Photo by Sage Ross from Wikimedia Commons, Creative Commons by SA license.

A commentary by María Elena Martínez et al., published in the Journal of the National Cancer Institute this month, nicely summarizes the current evidence for reducing cancer risk with dietary supplements. In short, the research findings to date are quite disappointing, with little high-quality evidence to support supplementation. In fact, evidence is building that some supplements may even increase cancer risk. This collides sharply with the common mentality that “more is better” and supplements “can only help.”

How do we convince consumers to exercise more caution with supplements? Although ongoing studies, professional guidelines, and summary papers like this one are helpful for educating clinicians and healthcare professionals, consumers need more direct and accessible communication about the true balance of evidence. Martínez and colleagues strike at the heart of the issue in their discussion of supplement regulation (or lack thereof). Since the 1994 Dietary Supplement Health and Education Act, dietary supplements have been regulated as foods, rather than drugs, substantially limiting the FDA’s regulatory authority over them. As a result, supplement manufacturers and marketers are relatively free to make health claims about their products – even when rigorous scientific evidence and professional consensus is lacking. These claims, often perversely reinforced by mainstream media outlets, become the primary source of information about supplements and their purported benefits for most consumers.

Granting the FDA more regulatory authority over even just the marketing of supplements would be a solid step toward reigning in the myriad marketing claims found on bottles lining the grocery store supplements aisle. This regulatory authority would be strongest if it allowed the FDA to reject not just direct claims of cancer prevention (e.g., contains compounds that help prevent prostate cancer), but indirect claims as well. Martinez et al. use the example of pairing a “supports prostate health” claim with “contains compounds that reduce the growth of prostate cells in culture” – not a direct claim of prevention, but the desired message is obvious. Lacking easily accessible, alternative sources of information about supplements and cancer, consumers cannot help but seek what the advertisements suggest is best for their long-term health.

More broadly, communicating the risks and benefits of supplements will require a shift in mindset away from supplements as harmless and beneficial additions to our diets and towards an understanding of these compounds as active substances that have much more in common with pharmaceuticals than we thought. Indeed, the public is much quicker to recognize the risks of drugs, with widespread media coverage of even rare harms common.

Hopefully the scant evidence for supplementation to prevent cancer and potential for unintended harms will gain more traction in the public mind –by new FDA authority and a broader shift in public perceptions – and empower consumers to critically evaluate the cancer claims found on supplements.

Photo by Sage Ross from Wikimedia Commons, Creative Commons by SA license.

May 30 sees this year’s Annual Meeting of the University of Michigan Risk Science Center – a chance to hear about some of the activities of the center and (more importantly) provide us with your thoughts and insights into where we should be going in the future.

The meeting is free and open to anyone, although we do ask that you register beforehand so that we know how many to expect.  The program for the day is below – further details can be found on the meeting website.

Hope to see you there!

Andrew Maynard

I am very pleased to announce that the University of Michigan Risk Science Center has just been joined by Tracy Swinburn as its new Managing Director.  Tracy has a background as an economic analyst, and will be working closely on building up the center’s strategic partnerships with stakeholders, as well as developing and contributing directly to center activities.  I am thrilled by what Tracy brings to the team, and looking forward to working with her as we ramp up the center’s activities.

Tracy graduated from Rhodes College in 2002 with a BA in Economics and Business Administration (summa cum laude), and went on to receive a MSc in Local Economic Development from the London School of Economics in 2003.  She has previously worked as a Research Associate for the Committee for Economic Development in Washington DC and a Senior Research Assistant at the Brookings Institution.  Between 2007-2009 she held the positions of associate and principle economist with Colin Buchanan – a UK research consultancy – where she was involved in a number of major civic development economic impact assessments (including assessing the London 2012 Olympics economic impacts). Most recently she was Center Manager for the University of Michigan Center for Value-Based Insurance Design.

In taking the Risk Science Center forward, I was looking for someone could help develop and implement our strategic plan and forge strong partnerships with stakeholders where there are common interests.  But I also wanted someone who’s expertise complemented the science, communication and policy skills already represented within the center.  Tracy’s expertise in economic analysis brings a unique and extremely valuable dimension to the center, and I am extremely excited about utilizing this in a number of areas to provide truly innovative and interdisciplinary approaches to understanding and addressing human health risks.

Tracy can be contacted at tracyks@umich.edu or 734-763-0656 – please feel free to get in touch with her if you would like to know more about the Risk Science Center and how you might work or partner with us.

]]> http://umrscblogs.org/2012/05/15/new-managing-director-joins-the-um-risk-science-center/feed/ 0 http://umrscblogs.org/2012/05/10/flame-retardants-in-furniture-foam-weighing-the-evidence/ http://umrscblogs.org/2012/05/10/flame-retardants-in-furniture-foam-weighing-the-evidence/#comments Fri, 11 May 2012 00:51:18 +0000 Andrew Maynard http://umrscblogs.org/?p=6694

The Chicago Tribune launched a hard hitting investigative series this week on the downsides of flame retardant chemicals. Opening with the line “The average American baby is born with 10 fingers, 10 toes and the highest recorded levels of flame retardants among infants in the world”, the series paints a picture of corporate greed, misinformation and questionable decisions as it takes a critical look at the possible health consequences, questionable benefits and alleged underhand business practices that in their words have “led to a proliferation of these chemicals, which don’t even work as promised”.

Not surprisingly, the series has attracted a lot of attention this week. Compellingly written, it tells a story of how cynical manipulation and misinformation has led to potentially harmful fire retardant chemicals being used widely in household products without clear evidence that they save lives.  But how accurate is the science behind the story?

The third article in the series turns to Vytenis Babrauskas – author of a 1980 study on the effectiveness of flame retardants in furniture.   According to the Chicago Tribune, manufacturers of flame retardants repeatedly point to this study as proof that flame retardants save lives.  Babrauskas strongly disagrees with this conclusion – a perspective he made clear in a paper presented to the 10th International Symposium on Fire Safety Science in 2011.

A pre-print of that paper is available from the Green Science Policy Institute, and it makes interesting reading.  While it is not clear what degree of peer review the paper has been through, it does have as a co-author the current Director of the National Institute of Environmental Health Sciences Linda Birnbaum, and was reviewed internally within that federal agency.

The paper considers the pros and cons of flame retardants in furniture foam, and in particular considers the significance of California Furniture Flammability Standard Technical Bulletin 117 (TB117) – the standard to which all furniture sold in California has to comply, and as a result the standard that most furniture across the US also complies with.

TB117 is important as it drives the use of flame retardant chemicals in products within the US.  But Babrauskas et al. claim that the standard does not reduce the chances of fires starting or spreading.  On the contrary, it encourages the widespread use of potentially hazardous chemicals. They conclude in their paper

“flame retardants commercially used to meet TB117 have been found to have negative impacts upon human, animal, and environmental health and notably, the TB117 standard has not been shown to have a measurable fire safety benefit.”

Studies cited in the paper showed no significant difference between foams with and without a typical domestic flame retardant treatment.  One study did find a difference with high performance flame retardant foams – of a type not used in domestic furniture.  That study concluded that

“The average available escape time was more than 15-fold greater for the FR products in the room burn tests, compared to the non- FR products” (113 s versus 1789 s according to Babrauskas et al.)

This is the comparison that has been used by manufacturers according to the Chicago Tribune to justify the use of flame retardants.  But as Babrauskas et al. write

“This statement has been distorted and improperly cited to imply that use of TB117 foams can create such a difference. This is incorrect, in that the study did not examine any TB117 foams but only a costly, state-of-the-art formulation not used in residential furniture. Furthermore, the tests were carried out in fully-furnished rooms where numerous combustibles were burned and were not tests of upholstered furniture items alone. … Thus, the answer to the first question, ― Is the severity of the fire significantly reduced by the use of TB117 foam?” is clearly No.”

TB117 relies on exposing foam alone to a small flame – without the covering it would usually be accompanied with in a piece of furniture.  Under such conditions according to Babrauskas et al. a foam with 3 to 5 % of flame retardant additive can resist the flame.  But the situation is very different when the foam is covered and incorporated into a piece of furniture.  Babrauskas et al. again:

“… actual upholstered furniture always consists of a composite of at least two layers, with a fabric cover on top of foam. Furthermore, fabrics are thin membranes of about 1 mm that do not serve as a barrier to the flow of heat from the outside to the foam and it is common for the upholstery fabric itself to ignite from small flame sources such as a candle or a lighter. Once the fabric is burning, the foam is presented with a flame challenge which is many times larger than the cigarette lighter flame which may have originally ignited the fabric. (Note that TB117 does not consider protection from ignition by large flame sources and that it is well-established that targets which might resist a smaller flame attack may be unable to resist one from a larger flame). It must additionally be noted that (a) the TB117 standard contains a separate test provision for fabrics. But this is a moot test since the procedure is the same as mandated in the Federal CS 191-53 test, which all fabrics sold in the US are already required to meet by the Federal government. (b) While an ostensible, but moot fabric test exists within TB117, the standard never assesses the behavior of an actual composite, i.e., a fabric on top of a layer of foam. However, the latter question has been experimentally investigated by two groups. Talley tested 15 different upholstery fabrics, each over non-FR and TB117 foams of matched density (24 kg·m-3). All specimens ignited except those using one of the 15 fabrics, and for that fabric neither of the foams used led to ignition. Talley also visually observed flame spread behavior of the specimens that did ignite, and his conclusion was that “The TB117 foam made no significant, consistent difference in either ignition or flame spread.” Talley also ran additional tests which showed that TB117 foams did not offer any benefit in regards to resisting smoldering ignition from cigarettes. In addition, the US Consumer Product Safety Commission (CPSC) conducted laboratory research on actual chairs and also found the test to be ineffective. More broadly, as part of their regulatory mission, they undertook to determine if adopting of the TB117 standard would likely reduce deaths and injuries due to fire and concluded that “TB117 component results were not predictive of full scale performance” and that “TB117…would not, if federally mandated, ensure a substantial reduction in the risk of small open flame ignition of finished articles of furniture.” Thus, the answer to the question “Does TB117 foam serve to prevent ignitions from small flame sources?” is also No.”

Against this safety performance – or lack of – Babrauskas et al. weigh the evidence for human health and environmental impacts associated with exposure to flame retardant chemicals.  Here the evidence is more complex, and yet there are a number of rather prominent red warning flags.

Up until 2004 the flame retardant pentabromodiphenyl ether – or pentaDBE – was widely used.  A wide range of adverse environmental and health effects have been associated with pentaDBE exposure, including in humans developmental, endocrine, thyroid, reproductive and neurological effects – these are extensively documented in the Babrauskas et al. paper.  As a result, pentaDBE was phased out in 2004 within the US and replaced with a number of other flame retardants.  However, despite these replacements being less extensively studied, chemical similarities with pentaDBE and other harmful chemicals combined with a growing body of data suggest that these alternatives are far from benign.  As a result, the paper’s authors conclude

“Since 1975, hundreds of millions of kilograms of pentaBDE and its replacements which include TDCPP and Firemaster 500 have been used to meet California TB117. A fire safety benefit has not been established. Research suggests that this standard should be reevaluated in light of the fire science and health in- formation discussed above. Prior to implementing new flammability standards, decision makers should evaluate the potential fire safety benefit as well as the health and environmental impacts of the chemicals, materials, or technologies likely to be used. Special scrutiny should be given to small open-flame standards that are likely to be met by adding organohalogen flame retardants to foam or plastic in consumer products.”

While it is not always easy to tease apart the story from the facts within investigative journalism, the Babrauskas et al. paper provides a scientifically comprehensive and credible assessment of the pros and cons of flame retardants as they are currently used within US domestic products.  And, like the Chicago Tribune series, it is not comforting reading.

The paper Flame Retardants in Furniture Foam: Benefits and Risks by Vytenis Babrauskas, Arlene Blum, Rebecca Daley and Linda Birnbaum can be downloaded for free from the Green Science Policy Institute.

]]> http://umrscblogs.org/2012/05/10/flame-retardants-in-furniture-foam-weighing-the-evidence/feed/ 0 http://umrscblogs.org/2012/05/08/radiation-as-currency-a-better-metaphor-for-understanding-risks/ http://umrscblogs.org/2012/05/08/radiation-as-currency-a-better-metaphor-for-understanding-risks/#comments Tue, 08 May 2012 16:56:07 +0000 Lindsay Ward http://umrscblogs.org/?p=6686

Today I want to discuss not only risk but also the usefulness of the science blogosphere. When casting about for a blog post topic (and trying hard to focus on studying for the UM EHS Doctoral Qualifying Exam next week!) I found a very interesting post about risk literacy on Everyday Einstein that describes an interesting method for understanding the magnitude of health risk posed by various radiation exposures. Boing Boing is another good resource for interesting perspectives on science and internet security–and they, too, noticed the cool currency post. Science blogs in general are a good window into specific corners of the science world, and there are enough of them that any specific issue (say, risk science?) will be covered somewhere. Even industry big-shots like Nature and the New York Times are paying attention to blogging, and both this list and this diatribe have resulted.

But back to the topic of the day: understanding the magnitude of radiation exposures. This is a problem for most individuals without significant training in nuclear physics or radiological health  (which is to say, most individuals). The units used in describing radiation neither represent a mass, like kilograms or ounces, nor do they represent a volume, like milliliters or the other ounces (fluid). They measure much more abstract things such as “decay product per time unit”–when describing a source of ionizing radiation like radio-labeled isotopes in a medical tracer dye, or a contaminated object from nuclear meltdown sites like Fukushima, the object itself gives off Curies, representing 37 billion decay events per second. These individual decay events per second are called becquerels.

Neither of these units can be used to describe human exposure to radiation, though, because that is determined by how many “decay events” result in ionizing radiation hitting or entering a person’s body. The human tissue dose measurements are called sieverts and rems (the latter is more popular in the United States than the rest of the world), and are calculated by multiplying the absolute dose of radiation that could be absorbed by any material by a “weighting factor” to understand how many sieverts or rems can reach vulnerable tissue in that organism. The weighting factor for mollusks is a fraction of the weighting factor for humans, for example, because mollusks have that thick protective shell and their vulnerable tissues will therefore be less exposed to radiation. But even knowing all these facts does not help much when faced with a sentence like, “a single TSA scan exposes a person to 0.00025 millisieverts (mSv).” Without context, it doesn’t mean a lot; this is where analogies come in.

It is relatively common to compare radiation exposures to the number of bananas one would need to eat in order to receive the same dose: because of their high potassium content, each banana counts as approximately 9.82×10⁻⁵ mSv or about 0.1 μSv. Unfortunately, this is still a bit ambiguous. The blogger Lee Falin at Everyday Einstein went one step further, though, and created a simple system with built-in analogy: if radiation exposure were currency, each millisievert is equivalent to one dollar. This would mean that a normal year would net an individual somewhere between $2-3 in radiation exposure, and eating a banana? One hundredth of a cent. As Dr. Falin describes, “the average chest X-ray adds only $0.02 to your annual total, mammograms have about twenty times the exposure, which is still only $0.40, and MRIs don’t expose you to ionizing radiation at all.”

Without a frame of reference, scientific data means nothing to those people who are hearing or reading about it. By understanding what the units of radiation exposure mean, we can better interpret stories about nuclear disasters or medical technologies when radiation doses are in the news.

Cross posted from 2020 Science

Robin Erb has a good piece on cosmetics and safe ingredients in the Detroit Free Press this week – it tackles the very limited regulation over what goes into cosmetics, but balances this with a useful perspective on consumer choice and how this in turn can drive business decisions on what is used and how.  I mention it because the issue of nanoparticles in sunscreens comes up briefly, and I am quoted on the matter.

Regular readers of this blog will know that I have been fairly vocal about the safety of nanoparticles in sunscreens.  I still contend that the weight of published evidence suggests that titanium dioxide and zinc oxide nanoparticles in sunscreens do not present a significant when the relevant products are developed and used responsibly – and that the benefits of using this technology over others may in fact outweigh any residual risk.  But I’m also aware that this isn’t a closed issue – there are niggling questions on the use of photoactive particles, on nanoparticle sunscreen applications on delicate or compromised skin, and on dermal penetration of chemicals within the nanoparticles, that all need further research.  So I was surprised to read that my mind is apparently made up here!

After talking with Robin about cosmetics, sunscreen and nanoparticles, she sent me draft of my comments to check for factual accuracy before the piece went to press.  The original text read:

“…Agreed Andrew Maynard, director of the Risk Science Center at the University of Michigan School of Public Health: “The industry seems reasonably well self-regulating.”

In his research, Maynard asked whether nanomaterials in sunscreen — the nearly molecular-sized particles that ease the lotion into our skin pores – are dangerous. His conclusion: They’re not.

“It was really surprising, to be honest,” he said.”

This was uncommonly generous of Robin by the way – many reporters will not do this (for good reason – they don’t want people interfering with the story), and in general I don’t expect it.

My response:

Hi Robin, and thanks for letting me see this – Scott’s comments are great here btw.

If you are able, could I just change one thing: instead of “In his research, Maynard asked whether nanomaterials in sunscreen — the nearly molecular-sized particles that ease the lotion into our skin pores – are dangerous. His conclusion: They’re not.”, is it possible to have something along the lines of “In his research, Maynard asked whether nanomaterials in sunscreen — the nearly molecular-sized particles that protect the skin from the sun – are dangerous. His conclusion: Not if they’re used responsibly”

It’s not as black and white admittedly, but there are still niggling uncertainties associated with the use of nanoparticles that I am on record as highlighting (as there are with other sunscreen ingredients), and it would look odd if I was quoted as saying something that seemed to contradict my usual message.

I should note at this point that, under these circumstances, my policy is to treat the reporter’s work with respect, and refrain from editing the text unless there is a compelling reason to do so.  But in this case I was concerned about the overstatement of my position on nanoparticle safety, and I thought that the technical error on the purpose of the nanoparticles being to ease the lotion into the skin pores should be addressed (in sunscreen the particles coat the skin and protect against UV exposure.  In some cosmetics, nanoparticles are used to help penetrate through the outer dead layers of skin cells – there may have been some confusion between the two here).

Robin responded back:

“Thanks for the response. No problem on tweaking the wording. I want it correct, of course.

Let me just ask this though: What would be an “irresponsible” use of sunscreen? I’m not trying to be funny – I just want to make sure the qualifier “if used responsibly” really translates for consumers.”

To which I replied:

“Understand – “responsible” can be a bit of an irresponsible blanket term

Here, I mean using nanoparticles after giving possible health and environmental impacts due consideration, and doing everything possible to ensure minimal impacts and significant benefits. A bit of a mouthful, but feel free to tweak the quote. I won’t be able to respond as I’m about to board a plane back to Michigan from Denmark (hence the delay with this response) – but am sure whatever you arrive at will be fine.”

I may have been a bit generous with that last statement, as what was published on Monday came out as:

“Andrew Maynard, director of the Risk Science Center at the University of Michigan School of Public Health, agreed. “The industry seems to be reasonably well self-regulating.”

In his research, Maynard asked whether nanomaterials in sunscreen — the nearly molecule-sized particles that ease the lotion into our skin pores — are dangerous. His conclusion: They’re not.

“It was really surprising, to be honest,” he said.”

The adherence to the original text isn’t a particularly big deal, and to be fair I almost definitely didn’t express myself as clearly as I could have in the original phone interview.  But just in case you read this and thought that the book was closed on nano-sunscreens from my perspective – it’s not!

Ignoring the crazy weather that March and April generated, the past two months have been particularly interested in the health world, as the United States population finally paid attention to just what exactly was in their processed food, namely, Lean Finely Textured Beef also known “affectionately” as Pink Slime.  Public attention appears to have been raised by an article published by ABC News, which claimed that 70 percent of ground beef in supermarkets contained the stuff. If you haven’t seen the video that goes along with it,  let me just give you a ‘taste’:

“Pink slime” is beef trimmings. Once only used in dog food and cooking oil, the trimmings are now sprayed with ammonia so they are safe to eat and added to most ground beef as a cheaper filler…. [USDA Scientists] warned against using what the industry calls “lean finely textured beef,” widely known now as “pink slime,” but their government bosses overruled them.”

Sounds pretty terrifying, right? It turns out that there are several every day products we eat that top ground beef in ammonia content.  So if it isn’t the potential health risks that upset consumers, what is it?  I’m going to go out on a limb here and guess that, like me, most people find the idea of my cheeseburgers coming out of a soft serve machine to be more than a little disturbing.

In fact, so many consumers expressed concern and discomfort with the idea, that three primary manufacturers of pink slime have suspended production. Beef Products Inc  (BPI) halted production at three of its four plants and announced a campaign to restore confidence in the product.  Cargill has also cut production significantly, amid warnings of higher hamburger prices this summer and AFA filed for Chapter 11 Bankruptcy at the beginning of April.  Not to mention the swarm of fast food chains, beef producers, food distributors and restaurants who jumped off the bandwagon as well (McDonalds, Burger King, Tyson Foods, Safeway and Winn-Dixie to name a few). Even Walmart will be offering slime-free meat in the future.

So if all of this upheaval is due to the sheer “Ick Factor” of Pink Slime, what else is out there that might be able to create an equal level of controversy? The media has obligingly begun trumpeting a new cause in food safety, but this time it’s something far more upsetting than our hamburgers put at risk, it’s our Strawberry Frappucinos.

A barista working at Starbucks noticed that the company had recently switched to cochineal extract as the dye in their Strawberry Frappucino mix, as well as three other products at Starbucks.  As the barista was also vegan (and cochineal extract is apparently not), she sent a warning to the vegan community via the This Dish is Veg website, and from there it got picked up by several news agencies such as NPR, CBS, and USA Today. However, it wasn’t Starbucks’ suddenly non-vegan dye that caught the media’s attention.

In black and white, cochineal extract is made from crushed insects.  More specifically, crushing cochineal insects extracts the dye, which is a natural defense mechanism of the cochineal. The mixture is then filtered to remove the insect remains, leaving a pure form of the dye.  Much the same as pink slime, when faced directly with knowledge on where their food comes from, many consumers have found themselves not quite as desperate for that next Strawberry and Crème Frappe.

Starbucks has responded, stating that they switched the strawberry dye to cochineal extract as a way to move away from artificial dyes and will be phasing it out in favor of lycopene, which is tomato-based. But I imagine that many will be thinking twice before ordering up a Venti next time they’re at Starbucks.

Pink slime was approved for human consumption in 2001, but cochineal extract has been used since long before then. Although it dates back to the 15th century as a textile dye, it gained prominence as an additive to consumables in the 1980s. Today, it’s used not only in Starbucks Drinks, it’s also used in yogurts, juices, sausage and artificial crab.  The dye is  also heavily used in  pharmaceuticals and cosmetics. So what does all of this mean? Are consumers suddenly starting to pay more attention to what they eat?

My guess is that “Look what companies are putting in your food NOW!” is too tempting a byline for reporters, bloggers and everyone else to pass up, so more stories are sure to follow. What other food additives out there have the “Ick Factor” that media sensationalism craves?  No doubt we’ll hear soon enough…..

Images are all used from the Wikimedia Commons and are free for public use:

Ground Beef: http://en.wikipedia.org/wiki/File:Ground_beef_USDA.jpg 

Cochineal bugs: http://en.wikipedia.org/wiki/File:Dactylopius_coccus_(Barlovento)_04_ies.jpg

You’ll have realized from Rick Neitzel’s post earlier this week that he has abandoned the delights of Ann Arbor this summer for those of Sweden (we’re just hoping we get him back before he gets a taste for the good life over there!).  Totally coincidentally as it turns out, he was the vanguard of a temporary Risk Science Center migration to Europe.  Hot on his heels, Diana Bowman headed across to Copenhagen for the launch of the new European Environment Agency report Late Lessons 2012 (a follow-up to the highly influential 2002 report Late Lessons from Early Warnings – the precautionary principle 1896-2000).  And just as she was leaving, I was on my way to Denmark also – this time to talk about new instruments for sampling airborne nanoparticles as part of the NANODEVICE Annual Forum.

While I head back for the US tomorrow, Diana is hanging around for a few more days – she’s currently believed to be in the Netherlands.  Rick of course is here for the duration.  Not to be outdone, RSC member Brian Zikmund-Fisher has been spending the week in Switzerland talking risk communication. And he will be followed shortly by Olivier Jolliet as he spends some time back in Switzerland.

Next year, we’ll make sure we at least get the Risk Science Center European Tour tee shirts out before the migration begins!

In an effort to further expand the international presence of the U-M Risk Science Center,  I’ve taken it upon myself to spend the next four months in Sweden to personally research a question that has plagued humanity for generations: exactly what is the health risk associated with a diet composed completely of Swedish pancakes?   Of course, in between sampling various smorgasbords, I also plan to do some actual research here in Sweden.  But before I briefly describe some of the projects I’ll be working on, let me note that even getting here in the first place has proven to be a monumental undertaking.  Without delving into painful detail, let me simply say that the act of obtaining a visiting researcher residence permit rivals (at least in my experience) the construction and operation of a nuclear plant in terms of complexity and risk of catastrophic failure.  Thankfully, I was able to avoid the latter in this case – but only narrowly!

I’ll be making semi-regular (and semi-serious) posts from various locations in Sweden over the next four months.  For the next month or so I’ll be working with Eva Andersson, head of occupational medicine at Sahlgrenska University Hospital in Gothenburg.  Eva and her colleagues have been following a cohort of pulp and paper mill workers in Sweden for a number of years and assessing risk of health effects such as cancers, cardiovascular mortality, and respiratory impairment.   I’ll be assisting them with issues related to exposure estimation for the cohort.  I’m amazed at the hospitality of the researchers at Sahlgrenska – for instance, they’ve given me an office and provided me with access to an astonishing array of automatic coffee-making devices. My caffeine titer is already off the charts!

From Gothenburg I’ll continue on to Gävle for about a month, where I will be working with ergonomist Svend Erik Mattiassen, Research Director of the Centre for Musculoskeletal Research of the University of Gävle on issues related to assessing the cost effectiveness of various approaches used to assess exposures to ergonomic hazards.  Finally, I’ll spend the last two months in Stockholm working with hearing researchers Ann-Christin Johnson, Eva Svensson, and Per Muhr of the Karolinska Institute on a project to evaluate the relative contributions of occupational and leisure time noise, and perceptions of hearing loss risk, among Swedish workers with high, medium, and low levels of occupational noise exposure.  One of the groups we’ll be studying – day care workers – is not one I would previously have rated as particularly noise-exposed.  However, since becoming a parent I now realize that a large group of shrieking children can produce potentially damaging (and certainly annoying) levels of noise.

I wonder if Swedish pancakes can somehow be molded into earplugs…?

Information about chemicals in U.S. workplaces is regulated by the U.S. Occupational Safety and Health Administration (OSHA) under the Hazard Communication Standard (“HazCom” for short).  Starting in the 1980s, HazCom set up a chain of communication in which hazard information (in the form of labels and material safety data sheets) flows from chemical manufacturers to distributors to employers, who provide this information to employees along with additional training.  HazCom covers employees working with hazardous chemicals in all kinds of applications, including manufacturing, healthcare, and foodservice.

On March 26, OSHA adopted a major revision of HazCom (previously scheduled for September 2011) that is being referred to as HazCom 2012.  HazCom 2012 makes changes to harmonize internationally with the Globally Harmonized System (GHS) for classification and labeling of chemicals.  This involves changes to how information is presented in chemical labels and safety data sheets (SDSs), including new pictograms, revised label text, and required subheadings in SDSs.  (Note: “SDSs” are the same as material safety data sheets or “MSDSs,” but with the “M” dropped for international harmonization.)

Image credit: GHS Pictograms

HazCom 2012 requires chemical manufacturers to follow a prescribed process (about 100 pages long – see Appendices in Federal Register (website or 52 MB PDF)) to classify chemical hazards to determine specific information to be provided on labels and SDSs.  To help employees interpret this information, OSHA is requiring employers to provide training on the new standard (particularly the new pictograms) no later than December 1, 2013.

In communication terms, the new standard changes the way information is “encoded” and “decoded.”  Just like sending and receiving messages with a set of old-time decoder rings, “encoding” refers to the process a source uses to create a message, and “decoding” refers to the process a receiver uses to interpret a message.  Complex encoding systems can result in delays or errors during encoding and decoding.  It will likely take some time before the new system under HazCom 2012 is working smoothly; OSHA is allowing until 2016 for HazCom 2012 to be fully implemented.

This article is cross -posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

This post was written by Candace Rowell, a second year MPH student in Environmental Health Sciences. She has a background in chemistry and is  interested in health programs development and evaluation in developing countries.

Access to Clean Water: A Basic Human Right

A simple turn of the faucet delivers an endless supply of clean and refreshing H₂O – in our homes, our offices, and even water used to flush our toilets. Clean drinking water is so readily available that we don’t have to think about where it is coming from or how we are going to get it. Access to clean drinking water is a basic human right that we enjoy on a daily basis. Unfortunately, this right isn’t the reality for millions of people around the world.

The World Health Organization [WHO] estimates that 884 million people world-wide do not have access to clean drinking water.  Over half of these individuals live in developing African countries where the consequences of drinking unclean water account for millions of deaths each year. Children, 5 years or younger, are the most vulnerable. In the past, drinking unclean water typically meant high risk to diarrheal diseases caused by bacteria or viruses. Today, drinking unclean water can mean much, much more.

With the ever ongoing and increasing industrial activities in developing nations across the globe, water quality in the most impoverished areas has become increasingly worse. Bacteria and parasites in the waterways of third world countries are no longer the only worries; issues of mining and heavy industry pollution are now adding to the clean water crisis- often times in the form of toxic heavy metals. Exposure to heavy metals [including: lead, mercury, copper, cadmium, chromium] can cause developmental defects in children, neurological effects such as memory loss and behavior changes, chronic diseases like cardiovascular disease, and it may lead to certain types of cancers.

Banana Peels: Removing the Metals

There have been numerous technologies developed to specifically remove metal toxicants from polluted waters- silica, alumina, activated carbon, and resins have all been proven successful… and expensive.  While they perform in the high tech laboratories of developed countries, mass manufacturing and distribution of these products in developing nations are expensive and impractical. For rural and remote villages, activated carbon filters are just not a sustainable option for water purification. But, banana peels are.

Using water from Brazil’s Paranhas River and locally grown bananas, researchers at Sao Paublo State University have demonstrated that dried banana peels can successfully remove copper and lead [two common metal pollutants] from contaminated water.

Banana peels contain nitrogen, sulfur, and carboxylic acids; the acids are responsible for the peels’ ability to bind the toxic metals and remove them from the water. Because of the high number of these acids in the peels, not only can banana peels remove the contaminants, but they can do it just as well, and in some cases better, than more expensive technological options.  And it’s easy. Without any technical preparation, dried banana peels successfully remove metals.

In areas in South America and sub-Saharan Africa where bananas are a common resource and contaminated water is a common problem, banana peels offer a sustainable and practical way to remove toxic metals from drinking water. By using the same banana peels up to 11 times without replacement, families can successfully minimize their risk of exposure.

Banana peels don’t kill parasites or bacteria, and they aren’t going to protect children from viruses. But, banana peels may offer millions of families around the world the opportunity to drink water free of heavy metals. A basic solution to promote a basic right.

I‘ve been following the Lean Finely Textured Beef (aka Pink Slime) story with interest for a few days now, and have been struck by how tough it is to dig up hard facts on what the basis of the concerns are here – beyond an instinctive distaste over finding out what goes into today’s processed foods.

One of the issues that is raised repeatedly is the use of ammonia as an antibacterial/preserving agent. Although ammonia in the form of ammonium hydroxide is Generally Regarded As Safe (GRAS) by the US FDA and is not associated with ill health in healthy individuals at low concentrations, there has been some resistance to its use as a processing agent and additive.  This has been driven in part by the philosophy that “less is more” when it comes to adding stuff to food. It’s also been driven by concerns that antibacterial agents allow the use of animal protein that is more likely to be contaminated by pathogens such as E. coli.

But how much ammonia is there in Pink Slime-augmented beef compared to other foods?

A fact sheet from the South Dakota Department of Agriculture estimates that a beef patty containing Pink Slime will contain around 200 parts per million ammonia – or 0.02 grams ammonia per 100 grams of meat.  That on its own is not a lot of help if you are trying to work out whether eating a burger or two is likely to lead to ammonia-overload.  Fortunately,   In 1973 a paper was published in the American Journal of Clinical Nutrition that listed the ammonia content analyzed in a wide range of foods.

Here are the findings from the paper:

The table requires a bit of explaining:The first column after the food type gives the total amount of nitrogen in the food, in grams of nitrogen per 100 grams of food.  The next column to the right gives what percentage of this is associated with ammonia – NH3.

To make the data a little easier to understand, here they are in terms of the amount of ammonia per 100 grams of food – I’ve also ranked them from the greatest concentration to the least:

Based on Rudman D.et al. (1973) Ammonia Content of Food. American Journal of Clinical Nutrition, Vol 26, 487-490

Interestingly, the 1973 burger only had around half the ammonia content of a 2012 Lean Finely Textured Beef-enhanced patty.  But there are plenty of foods here that top the augmented burger in terms of ammonia content – including onions, mayonnaise, margarine, salami, and cheese.

These figures don’t detract from yuck factor associated with discovering what goes into some food products (you know what they say about sausages…).  But they do help put the ammonia exposure into context.

The annual competition for Risk Science Fellowships provides summer stipend support for students from the School of Public Health (SPH). UMRSC fellowships enhance education and training in the risk sciences and prepare public health students to pursue careers in the field of risk analysis. These awards are made possible through generous support to the Risk Science Fellowship Fund. This blog is the first in a series by  the 2012 Risk Science  Fellows introducing themselves and their projects. This blog is written by Lindsay Weir. For more information about the Risk Science Fellowship please see our website.

For the severely ill and injured, our nation’s hospitals are supposed to be places of healing and recovery—not reservoirs of potentially life-threatening infections. The unfortunate reality is that, every year, hundreds of thousands of people die from hospital acquired infections (HAIs). The opportunistic pathogens causing these infections threaten health outcomes and significantly increase ICU and overall hospital stays by compounding patients’ preexisting conditions. Therefore, they cost hospitals thousands of extra dollars per patient due to increased therapy and services. More importantly, they significantly increase the morbidity and mortality rates of already critically ill patients.

Controlling these infections—which include ventilator-associated, surgical site, and catheter-associated infections—poses an immense challenge to the medical community, especially in light of increasing antimicrobial resistance. Infection control professionals have developed extensive policies to control these vicious microbes. Passive and active surveillance policies have sought to identify asymptomatic carriers to prevent their transmission from patient to patient. Contact and respiratory precautions have been developed to break the chains of transmission of highly transmissible bugs. Intense environmental decontamination through the use of harsh chemicals or physical methods is aimed at removing lingering microbes from the hospital environment. Despite these multifaceted efforts, HAIs continue to threaten patient outcomes and take lives. Therefore, the lingering question is: what can public health professionals do to stop opportunistic infections once and for all?

Through the opportunity afforded to me by the 2012 Risk Center Fellowship, I hope to address this question by investigating Acinetobacter baumannii retention in the hospital environment. A. baumannii is an emerging hospital pathogen, and it is a particular menace to intensive care units with its ability to cause meningitis, skin infections, bacteremia, and pneumonia(1). For high-risk patients, A. baumannii has been associated with mortality rates as high as 70% (2). To make matters worse, this pathogen is acquiring antimicrobial resistance at an alarming rate (3).

Image Source: http://www.policymed.com

Evidence suggests that one of the keys to pathogen retention in the hospital environment may be a phenomenon known as coaggregation. Coaggregation, which is the intimate association between genetically-distinct bacteria mediated through specific adhesins and receptors, has not only been demonstrated to play an important role in multiple environments, but it has also been implicated in protecting bacteria from antimicrobial agents and environmental stressors (4,5). Our belief is that understanding these dynamic and complex interactions between A. baumannii and indigenous freshwater biofilm bacteria may be key to controlling potential reservoirs of infection.

HAIs are a growing problem that the public health and medical communities cannot ignore, and with antimicrobial resistance threatening our ability to combat them, we must start looking for innovative ways to control them. I am very proud that the Risk Science Center recognized the critical importance of my research and has afforded me the opportunity to explore innovative solutions to, what I believe, is one of the biggest crises in the medical field today. I look forward to presenting my work alongside my fellow recipients in the fall, and I hope my receipt of this fellowship and the findings it generates will help raise awareness for this critical public health threat.

References:

(1)  Wisplinghoff H, Edmond MB, Pfaller MA, et al. Nosocomial Bloodstream Infections Caused by Acinetobacter Species in United States Hospitals: Clinical Features, Molecular Epidemiology, and Antimicrobial Susceptibility. Clinical Infectious Diseases 2000; 31: 690-67.

(2)  Mihu MR, Martinez LR. Novel therapies for treatment of multidrug-resistant Acinetobacter baumannii skin infections. Virulence 2011; 2: 97-102.

(3)  Fournier PE, Richet H. The Epidemiology and Control of Acinetobacter baumannii in Health Care Facilities. Clinical Infectious Diseases 2006; 42: 692-699.

(4)  McCormick DW, Stevens MRE, Boles BR, et al. Does it take Two to Tango? The Importance of Coaggregation in Multi-Species Biofilms. Culture 2011; 32: 1-5.

(5)  Rickard AH, Gilbert P, High NJ, et al. Bacterial coaggregation: an integral process in the development of multi-species biofilms. TRENDS in Microbiology 2003; 11: 94-100.

Richard Rood is a professor at the University of Michigan’s College of Engineering and faculty within Atmospheric, Oceanic and Space Sciences. He also writes for Wunderground.com, where this article was originally posted.

The U.S. has just experienced an intense heat event with many records falling in the eastern half of the U.S. Here is Chris Burt’s post on the historic event. There is an excellent discussion of this event and its relation to a warming climate by Andrew Freedman at Climate Central. (Global Warming May Have Fueled March Heath Odds) I have a talk to give next week, and I am sure that the heat will contribute to questions. A question that has been put to me frequently in the past weeks is that should we expect such high temperatures in the future?

Usually when I talk about evidence of a warming, I talk about coherent and convergent evidence. That is, one can’t just look at the global surface temperature data and state that the planet has warmed. But if you look at the surface temperature data along with many other sources of data, then one finds that the evidence of warming is overwhelming. If you add the impacts of this warming to ecosystems, for example, the observations that spring is coming earlier over most of the land area in the Northern Hemisphere, then the evidence becomes smothering. For me and many others this evidence of warming is convincing, but it relies on pulling together information from many sources, explaining their relationships, and presentation of the information. So as people have asked me about the heat in Michigan and Maine this past week, I have thought of what I could do with just temperature. Here is the thread that I put together.

The last month when the global mean monthly average was below the 20th century average was February 1985. Here is a picture of the difference from the 100 year average of temperature data from each February. It has been 324 months since there was a month below the global average temperature. (Not 324 Februarys, 324 consecutive months.) Looking at the graph, the Southern Hemisphere, which is dominated by the ocean, goes back into the 1970s. There have been Februarys in the Northern Hemisphere with little blips below average.

Figure 1: February monthly difference from a 20th century average of all Februarys. From the National Climatic Data Center.

The average in this figure is based on the entire 20th century. Therefore, if you look at the record during the 20th century, there is a balance between the warm and the cold months. This fact comes directly from the definition of calculating the differences from an average. There is a famous 1930s warm period. This warm period is present in the February times series, but compared with a later span centered around 1960, this period in not as intense. A prominent characteristic of the graph is that on the left, in the first part of the 20th century, it is cooler than the average and on the right, the here and now, it is warmer.

To go along with the February graph, I have placed the graph from August 2011. The main part of the story, that in 1900 it was cooler than in 2000 remains the same. Here, in the Northern Hemisphere summer, the 1930s warm period is more prominent and more global than in February. In is easy to conclude from this figure that the spatial extent and the temporal persistent of the current warming are both far larger than in the spurt of warmth of the 1930s.

Figure 2: August monthly difference from a 20th century average of all Augusts. From the National Climatic Data Center.

I started this article with the question is the current heat event in the U.S. what we can expect in the future? Taking this simple argument, looking at the average for the past, almost 30 years, it seems reasonable to expect it be warm. And given, the relentless increase of carbon dioxide in the atmosphere, we should expect it to be warmer in the future. To expect otherwise would be betting against the average.

Betting against the average – the next plot, Figure 3, is adapted from a 2009 paper by Jerry Meehl and a host of other authors. (Original Paper, Paper Discussion from NCAR ) What this figure shows, for the U.S., is the number of new record highs divided by the number of record lows – the ratio of highs to lows. In a simplistic, intuitive way, if the average temperature where staying the same, then one would expect the number of new record highs and the number of new record lows to be about the same. What is seen in the figure is as we go from the 1980s to the 1990s to the 2000s, there is trend of record highs out numbering record lows by a factor of 2 to 1. Comparing this with Figures 1 and 2, this evolution of new record highs outpacing new record lows occurs during the time when there has not been a month below the global 20th century average.

Figure 3: Adapted from Meehl et al. (2009) the ratio of U.S. record highs and record lows by decade.

The next figure I show is another version of the global difference figure. This one is calculated as differences from 1950 onwards in order to overlap with the data from the Climate Prediction Center that identify El Nino and La Nina Cycles. El Nino and La Nina are names given to frequently occurring patterns of variation that are concentrated in the tropical Pacific Ocean, but that change the average temperature of Earth for about a year. When there is an El Nino then the globe is warmer and when there is a La Nina the globe is cooler.

Figure 4: Global temperature differences with El Nino (warm) and La Nina (cool) years marked. From National Climatic Data Center.

Looking first at the La Nina years, 1985, the last year when the Earth was cooler that the 20th century average was a La Nina year. One could say that this was the last year when the variation associated with La Nina was strong enough to counter the warming trend enough for the Earth to appear “cool.” What is striking is that the La Nina years in the past three decades are systematically warming. This suggests that in the La Nina cool period, we are seeing a warmer and warmer background, average, temperature evolving.

The warm phase of this variation does not paint as easy a picture. The very strong 1997-1998 El Nino famously raised the Earth’s temperature to a point that many argue was the warmest year observed. The subsequent El Nino events are not as strong as the 1997-1998 El Nino, and each one has temperature maximum that flirts with the 1998 maximum. It is important to note that in 1998 the entire positive anomaly of temperature was not due to the presence of El Nino. The El Nino events take place on a background of increasing temperature, and each event is a burst towards new historic highs in temperature. It is useful to look back earlier in the graph, say 1970 and earlier, to get an idea of the size of variation that can be associated with El Nino and La Nina.

Returning again to the question posed in the beginning, can we expect to regularly see such warm temperatures going forward? Yes, it makes sense that we will see more and more record high temperatures. To not expect that is to bet against the emerging observed trend of warmer and warmer temperatures that is a metric of the warming climate.

I will finish this just temperature story with a map of the Plant Hardiness Zones. Here is the official version from the US Department of Agriculture with an service that lets you pick out your zip code. I show a map of Michigan. In 1990 the green zones, 6, were down around the Ohio River in southern Ohio. This is a measure of not only warming, but also of the definitive changes in the onset of spring. The Washington Post has an excellent graphic that shows the changes between 1990 and 2012.

Figure 5: Plant hardiness zones in Michigan for 2012. From US Department of Agriculture.

We have just experienced in the U.S. a record extreme heat event. This raises the natural questions of climate, weather, and climate change. I have linked a couple of excellent discussions of these issues in the opening paragraph. What I have done in my article is to focus simply on temperature. I have laid out a thread that starts from the globe and the remarkable observation that we have not seen a month below the 20th century global average in more than 25 years. This I followed with the observation that we are in a time when we are setting more than twice as many record highs as record lows. After that I discussed the role of one of the most prominent forms of planetary temperature variations, El Nino and La Nina. The compelling point from this graph was that in the past 30 years during the cool phase, La Nina, the planet shows a warming trend. Finally, I introduce the plant hardiness zones, which show warmer winters, and can be translated to earlier springs. So the question that has been posed to me last week, can we expect such high temperatures in the future? Yes. If we use our experience and observations for the basis of decision making, then the rational answer is yes. We will see more records. We will see an earlier spring. We will see warmer times.

The annual competition for Risk Science Fellowships provides summer stipend support for students from the School of Public Health (SPH). UMRSC fellowships enhance education and training in the risk sciences and prepare public health students to pursue careers in the field of risk analysis. These awards are made possible through generous support to the Risk Science Fellowship Fund. This blog is the first in a series by  the 2012 Risk Science  Fellows introducing themselves and their projects. This blog is written by Natalie Sampson. For more information about the Risk Science Fellowship please see our website.

The phrase ‘heat wave’ may conjure up idyllic images: children playing in sprinklers or elderly neighbors sitting on their porches sipping lemonade. To those of us living in climates characterized by months of grey, wintry weather, this sounds quaint. Yet, these images fail to capture the potentially serious public health consequences of extreme heat. Heat is often referred to as a ‘silent killer.’ Historically, heat events have resulted in 100’s or even 1000’s of deaths, as seen in Chicago in 1995 and Europe in 2003, respectively. (Read Eric Klinenberg’s book, Heat Wave: A Social Autopsy of Disaster in Chicago, for a provocative sociological account of the 1995 event.) Floods and earthquakes are devastating and often elicit the most awe-inspiring media stories, but it may surprise you to know that among all natural disasters, heat is the leading cause of death. Many researchers, including those on the renowned Intergovernmental Panel on Climate Change, predict that heat-related illness and death will increase substantially in the coming decades with the convergence of climate change, continued urbanization, and aging populations.

Lists of ‘dos’ and ‘don’ts’ disseminated by public health agencies during hot weather tell us to drink more water, wear light clothing, and avoid going outside during the hottest parts of the day. Sounds easy enough, right? Not quite. As with most other public health threats, there are many unrealized barriers and facilitators to our responses, both at home and in our communities. Do you have an air conditioner or fan? If you have an air conditioner, can you afford to turn it on? Do you have access to potable water? Do your windows and doors open easily to a safe, clean environment? Do you have transportation to get you to a public cooling center and feel comfortable going to one? Do you take medications that affect your body temperature? Vulnerable populations that are elderly, living in poverty, or chronically ill are at greatest risk to heat-related outcomes such as heat stroke or worsening of pulmonary or cardiovascular conditions.

Across the U.S., attention to heat waves as a public health threat is increasing among local municipalities. If you enter ‘heat wave’ and ‘health’ into your favorite search engine, you will discover a variety of department or organizational websites, including those responsible for emergency preparedness, public health, environmental health, planning, or energy management. Government, non-profit, academic, and community leaders are developing interventions to assist community adaptation to heat. In our recent four-city case study conducted by researchers from George Washington University, University of Iowa, and University of Michigan, we found that in Detroit, New York, Philadelphia, and Phoenix, interventions have included the use of cooling centers; air conditioning or fan distribution programs; energy assistance and weatherization programs; heat hotlines; block or floor captain programs for checking on neighbors; and a variety of outreach materials. Based on their experiences, interviewees revealed a host of potential next steps, such as increasing inter-generational or peer health education messages, integrating heat and health programming into existing social services like senior centers, improving surveillance to track heat-related illness and death, and expanding existing approaches to additional cities such as the use of interactive online maps indicating the location of cooling center sites.

This summer, as a recipient of a 2012 Risk Science Fellowship, I have the opportunity to expand this work and team up with local leaders already planning diligently for future heat events. First, I will be working with the designers of a NASA-funded Internet-based Heat Evaluation and Evaluation Tool (http://www.biomedware.com/?module=Page&sID=i-heat), appropriately shortened as I-HEAT. Currently in development, this software integrates remotely-sensed imagery of NASA Web-Enabled Landsat Data, demographic, socioeconomic, and health data to identify populations at-risk during heat events. Through surveys and focus groups, our team will pilot this tool with local government agencies in Detroit to determine and improve its effectiveness. Also, through partnership with Detroit’s social service providers and the Metro Detroit Climate Justice Task Force, I will assist the pilot of a daylong training curriculum to deliver to those working with populations most at-risk for heat-related illness and death.

In public health, and specifically in the context of climate change, it has become quite common to tout the ‘co-benefits’ of a policy or program. In this regard, heat-specific interventions not only address heat’s threats to public health, but also advance how we address emergency preparedness, climate mitigation and adaptation, risk assessment, population health, aging, and chronic illness. By developing the I-HEAT, for instance, researchers are advancing promising dialogue of how spatial assessments identify vulnerable populations to prepare for other public health threats also. There is much momentum in Detroit and the greater region, where a network of scholars and practitioners recognizes the co-benefits of acting to address heat as a public health issue.

Alongside other RSC fellows next fall, I will be presenting the results and potential co-benefits of these pilot projects, highlighting the work of the proverbially giants whose shoulders I stand upon. In the meantime, if you’re interested in climate, heat and public health, check out some of these resources:

• Centers for Disease Control and Prevention’s ‘Climate Change Webinars: A Public Health Response’

• Michigan Climate & Health Adaptation Plan

• Preparing for the Health Impacts of Increased Heat Workshop Series

Last Monday, stories about a new study linking red meat consumption to death began popping up all over the internet. As much as this seems frightening to those of us who are prone to enjoying a nice bowl of chili con carne or cheeseburger every now and then, the attention this study has garnered among science journalists may mystify some readers. Haven’t we already known that eating a lot of red meat is bad for us, for a long time now? Why would a prestigious university like Harvard waste resources on re-stating a well-understood principle of health?

The answers to these questions lie in the realms of both science and history. What may seem like common sense has not always been that way, and it requires a very large body of corroborating evidence to take an idea from merely plausible to “this is the truth as we understand it.”

This particular paper, published in March’s issue of Archives of Internal Medicine, is entitled “Red Meat Consumption and Mortality: Results from Two Prospective Cohort Studies.” Main author An Pan is a post-doctoral fellow at Harvard School of Public Health, and works with principal investigator Frank B. Hu. The data for the paper was amassed from two much larger studies being carried out at Harvard and analysis was carried out in cooperation with the Wellness Institute of the Cleveland Clinic, Cancer Registries in three dozen of the United States, and the German Institute of Human Nutrition. The dietary data was based on responses to a food frequency questionnaire which was administered to participants every four years throughout the study. Because the scope of this research was so vast, separate papers were even published to establish the validity (accuracy) and reliability (replicability, or precision) of those questionnaires (Salvini, et al., 1989; Hu, et al., 1999). Over 100,000 individuals were followed as part of either the Health Professionals Follow-Up Study (HPFS, 1986-2008) or the Nurses Health Study (NHS, 1980-2008).

Yum.....

With so many participants, such long data collection time periods, and remarkably high rates of response and compliance, the investigators were able to put together data sets about a wide variety of predictors and outcomes. Study subjects were recruited in young adulthood, and for the Pan study in particular, exclusionary criteria were applied so that no participants who began the study with cancer or cardiovascular disease were included. Previous papers examining different permutations of the same data have examined the influence of red meat consumption on development of Type 2 diabetes in women (Fung, et al., 2004) and dietary fat influencing Type 2 diabetes in men (van Dam, et al., 2002). The unique discovery in Pan’s study was the correlation between red meat consumption and death: replacing one serving per day of red meat with an alternative like fish, legumes, or poultry was associated with around 10% decreased mortality risk, and similarly replacing one serving per day of processed red meat was associated with around 20% decreased mortality risk (Pan, et al., 2012). Due to our general knowledge of increased cancer and diabetes rates among individuals with less-healthy diets, and that red meat is less healthy than most other foods one could consume, the logical step seems obvious. But in the world of science and epidemiology, such a logical conclusion cannot be believed until it is seen.

And this, I think, is where the divide between scientific professionals and those people with non-scientific expertise come upon a significant misunderstanding. For example, when questions of funding for basic science arise, those researchers who want to influence the data-supported understanding of the world may be making arguments that non-scientists do not accept. A lack of concrete evidence does not mean that the ostensible relationship between natural or social phenomena does not exist, but scientists cannot and will not state that it does until the relationship has empirical support.

References:
Fung, T.T., et al. (2004). Dietary Patterns, Meat Intake, and the Risk of Type 2 Diabetes in Women. Arch. Intern. Med. 164, 2235-2240.

Hu, et al. (1999). Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am. J. Clin. Nutr. 69, 243-249.

Pan, A. et al. (2012). Meat Consumption and Mortality: Results from Two Prospective Cohort Studies. Arch. Intern. Med. 172, ePub ahead of print.

Salvini, et al. (1989). Food-based Validation of a Dietary Questionnaire: The Effects of Week-to-Week Variation in Food Consumption. Int. J. Epidemiol. 18, 858-867.

van Dam, R.M., et al. (2002). Dietary fat and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care 25, 417-424.

This article is cross -posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

This article was written by Ashley Alexander, a first-year Health Behavior and Health Education Masters of Public Health student. She is interested in many topics related to public health, but particularly in health communications.

As spring approaches, so does the end of the semester, and my Google calendar is quickly becoming a blur of colored boxes that signify classes, group project meetings, and florist appointments (because for some reason, I thought it was a good idea to plan a wedding while I was earning my MPH).  With a full schedule, impending finals, and a wedding that gets closer by the day, it’s difficult not to feel the pressure.  While the things that fill my schedule are unique, I think it’s probably a safe bet that most everyone can identify with a hectic life…and the stress that comes with it.

Stress, despite the unpleasant feelings that often accompany it, is actually meant to be protective, preparing our “fight-or-flight” response in the face of something we perceive as a threat.  Unfortunately, extended periods and excessive amounts of stress have effects on our brains and our bodies that are far from healthy.

Researchers at Yale University recently published findings that stressful events that accumulate over time appear to cause a reduction of the gray matter in our brains.  The brains of more than 100 healthy adults were observed, specifically looking for areas that showed decreased volume.  The participants were also given a questionnaire to assess recent stressful events, major traumatic life events, and chronic stress in order to compare their stress level with their brain scan.  Cumulative stressful life events, regardless of whether they occurred recently or distantly in the past, showed a strong connection to decreased brain volume in certain regions.  The areas that were seen to have smaller volumes play a critical role in social interactions, processing of emotions, and coping.

Because of the nature of these brain regions and the functions associated with them, it’s not surprising that these sections are also smaller in people with depression.  The Yale researchers suspect that reductions in brain volume in these areas which appear to occur from prolonged stress, may make it more difficult to cope with stress in the future.  Promisingly, the study noted that reduced brain volume in these key areas that results from a recent stressful life event may be reversible.  The changes are more problematic when they are caused by the reoccurrence of stressful or traumatic experiences and chronic stress.

In addition to the way it impacts the brain, stress also has consequences to our physical health.  According to the Mayo Clinic, when we perceive something to be stressful our bodies release a surge of hormones including adrenaline and cortisol to prep us for fighting back.  These hormones are responsible for the unpleasant symptoms we may feel when we find ourselves under pressure (racing heart, upset stomach, headache, irritability…just to name a few).  Just like in the brain volume study, the real health concern comes in with long-term exposure to traumatic events and stress.  Then, the adrenaline and cortisol stop being protective and start becoming harmful, increasing our risk of becoming obese and developing heart disease, digestive problems, sleeping troubles, and memory loss.  Uh oh.

Clearly it’s important to manage stress in order to help prevent the possible mental and physical consequences.  Personally, I feel that managing my stress can be quite a challenge, especially given my crazy calendar.  However, it is possible.  So if you’re feeling the weight of stress too, take some deep breaths, and check back next week for more suggestions!

Should young women who aren’t ready to have children have their eggs extracted and frozen as an “insurance policy” for future motherhood? Several recent media features seem to be promoting egg freezing, with little or no mention of the risks involved for women who undergo egg retrieval procedures or for the children that might be born as a result.

A January 23 article in Newsweek / The Daily Beast leads with Diane Sawyer encouraging young women who work for her to freeze their eggs and is illustrated with glamorous photos of celebrities who have themselves used egg freezing, egg donors, or surrogates. The article is unabashedly enthusiastic about egg freezing, but makes no mention at all of the significant down sides.

A CNN special report, titled Baby Quest, features an inside look at the vitrification process behind freezing eggs. The report encourages women who are concerned with their fertility to consider taking the leap by stimulating the growth of as many eggs as possible in their 20s and 30s, and freezing them in time.

And last week the Huffington Post published a first-person account of a 34-year-old woman freezing her eggs to safeguard her future fertility. She encourages more women to start talking about egg freezing, but within the article itself there is no discussion of the relevant risk factors women might consider before opting in.

While the American Society for Reproductive Medicine (ASRM) clearly states that all egg freezing should be considered experimental, this recent media coverage has sent a different but also clear message: egg freezing can prevent infertility – and you need it as an “insurance policy.”

Diane Sawyer has even endorsed a particular egg freezing go-to clinic: New York University’s Langone Medical Center Fertility Clinic. Sawyer froze her own eggs there, and urges colleagues and staff to similarly attain “reproductive autonomy” from her personal fertility specialist, Dr. Nicole Noyes.

Noyes and her Langone partner, Dr. James Grifo, were also featured in the recent CNN segment, which is light on information and heavy on infomercial. Their comments neglected any of the risks associated with egg retrieval or freezing.  Perhaps this is unsurprising in light of Noyes’ comment in Nature last August that the experimental label should be eliminated. “The change in perception,” she says, “will make freezing more widely available and advance the field.”

One has to wonder whether the incentive to “advance the field” might be tied to egg freezing’s $15,000 price tag, and to the new business opportunities opened by a procedure that can be marketed to large numbers of young women rather than only to people with medically known fertility problems.

There are good reasons that egg freezing has been deemed experimental. ASRM’s focus was on the unpredictability of successful pregnancies initiated with embryos made from thawed eggs, and on the lack of research about the effects of the procedure on children born from frozen eggs. As ASRM Practice Committee Chair Samantha Pfeifer pointed out, “Some of the chemicals used in the freezing process are toxic to embryos, and no one knows how much the eggs absorb. Moreover, there has been no systematic follow-up of children born from frozen eggs.”

In addition, it’s important to consider the short-term and long-term risks of egg extraction, which are known to be significant but are also under-studied and under-reported. If the recent spate of media treatments is any indication, many women who consider egg extraction – whether for immediate fertility treatment, possible future fertility treatment, or to sell their eggs – will remain unaware of these risks.

This article is cross -posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

Marisa Mead is a first year Masters of Public Health student in the department of Environmental Health Sciences studying Human Nutrition and Dietetics. Her interests are in Food, Science and Community Health.

When I moved from California to Ann Arbor last fall to start graduate school I was warned many times of the cold, intense winter ahead. Except that this Michigan winter boasted unusually warm temperatures, making it the 5^th warmest winter on record, with little snowfall. I can’t help but smile when I think that I may have avoided suffering through the bitter cold. I may consider myself “lucky” so far (although the weather forecast is calling for blizzards this week), but low snowfall this winter has been hurting other parties, such as winter tourism businessand the flu virus.

The end of February is normally peak flu season. However, flu experts around the country searching for the flu can’t seem to find it. NPR reports that since the flu virus survives best in cold and dry conditions, the abnormally warm temperatures seen across the country may be one of the reasons for the slowest start to the flu season in 29 years. I’ve heard my friends and colleagues joke that “global warming” is the culprit behind these warm winter temperatures, but climate change may actually play a role in flu season patterns.

Public health science researchers from Columbia and Harvard Universities have found a link between La Niña weather patterns and the four most recent worldwide flu pandemics (worldwide epidemics). The pandemics in 1918, 1957, 1968 and 2009 were all preceded by below normal sea surface temperatures, consistent with the La Niña phase of the El Niño Southern Oscillation (ENSO). Put simply, ENSO is the El Niño/La Niña cycle, where El Niño is characterized by unusually warm temperatures in the equatorial Pacific, and La Niña is characterized by unusually cold temperatures in the equatorial Pacific.

The findings of the study indicate an association between flu pandemic and ENSO patterns. This association does not mean La Niña is causing flu pandemics, but there’s other evidence to suggest it might. ENSO has been shown to affect the health and behavior of migratory birds. Wild birds are thought to be a primary reservoir of influenza A viruses that cause avian flu such as the recent H5N1 outbreak. Migratory birds travel long distances and have frequent stopovers—conditions that favor gene re-assortment and mixing of the influenza virus genomes necessary for new variations of viruses and crossover to the human species.

Influenza pandemics are rare, but being able to analyze virus gene flow within migratory birds, along with bird health and migratory behavior in response to ENSO patterns can help predict whether or not a new flu pandemic is likely after the La Niña season.

So what role does climate change have on the impact of the flu season? Since ENSO is part of a broader climate system, climate change could theoretically change how the cycles operate, to be more or less severe, or have shorter or longer cycle durations. Climate scientists are still debating if and how climate change influences ENSO, but if it does then that’s another factor to consider when analyzing migratory bird patterns, influenza viruses, and La Niña cycles.

Our unusually warm Michigan winter may or may not be due to climate change, but I’m not complaining, and neither are the hospitals and doctors that are experiencing less flu this season.

Reference:

Jeffrey Shaman and Marc Lipsitch. The El Niño–Southern Oscillation (ENSO)–pandemic Influenza connection: Coincident or causal? PNAS. January 17, 2012.

Main photo by Jim Bahn, Flickr

A guest blog by RHReality Check and Huffington Post writer Soraya Chemaly.

Soraya Chemaly writes about gender and culture for The Huffington Post, RHReality Check, The Feminist Wire, BitchFlicks, Fem2.0 and Alternet among other online media. This article was originally posted at RH Reality Check

What happens when women, like men, can be parents without bearing children?  Does one form of gestation become a status symbol? Another a stigma? Who decides which gestation environment is healthier or more economical? You? Your gamete-partner? Your priest? Your employer? Your insurance company? If we think we have a complicated debate now, just wait. The current War on Women pales in comparison to the potential impact that ectogenesis, a technology in which a human fetus gestates completely out of a mother’s body, will have. It is, in its ultimate manifestation, qualitatively different from birth control or other assisted reproductive technologies. This change has the power to alter, in unprecedented ways, the interests, rights and responsibilities of women, men and the state.

J.B.S. Haldane, a British scientist, who predicted that by 2074 live human births would make up less than 30 percent of all births, first coined the term ectogenesis in 1924. His prediction was ambitious, but not unrealistic.  Despite the sci-fi horrors evoked by “artificial wombs,” this isn’t the stuff of dark dystopias. It is a partially realized, life-saving technology. Since the 1920s, researchers have seen the development of artificial wombs as a final goal of assisted reproductive technologies. Research focuses variously on helping premature babies to survive to finding substitutes for women’s bodies as baby machines. In the past 30 years, our reproductive technologies have achieved what would have previously been considered miraculous. Artificial wombs, a form of life support, are the logical conclusion of those efforts.

Current Research

There are two commonly cited endeavors in progess. Focusing on finding ways to save premature babies, Japanese professor Dr. Yoshinori Kuwabara of Juntendo University, has successfully gestated goat embryos in a machine that holds amniotic fluid in tanks.  On the other end of the process focusing on helping women unable to conceive and gestate babies, is Dr. Helen Hung-Ching Liu, Director of the Reproductive Endocrine Laboratory at the Center for Reproductive Medicine and Infertility at Cornell University.  Quietly, in 2003, she and her team succeeded in growing a mouse embryo, almost to full term, by adding engineered endometrium tissue to a bio-engineered, extra-uterine “scaffold.” More recently, she grew a human embryo, for ten days in an artificial womb. Her work is limited by legislation that imposes a 14-day limit on research project of this nature.  As complicated as it is, her goal is a functioning external womb.

Predictions for the full realization of what scholars Scott Gelfand and John Shook call “immaculate gestation”* range from 10 to 60 years.  However, it is already partially possible and entirely within the spectrum of acceptable practices.  Even if it takes scientists several decades, medical advancements are steadily narrowing the gap between in vitro conception and fetal viability outside of the womb.  When the gap closes then babies, navel-less, will no longer have to be “born” through women.

Is that an advantageous human adaptation?

Medical Benefits

The medical benefits seem clearest – the technology will help infertile couples, enable premature babies to survive, create an alternative to surrogacy when needed, and help women unable to carry their own babies. Ectogenesis can provide safe, healthy gestational environments – free from drugs and alcohol. It will give gay couples new fertility options.  Other benefits posited by advocates of the technology range from better-adjusted children, freed from mothers who are overly invested in them, to, although morally repugnant, the steady supply of “spare parts” that could be harvested from “bottled” embryos.

Societal Consequences

The moral, ethical, legal and societal consequences are profound and we are unprepared for them.  Definitions and distinctions, the meanings of words like “life,” “human,” “embryo,” “natural,” and even “mother,” that we’ve historically relied on to make ethical decisions, are dissolving faster than we are adapting. What happens when both men and women contribute equally – by providing only gametes – to reproduction? Do women have to carry human babies? What if they don’t want to? Who decides? What does it mean to sever human “birth” from the human body? This connection, between women and babies, is one of the sole sources of power that women have in some societies.

Abortion, Reproductive Rights and Equality

In immediate terms, the foundations on which a woman’s rights to choose are predicated in Roe v. Wade, namely the issue of fetal viability and the right to privacy (the right not to be pregnant), will be rendered virtually meaningless.  First, once a fetus can be safely and entirely gestated outside of a biological womb, it can be removed from its mother.  Second, ectogenesis means that viability starts with conception.  Both consequences radically alter the terms of the pro-choice debate as it is currently framed and understood.  The tension inherent in the current debate, between the rights of the woman and the state’s interest in the fetus, disappears when the woman and the fetus can be safely and immediately made independent of one another.  The reproductive choices of men and women become equal and women lose the primacy now conferred on them as a result of gestation. States could require women to have their fetuses extracted as an alternative to abortion, with serious long-term negative impacts.  Reproductive rights and social justice issues will take on an even more surreal dimension.

Feminists, not surprisingly, have extensively considered what ectogenesis could mean for women’s rights, the structure of the family, class, and society.  Right wing anti-choice activists, although perhaps initially delighted to have an alternative to abortion, will have to contend with a radical redefinition of “motherhood” and the hierarchical and gendered societal relationships for which it is an antecedent.  There is no guarantee that these changes will be good for women who currently already struggle to defend reproductive freedoms. Feminist critique ranges from one extreme to the other in terms of whether ectogenesis will liberate or further oppress women.

In her seminal work, The Dialectic of Sex, written in 1970, Shulamith Firestone argued that inequality between genders, and women’s virtual imprisonment in the home, was the direct result of biological reproductive differences and women’s correlating investments in mothering.  For her, ectogenesis, accompanied by revolutionary social changes, was the way to free women from the tyranny of their own biology put in the employ of patriarchal structures, including the traditional family.  She noted that, so far, these technical and social changes have been impeded by medicine’s domination by men, who have no vested interest in upsetting the traditional status quo.

This same status quo has demonstrated the extent to which it is willing to view mothers as flesh and blood mother machines**.  Ann Oakley’s book The Captured Womb: A History of the Medical Care of Pregnant Women illustrates how ectogenesis would be part of a long-standing process by which virtually all male and often misogynistic medical cultures have taken control of birth and women’s wombs in the name of science.  In this framework, ectogenesis will potentially exaggerate preexisting inequities and biases.  In this equation women aren’t liberated, they are further subjugated and alienated from their own bodies and abilities.  This Handmaiden’s Tale scenario is fairly believable if you pay any attention to, for example, Rick Santorum’s antediluvian reproductive rights agenda and the number of people willing to vote for him.

Prominent feminists and activists, including Andrea Dworkin and Janice Raymond, have concluded that not only will women be further marginalized and oppressed by this eventuality, but they will become obsolete.

Fertility, and the ability to be the species’ reproductive engine, are virtually the only resources that women collectively control, they argue. And, although women do have other “value” in a patriarchal society–child rearing, for example–gestation remains, worldwide, the most important.  Even in the most female-denigrating cultures women are prized, if only, for their childbearing. If you take that away, then what? This technology becomes another form of violence.

Other feminist analyses takes into account the class and race implications of the enthusiastic adoption of assisted reproductive technologies by the wealthy. Some, eco-feminists, relate the eventuality to correlating a general campaign against nature. Ectogenesis also opens up the real possibility of men becoming mothers and primary care takers.***

Who controls ectogenesis and how it is utilized is the key to whether or not it is a tool of liberation or oppression for women. Men rule, literally, and until we have more gender balanced representative leadership in all sectors of society, that has predictable consequences. Women are outnumbered as researchers and scientists in the field of reproductive technology, as opinion-shaping media commentators and pundits, as clerical and religious leaders, and as governmental policy makers and regulators.  In this context, as with the current contraception/Catholic church debacle, is highly unlikely that woman-centered reproductive agendas, especially those that take into account the needs and health of poor women and women of color, will result.

Bioethics and Regulation

Scientists are the first to admit the complexity of gestation.  They don’t understand the subtle interactions – everything from the nature of the mother-child bond to the necessary and ideal balance of temperature, sounds, fluids and hormones - between women’s bodies and the bodies and development of fetuses.  As with all new technologies, particularly biotechnological ones like in vitro and cloning, bioethicists are thinking about the social, legal and ethical implications. But, compared to other developed countries, the United States  has very little regulation regarding assisted reproductive technology.   And, although lots of people in Congress are eager to wax on about the moral status of embryos and the definition of personhood there are currently virtually no federal or state regulations regarding the impact of how we use gametes, embryos, artificial wombs and engineered birth to define those terms. A quick search of the Presidential Council on Bioethics’ website for “artificial womb,” “ectogenesis,” “gestation,” yielded only one result on the not-specific-to-reproduction moral science of limiting human subject research.  A 2004 Presidential Commission on Regulation of New Biotechnologies was concerned with commercialization of ova and sperm donations, insurance coverage, truth in advertising and patent issues.  The NIH is primarily in the business of monitoring stem cell research. The FDA with regulating substances used in IVF.

Any integrated, comprehensive pragmatic and/or philosophical approaches are political nightmares in this country. However, not any longer in others. Britain, for example, established a Human Fertilization and Embryology Authority (HFEA) in 1990. HFEA has authority, independent from the health and research facilities and the government, to regulate assisted reproductions services and products.

Decisions about reproductive technologies are more often then not made by doctors and individuals in the absence of a social justice framework. Progressive people, interested in equality and social justice, need to prepare for how rapidly evolving technology will shift reproductive rights and responsibilities. The real dystopian future is one where we look back with nostalgia at the brief period during which Roe vs. Wade had its fragile relevance and impact as a high point in women’s reproductive freedom. It may sound alarmist, but really, we have time to consider the ethical, moral, societal ramifications of this technology and frame the arguments of the future before others do it for us. We have some time, but, not much.

Sources and Additional Reading

* Scott Gelfand and Shook, John R., eds., Ectogeneis: Artificial Womb Technology and The Future of Human Reproduction, Editions Rodopi, B.V., 2006

** Gena Corea, The Mother Machine: Reproductive Technologies From Artificial Insemination To Artificial Wombs, Harper Collins, 1985

***Maureen Sander-Staudt, Of Machine Born?, Ectogeneis: Artificial Womb Technology and The Future of Human Reproduction,Editions Rodopi, B.V., 2006

Richard T. Hull, Ethical Issues in the New Reproductive Technologies, Prometheus Books, 2007

Christopher Kaczor, The Ethics of Abortion: Women’s Rights, Human Life, and the Question of Justice, Routledge, 2011

Jessica Pierce and Georgle Randels, Contemporary Bioethics: A Reader with Cases, Oxford University Press, 2010

J.B.S. Haldane, Daedalus Revisited, Oxford University Press, 1995

Shulamith Firestone, The Dialectic of Sex, 1970

Ann Oakley, The Captured Womb: A History of the Medical Care of Pregnant Women, Blackwell Publishers, 1985

Follow Soraya Chemaly on Twitter, @schemaly

This article is Cross Posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

Joseph Martin is a second year Masters of Public Health student in Environmental Quality and Health. After graduation, he will pursue a Ph.D. in soil science. His interests lie in soil science and chemistry, human health and how they interact, especially in regards to agricultural practice and productivity.

It’s no secret that Americans, as a society, love to eat meat. According to the USDA, we produced 26.41 billion pounds of beef, and exported only 2.3 billion pounds of that in 2010. Add to that our dairy cattle, pig, and chicken farming, and we raise a lot of animals in this country. And those animals poop.

Not pictured: Subject of today's post. Image Credit: Boogeyman13

This unavoidable toxic waste builds up. In Jan. 1, 2010 the USDA estimates there were 92.6 million head of cattle in the united states. That doesn’t include pigs, goats, or other mammals. (Birds, like chickens and ducks, do not excrete waste in the same way, and as such the disposal of their wastes is not the same. For the sake of simplicity, I’ll not include them in this discussion). We have to put it somewhere.

The answer is usually manure lagoons, also called anaerobic lagoons. These excessive amounts of manure and/or urine are pooled in trenches dug for this purpose. Some of it may be removed to be used as fertilizer, but for the most part it is meant to degrade there in the pits. As detailed by the National Resources Defense Council, (NDRC), there are multiple human health and environmental consequences of collecting and condensing animal waste into these lagoons. In acute health concerns, the most prominent concerns are the gasses produce by the anaerobic digestion of the manure. (Most manure lagoons do not appear to be aerated, and so only the waste on the surface have access to oxygen. As such, the bacteria in the manure lagoon use anaerobic digestion for the most part.) Poisonous gases such as methane and hydrogen sulfide can build up, especially in closed or in-doors waste containment. Hydrogen sulfide is very toxic by itself, and when coupled with methane and carbon dioxide (the product of the aerobic degradation that occurs on the surface of the lagoon), can significantly displace oxygen. Finally, when released into the air, or if a closed or indoors waste container is vented or opened, the methane presents a real explosion hazard.

Secondly, there is a biological risk from these wastes. They are literally the perfect environment for many bacteria to proliferate and provide a reservoir of pathogens that can escape via farm workers, manure transporters, and people who live too close to fields fertilized with such manure. This is multiplied under conditions which may cause the lagoon to spill over, such as heavy rains.

Spills, as I just mentioned, are a major source of environmental concerns. Aside from newly released pathogens, these wastes spills can introduce large amounts of nutrients into water ways. This results in the classic eutrophication** and anoxic conditions events which can destroy entire food webs in rivers, ponds, and streams. In some waste pools, ammonia can build up to such a degree that when spilled over land or into surface water, it can actually prove directly toxic to the plants and animals which live there. Antibiotics and other pharmaceuticals, (such as artificial hormones), may also build up in these pools and prove disastrous when released in spills.

Of course, spills are not the only source of environmental concern. While lagoons, under laws such as the Clean Water Act and regulations like National Pollutant Discharge Elimination System (NDPES), are not allowed to simply dump into open water ways, they do not bear the requirement to line their lots like solid-waste landfills. This means the pharmaceuticals, (i.e. antibiotics and hormones), and nutrients like nitrates, are able to leach into groundwater, and in some cases into surface water by way of ground leaching. The consequences of nitrate contamination are well known. The effects of these leached pharmaceuticals are still being discovered.

So what do we do then? The NDRC article linked above has some excellent suggestions concerning policy and regulation. But I have one real suggestion. Individually, we can start by eating less meat, and if you eat meat try to make sure it is from a non-factory farm. Small farms do not experience the same issues with waste that large farms do. In other words, the troubles with manure lagoons is not the how but the how much. Placing the waste of 10 pigs into a ditch will not likely cause these issues. The ground is prepared to absorb that amount of waste and use it as added nutrients, and do it quickly enough to prevent pathogen development and gas build-up. Similarly, if you’re a beef eater, free-range or grazed cattle (which is not the same as grass-fed), avoid most of these situations. As the cattle graze, they just leave their droppings in the field, where it remains unconcentrated. This is compounded by the needs of cattle to each eat enough, ensuring they graze over a wide enough area to avoid significant concentration of wastes. All in all, eating less meat and being more mindful of the source of your meat is one of the best ways to reduce the pollution resulting from these factory farms. But if you feel the need, organizations like the NRDC are always ready for more support, be it your time or your money.

**I know I get plenty of legitimate critiques on my overly-technical language, but I cannot simplify the issue of eutrophication. If you count yourself as any sort of environmentalist, or just a person who cares about the environment, you need to know about eutrophication, also called algal blooms. It is one of the most common types of pollution events and consequently most destructive in terms of economy and environmental degradation. Click through to the wiki article, and read up.

This article is Cross Posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

This post was written by Seema Jolly. Seema is a  second year MPHS student in Environmental Health Sciences, specializing in Human Nutrition. Her specific interests include sustainable food systems and food and environmental justice.

Here’s something I’ve never thought twice about (and maybe you haven’t either): the potential health concerns for workers at a nail salon.  Yes, a nail salon.  Have you heard a story about someone getting a bacterial or fungal infection after going to a nail salon, perhaps because of unsanitary conditions?  Consumer health and safety is a valid concern, but why don’t we ever hear about the health or safety of the workers at a nail salon?

There are approximately 350,000 licensed nail technicians in the United States.  It shouldn’t be a surprise that workers at nail salons are breathing in different types of chemicals: nail polish, glues, solvents, and disinfectants, just to name a few.  But just because workers breathe these chemicals, are they actually being exposed to these chemicals at levels that may be harmful to their health?  A study conducted in Oakland, California, measured worker exposure to chemicals that are commonly used in nail salons.  80 Vietnamese women from 20 nail salons wore personal air monitors to sample the air around the women while they worked.  Vietnamese immigrants comprise a large proportion of this workforce, yet, due to cultural barriers, this is a population that has been difficult to study in the past.

What was measured?

Three chemicals, toluene, ethyl acetate, and isopropyl acetate, were measured in this study.  These chemicals are found in gasoline, glues, perfumes, cosmetics, and printing inks – in short, they are widely used.  These types of chemicals may cause allergies, neurologic and reproductive harm and some have been linked to cancer.  All measured chemicals from the air monitors on workers had lower values than the California Division of Occupational Safety and Health limit, which might mean that workers may not be at risk from these exposures.  However, toluene was higher than the recommended levels.

Air monitors in the salon measured methyl methacrylate, which is an adhesive used in acrylic nails (and was banned by the Food and Drug Administration in the 1970s because of its potential to cause injury to fingernails).  Levels were 3 times higher than the US EPA’s recommendation despite its ban in cosmetic products.

It’s important to remember that while there are thousands of chemicals that are manufactured and used in this country, only about 10% of chemicals in cosmetics have actually been tested and approved by the Food and Drug Administration.  While the other 90% of chemicals haven’t necessarily been determined to be “unsafe,” they also haven’t been determined to be “safe.”

Even though these workers weren’t exposed to chemicals at an “unsafe” level according to the California state standards, almost one third of all participants reported health problems such as headaches, nausea, breathing problems, and irritation in the nose, throat, lungs, skin or eyes.  These symptoms all began after working in the salon, which may be due to the exposure to these chemicals.

Why do we care?

While some of these reported health problems may not seem so severe on the surface, we do not have a clear understanding of the potential health effects workers may face after being exposed to these chemicals day in and day out.  This study provides support for taking precautions, like increasing ventilation in the nail salons or wearing masks, to reduce workers’ exposures to the chemicals that they are surrounded by all day.

So, am I telling anyone to boycott nail salons?  Not at all.  But this study reminds us that there are many aspects of our day-to-day lives where we do not to think about our surroundings and how they impact our health.  Whether it’s while we’re cleaning our house, getting clothes dry-cleaned, or stopping at a nail salon, we (and the workers in these industries) are exposed to dozens and dozens of chemicals everyday, some of which may be harmful and some of which may not.

Source:

This article is Cross Posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

Joseph Martin is a second year Masters of Public Health student in Environmental Quality and Health. After graduation from this program, he will pursue a Ph.D. in soil science. His interests lie in soil science and chemistry, human health and how they interact, especially in regards to agricultural practice and productivity.

On July 26th, 2010, an Enbridge Energy Oil Pipeline leaked nearly 1,000,000 gallons of bituminous oil (that is, oil from tar sands) into a tributary of the Kalamazoo River. This was, in technical terms, very bad. The volatilizing organics caused many health problems, prompting evacuation of many residents, capping of wells and irrigation pumps, and a total ban on contact or fishing from the tributary and major portions of Kalamazoo River. (By contact, I mean any sport or activity which might potentially put you in contact with the water. All boating, swimming, synchronized swimming, or establishing underwater secret lairs is strictly forbidden.) Health suits are common against Enbridge, who has been tasked with cleaning and monitoring the affected water  bodies until they are safe again for human interaction.

Nearly two years later, there is still a total ban on surface contact or fishing from the affected waters. Farmers are losing income for lack of irrigation. Yet Enbridge claims that 766,000 gallons of the 843,000 spilled have been removed. What, as it has been asked, gives? Part of the reason is that yes, 77,000 gallons is a whole lot of petroleum to still be in a river ecosystem. But that doesn’t completely answer the question. Another important reason lies in the chemical properties of oil.

That last sentence was a bit of misdirection. Petroleum isn’t a chemical; it is many hydrocarbons plus a good deal of contaminants of varying types. Even if we ignore the contaminants (like sulfur), petroleum is a hugely complex mixture with many different chemicals to consider. A considerable portion of these chemicals violate one of the basic rules of “oil” – they sink. A portion of petrochemicals are denser than water and, though they will not dissolve, will sink to the bottom where it cannot be skimmed. In the lazy river attractions now ubiquitous at water parks, this would still not be a terrible problem. You could put a hose at the bottom and start pumping. It might take some time, but the way forward is clear.

But the big difference between the lazy river and a real river is the degree to which life proliferates, the usual sunburnt habitants of a lazy river notwithstanding. The Kalamazoo River, like most rivers in Michigan, has been full of living and dying creatures for the 11,000 or so years. The muck and sediment on the bottom, even when it looks just like sand, is full of organic matter, both living and not. And many of the petroleum sinkers will complex and bind with the organic and inorganic matter which makes up the river bed. (Similarly, if the sediment is churned up, or even in regular river water, floating petroleum chemicals can be bound to the sediment and contribute a significant or even majority portion of the total sediment contamination). All of this is combined with the fact that a lot of the oil itself, not just contaminated sediment, is sitting on the river bottom, (reportedly, some 200 acres of river bottom are still covered in this petroleum). All this also have to be cleaned up.

In truth, the fact that the sediment is contaminated isn’t of great human health concern – it’s really more the 200 acres covered in submerged oil. As long as you don’t spend a lot of time eating river dirt, swimming and boating should be fine. Where concerns could come up is with eating fish. Bottom-feeding fish, such as catfish, as well as many the tiny organisms which proliferate on the river bed, consume this bound petroleum and get it all up in them. All of this is great for making poison darts out of the entrée at a Kalamazoo fish fry. (Unfortunately, that’s not a big problem. A limited fish consumption advisory has existed for the Kalamazoo River since 1970’s, due to PCB contamination. In fact, in 1990, 35 miles of the Kalamazoo river was designated a Superfund site.)

In conclusion – this river’s messed up. But suffice to say, the effects from the contamination of this river will be felt for years and years, even after the submerged oil is dredged and the waterways re-opened for human use. (It will be a long time until the fish are okay to eat. The PCB’s themselves last for long time, regardless of the petroleum contamination). I think the best we can do now is remember that an ounce of prevention is worth a pound of cure.

Addendum – As you may have noticed, I’m kind of into dirt, and it’s what I’m trying to become good at writing about. All of my posts in this class/on this blog will be about the places where soil (even if underwater) and human health interact. But in writing about the sediment contamination from this spill, I glossed over what is likely the major cause of the health problems from this oil spill. Many of the really scary chemicals, like the infamous BTEX (benzene, toluene, ethylbenzene, and the xylenes) chemicals, will volatilize off into the air. It is these volatile chemicals which were responsible for the horrible smell from the spill. Chemicals like benzene and toluene are known to have serious health effects, (benzene is known to cause leukemia among many other health problems, and toluene can cause neurological damage.) I wanted to mention this to establish that the health concerns and claims of those affected by the spill against are serious and legitimate. Here is an excellent article on the spill and the health effects on those exposed from Al-Jizeera.

Image Credit: Mic Stoltz

This article is Cross Posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

Colleen Davis is a second-year Human Nutrition and Dietetics Masters of Public Health student at the University of Michigan, and she holds a B.S. degree in Biology from Hillsdale College. Her interests include all things nutrition–everything from clinical dietetics to food and nutrition policy.

Winter break officially starts next week, but my mind is already at the beach. I’m ready to relax by the water and trade in my textbooks for a stack of magazines. After reading this study, however, I’m inclined to keep my hands out of the sand.

A research study published in Epidemiology last month investigated the relationship between sand-contact activities and enteric illness. Enteric illness refers to intestinal infections acquired by contact with bacteria-contaminated sources such as food, or by contact with contaminated feces or vomit. The effects of enteric illness run on a continuum from mild gastrointestinal discomfort to severe GI complications and diarrheal disease that can cause death. The study in Epidemiology found a positive relationship between engaging in sand-contact activities and the development of enteric illness from pathogens associated with fecal contamination.

The impetus to conduct this research resulted from previous studies that confirmed the presence fecal matter and the associated enteric pathogens such as E. coli in beach sand. Water quality of beaches is a hot topic in research, but sand quality doesn’t receive as much attention. Since beach-goers are likely to spend time on, well, the beach, further research in this area was certainly justified.

The researchers analyzed data from the 2007 trials of the National Epidemiological and Environmental Assessment of Recreational Water Study, which took place at 2 recreational beach sites, one at Mobile Bay in Fairhope, Alabama and the other at Greenwich Bay in Warwick, Rhode Island. Beachgoers were questioned at each site as they left the waterfront about their sand-contact activities. They were asked to report all varieties of contact with sand, including digging and playing in the sand, swimming, building sandcastles, and being buried in the sand. Participants were also asked if they washed their hands before eating or drinking on the beach, and researchers inquired if beachgoers had consumed raw or undercooked food in the past three days. On the same day, researchers collected sand samples from each beach site (144 samples total) and tested for the presence of enteric pathogens known to cause gastrointestinal stress.

Ten to twelve days later, a member of each beach-going group was interviewed regarding his or her group’s gastrointestinal health after visiting the beach. Specifically, researchers asked the group representative if he or she or any of the members of the group experienced vomiting, diarrhea, cramps, or general gastrointestinal distress in the time following the beach outing. Participants were again asked about their consumption of raw or undercooked foods in the time since visiting the beach. A total of 4948 beachgoers fully participated in the research study.

The results? Playing in the sand could be hazardous to your health. A positive association was found between digging and being buried in the sand and enteric illness at both beach sites. Specifically, enteric-illness causing pathogens Enterococcus and Bacteroidales were found in the sand samples.

The results cast a small cloud over my upcoming beach getaway, but knowledge is power. The spread of enteric illness can be prevented by thorough hand-washing and sanitation practices that can easily be applied at the beach. I’ll toss a bar of soap into my beach bag and pass on the full-body sand application.

Shobita Parthasarathy is an Associate Professor at University of Michigan’s Ford School of Public Policy. She is also a member of the Risk Science Center and sits on our Internal Advisory Board. Dr. Parthasarathy is currently on sabbatical as a Visiting Scholar at the American Bar Foundation.

Building Genetic Medicine: Breast Cancer, Technology, and the Comparative Politics of Health Care.

Shobita Parthasarathy’s first book, which has influenced legal and policy debates about genetic testing and patenting, has been released in paperback by MIT Press. Building Genetic Medicine: Breast Cancer, Technology, and the Comparative Politics of Health Care compares the development of genetic testing for breast and ovarian cancer in the United States and the United Kingdom. It demonstrates how national approaches to health care, to patient advocacy, and to commercializing scientific work led to different understandings of risk and disease, the rights and responsibilities of users, and even the role of the test itself in the two countries.

The book’s findings have influenced an ongoing federal lawsuit by breast cancer patients, scientists, and physicians (led by the American Civil Liberties Union) against Myriad Genetics, the US company who owns the genes linked to breast and ovarian cancer (known as the BRCA genes). Based on the book, Parthasarathy submitted an expert declaration that disputed Myriad’s claim that it was the sole inventor of the BRCA genes. She also described Myriad Genetics’ aggressive strategy to use its patent rights to shut down other BRCA gene testing services in the United States, and the implications of the company’s eventual monopoly for users. In sum, the declaration disputed the idea that patents are necessary for research and development and that they are beneficial for society. In his March 2010 judgment against Myriad Genetics, NY District Court Robert Sweet cited Parthasarathy’s declaration extensively when he ruled that genes are “products of nature” and therefore unpatentable. While an appeals court overturned the decision, the Supreme Court is now considering the case. Parthasarathy has also testified about the book’s findings to the Secretary’s Advisory Committee on Genetics, Health, and Society (US Department of Health and Human Services), the Dutch Medical Biotechnology Commission, Austrian Genome Research Program, and individual staff members of the US Congress.

You can find the paperback version of Dr. Parthasarathy ‘s book on amazon here.

This article is Cross Posted from Mind the Science Gap. Under the guidance of the Risk Science Center’s director Andrew Maynard, for ten weeks between January and April 2012, Ten Masters of Public Health students from the University of Michigan will post weekly articles, translating complex sciences into accessible science communication for a broad audience.

This article was written by Drew Heyding. Drew is an MPH student in the Epidemiology department, his background is clinical medicine, having practiced internal medicine at Harlem Hospital before coming to the University of Michigan for additional training in preventive medicine.

“There is a cure for poverty.  It is a rudimentary one, it does work, though.  It works everywhere, and for the same reason.  It’s colloquially called ‘the empowerment of women.’  It’s the only thing that does work.  If you allow women control over their cycle of reproduction, so that they are not chained by their husbands or by village custom to annual animal-type pregnancies, early death, disease, and so on.  If you will free them from that, give them some basic health of that sort—and if you are generous enough to throw in, perhaps, a handful of seeds and a bit of credit—the whole floor, culturally, socially, medically, economically of that village will rise.  It works every time.”

—Christopher Hitchens, in a debate with William Dembski at Prestonwood Baptist Church in Plano, Texas

This is not a political rant.  This has nothing to do with religion or individual beliefs.  This post has to do with science.  By that, I mean what has humankind been able to learn about our universe and world, what can be demonstrated, what can be shown.

I have long been an admirer of Christopher Hitchens.  However, as the Risk Science blog is focused on health issues, I could never think of a way to involve him in any of my posts.  Furthermore, I was worried that his atheism, his political views, his opinions of various sacred cows, or his career as an iconoclast and contrarian would anger people causing them not to listen to what I had to say.  But, I am now grateful that the recent conflict between the Susan G. Komen Foundation and Planned Parenthood allows me to quote him.  I am also glad to have the opportunity to lay out some of my observations and conclusions that I have come to regarding various ills of our societies around the world.  And, I now have the opportunity to demonstrate what humankind has learned about contraceptives and abortion.

“The cure for poverty around the world is the empowerment and emancipation of women.”  If Christopher Hitchens’s word is not enough for you, even the United Nations feel that the empowerment of women is what leads to development.  They have listed the empowerment of women as a necessity to reach their Millennium Development goals.  And, in my time in the United States Peace Corps in Cameroon where I worked to combat HIV, I would agree wholeheartedly with their assessment.  When women have control over their bodies and minds, when women are educated, the society benefits.  Women are still the primary caregivers and early educators of their children.  If they are able to determine “when” and “how many,” the next generation will be better cared for and better educated.  And on and on the generations will pass.  “When you teach women, you teach the nation.”

If this is still not enough to convince you, I have one more arrow in my quiver.  In the middle of last month, a Lancet article was electronically published in advance of the journal publication.  It was an examination of the last 15 years of abortion around the world.  I would like to quote an excerpt from this article.  It follows.

 “We found that the proportion of women living under liberal abortion laws is inversely associated with the abortion rate in the sub-regions of the world. Other studies have found that abortion incidence is inversely associated with the level of contraceptive use, especially where fertility rates are holding steady, and there is a positive correlation between unmet need for contraception and abortion levels.”

In other words, what humankind has learned, what can be demonstrated, what can be shown, is that when abortion and contraception is legally available, abortions are less frequent and contraception is used more effectively.  Furthermore, the researchers discovered something else.  “Our findings show that the substantial decline in the abortion rate observed between 1995 and 2003 has tapered off, and the proportion of abortions that are unsafe has increased since 1995, such that nearly half of all abortions worldwide were unsafe in 2008.”  They relate these findings to changes in laws around the world that make abortion illegal and contraceptives less easily available.

Thus, when contraceptives are available,the evidence suggests that abortions are less frequent, and the ones that do occur are carried out safely.  The previous sentence could be one of the sentences of a mission statement of Planned Parenthood.  And, oh by the way, according to Planned Parenthood’s Annual Report, 35% of their funding goes to contraceptives, and only 3% goes to abortion services.  Also, Planned Parenthood offers health services to women with low incomes who often have no other sources for medical care, cancer and STD screenings, or reproductive services.

Thus, it seems the opponents of abortion who pressured the Susan G. Komen Foundation to sever its ties with Planned Parenthood ended up working towards increasing the number of abortions.  Furthermore, as Susan G. Komen board members realized, cutting ties with Planned Parenthood leads to cutting ties with the health of poor women.  Thankfully, advocates for women made a massive push to make sure this was understood.  They were successful.  The mistake was corrected.  Thanks be to humankind.

 Citations

Sedgh G, Singh S, Shah IH, Ahman E, Henshaw SK, Bankole A.  Induced abortion: incidence and trends worldwide from 1995 to 2008.  Lancet.  2012 Jan 18. (Epub ahead of print)

Planned Parenthood Annual Report

 The controversy over adverse health effects from wind turbine installations is an interesting one: both sides of the debate present compelling scientific evidence in favor of their particular perspective on the issue. A recent entry on the New York Times’ Green blog describes metastudies carried out by the state EPA branches of Massachusetts and Oregon, both concluding that the weight of scientific evidence indicates that direct wind turbine-related illness events are insignificant at present and unlikely to present a substantial risk with their increasing installation.

This is in stark contrast to the ideas presented by the group Save Western NY, an organization comprised of residents of Wethersfeld, a small New York town, who believe that the proposed 67-70 wind turbines in their region will be detrimental to the town and its surroundings from economic, environmental, and health perspectives. Their website’s “Health Concerns” page primarily cites newspaper articles quoting local doctors who say they’ve seen an uptick in the mild neurological disturbances, headaches, palpitations and dizziness commonly seen in vibro-acoustic disease (VAD). VAD is most prevalent in occupational contexts such as construction, where workers are likely to use loud, vibrating tools such as jackhammers or sand-blasters for hours on end.  While this sounds like anecdotal information that wouldn’t hold water in any serious scientific context, I’m more interested in exploring the different tactics taken by these two organizations (The New York Times’ blog and Save Western NY) in their attempts to inform the public about the risks of wind turbine farms.

Wind Turbine by Petr Kratochvil

A study published in Environmental Health in September of last year set out to examine the difference between scientific and popular depictions of the risks presented by wind turbines in the residential setting. The authors filtered thousands of results containing keywords like “wind turbines”, “health problem”, “annoyance”, and others into a pool of fifteen relevant pieces of peer-reviewed literature. At the same time, they identified half a dozen studies that are referenced the most often in popular contexts, all of which were carried out by individuals or groups with scientific credentials but never published in peer-reviewed contexts. These studies presented results in a more anecdotal way and were not likely to contain descriptive or regression-based statistics.

The authors of this meta-study found that both scientific and more anecdotal studies were very likely to describe problems of annoyance with the presence of wind turbines. However, a particularly interesting pattern notable in the scientific studies was that annoyance and self-reported health effects were more strongly correlated with subjective characteristics like opinions that wind turbines were ugly or intrusive, or in individuals who had high sensitivity to noise in the first place. Actual noise coming from the wind turbines didn’t relate as directly to these negative outcomes or opinions. Popular literature tended to strictly attribute increasing annoyance and behavioral or health effects to decreasing distance from the base of the turbines.

Taken together, this evidence indicates that proponents of wind-generated energy have an uphill battle to face: additional study on the exact health effects of infrasound and flickering from wind turbines is certainly necessary until clear relationships and consensus are reached.  But even more importantly, campaigns touting this alternative source of energy have failed to win over the hearts of citizens in affected neighborhoods or regions. Until the public image of this new technology improves, logistical and political barriers will stand taller and more obnoxious than the turbines themselves.

References:

NYTimes Green blog: http://green.blogs.nytimes.com/2012/01/18/wind-turbines-and-health-hazards/

Save Western NY: http://www.savewesternny.org/health.html

Env Health paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179699/?tool=pubmed

Image Credit: http://www.publicdomainpictures.net/view-image.php?image=137&picture=wind-turbine

Cross posted from 2020 Science

The US National Academy of Science today published its long-awaited Research Strategy for Environmental, Health, and Safety Aspects of Engineered Nanomaterials. I won’t comment extensively on the report as I was a member of the committee that wrote it. But I did want to highlight a number of aspects of it that I think are particularly noteworthy:

Great progress so far, but it’s time to change gears. Something we grappled with as a committee was what the value of yet another research strategy was going to be. After all, it wasn’t so long ago that the US federal government published a well received strategy of its own. A key driver behind our strategy was a sense that the past decade has been one of defining the challenges we face as the field of nanotechnology develops, while the next decade will require more focus as an ever greater number of nanotechnology-enabled products hit the market. In other words, from a research perspective it’s time to change gears, building on past work but focusing on rapidly emerging challenges.

Combining life cycle and value chain in a single framework for approaching nanomaterial risk research. As a committee, we spent considerable time developing a conceptual framework for approaching research addressing the health and environmental impacts of engineered nanomaterials. What we ended up using was a combination of value chain – ranging from raw materials to intermediate products to final products – and material/product life cycle at each stage of the value chain. This effectively allows risk hot spots to be identified at each point of a material and product’s development, use and disposal cycle.

Principles, not definitions. Rather than rely on a single definition of engineered nanomaterial to guide risk-related research, we incorporated a set of principles into our conceptual framework to help identify materials of concern from an environment, health and safety impact perspective. These build on the principles proposed by myself, Martin Philbert and David Warheit in a toxicology review published last year. From the National Academies report: