Noresthisterone period delay pill now sold over the counter : is it safe ?

What will be the real cost of “giving women more choices” and messing with their bodies” ?

“The Period Delay Pill has been available on our Online Doctor service previously and now introducing it in our pharmacies and nurse clinics with a consultation and questionnaire allows women to make the choice easily and quickly should they choose to delay their period.”

Michael Henry, healthcare director for Superdrug.

Reported Side Effects

Asthma; cardiac dysfunction; conditions that may worsen with fluid retention; diabetes (progestogens can decrease glucose tolerance—monitor patient closely); epilepsy; history of depression; hypertension; migraine; susceptibility to thromboembolism (particular caution with high dose).

When used for contraception

Active trophoblastic disease (until return to normal of urine- and plasma-gonadotrophin concentration)—seek specialist advice; arterial disease; functional ovarian cysts; history of jaundice in pregnancy; malabsorption syndromes; past ectopic pregnancy; sex-steroid dependent cancer; systemic lupus erythematosus with positive (or unknown) anti-phospholipid antibodies with intramuscular use for contraception disturbances of lipid metabolism; history during pregnancy of deterioration of otosclerosis; history during pregnancy of pruritus; possible risk of breast cancer.

Cautions, further information

A possible small increase in the risk of breast cancer should be weighed against the benefits.

The product literature advises caution in patients with history of thromboembolism, hypertension, diabetes mellitus and migraine; evidence for caution in these conditions is unsatisfactory.

Read NICE guidelines about norethisterone.

“Like the contraceptive pill, period delay pills are not side-effect free. Norethisterone is a synthetic version of the naturally occurring hormone progesterone and, like the other synthetic hormones in contraception, it can cause breast tenderness, nausea, headaches, low libido and, crucially, ‘disturbances in mood’. What the NHS likely means by this is mental health side effects which can range from ‘feeling a bit low’ to full-blown depression and anxiety. No two women are the same and so no two women will respond to a pill in the same way.”

Read Why no one’s talking about the worrying side effects of period delay tablets on Metro, 10 Aug 2019.

Occurrence of microplastics in raw and treated drinking water

Microplastics: new methods are needed to filter tiny particles from drinking water, 2019

The presence of plastics in aquatic environments is a growing concern across the EU. This study explored the amount of microplastic particles present in raw and treated water at three water-treatment plants in the Czech Republic. While treated water contained fewer particles than raw1 fresh water, the amount found in treated water was not negligible, and largely comprised tiny particles of <10 micrometres (μm) in diameter. Ways to filter microplastics from potable water must be identified and their risk to humans, sources and routes into drinking water determined, say the researchers, Science for Environment Policy reports.

Highlights

  • Microplastics were present in all water samples from different treatment plants.
  • The concentration of microplastics was higher in raw water than in treated water.
  • Particles of 1–10 μm were the most abundant, accounting for up to 95%.
  • Polyethylene terephthalate, polypropylene and polyethylene microplastics prevailed.

Abstract

The study investigates the content of microplastic particles in freshwater and drinking water. Specifically, three water treatment plants (WTPs) supplied by different kinds of water bodies were selected and their raw and treated water was analysed for microplastics (MPs). Microplastics were found in all water samples and their average abundance ranged from 1473 ± 34 to 3605 ± 497 particles L−1 in raw water and from 338 ± 76 to 628 ± 28 particles L−1 in treated water, depending on the WTP. This study is one of very few that determine microplastics down to the size of 1 μm, while MPs smaller than 10 μm were the most plentiful in both raw and treated water samples, accounting for up to 95%. Further, MPs were divided into three categories according to their shape. Fragments clearly prevailed at two of the WTPs and fibres together with fragments predominated at one case. Despite 12 different materials forming the microplastics being identified, the majority of the MPs (>70%) comprised of PET (polyethylene terephthalate), PP (polypropylene) and PE (polyethylene). This study contributes to fill the knowledge gap in the field of emerging microplastic pollution of drinking water and water sources, which is of concern due to the potential exposure of microplastics to humans.

Chemicals, pesticides, microplastics added to supermarket food

The Honest Supermarket – What’s Really in Our Food ?

Can we trust our supermarkets to tell us the truth about what we are buying and how it was produced ?

For every pound we spend on food shopping, 77p goes to the supermarkets, giving them a huge influence over what we eat. Do their profits come first ?

In an experiment to discover the hidden truths about our everyday foods, Horizon has built the first ever truly ‘honest supermarket’. Drawing on the latest scientific research and leading experts from across the UK, the team have built a supermarket where the products are labelled with the real story of how they are produced and their effect on us and the environment. We invite the British public to come in and discover the truth about their favourite foods. And in our on-site lab, new scientific discoveries reveal the food facts the supermarkets aren’t telling you.

Presented by Dr Hannah Fry and dietician Priya Tew, The Honest Supermarket takes a cold hard look at what’s really going on with the food we eat. From new research that reveals you’re likely to be ingesting plastic particles along with your bottled water to the lab tests that uncover the disturbing truth about just how old your ‘fresh’ supermarket fish really is…

You’ll never look at the food on your supermarket shelves in the same way again says BBC2 Horizon, Jul 2019.

Prenatal exposure to chemicals in personal care products linked to earlier puberty in girls

Association of phthalates, parabens and phenols found in personal care products with pubertal timing in girls and boys

Girls exposed to chemicals commonly found in toothpaste, makeup, soap and other personal care products before birth may hit puberty earlier, according to a new longitudinal study led by researchers at UC Berkeley (see press release).

2019 Study Abstract

STUDY QUESTION
Are in-utero or peripubertal exposures to phthalates, parabens and other phenols found in personal care products associated with timing of pubertal onset in boys and girls?

SUMMARY ANSWER
We found some associations of altered pubertal timing in girls, but little evidence in boys.

WHAT IS KNOWN ALREADY
Certain chemicals in personal care and consumer products, including low molecular weight phthalates, parabens and phenols, or their precursors, are associated with altered pubertal timing in animal studies.

STUDY DESIGN, SIZE, DURATION
Data were from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) longitudinal cohort study which followed 338 children in the Salinas Valley, California, from before birth to adolescence.

PARTICIPANTS/MATERIALS, SETTING, METHODS
Pregnant women were enrolled in 1999–2000. Mothers were mostly Latina, living below the federal poverty threshold and without a high school diploma. We measured concentrations of three phthalate metabolites (monoethyl phthalate [MEP], mono-n-butyl phthalate and mono-isobutyl phthalate), methyl and propyl paraben and four other phenols (triclosan, benzophenone-3 and 2,4- and 2,5-dichlorophenol) in urine collected from mothers during pregnancy and from children at age 9. Pubertal timing was assessed among 179 girls and 159 boys every 9 months between ages 9 and 13 using clinical Tanner staging. Accelerated failure time models were used to obtain mean shifts of pubertal timing associated with concentrations of prenatal and peripubertal biomarkers.

MAIN RESULTS AND THE ROLE OF CHANCE
In girls, we observed earlier onset of pubic hair development with prenatal urinary MEP concentrations and earlier menarche with prenatal triclosan and 2,4-dichlorophenol concentrations. Regarding peripubertal biomarkers, we observed: earlier breast development, pubic hair development and menarche with methyl paraben; earlier menarche with propyl paraben; and later pubic hair development with 2,5-dichlorophenol. In boys, we observed no associations with prenatal urinary biomarker concentrations and only one association with peripubertal concentrations: earlier genital development with propyl paraben.

LIMITATIONS, REASONS FOR CAUTION
These chemicals are quickly metabolized and one to two urinary measurements per developmental point may not accurately reflect usual exposure. Associations of peripubertal measurements with parabens may reflect reverse causality: children going through puberty early may be more likely to use personal care products. The study population was limited to Latino children of low socioeconomic status living in a farmworker community and may not be widely generalizable.

WIDER IMPLICATIONS OF THE FINDINGS
This study contributes to a growing literature that suggests that exposure to certain endocrine disrupting chemicals may impact timing of puberty in children.

STUDY FUNDING/COMPETING INTEREST(S)
This study was funded by the National Institute of Environmental Health Sciences and the US Environmental Protection Agency. The authors declare no conflicts of interest.

TRIAL REGISTRATION NUMBER
N/A.

Maternal exposure to workplace solvents may increase the risk for ASD in children

The CHARGE study : an assessment of parental occupational exposures and autism spectrum disorder

Children whose mothers are exposed to solvents at work are at higher risk of autism, shows new research.

The study found that women who are exposed to workplace solvents are 1.5 times more likely to have a child on the autistic spectrum, newnationnews reports. Image credit @ATEN_Int.

2019 Study Abstract

Objectives
The aim of this study is to determine if parental occupational exposure to 16 agents is associated with autism spectrum disorder (ASD).

Methods
Demographic, health and parental occupational data were collected as part of the CHildhood Autism Risks from Genetics and Environment (CHARGE) study. The workplace exposure assessment was conducted by two experienced industrial hygienists for the parents of 537 children with ASD and 414 typically developing (TD) children. For each job, frequency and intensity of 16 agents were assessed and both binary and semi-quantitative cumulative exposure variables were derived. Logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess associations between parental occupational exposures 3 months pre-pregnancy until birth.

Results
The OR of ASD in the children of mothers exposed to any solvents was 1.5 times higher than the mothers of TD children (95% CI=1.01–2.23). Cumulative exposure indicated that the OR associated with a moderate level of solvent exposure in mothers was 1.85 (95% CI=1.09, 3.15) for children with ASD compared with TD children. No other exposures were associated with ASD in mothers, fathers or the parents combined.

Conclusion
Maternal occupational exposure to solvents may increase the risk for ASD. These results are consistent with a growing body of evidence indicating that environmental and occupational exposures may be associated with ASD. Future research should consider specific types of solvents, larger samples and/or different study designs to evaluate other exposures for potential associations with ASD.

Exposure to Common Flame Retardants May Contribute to Attention Problems in Children

Prenatal exposure to polybrominated diphenyl ethers and child attention problems at 3–7 years

Prenatal exposure to some flame retardants that have been widely-used in consumer products is associated with attention problems in children ages three through seven, according to a study by researchers at the Columbia Center for Children’s Environmental Health, within Columbia’s Mailman School of Public Health, ccceh reports.

Abstract

Introduction
Polybrominated diphenyl ethers (PBDEs) comprise a class of halogenated compounds used extensively as flame retardant chemicals in consumer products resulting in nearly ubiquitous human exposure. Mounting evidence suggests that PBDEs are developmental neurotoxicants; however, associations between early life exposure and child behavior have been largely limited to a single developmental time point.

Methods
The study population consists primarily of white, black and Chinese women who were pregnant on 11 September 2001 and delivered at 1 of 3 downtown New York City hospitals. Maternal–child pairs were followed through age 7 years. Cord blood was collected at delivery and PBDE plasma levels for 210 samples were analyzed by the U.S. Centers for Disease Control and Prevention. The Child Behavior Checklist, a validated maternal-report instrument used for assessing child behavior, was administered annually between the ages of 3 and 7 years. We analyzed the association between natural log-transformed and dichotomized (low vs. high) PBDEs and attention problems using multivariable adjusted negative binomial regression.

Results
We detected 4 PBDE congeners in more than 50% of samples, with concentrations highest for BDE-47 (median ± IQR: 11.2 ± 19.6 ng/g). In adjusted analyses, we detected associations between BDE-47 (1.21, 95% CI: 1.00, 1.47), and BDE-153 (1.18, 95% CI: 1.00, 1.39) in cord plasma and increased attention problems among children at age 4 (n = 109) but not 6 (n = 107) years.

Conclusions
Our findings demonstrate a positive trend between prenatal PBDE exposure and early childhood attention problems, and are consistent with previous research reporting associations between prenatal PBDE exposure and disrupted child behaviors.

Sex, Lies and Pharmaceuticals

The merging of marketing and medical science : female sexual dysfunction

As the search for the so-called ‘Pink Viagra’ continues, controversy surrounds the nature of the medical ‘condition’ such a pill would treat.

  • Do women with a low libido really have a disease called ‘hypoactive-sexual desire disorder’?
  • Does it really affect one-in-ten women as drug companies claim?

There’s already a marketed treatment for HSDD in the form of a pill called Addyi, a drug whose 2015 FDA approval came with intense debate over whether sexual desire was indeed a medical issue. Addyi has since become a commercial nonentity, in large part because women are restricted from drinking alcohol before taking it. The controversy around the drug’s approval faded along with its meager sales.

But bremelanotide, which promises a similar effect with fewer side effects, has rekindled the conversation around whether sexual desire can be a matter of pharmaceutical science.

Continue reading on stat news.

In an article in the BMJ almost 10 years ago I described the making of female sexual dysfunction as the freshest, clearest example of the “corporate sponsored creation of a disease.”1 Looking back over the past decade, it has become clear that drug companies have not simply sponsored the science of this new condition; on occasions they have helped to construct it. Corporate employees have worked with paid key opinion leaders to help develop the disease entity; they have run prevalence surveys to portray it as widespread; and they helped create the measurement and diagnostic instruments to persuade women that their sexual difficulties deserve a medical label and treatment. Drug marketing is merging with medical science in a fascinating and frightening way, raising questions about whether a new approach to defining diseases is warranted.

Continue reading on the BMJ.

Condition branding is a marketing technique in which companies develop conditions concurrently with developing drugs; examples include gastro-oesophageal reflux disease, premenstrual dysphoric disorder, social anxiety disorder, erectile dysfunction and hypoactive sexual desire disorder. Although it is illegal for pharmaceutical companies to market drugs prior to regulatory approval, there are no restrictions on marketing diseases, and industry seeks to establish a disease state in the minds of clinicians years before an expected drug launch. Continuing medical education (CME) courses are an important part of promotion prior to drug approval and have become a key marketing tool for increasing clinician receptivity to new products. We systematically identified 14 free, internet-based, industry-funded, accredited CME modules on hypoactive sexual desire disorder in women which came out before a new drug, flibanserin, was being considered for regulatory approval in the USA. Common themes in these modules included the following: Hypoactive sexual desire disorder is common, underdiagnosed and can have a profound effect on quality of life. Women may not be aware that they are sick or distressed. Simple questionnaires can assist clinicians in diagnosing the disorder. It is problematic that there are medicines available to treat sexual problems for men but not women. In fact, there is no scientifically established norm for sexual activity, feelings or desire, and there is no evidence that hypoactive sexual desire disorder is a medical condition. Hypoactive sexual desire disorder is a typical example of a condition that was sponsored by industry to prepare the market for a specific treatment.

Continue reading on the BMJ.

A complete and comprehensive ban on fracking is needed to mitigate its grave harm to public health and the climate

Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking (Unconventional Gas and Oil Extraction), Sixth Edition, June 19, 2019

A group of doctors and scientists have released a comprehensive report highlighting that 84 percent of studies published from 2009-2015 on the health impacts of fracking conclude the industry causes harm to human health, Environmental Health News reports.
Concerned Health Professionals of New York compendium.

Abstract

Conclusion

All together, findings to date from scientific, medical, and journalistic investigations combine to demonstrate that fracking poses significant threats to air, water, human health, public safety, community cohesion, long-term economic vitality, biodiversity, seismic stability, and climate stability.

The rapidly expanding body of scientific evidence compiled and referenced in the present volume is massive, troubling, and cries out for decisive action. Across a wide range of parameters, from air and water pollution to radioactivity to social disruption to greenhouse gas emissions, the data continue to reveal a plethora of recurring problems and harms that cannot be sufficiently averted through regulatory frameworks.There is no evidence that fracking can operate without threatening public health directly and without imperiling climate stability upon which public health depends. The only method of mitigating its grave harm to public health and the climate is a complete and comprehensive ban on fracking.

In the words of investigative journalist Andrew Nikiforuk:

Industry swore that its cracking rock technology was safe and proven, but science now tells a different story. Brute force combined with ignorance … has authored thousands of earthquakes … [and] called forth clouds of migrating methane…. The science is complicated but clear: cracking rock with fluids is a chaotic activity and no computer model can predict where those fractures will go. The regulatory record shows that they often go out of zone; extend into water; and rattle existing oil and gas wells, and these rattled wells are leaking more methane.

In closing, we cite comments by epidemiologist Irena Gorski, co-author of the 2019 review of fracking’s health concerns published in the Oxford Research Encyclopedia of Global Public Health. Her words speak for all who have contributed to this Compendium:

What we found pushes back against the narrative we often hear that say we don’t know enough about the health impacts yet. We have enough evidence at this point that these health impacts should be of serious concern to policymakers interested in protecting public health….As a fossil fuel, natural gas extraction and use is contributing to climate change, of course. But before conducting this study, I didn’t realize the amount of evidence we have that it may be even worse than coal. We included this in our study because climate change has its own contributions to health impacts. These indirect impacts will take longer to appear than the direct health impacts, but they have the potential to be significant.

Farming causes harm to rural air quality, recent review says

A systematic review of the public health risks of bioaerosols from intensive farming

A recent review by he found evidence of respiratory problems in farm workers and raised concerns about exposure for people living close to intensive livestock farms, including some evidence of increased asthma in children, The Guardian reports.

Abstract

Background
Population growth, increasing food demands, and economic efficiency have been major driving forces behind farming intensification over recent decades. However, biological emissions (bioaerosols) from intensified livestock farming may have the potential to impact human health. Bioaerosols from intensive livestock farming have been reported to cause symptoms and/or illnesses in occupational-settings and there is concern about the potential health effects on people who live near the intensive farms. As well as adverse health effects, some potential beneficial effects have been attributed to farm exposures in early life. The aim of the study was to undertake a systematic review to evaluate potential for adverse health outcomes in populations living near intensive livestock farms.

Material and methods
Two electronic databases (PubMed and Scopus) and bibliographies were searched for studies reporting associations between health outcomes and bioaerosol emissions related to intensive farming published between January 1960 and April 2017, including both occupational and community studies. Two authors independently assessed studies for inclusion and extracted data. Risk of bias was assessed using a customized score.

Results
38 health studies met the inclusion criteria (21 occupational and 1 community study measured bioaerosol concentrations, 16 community studies using a proxy measure for exposure). The majority of occupational studies found a negative impact on respiratory health outcomes and increases in inflammatory biomarkers among farm workers exposed to bioaerosols. Studies investigating the health of communities living near intensive farms had mixed findings. All four studies of asthma in children found increased reported asthma prevalence among children living or attending schools near an intensive farm. Papers principally investigated respiratory and immune system outcomes.

Conclusions
The review indicated a potential impact of intensive farming on childhood respiratory health, based on a small number of studies using self-reported outcomes, but supported by findings from occupational studies. Further research is needed to measure and monitor exposure in community settings and relate this to objectively measured health outcomes.

Overview of known plastic packaging-associated chemicals and their hazards

Which hazardous chemicals are associated with plastic packaging?

The use of plastic packaging is increasing globally, causing environmental and human health concerns. In 2015 annual plastic production was 380Mt, of which about 40 per cent was used in packaging, with the majority being used in food packaging.

The 906 substances which are most likely to be associated with plastic packaging have been published on the Data Commons websiteAt least 148 of the 906 chemicals most likely to be associated with plastic packaging were identified as particularly hazardous based on several harmonized hazard data sources, and 35 of the chemicals listed are regarded as endocrine disrupting chemicals (EDCs), CHEM Trust reports.

2018 Study Highlights

  • Database of Chemicals associated with Plastic Packaging (CPPdb) is presented.
  • CPPdb contains chemicals used in manufacturing and/or present in final articles.
  • 906 chemicals identified as likely, 3377 chemicals as possibly associated.
  • Hazard data: CLP classifications, EDC, PBT, vPvB identifications explored.
  • Data gaps concerning both the use and toxicity of numerous substances identified.

Abstract

Global plastics production has reached 380 million metric tons in 2015, with around 40% used for packaging. Plastic packaging is diverse and made of multiple polymers and numerous additives, along with other components, such as adhesives or coatings. Further, packaging can contain residues from substances used during manufacturing, such as solvents, along with non-intentionally added substances (NIAS), such as impurities, oligomers, or degradation products. To characterize risks from chemicals potentially released during manufacturing, use, disposal, and/or recycling of packaging, comprehensive information on all chemicals involved is needed. Here, we present a database of Chemicals associated with Plastic Packaging (CPPdb), which includes chemicals used during manufacturing and/or present in final packaging articles. The CPPdb lists 906 chemicals likely associated with plastic packaging and 3377 substances that are possibly associated. Of the 906 chemicals likely associated with plastic packaging, 63 rank highest for human health hazards and 68 for environmental hazards according to the harmonized hazard classifications assigned by the European Chemicals Agency within the Classification, Labeling and Packaging (CLP) regulation implementing the United Nations’ Globally Harmonized System (GHS). Further, 7 of the 906 substances are classified in the European Union as persistent, bioaccumulative, and toxic (PBT), or very persistent, very bioaccumulative (vPvB), and 15 as endocrine disrupting chemicals (EDC). Thirty-four of the 906 chemicals are also recognized as EDC or potential EDC in the recent EDC report by the United Nations Environment Programme. The identified hazardous chemicals are used in plastics as monomers, intermediates, solvents, surfactants, plasticizers, stabilizers, biocides, flame retardants, accelerators, and colorants, among other functions. Our work was challenged by a lack of transparency and incompleteness of publicly available information on both the use and toxicity of numerous substances. The most hazardous chemicals identified here should be assessed in detail as potential candidates for substitution.