitudinal studies have assessed the long-term influence of poisoning on depressive symptoms. The purpose of this study was to describe the associations between pesticide poisoning and depressive symptoms in a cohort of farm residents.
Methods: Farm operators and their spouses were recruited in 1993 from farm truck registrations using stratified probability sampling. The Center for Epidemiologic Studies-Depression scale was used to evaluate depression in participants using generalized estimating equations. Baseline self-reported pesticide poisoning was the exposure of interest in longitudinal analyses.
Results: Pesticide poisoning was significantly associated with depression in three years of follow-up after adjusting for age, gender, and marital status (odds ratio [OR] 2.59; 95% confidence interval [CI] 1.20-5.58). Depression remained elevated after adjusting for health, decreased income, and increased debt (OR 2.00; CI 0.91-4.39) and was primarily due to significant associations with the symptoms being bothered by things (OR 3.29; CI 1.95-5.55) and feeling everything was an effort (OR 1.93; CI 1.14-3.27).
Conclusions: Feeling bothered and that everything was an effort were persistently associated with a history of pesticide poisoning, supportive of the hypothesis that prolonged irritability may result from pesticide poisoning.
Sources and more information
Pesticide Exposure and Depression among Male Private Pesticide Applicators in the Agricultural Health Study, ehp, 1 September 2014.
Depression and pesticide exposures among private pesticide applicators enrolled in the Agricultural Health Study, NCBI PMID: PubMed 19079725, 2008 Sept 9.
A cohort study of pesticide poisoning and depression in Colorado farm residents, NCBI PMID: PubMed 18693039, 2008 Aug 9.
A visionary who worked tirelessly to protect the public from chemicals with hormone disrupting properties
Theo Colborn passed away yesterday, at the age of 87. She had immersed herself in decades of research and co-authored a popular science book about the health and environmental threats created by man-made chemical contaminants that interfere with hormones in humans and wildlife: Our Stolen Future.
Her key message is still incontestable: over 60 years ago, we began to introduce all of these chemicals into the environment, and we still have no idea what most of them do to us…
Letter to the president about chemicals disrupting our bodies: Theo Colborn at TEDxMidAtlantic 2012
Dr. Theo Colborn, Founder and President of The Endocrine Disruption Exchange (TEDX), based in Paonia, Colorado, reads a letter she wrote to President Obama asking for better regulation of health disrupting chemicals. Video published on 10 Dec 2012 by TEDx Talks.
Sources and more information
Remembering the genius who got BPA out of your water bottles, and so much more, grist, 16 Dec 2014.
” A healthy diet is part of the foundation for optimal hormone balance. Achieving good health is best accomplished by incorporating small positive changes into your lifestyle. Here are some quick Do’s and Don’ts to start your path to health improvement. ”
Patients Don’t Understand Risks of Unnecessary Antibiotics
Over prescription of antibiotics is a major factor driving one of the biggest public health concerns today: antibiotic resistance. In a first-of-its-kind study, research led by the George Washington University suggests that public health educational materials may not address the misconceptions that shape why patients expect antibiotics, driving doctors to prescribe them more. The research appeared in October in the journal Medical Decision Making.
Researchers from George Washington, Cornell and Johns Hopkins universities surveyed 113 patients in an urban hospital to test their understanding of antibiotics. They discovered a widespread misconception: patients may want antibiotics, even if they know that, if they have a viral infection, the drugs will not make them better. These patients believe that taking the medication will not worsen their condition—and that the risk of taking unnecessary antibiotics does not outweigh the possibility that they may help.
“Patients figure that taking antibiotics can’t hurt, and just might make them improve. When they come in for treatment, they are usually feeling pretty bad and looking for anything that will make them feel better. These patients might know that there is, in theory, a risk of side effects when taking antibiotics, but they interpret that risk as essentially nil,” said David Broniatowski, assistant professor in GW’s School of Engineering and Applied Science.
Contrary to these patients’ beliefs, there are risks associated with taking unnecessary antibiotics, such as secondary infections and allergic reactions.
“More than half of the patients we surveyed already knew that antibiotics don’t work against viruses, but they still agreed with taking antibiotics just in case,” Dr. Broniatowski said. “We need to fight fire with fire. If patients think that antibiotics can’t hurt, we can’t just focus on telling them that they probably have a virus. We need to let them know that antibiotics can have some pretty bad side effects, and that they will definitely not help cure a viral infection.”
Dr. Broniatowski’s research found that most educational tools used to communicate the dangers of taking unnecessary antibiotics focus on the differences between bacteria and viruses—the idea that “germs are germs”—but do not address patients’ widespread “why not take a risk” belief.
While the study – Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics In an Inner-City Emergency Department – was small, the results signal the need for a shift in the way health care officials educate patients and caretakers. Dr. Broniatowski urges members of the public health community to reconsider their communication tactics and adjust educational materials to address patients’ concerns and beliefs.
In the future, Mr. Broniatowski and his team, which included Eili Klein at Johns Hopkins and Valerie Reyna at Cornell, hope to test these communication strategies in a clinical setting and, ultimately, reduce the rate of over prescription.
Sources and more information
Patients Don’t Understand Risks of Unnecessary Antibiotics, GW Study Shows, GWU, December 15, 2014.
Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department, Medical Decision Making, October 20, 2014 .
solve an everyday health problem like heartburn or high cholesterol;
have a fun or memorable ad campaign;
get social buzz;
and be sold to a large number of people quickly.
The last qualification—quick sales to millions—is crucial because Big Pharma has a small sales window before a patent runs out. But it’s also dangerous because many risks don’t emerge until millions take the drug so the public serves as unwitting guinea pigs.
When risks can’t be ignored, even if the drug is selling briskly, the drug will be unceremoniously withdrawn and seldom mentioned again. Here are some blockbusters in the drug graveyard that Big Pharma hopes we will forget about.
Darvon and Darvocet
Find out more on AlterNet:
Are We Big Pharma’s Guinea Pigs? 8 Drugs Used by Millions Before Being Pulled for Dangerous Side-Effects, AlterNet, December 2, 2014.
7 Drugs Whose Dangerous Risks Emerged Only After Big Pharma Made Its Money, AlterNet, January 2, 2014.