Addressing endocrine disrupting chemicals requires an integrated strategy

It is time to disrupt business as usual and put the health of the current and future generations first

The dangers of endocrine disrupting chemicals (EDCs) for human health and the environment have long been documented and the evidence keeps piling up every day, yet Europe’s approach to this challenge has been lukewarm, writes Genon Jensen, he Executive Director of Health and Environment Alliance (HEAL).

From bisphenol A to cadmium or a whole variety of pesticides, we are all exposed to EDCs. However, as the debacle on the identification criteria of endocrine disruptors for pesticides illustrates, the European approach to this emerging challenge lacks ambition. Not only does it fail to follow the latest scientific developments, but also to acknowledge the societal demands for a transition to safer alternatives.

On 4 July, a European Commission proposal for criteria to identify endocrine disrupting chemicals for pesticides was agreed by representatives of EU governments – the end of a four-year process.

For health and environment advocates, scientists, or public interest groups such as health professionals or non-profit insurers, these criteria have a bitter and toxic taste. Leaving aside the significant corporate lobbying interference in the process, one is struck by the health and economic burden that a lack of ambition and political will result in for society.

According to a conservative estimate, diseases arising from exposure to EDCs weigh at least €163 billion on European public health budgets.

Meanwhile, urine tests and hair samples from populations all across Europe show the presence of chemicals that should not be there in people’s bodies: for instance, a study carried out in France in 2015 found no less than 21 endocrine disruptors’ residues per women tested, including toxic chemicals that have been banned from the market.

Keeping these numbers in mind, addressing the emerging challenges posed by the exposition to endocrine disruptors across their uses (beyond pesticides, from cosmetics to food packages, or toys) based on precaution and consistency appears both an urgent and obvious need.

Unfortunately, the criteria agreed are narrow, insufficient, impractical, and they will make it very difficult – if not impossible – to prove that a pesticide is disrupting the endocrine system.

Why does this matter? Because the higher the burden of the proof and the bigger the loopholes in the identification criteria, the longer the products will remain on the market, leaving people exposed to their effects and weighing heavily on public health budgets.

What should be done now?

The battle over the identification criteria for pesticides is not completely over yet. After the summer, the European Parliament will be asked to vote on the European Commission proposal – either to sign it off or to veto it.

This is an important opportunity for MEPs to echo the existing concerns, give a voice to almost 500,000 citizens who have asked for more protective criteria without being heard. Therefore, MEPs should reject the current criteria and defend an ambitious approach that reflects the latest state of science.

Traces of endocrine disrupting chemicals are found everywhere, including in our bodies, which means that we are all concerned by their effects. The Endocrine Disruption Exchange lists about 1,300 potential EDCs, and many more suspected substances need to be investigated.

While scientists and public interest groups are doing their share to address this emerging challenge, decision-makers should have the courage to take political steps that are already available. This can start in the European Parliament with the rejection of the flawed pesticides criteria.

It is time to disrupt business as usual and put the health of the current and future generations first.

An Investigation
  1. The Manufacture of a Lie.
  2. A Denial of the State of the Science.
  3. The Interference of the United States.
  4. The Discreet but Major Gift to the Pesticides Lobby.
Endocrine Disruptors

Evaluating low-dose toxicity from endocrine active chemicals

Application of Systematic Review Methods in an Overall Strategy for Evaluating Low-Dose Toxicity from Endocrine Active Chemicals

A new report by the National Academies of Sciences, Engineering, and Medicine proposes a strategy that the U.S. Environmental Protection Agency (EPA) should use to evaluate the evidence of adverse human health effects from low doses of exposure to chemicals that can disrupt the endocrine system.

The report’s proposed strategy has three broad steps that can help evaluate evidence of impacts from low-dose chemical exposure:

  • Surveillance
    Surveillance can detect signals of possible health effects by actively monitoring new data, scientific literature, nontraditional information sources, and stakeholder input to ensure health effects are being identified and analyzed on a regular basis.
  • Investigation and Analysis
    To further investigate the signals, the agency should analyze existing data, generate new data to fill gaps, conduct a systematic review of evidence, or integrate evidence from human and animal studies. One or more of these options might be needed to answer questions about potential signals.
  • Action
    Possible actions the agency could take include updating chemical assessments, regularly monitoring for new data, requiring new data or models to reduce uncertainties, or updating toxicity-testing designs and practices. Additional considerations, such as the public health significance and available resources, would also factor into the decision making.

Sources

Endocrine Disruptors

The pitfalls of big data and the cost of missing something

The human insights missing from big data – TEDx Talks, Nov 2016

With stories from Nokia to Netflix to the oracles of ancient Greece, Tricia Wang demystifies big data and identifies its pitfalls, suggesting that we focus instead on “thick data” – precious, unquantifiable insights from actual people – to make the right business decisions and thrive in the unknown.

Use of antibiotics during pregnancy and the risk of major congenital malformations

Clindamycin, doxycycline, quinolones, macrolides and phenoxymethylpenicillin in utero exposure were linked to major congenital malformations

2017 Study Abstract

Introduction
Few studies have investigated the link between individual antibiotics and major congenital malformations (MCMs) including specific malformations owing to small sample size. We aimed – population based cohort study, British Pharmacological Society, 19 July 2017 – to quantify the association between exposure to gestational antibiotic and the risk of MCMs.

Methods
Using the Quebec pregnancy cohort (1998 -2008), we included a total of 139,938 liveborn singleton alive whose mothers were covered by the “Régie de l’assurance maladie du Québec” drug plan for at least 12 months before and during pregnancy. Antibiotics exposure was assessed in the first trimester and MCMs were identified within the first year of life.

Results
After adjusting for potential confounders, clindamycin exposure was associated with an increased risk of MCMs (aOR 1.34, 95%CI, 1.02-1.77, 60 exposed cases), musculoskeletal system malformations (aOR 1.67, 95%CI, 1.12-2.48, 29 exposed cases) and ventricular/atrial septal defect (aOR 1.81, 95%CI, 1.04-3.16, 13 exposed cases).

Doxycycline exposure increased the risk of circulatory system malformation, cardiac malformations and ventricular/atrial septal defect (aOR 2.38, 95%CI ,1.21-4.67, 9 exposed cases; aOR 2.46, 95%CI, 1.21-4.99, 8 exposed cases; aOR 3.19, 95%CI, 1.57-6.48, 8 exposed cases, respectively). Additional associations were seen with quinolone (1 defect), moxifloxacin (1 defect), ofloxacin (1 defect), macrolide (1 defect), erythromycin (1 defect) and phenoxymethylpenicillin (1 defect). No link was observed with amoxicillin, cephalosporins and nitrofurantoin. Similar results were found when penicillins were used as the comparator group.

Conclusions

  • Clindamycin, doxycycline, quinolones, macrolides and phenoxymethylpenicillin in utero exposure were linked to organ specific malformations.
  • Amoxicillin, cephalosporins and nitrofurantoin were not associated with MCMs.

Late-breaking mutations may play an important role in autism

Rates, distribution and implications of postzygotic mosaic mutations in autism spectrum disorder

Over the past decade, mutations to more than 60 different genes have been linked with autism spectrum disorder (ASD), including de novo mutations, which occur spontaneously and aren’t inherited. But much of autism still remains unexplained.

A new study of nearly 6,000 families implicates a hard-to-find category of de novo mutations: those that occur after conception, and therefore affect only a subset of cells.

2017 Study Abstract

We systematically analyzed postzygotic mutations (PZMs) in whole-exome sequences from the largest collection of trios (5,947) with autism spectrum disorder (ASD) available, including 282 unpublished trios, and performed resequencing using multiple independent technologies. We identified 7.5% of de novo mutations as PZMs, 83.3% of which were not described in previous studies. Damaging, nonsynonymous PZMs within critical exons of prenatally expressed genes were more common in ASD probands than controls (P < 1 × 10−6), and genes carrying these PZMs were enriched for expression in the amygdala (P = 5.4 × 10−3). Two genes (KLF16 and MSANTD2) were significantly enriched for PZMs genome-wide, and other PZMs involved genes (SCN2A, HNRNPU and SMARCA4) whose mutation is known to cause ASD or other neurodevelopmental disorders. PZMs constitute a significant proportion of de novo mutations and contribute importantly to ASD risk.

Sources
  • Rates, distribution and implications of postzygotic mosaic mutations in autism spectrum disorder, Nature Neuroscience, doi:10.1038/nn.4598, 17 July 2017.
  • Late-breaking mutations may play an important role in autism, Boston Children’s Hospital, July 17, 2017.

Epigenetics : Nature v. Nurture

The University of Oslo Faculty of Medicine, 2016

How do the identical twins Lucky Lyle and Troubled Tim end up with different personalities? Is it the environment or genes? Or perhaps both?

Video published by The University of Oslo Faculty of Medicine, 29 Jan 2016.

Anyone got any health problems after the HPV vaccination ?

Contact “TimeForAction”, a campaign group run by UK families for UK families

My daughter has developed health problems after receiving the Gardasil vaccine, what should I do ?

If your daughter has developed health problems after HPV vaccination, please get in touch with TimeForAction – a campaign group run by UK families for UK families. They’re campaigning hard to ensure that these health problems are properly acknowledged and investigated, that families are treated with compassion and respect within the health service and that there is educational support in place for the girls who are struggling to attend school on a full timetable.

TimeForAction is also calling for a full disclosure of all the potential risks associated with the HPV vaccination to be given to parents when seeking consent, in conjunction with a more accurate assessment of the stated benefits. For more information, visit TimeForAction website, call 07885 422690, email, tweet or use this form.

How big data’s big bias is bringing noise and conflicts to US drug regulation

Jeanne Lenzer investigates, The BMJ, July 2017

A little known private foundation to support FDA’s “regulatory science” takes money out of the FDA’s coffers to support analyses using levels of evidence recommended by industry; many of the foundation’s directors have financial links to the drug and device makers that the FDA regulates.

Overview
  • No drug risks identified
  • Reagan-Udall Foundation
  • Directors’ ties to industry
  • Panel stacking
  • Funding the foundation
  • Funding the Medical Evidence Development and Surveillance (IMEDS)
  • Light touch FDA

Big data can be used cautiously to examine real world outcomes and to improve surveillance of drug safety. For example, it has been used to identify overuse of some interventions and can show drug and device complications in real world settings rather than idealized controlled trials.

However, big data are a noisy mess, and analyses by entities with profit motives may identify spurious associations that support fast track approvals and indication creep (broadening the indications for drugs and devices).” …

continue reading Jeanne Lenzer investigation Big data’s big bias: bringing noise and conflicts to US drug regulation on The BMJ, 18 July 2017.

Comment lutter contre les maltraitances médicales ?

La violence médicale est-elle une exception et comment faire évoluer les pratiques de certains soignants ?

LA question que LE DÉBAT DE MIDI s’est mise sous la dent.

Source : Comment lutter contre les maltraitances médicales ?, France Inter, Le débat de midi du lundi 17 juillet 2017.

Les invités de l’émission LE DÉBAT DE MIDI

  • Dominique Dupagne
    médecin généraliste, spécialisé dans la santé et les forums médicaux
  • Marie-Hélène Lahaye
    juriste, blogueuse
  • Odile Buisson
    gynécologue obstétricienne

Quelques Tweets

We are more than the sum of our genes

Epigenetics between the generations : we inherit more than just genes

Epigenetic mechanisms modulated by environmental cues such as diet, disease or our lifestyle take a major role in regulating the DNA by switching genes on and off. It has been long debated if epigenetic modifications accumulated throughout the entire life can cross the border of generations and be inherited to children or even grand children. Now researchers from the Max Planck Institute of Immunobiology and Epigenetics in Freiburg show robust evidence that not only the inherited DNA itself but also the inherited epigenetic instructions contribute in regulating gene expression in the offspring. Moreover, the new insights by the Lab of Nicola Iovino describe for the first time biological consequences of this inherited information. The study proves that mother’s epigenetic memory is essential for the development and survival of the new generation.

Abstract

Gametes carry parental genetic material to the next generation. Stress-induced epigenetic changes in the germ line can be inherited and can have a profound impact on offspring development. However, the molecular mechanisms and consequences of transgenerational epigenetic inheritance are poorly understood. We found that Drosophila oocytes transmit the repressive histone mark H3K27me3 to their offspring. Maternal contribution of the histone methyltransferase Enhancer of zeste, the enzymatic component of Polycomb repressive complex 2, is required for active propagation of H3K27me3 during early embryogenesis. H3K27me3 in the early embryo prevents aberrant accumulation of the active histone mark H3K27ac at regulatory regions and precocious activation of lineage-specific genes at zygotic genome activation. Disruption of the germ line–inherited Polycomb epigenetic memory causes embryonic lethality that cannot be rescued by late zygotic reestablishment of H3K27me3. Thus, maternally inherited H3K27me3, propagated in the early embryo, regulates the activation of enhancers and lineage-specific genes during development.

Sources
  • Epigenetics between the generations : researchers prove that we inherit more than just genes, Max-Planck-Gesellschaft, July 13, 2017.
  • Germ line–inherited H3K27me3 restricts enhancer function during maternal-to-zygotic transition, sciencemag, DOI: 10.1126/science.aam5339, 14 Jul 2017.
  • Featured image © MPI of Immunobiology a. Epigenetics / F. ZenkEgg-cell of a female fruit fly with the egg cell in which H3K27me3 was made visible through green staining. This cell, together with the sperm, will contribute to the formation of the next generation of flies. In the upper right corner, a maternal and paternal pre-nucleus are depicted before their fusion during fertilization. The green colouration of H3K27me3 appears exclusively in the maternal pre-nucleus, indicating that their epigenetic instructions are inherited into the next generation.