Trusted Information for Healthy Pregnancies
toxins
Wanted: Volunteers, All Pregnant
Feb 16th
The woman sent by government scientists visited the Queens apartment repeatedly before finding anyone home. And the person who finally answered the door - a 30-year-old Colombian-born waitress named Alejandra - was wary.
Although Alejandra was exactly what the scientists were looking for - a pregnant woman - she was "a bit scared," she said, about giving herself and her unborn child to science for 21 years.
Researchers would collect and analyze her vaginal fluid, toenail clippings, breast milk and other things, and ask about everything from possible drug use to depression, At the birth, specimen collectors would scoop up her placenta and even her baby’s first feces for scientific posterity.
She ultimately decided that participating would “help the next generation.”
Chalk one up for the scientists, who for months have been dispatching door-to-door emissaries across the country to recruit women like Alejandra for an unprecedented undertaking: the largest, most comprehensive long-term study of the health of children, beginning even before they are born.
Authorized by Congress in 2000, the National Children’s Study began last January, its projected cost swelling to about $6.7 billion. With several hundred participants so far, it aims to enroll 100,000 pregnant women in 105 counties, then monitor their babies until they turn 21.
It will examine how environment, genes and other factors affect children’s health, tackling questions subject to heated debate and misinformation. Does pesticide exposure, for example, cause asthma? Do particular diets or genetic mutations lead to autism?
But while the idea is praised by many experts, the study has also stirred controversy over its cost and content.
In August, the Senate committee overseeing financing for the study accused it of “a serious breach of trust” for not disclosing that the initial price tag of $3.1 billion would more than double, and said the study needed to release more information if it wanted to get “any” financing in the next budget year.
And an independent panel of experts and some members of the study’s own advisory committee say it misses important opportunities to help people and communities — emphasizing narrower medical questions over concerns like racial and ethnic health differences, leaving unresolved crucial ethical questions concerning what to tell participants and communities about test results.
“This study is of the magnitude of the accelerator in CERN, or a trip to the moon — a really big science issue,” said Milton Kotelchuck, a professor at the Boston University School of Public Health and a member of the independent panel. “But if you have a flawed beginning, then you’ve got 20 years of working on a flawed study.”
Officials are making changes, putting all but the pilot phase, to involve 37 locations, on hold while conducting an inquiry into the cost and scientific underpinnings, Dr. Collins said. Some data may no longer be collected if “we can’t afford” it, he said, and every aspect will receive “the closest possible scrutiny.”
The study is far from its plan of recruiting 250 babies a year for four or five years in each community. By December, 510 women were enrolled and 83 babies were born in the first seven locations, including Orange County, Calif., and Salt Lake County, Utah.
That was after knocking on nearly 64,000 doors, screening 27,000 women and finding 1,000 who were pregnant and in their first trimester (and therefore eligible).
The time and information required from families could also make the study “too burdensome to be conducted the way it is,” said Dr. Susan Shurin, former acting director of the National Institute of Child Health and Human Development, part of the National Institutes of Health and the study’s supervising agency. The fear is women will “go ‘Oh no, you again,’ and slam the door in your face.”
Specimens include blood, urine, hair and saliva from pregnant women, babies and fathers; dust from women’s bedsheets; tap water; and particles on carpets and baseboards. They are sent to laboratories (placentas to Rochester, N.Y., for example), prepared for long-term storage, and analyzed for chemicals, metals, genes and infections.
Participants provide the names and phone numbers of relatives and friends, so researchers can find them if they move. As children grow, scientists, including outside experts, can cross-reference information about their medical conditions, behavioral development and school performance.
Besides looking at widespread conditions, like diabetes, the study will consider regional differences. Maureen Durkin, principal investigator in Waukesha County, Wis., wonders if radium in the county’s water, and houses built on “farm fields that may be contaminated with nitrates and atrazine,” have different health consequences than pollution or industrial chemicals in Queens.
But study officials are trying to determine what information to give participants and when. Some experts say people should get results of their chemical or genetic tests only if medical treatments exist because otherwise it only causes anxiety. Others agree with Patricia O’Campo, a member of the study’s advisory committee and the independent panel, who says the study should be “less ivory towerish” and disclose more information to families and communities.
Source
How can a pregnant homeowner avoid remodeling hazards?
Feb 12th
There are two points during a remodeling project that are critical times at which to consider the impact of potentially hazardous materials during pregnancy.
The first is during demolition, when materials are removed or disturbed, as some of the materials may have been manufactured with known toxins such as asbestos and lead.
The second is during the construction phase, when you should be aware of potentially harmful products used to manufacture building materials that will go in your home.
To stay safe, before beginning demolition, I recommend getting a hazmat inspection by a licensed inspector. This inspection will determine if there is asbestos in any materials that will be removed or disturbed.
For example, asbestos was used in old vinyl sheet flooring, in adhesives used for installing floor tile, in popcorn ceilings and in insulation around furnaces and ducts.
While the asbestos in these building materials is not a danger to health if left undisturbed, demolition or removal of the materials releases the asbestos into the air and becomes a health hazard.
As most people are aware, paint manufactured before 1978 may contain lead, which could lead to lead poisoning if ingested.
Not so well known is that pre-1978 ceramic tile may also contain lead. When lead compounds are locked up in the paint or tile glazing, they are benign to human health.
However, crushing, abrading or shattering of a glaze and sanding or scraping of paint can release a fine dust in which the lead becomes a health risk.
So don't think just because you're not ingesting flaky paint chips that you're safe from lead.
With demolition over, when you begin selecting products for the remodel, pay attention to products that may contain formaldehyde and/or other volatile organic compounds (VOCs).
Both formaldehyde and VOCs can be found in a variety of building materials. Cabinets and shelving often are constructed from pressed-wood products that use glues that may contain formaldehyde.
In general, formaldehyde off-gassing sources emit less and less formaldehyde over time.
However, it can take weeks, and sometimes even months or years, to disappear completely.
Long-term exposure to moderate formaldehyde concentrations (at levels lower than those causing irritation) may be linked to respiratory symptoms and allergic sensitivity, especially in children.
Many contractors and building-material suppliers are aware of the importance of good indoor air quality and can guide you to products and practices that will provide a healthy environment for you and your family.
Source
Third-hand smoke a danger to babies, toddlers
Feb 10th
Add a new health threat to smoking: In addition to the harm caused by actually smoking and exposure to second-hand smoke, so-called third-hand smoke may also pose a threat, particularly to babies and toddlers.
A new study reveals that the residue of nicotine that lingers on surfaces can react with another chemical in the air to form potent carcinogens - chemicals linked to various cancers. While first-hand smoke is that inhaled directly by the smoker and second-hand is the smoke exhaled (and inhaled by others), third-hand smoke is the residue from second-hand smoke.
Anyone who has entered a confined space — a room, an elevator, a vehicle, etc. — where someone has recently been smoking, knows that the scent lingers for an extended period of time.
"The burning of tobacco releases nicotine in the form of a vapor that adsorbs strongly onto indoor surfaces, such as walls, floors, carpeting, drapes and furniture. Nicotine can persist on those materials for days, weeks and even months," said Hugo Destaillats, a chemist with Lawrence Berkeley National Laboratory in San Francisco, and one of the authors of the study.
Scientists have been aware for several years that tobacco smoke sort of sticks to surfaces where it can react with other chemicals. But reactions of residual smoke constituents with molecules in the air have been overlooked as a source of harmful pollutants, the researchers of the new study say.
"Our study shows that when this residual nicotine reacts with ambient nitrous acid it forms carcinogenic tobacco-specific nitrosamines or TSNAs," Destaillats said. "TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke."
Unvented gas appliances are the main source of nitrous acid indoors.
The researchers used cellulose as a model of indoor material, and exposed it to cigarette smoke. They then exposed it to a "high but reasonable" concentration of nitrous acid for three hours. The levels of newly formed TSNAs were 10 times higher after the nitrous acid exposure. The TSNAs also formed quickly, the researchers found.
"Given the rapid absorption and persistence of high levels of nicotine on indoor surfaces, including clothing and human skin, our findings indicate that third-hand smoke represents an unappreciated health hazard through dermal exposure, dust inhalation and ingestion," said lead author Mohamad Sleiman, also of Berkeley Lab.
Since most vehicle engines emit some nitrous acid that can infiltrate the passenger compartments, tests were also conducted on surfaces inside the truck of a heavy smoker, including the surface of a stainless steel glove compartment. These measurements also showed substantial levels of TSNAs.
Individuals are most likely exposed to these TSNAs through either inhalation of dust or the contact of skin with carpet or clothes, suggesting third-hand smoke might pose the greatest hazard to infants and toddlers.
And the study's findings, detailed in the Feb. 8 issue of the journal Proceedings of the National Academy of Sciences, indicate that opening a window or deploying a fan to ventilate the room while a cigarette burns does not eliminate the hazard of third-hand smoke.
"Smoking outside is better than smoking indoors but nicotine residues will stick to a smoker's skin and clothing," said study co-author Lara Gundel, also of Berkeley Lab. "Those residues follow a smoker back inside and get spread everywhere."
Source
Newborn testing faces challenges in using leftover blood spots for research
Feb 9th
A critical safety net for babies - that heelprick of blood taken from every newborn in the U.S. - is facing an ethics attack.
After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus's developing heart or which genes trigger childhood cancers.
But seldom are parents asked to consent to such research - most probably do not know it occurs - raising privacy concerns that are shaking up one of public health's most successful programs. Texas is poised to throw away blood samples from more than five million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota.
Michigan just moved four million leftover blood spots into a new "BioTrust for Health," planning a public education campaign about the research potential and how families can opt out.
Advisers to the U.S. government hope to have national recommendations in two months on how to assure all babies still get their newborn tests while allowing parents more say in what happens next.
"It's a critical thing that we take action," says advisory board member Sharon Terry of the non-profit Genetic Alliance. She says distrust over the leftover blood spots threatens public confidence in newborn screening itself.
"The sunshine on the information - educating parents - is the way lesser threat. Done well and done right, there will be an enormous benefit overall to the system," she says.
Newborn screening is not new. It began in the 1960s, and today every baby is supposed to be tested for at least 29 rare genetic diseases in hopes of catching the fraction who need early treatment to help avoid brain damage or death. Now being added to the list: Bubble-boy disease, formally known as SCID for severe combined immune deficiency.
The program catches about 5,000 babies a year in need of treatment.
Because newborn screening is mandatory, only a handful of states provide much upfront parent education. Leftover spots mainly are used for double-checking that newborn tests are accurate. Sometimes, families ask geneticists to study them after a child's death from a disease doctors can't immediately diagnose.
But as scientists sought to use the leftovers for broader research, suddenly the informing of parents - especially about long-stored spots - became an issue. While blood spots are stripped of identifying information before being handed over to scientists, people generally need to consent to participate in research.
"My kid is not a lab rat. You have to ask before you can use him in an experiment, before you can use his blood, his tissues, his DNA, whatever," says Andrea Beleno, one of the Texas parents who sued. Among their worries: that genetic information about the children could fall into the wrong hands.
Had she only been asked, Beleno adds, she probably would have let her son's blood spot be stored.
To scientists who pore through dusty warehouses in search of blood samples stored by health department ID codes - not the babies' names - privacy concerns are exaggerated.
"There's a gap between the name and the DNA. ... There's no way one could just put one's hands on these blood spots and know anything about that person," says Dr. Christopher Loffredo of Georgetown University, who needed families' permission to cull about 1,200 blood spots stored in Maryland for a study that linked a pregnant woman's smoking or exposure to certain chemical solvents to fetal heart defects.
Still, Dr. Jennifer Puck of the University of California, San Francisco, who created the new SCID test using leftover blood spots, understands parents' concerns.
"DNA is your personal signature, and it uniquely identifies us," Puck says. "We all have to become more careful and more specific in terms of what we're going to do with the blood spots."
Bioethicist Aaron Goldenberg of Case Western Reserve University studied parent attitudes, and found three-quarters would be willing to have their baby's leftover blood spot used for research if they were asked first. But they generally oppose that research without consent.
The balancing act for states, he says, is separating the two issues - lifesaving newborn screening and other use of the leftover blood - in the little time available to educate parents.
Source
Older mothers’ kids have higher autism risk, study finds
Feb 8th
A 10-year study examining 4.9 million births in the 1990s has found more evidence that there's a link between autism and the mother's age at conception.
The link between the parents' age and children's health is not entirely new. Prior studies have indicated that babies born to older women have higher risks of birth defects, low birth weight and certain chromosome problems, such as Down syndrome.
A 2007 Kaiser Permanente study conducted in California reported that autism risk increased with both the mother's and father's age. An Israeli study based in statistics from 1980s had isolated only paternal age as being linked with increased risk for autism.
Dr. Max Wiznitzer, a pediatric neurologist at Rainbow Babies & Children's Hospital in Cleveland, Ohio, said the latest research had a far larger sample size.
In the latest study, researchers found that mothers over the age of 40 had 51 percent higher odds of having children with autism compared with mothers between the ages 25 and 29.
The father's age also played a factor, but only when he had a child with a woman under 30.
"When the mom has minimal age risk of an autistic child, we do see increased risks as dads get older," said lead author Janie Shelton, a graduate student researcher at UC-Davis.
It's unclear why the mother's age has more bearing in autism risk than the father's.
The study authors emphasize that while autism rates have risen 600 percent in the past two decades, older women having children contributed to only 5 percent more cases of autism.
As more women delay childbearing, it's important to keep the study in perspective, said Geraldine Dawson, chief science officer of Autism Speaks, the nation's largest autism science and advocacy organization.
"I don't think a mom blaming herself is going to help us understand what's causing autism or help prevent further cases," she said. "I would urge parents not to blame themselves, regardless of what age they are."
Shelton and the co-authors obtained all birth records in California from 1990 to 1999 and then collected data from the state's Department of Developmental Services to count the number of autism diagnoses from children born during that decade.
How parental age increases autism risks remains unknown, but several hypotheses exist. Some suggest that the cumulative effects of the environment, changes to the autoimmune system, stress and reproductive technology may affect autism risk.
Source
Agricultural Chemical Spray Linked to Birth Defect Risk
Feb 5th
There's a link between a birth defect called gastroschisis and the agricultural chemical atrazine, a new study has found.
Gastroschisis is an abdominal wall defect in which the intestines, and sometimes other organs, develop outside the abdomen through an opening in the abdominal wall. The incidence of this birth defect, also called infant abdominal hernia, has doubled to quadrupled over the past 30 years.
In the new study, researchers at the University of Washington in Seattle investigated whether environmental exposures were a factor in a higher than normal number of cases in the eastern part of the state.
"Our state has about two times the national average number of cases of gastroschisis," study co-author Dr. Sarah Waller said in a news release. "The life expectancy for fetuses with this diagnosis is better than 90 percent; however it requires delivery at a tertiary care center with immediate neonatal intervention, which often separates families and can cause serious financial and emotional stress."
Waller and colleagues analyzed 805 cases of live-born infants with gastroschisis between 1987 and 2006, along with 3,616 normal infants who acted as controls. The researchers matched birth certificates with U.S. Geological Survey databases of agricultural spraying of atrazine, nitrates, and 2,4-dichlorophenoxyacetic acid.
Gastroschisis occurred more often among infants born to mothers who lived less than 25 kilometers (or about 15.5 miles) from the site of high surface water contamination with atrazine. There was no increased risk associated with the other chemicals. The study authors also found that the risk of gastroschisis was higher for women who conceived in the spring (March through May), when agricultural chemical use is more prevalent.
Source
Prenatal Exposure to Flame-Retardant Compounds Affects Neurodevelopment of Young Children
Jan 27th
Prenatal exposure to ambient levels of flame retardant compounds called polybrominated diphenyl ethers (PBDEs) is associated with adverse neurodevelopmental effects in young children, according to researchers at the Columbia Center for Children's Environmental Health (CCCEH) at Columbia University's Mailman School of Public Health.
The study is online in Environmental Health Perspectives and will be released in the April 2010 print issue.
PBDEs are endocrine-disrupting chemicals and widely used flame-retardant compounds that are applied to a broad array of textiles and consumer products, including mattresses, upholstery, building materials, and electronic equipment. Because the compounds are additives rather than chemically bound to consumer products, they can be released into the environment. Human exposure may occur through dietary ingestion or through inhalation of dust containing PBDEs.
The researchers found that children with higher concentrations of PBDEs in their umbilical cord blood at birth scored lower on tests of mental and physical development between the ages of one and six. Developmental effects were particularly evident at four years of age, when verbal and full IQ scores were reduced 5.5 to 8.0 points for those with the highest prenatal exposures.
"The neurodevelopmental effects of prenatal exposure to PBDEs have not previously been studied among children in North America, where levels are typically higher than in Europe or Asia," said Julie Herbstman, PhD, first author on the paper and a research scientist in Environmental Health Sciences at the Mailman School of Public Health. "The findings are consistent with effects observed in animal studies and, if replicated in other North American populations, they could have important public health implications."
Frederica Perera, DrPh, professor of Environmental Health Sciences at the Mailman School, CCCEH Director, and coauthor added, "These findings are of potential concern, because IQ is a predictor of future educational performance; and the observed reductions in IQ scores are in the range seen with low level lead exposure." This research underscores the need for preventive policies to reduce toxic exposures occurring in utero."
The investigators controlled for factors that have previously been linked to neurodevelopment in other studies, including ethnicity, mother's IQ, child's sex, gestational age at birth, maternal age, prenatal exposure to environmental tobacco smoke, maternal education, material hardship, and breast feeding.
The study is part of a broader project examining the effects of chemicals released by the World Trade Center's destruction on pregnant women and their children. However, residential proximity to the World Trade Center site did not affect levels of PBDE exposure.
Source
Tips for Pregnant Pet Owners
Jan 12th
Stephanie Shain lives with her husband, Adam, two daughters, two dogs and five cats.
Everyone needs attention. So when she was pregnant with her youngest, Mia, she knew she had to get her animals used to the idea of having a new baby in the house. Because of her work with the Humane Society, she knew animals handle change slowly.
Two or three months out start making those changes, so it's not a lot of changes all at once.
That means setting up the baby's room in front of the pet, and if the pet isn't allowed in the room keep the door shut.
And know your pet. If your cat or dog is protective, try to wean yourself away but let them know they are still loved.
If you're primarily the one who walks the dog, have someone else walk the dog; if you're spending a lot of time playing with your cat every day, make sure that someone else starts playing with your cats.
And if you're pregnant and have a cat, experts say be aware of Toxoplasmosis, a disease, caused by a parasite found in cat feces. It can cause birth defects. Doctors say the disease can be avoided by practicing good hygiene.
Usually the recommendation is to get somebody else to change the litter box.
Shain says taking precautions has paid off. Five-year-old Mia loves her fuzzy house mates and they seem happy to share the house with her.
Source
Birth defects in babies linked to mother’s job
Dec 29th
Women working as scientists and pharmacists run a greater risk of having babies with birth defects as compared to women in other professions, suggests a new study by the New York State Department of Health.
The study, published in the journal Occupational and Environmental Medicine, involved 8,977 cases of birth defects and 3,833 healthy controls from the National Birth Defects Prevention Study.
On analyzing mothers of around 9,000 children with birth defects, the researchers observed that certain abnormal birth conditions were more likely to be found in children of janitors, pharmacists or biological and chemical scientists.
"Given those job titles, one would expect those women to work with different chemicals or something that could possibly be an exposure," said lead author Michele Herdt-Losavio from the New York State Department of Health.
Depending on the profession of the mother, the baby could be born with any of the physical defects, which are not related to the DNA, found Dr. Herdt-Losavio and her colleagues after studying 45 specific birth defects among mothers with 24 different occupations.
Women working as janitors were found to be more likely to give birth to a child with one or more of the defects including ear and eye defects, musculoskeletal problems, gastrointestinal problems, oral clefts and various other defects.
However, not all women working as janitors face similar risks, as Dr. Herdt-Losavio said, "There's lots of questions that can be asked.... What do you do as a janitor? What products do you use? What hours do you work? How many hours do you work?"
The researchers, however, did not probe the probable reasons for this association between the birth defect of a child and his mother’s profession but they did offer a possible reasoning.
"What we can guess by looking at these job titles is that ... it's possible that they work with chemicals," said Dr. Herdt-Losavio. "It's not possible to say what those chemicals might be, or how much they might work with. But what we can do is point other [researchers] in the direction and give them some idea of where they might want to dig further and collect more data."
Source
Stain repellents linked to low birth weight and premature births
Dec 7th
Research finds that stain repellent and anti-adhesive chemicals may be linked to low birth weight and premature births in those born near a factory that both produces and uses the chemicals.
A study that surveyed members of a West Virginia community finds that higher exposures - presumably through water and air - to antistick chemicals released from a nearby factory may be linked to low birth weight and early birth in babies born to women who live in the area.
The synthetic chemicals of concern in the study are called polyfluorinated compounds (PFCs). They are widely used in the manufacture of stain repellents applied to carpets and furniture and as anti-adhesives in pots and pans.
Two of the most common PFCs are perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). While they are designed for use in product coatings, PFOA and PFOS may also form when other PFCs break down. The chemical plant located near Parkersburg, West Virginia used PFOA since 1951 to make nonstick coatings.
These chemicals are very persistent and have been detected worldwide in wildlife and humans. The most recent National Health and Nutrition Examination Survey (NHANES) reported that virtually all US residents are exposed to PFOA and PFOS.
Animal studies have reported reduced fetal weight and increased neonatal mortality after exposure to high doses of PFCs. Results from previous human studies have been inconsistent.
In this study, women with PFOS blood levels above the median (13.6 nanograms/milliliter (ng/mL)) had a 50 percent increased risk of low birth weight and a 10 percent increased odds of preterm birth when compared with women with exposure below the median. These women were also 30 percent more likely to have preeclampsia, which is characterized by high blood pressure during pregnancy and is in turn a risk factor for abnormally slow fetal growth.
Data were collected as part of a survey of more than 69,000 people living close to a chemical plant located in the Mid-Ohio Valley in West Virginia. These data were collected following a class action lawsuit alleging health damage due to exposure to PFOA, which is believed to have occurred through groundwater contamination and air deposition. Researchers measured PFCs in the blood of 1,845 women and obtained information on pregnancy outcomes based on participant interviews.
Source