Wednesday, February 14, 2024

The REAL Cause and Effect of ENVIRONMENTAL TOXINS

 Source: ECOSMART NEWS  Vol 2-2024

 By: Dr. Roberta Kline / Women’s Health Digest – Editor

The role of environmental toxins in a wide variety of health issues is a huge public health crisis that is not receiving the attention it needs. While it is well known that making healthy diet and lifestyle choices can significantly improve health outcomes, this is only one part of the equation. Putting the burden of responsibility solely on the individual is no longer effective when their greater environment is full of toxic threats they cannot see or control. 










HOW BIG IS THE PROBLEM REALLY?

The reality is that we are exposed to numerous toxins over the course of our lives – starting even before birth. Over the last 50 years, more than 87,000 chemicals have been approved for commercial use. Yet only about 1% (about 1,000 chemicals) have been actually evaluated for health risk. Half of those have been found to have some risk of causing cancer by the WHO: 120 as known carcinogens, 81 as probably carcinogens, and 299 as possible carcinogens. [1] 

Here in the U.S. we have lagged behind. To date, the EPA has only banned 9 chemicals, and the National Toxicology Program has identified 27 chemical substances as carcinogens. [2] Clearly, there is much more work to do.

Neither of these addresses the increasing burden of a newer class of chemicals called endocrine disruptors. Classic carcinogens cause cancer through cell damage and mutations. Endocrine disruptors operate differently, mimicking hormones and causing subtle but significant alterations in our biological communication system. [1] Often there is synergy between the effects of these different types of chemicals, making it difficult to show direct cause-and-effect for health risks. 

A recent update by the EPA revealed that less than half of the 87,000 identified chemicals are currently in commercial use). [3] That may sound promising, but it is estimated that many more chemicals are present in our everyday environment, including pharmaceuticals and byproducts of degradation. On top of this, most monitoring protocols only report on a small number of these. Thus, while it is impossible to state the exact burden of toxins accurately, it is clear that this is a significant problem.

A COMPLEX INTERACTION
Not everyone who is exposed to environmental chemicals will develop disease or cancer. The outcome for each individual is the result of a complex interplay of their genetic predispositions, epigenetics, and environmental exposures over their lifetime. We all have biological processes to clear many different chemical substances from our bodies. How well these systems function can be affected by many factors, including genetics and epigenetics, along with a person’s health and nutrition status, exposure level, and even stress. The more suboptimal these are, the higher a person’s risk for consequences to their health from environmental toxins.

By looking at larger trends, it is possible to get different perspectives on how these risks manifest. The role of Social Determinants of Health (SDoH) is the focus of many health initiatives, including the CDC’s Healthy People 2030. People who are of lower economic status are exposed to more toxic environments, often accompanied by fewer resources to offset them. [4]

Image source: Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved 2.8.2024 from https://health.gov/healthypeople/objectives-and-data/social-determinants-health


The role of these factors included in SDoH cannot be underestimated. In fact, research has shown them to be significant independent risk factors for many health issues. One of the most shocking insights is that a person’s zip code can reveal more than their genetics. [5] A large part of this is the disparity in exposure to environmental toxins, access to healthy food, health care services, and life stressors.


BEYOND LOCAL
Environmental pollution is not just a local issue. Once chemicals enter the local environment, they are difficult to contain, so they often pollute multiple aspects of the environment – often as far away as other continents or even deep in atmospheric space. 

One of the most obvious sources comes from our insatiable appetite for more goods, and the manufacturing plants that make them continue to dump chemicals into the surrounding air, soil, and water. Consumer products themselves contain a variety of chemicals. Computers, smartphones, and other communication devices are central to our everyday lives, and yet processes from extracting raw materials to manufacturing leave their toxic footprint. Plastics are omnipresent, and their outsized role in the long-term environmental dangers is becoming quite clear. Our need for transportation, utilities to heat, cool, and light our homes and offices, and even our medications, medical supplies, and treatments all contribute. Current large-scale agricultural and food distribution practices play a role as well. 

Clearly, many of the products created make our lives better. But how we think about them - and the actual cost of producing them - has to change.


NATURAL DISASTERS INCREASINGLY PLAY A ROLE

It’s not just these obvious sources that are contaminating our environment. Natural disasters produce their own share of toxins, directly and indirectly. Toxins that normally aren’t released into the environment directly can pose new threats when natural disasters overwhelm current measures. For example, today’s fires release toxins as materials burn, whether these materials are those found in nature or those that are manufactured. Floods cause sewage and industrial or agricultural waste to enter  waterways and groundwater systems. As these natural disasters these become increasingly more frequent and more devastating, we’ll need new ways of addressing their impact.

Image source: G. Muir, D. C., Getzinger, G. J., McBride, M., & Ferguson, P. L. (2023). How Many Chemicals in Commerce Have Been Analyzed in Environmental Media? A 50 Year Bibliometric Analysis. Environmental Science & Technology, 57(25), 9119-9129. https://doi.org/10.1021/acs.est.2c09353


INVISIBLE ENEMY
A stealthy adversary, environmental toxins are often invisible, and the diseases they cause are not often immediate. Rather, they often alter a person’s biology so that illness develops over time. This makes it difficult to connect with the abstract concept of their risk. Additionally, many toxins individually may not have such potent effects, but collectively the risk is magnified. Thus, the risk from our exposure to multiple toxins over many years can be much greater than the risk of a single or short-term exposure to a single toxin. 

The current level of scientific and clinical knowledge is more than enough to demonstrate the ongoing risks to health and the role of a wide array of environmental toxins in devastating diseases, including cancer. We have been contaminating our food, water, and air for centuries. But with a sharp increase in new chemicals being developed over the past 30 years, it is now accelerating at a breakneck pace. 

It is impossible to rid our world of every environmental toxin, and inconceivable that we could ever go back to a world where no chemicals will be utilized to create the goods and services we need. So the way forward is to reimagine the future to alter how we support modern lifestyle needs in a way that also supports a healthy environment for all.



CHANGE REQUIRES FUNDAMENTAL SHIFT
Change is possible, but it is not easy nor is it fast. Just look at the slow progress since the passage of the Toxic Substances Control Act (TSCA) in 1976. With all existing chemicals being deemed “safe for use” and grandfathered in, it was only designed for evaluating new chemicals. And yet, only about 20% of new chemicals were reviewed, with the remaining 80% allowed to go to market without any oversight. 

It was only in 2016 that this legislation was updated in an effort to address these shortcomings. The EPA has since completed its initial evaluation of all chemicals in its database, finding that only about half of the 87,000 listed chemicals were still in commercial use. But safety data is still unknown for most of these, and the next task is to start addressing this large void. [6] 

Altering course demands a shift in societal values that will support critical evaluation of current practices, and the will to enact significant modifications in public and private policies operating under an old paradigm. Many may need to be completely overhauled at a high short-term monetary cost. But this short-term cost will be more than offset by long-term savings in environmental toxin-related health services and the cost of premature loss of health and life. 

Creating this paradigm shift will require extensive education and advocacy to communicate the existing research and knowledge about risks and potential solutions and put them into action. We must also prioritize ongoing research and development to address this crisis with practical solutions on both a local and global scale. 


REFERENCES

1) Cohen, L., & Jefferies, A. (2019). Environmental exposures and cancer: Using the precautionary principle. Ecancermedicalscience, 13. https://doi.org/10.3332/ecancer.2019.ed91 

2) https://www.cancer.gov/about-cancer/causes-prevention/risk/substances

3) https://www.epa.gov/newsreleases/epa-releases-first-major-update-chemicals-list-40-years

4) https://health.gov/healthypeople/priority-areas/social-determinants-health

5) Graham GN. Why Your ZIP Code Matters More Than Your Genetic Code: Promoting Healthy Outcomes from Mother to Child. Breastfeed Med. 2016 Oct;11:396-7. doi: 10.1089/bfm.2016.0113. Epub 2016 Aug 11. PMID: 27513279

6) https://www.epa.gov/reviewing-new-chemicals-under-toxic-substances-control-act-tsca/statistics-new-chemicals-review


AUTHOR:

DR. ROBERTA KLINE is a life-long advocate for women's health.  She is a board-certified ObGyn physician and an Integrative Personalized Medicine & Functional Genomics specialist. She is a recognized published author and educator whose mission is to change how we approach health by combining cutting-edge science with heart-centered care. In 2023, she was recognized by the AngioFoundation for her educational achievements and her contribution to the development of the national Earlier Detection initiative, the Coalition of Cancer Resources and the establishment of the Women’s Health Collaborative (a global alliance of women's health advocates). Today, Dr. Kline continues to forge new partnerships in support of underdiagnosed and underserved women with her educational programs for medical conferences such as the Endometriosis Foundation of America.


WEBSITES:

www.WomensHealthDigest.org

www.Pevention101.org

www.RobertaKlineMD.com

www.AngioFoundation.org

This feature article is originally published in EcoSmart News 




LONG ISLAND CANCER- THEN AND NOW by: Robert L. Bard, MD

Since the early 1940’s, Long Island became riddled with countless cases of toxic waste and hazardous dump sites contaminating groundwater and wells with volatile organic chemicals and carcinogens.  Much of this was known as the Bethpage Plume thanks in part to the Grumman manufacturing plant, Naval Weapons Industrial Reserve plant and Hooker Chemical/Ruco Polymer site.  Record levels of radioactive materials such as chromium and radium continue to plague its drinking water today despite decades of cleanup efforts and water treatment plant upgrades.  Scientists have speculated a direct connection between Long Island’s reportedly high rate of breast cancer (alongside other cancers) over the national average and this cancer plume.

In 1985, a major study of Long Island patients in the NY State Journal of Medicine showed over 90% of the suspect calcifications that showed up in mammograms were proven benign after surgical biopsy, resulting in unnecessary treatments that nowadays are avoidable.  Unfortunately, the increase in inflammation in the breast which was causing the calcification was what instigated the greater risk of developing actual breast cancer. The current 2018 American College of Radiology statistics state that women with dense breasts are 500% more likely to develop benign, or malignant tumors than women without dense or lumpy breasts.

To address this overdiagnosis, they started using the MRI to detect breast cancer in the 1990’s- but this too showed inconsistent levels of inaccurate readings as far as things that looked suspicious and looked like breast cancer- similar to Dr. Leis’ negative mammogram readings.   By the advancement of the new 3D ultrasound systems, we were able to find and discern a true cancer from a cyst, or one of these benign post-inflammatory reactions mimicking a cancer on the MRI and the mammogram.

Some women (with diabetes as one example) tend to have inflammation that forms lumpy areas in the breast which causes scarring - scarring that can give a false reading and actually feels like a breast cancer.  Scenarios like these tend to trick the less experienced diagnostician or older technologies into false reports.   Since the introduction of the Doppler blood flow technology, we are able to see the entire cancer vessels and actually gives you a road map to the tumor. The 3D technology allows you to look at the map and measure how many cancer vessels there are. In patients who are taking non-traditional treatment or on immune or chemotherapies, you can see if the number of cancerous vessels are larger, which means the treatment is failing. Or, if it goes from five blood vessels down to one tumor vessel- an indication that the treatment is working.

WHY GO DOPPLER?
There are other ways of looking at blood flow in tumors. CAT scans and CT radiation imaging was spectacular at finding breast cancer except the radiation dose was so high that patients were developing lung cancer from it. Also, claustrophobic people couldn't fit into the CT or the MRI tube. MRI also uses the blood flow technology but some people are allergic to the contrast from the CT or the MRI. We also learned that the MRI contrast is depositing now in the brain, causing other problems that we're just being aware of. 

The Doppler Sonogram is technically instantaneous. You put the probe on the breast, find the area, pinpoint it, press a button and seconds later you have the map showing the types of vessels, the location of the  vessels. You have a program on the computer to give you a vessel density measurement which shows how aggressive this is. Instead of the genetic markers, which are very popular, showing how aggressive a tumor will be, this is a visual way in seconds that's being used worldwide to show cancer vessel aggression. Tumor aggression by blood flow evaluation is used worldwide in nuclear medicine, CT  scans and MRI technology, however, the simplest way is the non invasive 3D Doppler breast procedure.


Additional References:
1) Local clustering in breast, lung and colorectal cancer in Long Island, New York

2) Breast Cancer Incidence- Nassau County, 2005-2009

3) 3-D Doppler Ultrasound Helps Identify Breast Cancer

4) Doppler ultrasound scoring to predict chemotherapeutic response in advanced breast cancer


 



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