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The studies are adding up that phthalates are harmful to humans of all ages, but uniquely so to the developing fetus. Boys exposed to high levels of phthalates before birth may have slightly altered genitals, specifically a shortened anogenital distance (the length between the anus and the genitals). This is concerning because in adulthood, this is associated with reduced semen quality and lower fertility in males - and considered a sign of incomplete masculinization. So try to avoid or lower exposure to phthalates during pregnancy (see posts on ENDOCRINE DISRUPTORS). From Environmental Health Perspectives:

Plastics chemical linked to changes in baby boys' genitals

Boys exposed in the womb to high levels of a chemical found in vinyl products are born with slightly altered genital development, according to research published today.The study of nearly 200 Swedish babies is the first to link the chemical di-isononyl phthalate (DiNP) to changes in the development of the human male reproductive tract.

Previous studies of baby boys in three countries found that a similar plastics chemical, DEHP, was associated with the same type of changes in their genitalia. Less is known about the reproductive risks of DiNP, a chemical which scientists say may be replacing DEHP in many products such as vinyl toys, flooring and packaging. In mice, high levels block testosterone and alter testicular development.

“Our data suggest that this substitute phthalate may not be safer than the chemical it is replacing,” wrote the researchers, led by Carl-Gustaf Bornehag at Sweden’s Karlstad University, in the journal Environmental Health Perspectives. Levels of DiNP in U.S. adults and children have more than doubled in the past decade.

The researchers measured metabolites of five phthalates in the urine of pregnant women during the first trimester. Development of male reproductive organs begins during that period, said senior study author Shanna Swan, a professor of reproductive science at Mount Sinai Hospital in New York. The researchers then measured the anogenital distance – the length between the anus and the genitals – when the boys were on average 21 months old. Boys who had been exposed to the highest levels of DiNP in the womb averaged a distance that was slightly shorter – about seven-hundredths of an inch – than the boys with the lowest exposures. “These were really subtle changes,” Swan said.

Considered a sign of incomplete masculinization, shortened anogenital distance in men has been associated with abnormal testicular development and reduced semen quality and fertility. In men, this measurement is typically 50 to 100 percent longer than in women. But it’s unknown whether a slightly shorter distance in infants corresponds with any fertility problems later in life.

For other phthalates, the study found shorter anogenital distance with higher concentrations, but the findings were not statistically significant, meaning they may have been due to chance. The Swedish women in the new study had phthalate levels similar to U.S. women in Swan's previous studies. Those studies, published in 2005 and 2008, linked several phthalates to shorter anogenital distance.

The scientists said exposures to the chemical can come from food or through skin contact with home furnishings or child-care articles. In 2008, the United States temporarily banned use of DiNP and two other phthalate plasticizers in toys and other children's products.... While it’s nearly impossible to eliminate exposure to phthalates, Swan suggested that pregnant women may be able to reduce their exposures by incorporating unprocessed, unpackaged foods into the diet and by avoiding heating or storing foods in plastic containers.

From Science Daily:

Don’t drink the (warm) water, study says

But a scientist warns Americans not to drink water from plastic bottles if it's been sitting in a warm environment for a long time. A research team examined 16 bottled water brands at 158 degrees for four weeks. The study found that as bottles warmed over the four-week period, antimony and BPA levels increased.

Plastic water bottles are made from polyethylene terephthalate. When heated, the material releases the chemicals antimony and bisphenol A, commonly called BPA.

While the U.S. Food and Drug Administration has said BPA is not a major concern at low levels found in beverage containers, it continues to study the chemical’s impacts. Some health officials, including those at the Mayo Clinic, say the chemical can cause negative effects on children’s health.And antimony is considered a carcinogen by the International Agency for Research on Cancer, part of the World Health Organization.

Of the 16 brands, only one exceeded the EPA standard for antimony and BPA....Based on the study, storage at warm temperatures would seem to not be a big problem, Ma said. Ma’s study found that as bottles warmed over the four-week period, antimony and BPA levels increased.The UF scientist warned against leaving bottled water in a hot garage for weeks on end or in your car all day during the summer....Drinking that water occasionally won’t be dangerous, but doing so regularly could cause health issues, she said.

The bottom line is to read the ingredients list on products, and avoid all products labeled "antimicrobial" or "antibacterial" (because those are the ones typically containing triclosan and triclorocarban). Over 2000 products contain antibacterial compounds. I've even seen them in pillows, pillow protectors, mattress pads, dish racks, toys, and blankets! As we know from the latest microbiology research, we need to cultivate a healthy microbiome, and not throw it out of whack by continuously trying to kill off all bacteria. From The Atlantic:

It's Probably Best to Avoid Antibacterial Soaps

Antimicrobial chemicals are so ubiquitous that a recent study found them in pregnant mothers' urine and newborns' cord blood. Research shows that their risks may outweigh their benefits.

Antimicrobial chemicals, intended to kill bacteria and other microorganisms, are commonly found in not just soaps, but all kinds of products—toothpaste, cosmetics, and plastics among them. There is evidence that the chemicals aren’t always effective, and may even be harmful, and their ubiquity means people are often continually exposed to them. One such chemical, triclosan, has previously been found in many human bodily fluids. New research found traces of triclosan, triclocarban, and butyl paraben in the urine of pregnant women, and the cord blood of newborn infants. 

The research looked at the same population of 180 expectant mothers living in Brooklyn, New York, most of Puerto Rican descent. In a study published last week in Environmental Science and Technology, researchers from Arizona State University and State University of New York’s Downstate School of Public Health found triclosan in 100 percent of the women’s urine samples, and triclocarban in 87 percent of the samples. Of the 33 cord blood samples they looked at, 46 percent contained triclosan and 23 percent contained triclocarban.

In another, still-unpublished study, the researchers found that all of the cord blood samples contained “at least one paraben,” according to Dr. Rolf Halden, director of ASU’s Center for Environmental Security. 

Triclosan and triclocarban are endocrine disruptors, Halden explains. The risk there is that the chemicals can mimic thyroid hormones, potentially disrupting the metabolism and causing weight gain or weight loss. Previous research has also shown a connection between higher levels of triclosan in urine, and allergy diagnoses in children.

In the study looking at butyl paraben, the researchers found an association between higher exposure to the chemical, and a smaller head circumference and length of babies after they were born. Butyl paraben is used as a preservative, so it’s found in a wider breadth of products, according to Halden.

From Science News: Pregnant women, fetuses exposed to antibacterial compounds face potential health risks 


As the Food and Drug Administration mulls over whether to rein in the use of common antibacterial compounds that are causing growing concern among environmental health experts, scientists are reporting that many pregnant women and their fetuses are being exposed to these substances. The compounds are used in more than 2,000 everyday products marketed as antimicrobial, including toothpastes, soaps, detergents, carpets, paints, school supplies and toys, the researchers say.

The problem with this, explains Pycke, a research scientist at Arizona State University (ASU), is that there is a growing body of evidence showing that the compounds can lead to developmental and reproductive problems in animals and potentially in humans. Also, some research suggests that the additives could contribute to antibiotic resistance, a growing public health problem.

Although the human body is efficient at flushing out triclosan and triclocarban, a person's exposure to them can potentially be constant. "If you cut off the source of exposure, eventually triclosan and triclocarban would quickly be diluted out, but the truth is that we have universal use of these chemicals, and therefore also universal exposure," says Rolf Halden, Ph.D., the lead investigator of the study at ASU.

Even though you may want to avoid phthalates, it is very hard to avoid them because they are commonly found in plastic food and beverage containers, perfume, hair spray, deodorants, almost anything fragranced (shampoo, air fresheners,etc.), insect repellent, carpeting, vinyl flooring, plastic toys, the steering wheel in cars, soft tubing in medical devices, etc. From Science Daily:

Reduced testosterone tied to endocrine-disrupting chemical exposure

Men, women and children exposed to high levels of phthalates -- endocrine-disrupting chemicals found in plastics and some personal care products -– tended to have reduced levels of testosterone in their blood compared to those with lower chemical exposure, according to a new study.

Testosterone is the main sex hormone in men. It contributes to a variety of functions in both sexes, including physical growth and strength, brain function, bone density and cardiovascular health. In the last 50 years, research has identified a trend of declining testosterone in men and a rise in related health conditions, including reduced semen quality in men and genital malformations in newborn boys.

Animal and cellular studies have found that some phthalates block the effects of testosterone on the body's organs and tissues. Researchers set out to examine whether these chemicals, which are widely used in flexible PVC plastics and personal care products, had a similar effect in humans.

"We found evidence reduced levels of circulating testosterone were associated with increased phthalate exposure in several key populations, including boys ages 6-12, and men and women ages 40-60," said one of the study's authors, John D. Meeker, MS, ScD, of the University of Michigan School of Public Health in Ann Arbor, MI. "This may have important public health implications, since low testosterone levels in young boys can negatively impact reproductive development, and in middle age can impair sexual function, libido, energy, cognitive function and bone health in men and women."

The cross-sectional study examined phthalate exposure and testosterone levels in 2,208 people who participated in the U.S. National Health and Nutrition Examination Survey, 2011-2012. Researchers analyzed urine samples to measure concentrations of 13 substances left after the body metabolizes phthalates. Each participant's testosterone level was measured using a blood sample.

Researchers found an inverse relationship between phthalate exposure and testosterone levels at various life stages. In women ages 40-60, for example, increased phthalate concentrations were associated with a 10.8 to 24 percent decline in testosterone levels. Among boys ages 6-12, increased concentrations of metabolites of a phthalate called di-(2-ethylhexyl) phthalate, or DEHP, was linked to a 24 to 34.1 percent drop in testosterone levels.

A favorite food of financially or time strapped people and students may be problematic. Just looking at the ingredient list and nutritional information should have been a clue. From Science Daily:

Can instant noodles lead to heart disease, diabetes and stroke?

Significant consumption of instant noodles -- ramen included -- may increase a person’s risk for cardiometabolic syndrome, especially in women, research shows. The findings could shed new light on the risks of a worldwide dietary habit. "This research is significant since many people are consuming instant noodles without knowing possible health risks," one researcher said. 

Because ramen consumption is relatively high among Asian populations, the research focused primarily on South Korea, which has the highest per-capita number of instant noodle consumers in the world. In recent years, South Koreans have experienced a rapid increase in health problems, specifically heart disease, and a growing number of overweight adults. Such changes could lead to increased mortality due to cardiovascular disease, as well as increased health care costs.

Dr. Shin, who led the study on behalf of the Baylor Heart and Vascular Hospital (BHVH), found that eating instant noodles two or more times a week was associated with cardiometabolic syndrome, which raises a person's likelihood of developing heart disease and other conditions, such as diabetes and stroke.

Dr. Shin also found that those results were more prevalent in women. He said that can likely be attributed to biological differences (such as sex hormones and metabolism) between the sexes, as well as obesity and metabolic syndrome components. In addition, men and women's varied eating habits and differences in the accuracy of food reporting may play a role in the gender gap.

Another potential factor in the gender difference is a chemical called bisphenol A (BPA), which is used for packaging the noodles in Styrofoam containers. Studies have shown that BPA interferes with the way hormones send messages through the body, specifically estrogen.

Informing pregnant women about environmental health hazards is absolutely necessary, especially because steps can be taken to avoid them (such as pesticides, mercury in fish, lead and BPA). Why isn't it happening routinely? Hey obstetricians - are you listening? From Huffington Post:

Doctors Fail To Counsel Pregnant Women On Toxic Chemical Risks

...dozens of environmental chemicals can course through a pregnant woman's body, cross the umbilical cord and wreck havoc on a developing fetus. Birth defects, IQ losses and childhood cancers are just some of the potential risks scientists have now tied to even low levels of exposure.

Among more than 2,500 doctors consulted for the survey, nearly all of them reported counseling patients on factors such as diet, exercise and cigarette smoking. However, only about 20 percent said they addressed environmental exposures. They pegged their hesitation to a number of factors, from the fear of overwhelming patients with anxiety-inducing worries to limited appointment time to a lack of environmental health education.

Just one in 15 doctors said they had received training on the harmful reproductive effects of toxic chemicals. "Medical school and residencies tend to frame their curriculum around the boards and required licensing exams," said Stotland. "This material is not yet on those tests." ... The American College of Obstetrics and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) issued a statement in October that underscored mounting evidence of "significant and long-lasting effects" caused by industrial chemicals, and emphasized doctors' role in protecting pregnant women.

The actual study from Plos One summed up the importance of knowing about exposures to environmental hazards during pregnancy very nicely in the introduction:

Counseling Patients on Preventing Prenatal Environmental Exposures - A Mixed-Methods Study of Obstetricians

Exposure to hazardous environmental chemicals, i.e., manufactured chemicals and metals, is linked to adverse health outcomes across all stages of the human life cycle including fertility, conception, pregnancy, child and adolescent development, and adult health [1][5]. Human exposure to environmental chemicals is ubiquitous. A population-based study found that virtually all pregnant women in the U.S. had measureable levels of at least 43 different environmental chemicals in their bodies, including chemicals that were measured at levels similar to those associated with adverse developmental and reproductive health outcomes in epidemiologic studies [6]. There are currently over 80,000 chemicals in commerce [7][8], and exposure occurs through air, water, food and consumer products in the home and workplace. The majority of industrial chemicals have not been tested for potential reproductive/developmental harm [9].

Obstetricians are uniquely positioned to help prevent exposures to environmental chemicals with adverse developmental and reproductive health effects [2]. Pregnancy is a time when exposure to environmental contaminants can disrupt or interfere with the physiology of a cell, tissue, or organ [4], leading to permanent and lifelong adverse health outcomes that may be passed down to future generations [10]. Pregnancy is also an opportune time to prevent harmful exposures as it is a period when patient interest about health can be extremely high.

The worrisome results are adding up for BPA and BPS. From Environmental Health News:

Miscarriage risk rises with BPA exposure, study finds

Women exposed to high levels of bisphenol A early in their pregnancy had an 83 percent greater risk of miscarriage than women with the lowest levels, according to new research. The scientists said their new study adds to evidence that low levels of the ubiquitous chemical, used to make polycarbonate plastic and found in some food cans and paper receipts, may affect human reproduction. The study involved 115 pregnant women who had visited a Stanford University fertility clinic within about four weeks of fertilization. The more BPA detected in the women’s blood, the higher their risk of miscarriage, according to the researchers.

“Couples suffering from infertility or recurrent miscarriages would be best advised to reduce BPA exposure because it has the potential to adversely affect fetal development,” wrote the scientists, led by Dr. Ruth Lathi, a Stanford University associate professor of obstetrics and gynecology. 

In 2005, a smaller study in Japan found that 45 women who had three or more first-trimester miscarriages had three times more BPA in their blood than 32 women with no history of pregnancy problems. 

From Science Daily:

BPA increases risk of cancer in human prostate tissue, study shows

Fetal exposure to a commonly used plasticizer found in products such as water bottles, soup can liners and paper receipts, can increase the risk for prostate cancer later in life, according to a study. Exposure of the fetus to BPA in utero is of particular concern, because the chemical, which mimics the hormone estrogen, has been linked to several kinds of cancer, including prostate cancer, in rodent models. The new findings show that human prostate tissue is also susceptible.

"Our research provides the first direct evidence that exposure to BPA during development, at the levels we see in our day-to-day lives, increases the risk for prostate cancer in human prostate tissue," Prins said

This study was done in rats, but thought to also apply to humans. From Science Daily:

Common BPA substitute, BPS, disrupts heart rhythms in females

Bisphenol S (BPS), a common substitute for bisphenol A (BPA) in consumer products, may have similar toxic effects on the heart as previously reported for BPA, a new study finds.

There is implied safety in BPA-free products. The thing is, the BPA analogs -- and BPS is one of them -- have not been tested for safety in humans." "Our findings call into question the safety of BPA-free products containing BPS," he said. "BPS and other BPA analogs need to be evaluated before further use by humans."

Another reason to try to avoid BPA. From Medical Xpress:

BPA stimulates growth of breast cancer cells, diminishes effect of treatment

Bisphenol A (BPA), a chemical commonly used in plastics, appears to increase the proliferation of breast cancer cells, according to Duke Medicine researchers presenting at an annual meeting of endocrine scientists.

The researchers found that the chemical, at levels typically found in human blood, could also affect growth of an aggressive hormone-independent subtype of  cells called inflammatory breast cancer and diminish the effectiveness of treatments for the disease.

"We set out to determine whether routine exposures to common chemicals such as those in plastics, pesticides and insecticides could influence the effectiveness of breast cancer treatments," said corresponding author Gayathri Devi, Ph.D., associate professor of surgery at Duke. "BPA was one of the top chemicals to show growth stimulatory effects in breast cancer cells."

Screenings identified several agents that appeared to increase the proliferation of inflammatory breast cancer cells. Among the most active was BPA, a chemical known to disrupt hormones. The researchers found that it caused breast cancer cells to grow at a faster rate in both estrogen-receptor positive and estrogen-receptor negative breast cancer cells.

The researchers also found that BPA doses in the range observed in human blood lowered the efficacy of FDA-approved anti-cancer drugs used in breast cancer therapy, notably lapatinib.

"These studies provide the foundation for additional research to develop tools that can be used to identify patients who may be at greater risk of developing treatment resistance," Devi said. "The findings could also lead to biomarkers that identify patients who have heavy exposure to compounds that could diminish the effectiveness of their cancer therapy."

An article comparing the U.S. versus the European Union's approach to chemicals in products (including in cosmetics, personal care products, and foods), which explains why a number of chemicals are banned in Europe, but allowed in the U.S. From Ensia:

BANNED IN EUROPE, SAFE IN THE U.S.

Atrazine, which the U.S. Environmental Protection Agency says is estimated to be the most heavily used herbicide in the U.S., was banned in Europe in 2003 due to concerns about its ubiquity as a water pollutant. 

The U.S. Food and Drug Administration places no restrictions on the use of formaldehyde or formaldehyde-releasing ingredients in cosmetics or personal care products. Yet formaldehyde-releasing agents are banned from these products in Japan and Sweden while their levels — and that of formaldehyde — are limited elsewhere in Europe. In the U.S., Minnesota has banned in-state sales of children’s personal care products that contain the chemical.

Use of lead-based interior paints was banned in France, Belgium and Austria in 1909. Much of Europe followed suit before 1940. It took the U.S. until 1978 to make this move, even though health experts had, for decades, recognized the potentially acute — even deadly — and irreversible hazards of lead exposure.

These are but a few examples of chemical products allowed to be used in the U.S. in ways other countries have decided present unacceptable risks of harm to the environment or human health. How did this happen? Are American products less safe than others? Are Americans more at risk of exposure to hazardous chemicals than, say, Europeans?

Not surprisingly, the answers are complex and the bottom line, far from clear-cut. One thing that is evident, however, is that “the policy approach in the U.S. and Europe is dramatically different."

A key element of the European Union’s chemicals management and environmental protection policies — and one that clearly distinguishes the EU’s approach from that of the U.S. federal government — is what’s called the precautionary principleThis principle, in the words of the European Commission, “aims at ensuring a higher level of environmental protection through preventative” decision-making. In other words, it says that when there is substantial, credible evidence of danger to human or environmental health, protective action should be taken despite continuing scientific uncertainty.

In contrast, the U.S. federal government’s approach to chemicals management sets a very high bar for the proof of harm that must be demonstrated before regulatory action is taken.

This is true of the U.S. Toxic Substances Control Act, the federal law that regulates chemicals used commercially in the U.S. The European law regulating chemicals in commerce, known as REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals), requires manufacturers to submit a full set of toxicity data to the European Chemical Agency before a chemical can be approved for use. U.S. federal law requires such information to be submitted for new chemicals, but leaves a huge gap in terms of what’s known about the environmental and health effects for chemicals already in use. Chemicals used in cosmetics or as food additives or pesticides are covered by other U.S. laws — but these laws, too, have high burdens for proof of harm and, like TSCA, do not incorporate a precautionary approach.

While FDA approval is required for food additives, the agency relies on studies performed by the companies seeking approval of chemicals they manufacture or want to use in making determinations about food additive safety. Natural Resources Defense Council senior scientist Maricel Maffini and NRDC senior attorney Tom Neltner “No other developed country that we know of has a similar system in which companies can decide the safety of chemicals put directly into food,” says Maffini.  The two point to a number of food additives allowed in the U.S. that other countries have deemed unsafe

Reliance on voluntary measures is a hallmark of the U.S. approach to chemical regulation. In many cases, when it comes to eliminating toxic chemicals from U.S. consumer products, manufacturers’ and retailers’ own policies — often driven by consumer demand or by regulations outside the U.S. or at the state and local level — are moving faster than U.S. federal policy. 

Cosmetics regulations are more robust in the EU than here,” says Environmental Defense Fund health program director Sarah Vogel. U.S. regulators largely rely on industry information, she says. Industry performs copious testing, but current law does not require that cosmetic ingredients be free of certain adverse health effects before they go on the market. (FDA regulations, for example, do not specifically prohibit the use of carcinogens, mutagens or endocrine-disrupting chemicals.) 

For the FDA to restrict a product or chemical ingredient from cosmetics or personal care products involves a typically long and drawn-out process. What it does more often is to issue advisories.

At the same time, built into the U.S. chemical regulatory system is a large deference to industry. Central to current U.S. policy are cost-benefit analyses with very high bars for proof of harm rather than a proof of safety for entry onto the market. Voluntary measures have moved many unsafe chemical products off store shelves and out of use, but our requirements for proof of harm and the American historical political aversion to precaution mean we often wait far longer than other countries to act.

Finally, a paper on some (but only some) of the chemicals linked to breast cancer and how to measure them in a woman's body. From Medical Xpress:

Study lists dangerous chemicals linked to breast cancer

Certain chemicals that are common in everyday life have been shown to cause breast cancer in lab rats and are likely to do the same in women, US researchers said MondayThe paper in the peer-reviewed journal Environmental Health Perspectives lists 17 chemicals to avoid and offers women advice on how to minimize their exposure. They include chemicals in gasoline, diesel and other vehicle exhaust, flame retardants, stain-resistant textiles, paint removers, and disinfection byproducts in drinking water.

Some of the biggest sources of mammary carcinogens in the environment are benzene and butadiene, which can come from vehicle exhaust, lawn equipment, tobacco smoke and charred food.

Other concerns are cleaning solvents like methylene chloride, pharmaceuticals used in hormone replacement therapy, some flame retardants, chemicals in stain-resistant textiles and nonstick coatings, and styrene which comes from tobacco smoke and is also used to make Styrofoam, the study said. Carcinogens can also be found in drinking water, researchers said.

"Unfortunately, the link between toxic chemicals and breast cancer has largely been ignored. Reducing chemical exposures could save many, many women's lives." Brody described the paper as the first to comprehensively list potential breast carcinogens and detail ways for experts to measure them in women's blood and urine.

The study also recommends seven ways for women to avoid these chemicals:

1) Limit exposure to exhaust from vehicles or generators, don't idle your car, and use electric lawn mowers, leaf blowers and weed whackers instead of gas-powered ones. 2) Use a ventilation fan while cooking and limit how much burned or charred food you eat. 3) Do not buy furniture with polyurethane foam, or ask for furniture that has not been treated with flame retardants4) Avoid stain-resistant rugs, furniture and fabrics5) If you use a dry-cleaner, find one who does not use PERC (perchloroethylene) or other solvents. Ask for "wet cleaning.6) Use a solid carbon block drinking water filter. 7) Keep chemicals out of the house by taking off your shoes at the door, using a vacuum with a HEPA (high-efficiency particulate air) filter, and cleaning with wet rags and mops.