BPA-free products and the next generation of bisphenols

An old culprit but a new story

Abstract

The concept that developmental events shape adult health and disease was sparked by the recognition of a link between maternal undernutrition and coronary disease in adults. From that beginning, a new field—the developmental origins of health and disease—emerged, and attention has focused on the effects of a wide array of developmental perturbations.

Exposure to endocrine-disrupting chemicals has been of particular interest, and a ubiquitous environmental contaminant bisphenol A (BPA) has become the endocrine-disrupting chemical poster child. Bisphenol A has been the subject of intense investigation for nearly two decades, and exposure effects have been described in hundreds of experimental, epidemiological, and clinical studies. From the standpoint of reproductive health, the findings are particularly important, as they suggest that the ovary, testis, and reproductive tract in both sexes are targets of BPA action. The findings and the media and regulatory attention garnered by them have generated increasing public concern and resulted in legislative bans on BPA in some countries.

An old culprit but a new story: bisphenol A and “NextGen” bisphenols, Fertility and Sterility, Volume 106, Issue 4, Pages 820–826, September 15, 2016.

The subsequent introduction of BPA-free products, although a masterful marketing strategy, is in reality only the beginning of a new and complex chapter of the BPA story. In this review we attempt to summarize what we have learned about the reproductive effects of BPA, present the reasons why studying the effects of this chemical in humans is no longer sufficient, and outline the challenges that the growing array of next generation bisphenols represents to clinicians, researchers, federal agencies, and the general public.

Inpatient Antibiotic Use Among US Hospitals

Antibiotics Are Still Overused in Hospitals

The most comprehensive study yet shows that antibiotic use hasn’t changed in hospitals, despite recent warnings that they drugs are overprescribed.

ABSTRACT

Objective
To use proprietary administrative data to estimate patterns of US inpatient antibiotic use in recent years.

Design, Setting, and Participants
For this retrospective analysis, adult and pediatric in-patient antibiotic use data was obtained from the Truven Health MarketScan Hospital Drug Database (HDD) from January 1, 2006, to December 31, 2012. Data from adult and pediatric patients admitted to 1 of approximately 300 participating acute care hospitals provided antibiotic use data for over 34 million discharges representing 166 million patient-days.

Estimating National Trends in Inpatient Antibiotic Use Among US Hospitals From 2006 to 2012, jama network, September 19, 2016.

Main Outcomes and Measures
We retrospectively estimated the days of therapy (DOT) per 1000 patient-days and the proportion of hospital discharges in which a patient received at least 1 dose of an antibiotic during the hospital stay. We calculated measures of antibiotic usage stratified by antibiotic class, year, and other patient and facility characteristics. We used data submitted to the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System to generate estimated weights to apply to the HDD data to create national estimates of antibiotic usage. A multivariate general estimating equation model to account for interhospital covariance was used to assess potential trends in antibiotic DOT over time.

Results
During the years 2006 to 2012, 300 to 383 hospitals per year contributed antibiotic data to the HDD. Across all years, 55.1% of patients received at least 1 dose of antibiotics during their hospital visit. The overall national DOT was 755 per 1000 patient-days. Overall antibiotic use did not change significantly over time. The multivariable trend analysis of data from participating hospitals did not show a statistically significant change in overall use (total DOT increase, 5.6; 95% CI, −18.9 to 30.1; P = .65). However, the mean change (95% CI) for the following antibiotic classes increased significantly: third- and fourth-generation cephalosporins, 10.3 (3.1-17.5); macrolides, 4.8 (2.0-7.6); glycopeptides, 22.4 (17.5-27.3); β-lactam/β-lactamase inhibitor combinations, 18.0 (13.3-22.6); carbapenems, 7.4 (4.6-10.2); and tetracyclines, 3.3 (2.0-4.7).

Conclusions and Relevance
Overall DOT of all antibiotics among hospitalized patients in US hospitals has not changed significantly in recent years. Use of some antibiotics, especially broad spectrum agents, however, has increased significantly. This trend is worrisome in light of the rising challenge of antibiotic resistance. Our findings can help inform national efforts to improve antibiotic use by suggesting key targets for improvement interventions.

France the first country to ban all plastic plates and cups by 2020

France to bid adieu to plastic dishes with controversial ban

Say goodbye to plastic plates in France. The country is the first to ban all plastic cups, plates and silverware in a law that will take full effect in 2020.

mr. cups by rooty.

The measure was passed last month, but businesses have until 2020 to fully comply, according to the Associated Press.

Pyrethroid pesticides detected in waterways and demonstrated to act as endocrine disruptors

Pyrethroids: Not as safe as you think

Abstract

Pyrethroids are now the fourth most used group of insecticides worldwide. Employed in agriculture and in urban areas, they are detected in waterways at concentrations that are lethally and sublethally toxic to aquatic organisms.

Highly lipophilic, pyrethroids accumulate in sediments and bioaccumulate in fishes. Additionally, these compounds are demonstrated to act as endocrine disrupting compounds (or EDCs) in mammals and fishes, and therefore interfere with endocrine signaling by blocking, mimicking, or synergizing endogenous hormones through direct receptor interactions, and indirectly via upstream signaling pathways.

Pyrethroid metabolites have greater endocrine activity than their parent structures, and this activity is dependent on the enantiomer present, as some pyrethroids are chiral. Many EDCs studied thus far in fish have known estrogenic or antiestrogenic effects, and as such cause the inappropriate or altered expression of genes or proteins (i.e., Vtg–vitellogenin, Chg–choriogenin), often leading to physiological or reproductive effects. Additionally, these compounds can also interfere with other endocrine pathways and immune response.

Pyrethroid Pesticides as Endocrine Disruptors: Molecular Mechanisms in Vertebrates with a Focus on Fishes, Environmental Science and Technology, July 27, 2016.

This review highlights studies that focus on the mechanisms of pyrethroid biotransformation and endocrine toxicity to fishes across a broad range of different pyrethroid types, and integrates literature on the in vitro and mammalian responses that inform these mechanisms.

Health and Wellness at Work, infographic

Integrating Effective Health and Wellness Strategies in the Workplace

The number of health risks in the United States is incredibly high. When employees feel sick or need medical attention, they are entitled to sick days, which means there will be less productivity at the workplace while labor costs will remain the same. Furthermore, other employees will have to do extra work to cover for the sick employee. That is why integration of health and wellness strategies in the workplace is highly recommended.

  • This infographic was created by Eastern Kentucky University’s Online Bachelor of Science in Occupational Safety program:
    – Number of Employees with Health Risks.
    – The Relationship Between Health and Workplace Productivity
    – Importance of Health and Wellness in the Workplace
    – Health and Wellness Programs
    – Encouraging Employee Participation in Wellness Programs
    – Wellness Incentives
    – The Impact of Health and Wellness Programs
  • Enjoy our health infographics album on Flickr.

Body of Evidence

An overview of the low dose effects of Bisphenol A in relation to breast cancer

Body of evidence report
Scientific evidence links our routine exposure to BPA to a range of diseases, including breast cancer.

BPA is an Endocrine Disrupting Chemical (EDC).  It is able to mimic oestrogen and can bind to the oestrogen receptors in a cell.  BPA has been linked to breast cancer, as well as to prostate cancer, heart disease, obesity and diabetes.

Breast Cancer UK submitted evidence to both of EFSA’s consultations expressing concern that studies relating to low dose EDCs exposures had been dismissed. Breast Cancer UK will continue to call for a ban on the use of BPA in food and drinks packaging  on the basis that studies show that low dose exposures to BPA have been shown to have an adverse effect on the mammary gland.

Abstract

… “Diethylstilboestrol (DES) is a synthetic oestrogen that was given to pregnant women in the 1950’s and 1960’s to help prevent miscarriage. Women who took DES were found to have a 40% increased risk of developing breast cancer in later life (Greenberg, A.B.Barnes et al. 1984). The first generation of daughters born to women who were exposed to DES, also had an increased risk of developing breast cancer after reaching 40 years of age (Palmer, Lauren A.Wise et al. 2006). It was found that intrauterine exposure to the DES caused an increase in the number of ductal stem cells, and thereby increased the risk of mutations in the cells of the mammary gland, consequently increasing the risk of developing breast cancer later in life. Ironically, men were not permitted to work in factories that synthesised DES because those that had developed painful swellings in the chest area. It was these links to breast cancer that led directly to DES being withdrawn from use in the USA in 1971 and the UK in 1975.”…

DES DiEthylStilbestrol Resources

Misuse of Stimulant Medication Among US College Students

1 in 6 College Students Misuses ADHD Drugs

More and more college students are misusing ADHD medications for a perceived academic boost — taking more than is prescribed, sharing it with others who don’t have a prescription, or selling the medication illegally. A 2015 study from the University of South Carolina found that 17 percent of college kids, or 1 in 6, misuses ADHD drugs.

Abstract

The misuse of stimulant medication among college students is a prevalent and growing problem. The purpose of this review and meta-analysis is to summarize the current research on rates and demographic and psychosocial correlates of stimulant medication misuse among college students, to provide methodological guidance and other ideas for future research, and to provide some preliminary suggestions for preventing and reducing misuse on college campuses.

Misuse of Stimulant Medication Among College Students: A Comprehensive Review and Meta-analysis, springer, 10 January 2015.

Random-effects meta-analysis found that the rate of stimulant medication misuse among college students was estimated at 17 % (95 % CI [0.13, 0.23], p < .001) and identified several psychological variables that differentiated misusers and nonusers, including symptoms of attention-deficit/hyperactivity disorder, problems associated with alcohol use, and marijuana use.

1 in 6 College Students Misuses ADHD Drugs — How Can We Break the Cycle?, healthline, 30 March 2015.

Boston College students by bc-burnslibrary.

A qualitative review of the literature also revealed that Greek organization membership, academic performance, and other substance use were associated with misuse. Students are misusing primarily for academic reasons, and the most common source for obtaining stimulant medication is peers with prescriptions. Interpretation of findings is complicated by the lack of a standard misuse definition as well as validated tools for measuring stimulant misuse.

The relation between stimulant medication misuse and extra curricular participation, academic outcomes, depression, and eating disorders requires further investigation, as do the reasons why students divert or misuse and whether policies on college campuses contribute to the high rates of misuse among students.

Future research should also work to develop and implement effective prevention strategies for reducing the diversion and misuse of stimulant medication on college campuses.

The personal care products negative impacts on aquatic species

Aquatic life needs further protection from effects of PCPs

In order to fulfill a broad range of functions, personal care products (PCPs) contain a wide range of chemicals, from filters that block out UV light to antibiotics and insect repellents. PCPs are generally washed off the skin and, as a result, chemicals from PCPs have been found in raw and treated wastewater, surface and ground water, and even drinking water.

There are potential human health implications from ingesting these chemicals by way of drinking water or seafood. In addition, the entry of PCPs into surface waters could be toxic for aquatic organisms. Some PCP chemicals that repel water are particularly difficult to remove during wastewater treatment (which aims to protect the environment from the adverse effects of pollution) and can accumulate up the food chain. Wastewater solids (sludge) and effluent are in some cases applied to land to improve soil and for irrigation purposes, respectively, creating a risk that these compounds will indirectly enter nearby water bodies, or food crops. Early findings suggest wastewater treatment processes do not always ensure a safe concentration of PCP chemicals.

Aquatic life needs further protection from effects of personal care products, Science for Environment Policy, 16 September 2016.

Lines on surface by patricksinot.

This review combined recent findings to build a picture of the concentrations of chemicals from PCPs found in the environment. The researchers collected over 5 000 environmental detections of PCPs from around the world, including several European countries. The concentrations of the 95 detected chemicals were added to a database. Most environmental detections (2 290) were in surface water, followed by 1 240 detections in wastewater effluent, 879 in wastewater solids, and 873 in raw wastewater. By comparing the data on occurrence with toxicity data, also from previously published studies, they found that some levels measured in raw wastewater, wastewater effluent and surface water could be toxic to aquatic life.

The results also emphasise just how ubiquitous these chemicals are in the aquatic environment. Many chemicals were detected in the wastewater of several countries, such as the fragrance compound tonalide; nonylphenol (used to manufacture antioxidants, detergents and emulsifiers); the UV filter benzophenone-3 (used in sunscreen); and the anti-microbial agent triclosan. The highest reported concentrations were in North America and Europe, likely because per-capita consumption is higher in these areas.

The literature review showed that, after treatment, concentrations of chemicals from PCPs in wastewater can be reduced by between 33% and 90%. The UV filter octinoxate showed the highest average removal efficiency by wastewater treatment, while nonylphenol showed the lowest. In some cases, chemicals in treated wastewater remain above a level which has been shown to have harmful effects on aquatic organisms (such as the fragrance compound galaxolide, detected above a level of 0.1 micrograms per litre, and anti-bacterial triclosan, which has been detected above toxicologically-relevant concentrations of 0.65 micrograms per litre). However, it is important to note that aquatic organisms are not exposed directly to the levels in treated wastewater, which is diluted (although not always by a large factor) when it enters the receiving water body, such as a river.

In addition to being diluted, chemicals from PCPs can be broken down in the water body, although some are more resistant to natural attenuation than others. For example, galaxolide, nonylphenol and the UV filters sulisobenzone and 4MBC are generally removed well, while others are more resistant, such as octinoxate, the insecticide N,N-diethyl-3- methylbenzamide (DEET) and paraben preservatives. On average, concentrations in surface water were around half those in wastewater effluent.

Chemicals from PCPs have been detected in the environment for at least 30 years, and as PCP consumption and production increases, the implications for the environment will become even greater. As such, the researchers make three recommendations for the future:

  1. Continued monitoring. Monitoring should be conducted for compounds that have known toxic effects on organisms at environmentally relevant concentrations. They recommend that UV filters, polycyclic musks (a type of fragrance chemical; these include tonalide and galaxolide) and triclosan be considered priorities.
  2. Expand analysis to new compounds. Only a small proportion of the hundreds of PCP chemicals have been monitored in the environment so far. It is important to expand analysis to new compounds. Understanding the environmental distribution and concentrations of all chemicals from PCPs — as well as their derivatives — will allow toxicity analysis to be made more relevant, and enable evidence-based decision-making.
  3. Developing effective treatment processes. There is a need for more effective methods of treating water to remove/de-toxify chemicals from PCPs, particularly those of highest concern, to prevent negative impacts on aquatic species and on people.

It should be noted that the full removal of PCP chemicals by urban wastewater treatment plants is difficult, expensive and has environmental impacts (e.g. use of energy and chemicals, contaminated sludge disposal). It is an EU principle that a preventive approach should be taken in relation to environmental damage, with the aim of tackling it at source, for example by not authorising chemicals that could be harmful, or by restricting use. Legislation is in place to prompt or require consideration of alternative chemicals should those present in products on the market be identified as posing a risk to the environment or human health.

Protecting you and your baby in pregnancy

A guide to avoiding hazardous chemicals in everyday products

EDCs: reduce your risk, there are things you can do.

There is growing scientific concern that early life exposures to certain harmful chemicals in our environment may lead to illnesses later in life.

This guide provides some information on what to look out for and what to avoid, both during pregnancy and as your family grows.

EDCs : are you being exposed?

Identify and avoid harmful chemicals in everyday products

EDCs: reduce your risk, there are things you can do.

Not all chemicals are harmful, but some are capable of causing cancer (carcinogens) and others can interfere with normal hormone functions; these are known as endocrine disrupting chemicals or EDCs. Some EDCs mimic the female hormone, oestrogen, which is a known risk factor for breast cancer.