Are My Household Products Trying to Kill Me?
Laura Barnhardt Cech’s Lifestyle article in (http://www.baltimoresun.com/features/bs-hs-mckay-jenkins-contamination-20160309-story.html) the Baltimore Sun is a well-intentioned summary of McKay Jenkins “ContamiNation: My Quest to Survive in a Toxic World” which depending upon one’s perspective and understanding of environmental health issues may cause the reader to “freak out” or delve deeper into the issue. The latter is very important as there is much implied and much missing from Ms. Cech’s summary.
While few can argue that questions remain about the health risks of household items and the lifestyle changes to limit their exposures, the term “reveals” is not appropriate. In 2006, The World Health Organization (WHO) estimated that 24% of global disease in adults is caused by environmental exposures while nearly 33% of disease in children under the age of 5 is similarly linked (http://www.who.int/mediacentre/news/releases/2006/pr32/en/). Environment includes the totality of an individual’s exposures from conception to death; currently known as the Exposome. Obviously, it includes household exposures. Furthermore, launched in 2001, and updated twice annually, the National Library of Medicine (NLM) Household Products Database (http://hpd.nlm.nih.gov) is a consumer’s guide to potential health effects of chemicals in 14,000 household products. This database allows one to research ingredients in brand-name products. Cech articulates Jenkin’s concern about cosmetics, but fails to note the efforts of the Cosmetic Ingredient Review (CIR) which studies individual chemical compounds as they are used in cosmetic products (http://www.cir-safety.org/).
The idea of limited information cannot be stressed enough. The demands of a technologically sophisticated and bottom-line driven society often ignore concerns about the consequences of providing quick solutions, benefits or innovations. Cech misses the opportunity to discuss the magnitude of the problem – 80,000 chemicals in commerce; 7000 chemicals in cigarettes – most falling in the limited data category. Scientists have known for over 50 years that cigarettes cause cancer, but they are still on the market. Since there is a difference between contamination and pollution, federal agencies work to define the distinction and establish unsafe levels for contaminants. The risk assessment process which Cech barely acknowledges is fundamental to establishing safe levels of contaminants for lifetime exposures. Human Health Risk values as products from the US EPA, ATSDR, OSHA, NIOSH and the TERA Center exist for 680 chemicals while roughly 700 new chemicals are added to commerce yearly. Risk Values for 10 chemicals are added annually. New chemical synthesis and use is easily outpacing the development of human health risk values contributing to Jenkin’s “toxic world”.
If one accepts the “toxic world” premise, he/she need not panic or “throw their hands up and say ‘What’s the point’”. As noted, many agencies with missions to protect public health in spite of limited resources continue their efforts. The US EPA’s National Center for Computational Toxicology (NCCT) is working to streamline the approach used to evaluate the safety of chemicals. NCCT researchers integrate advances in biology, biotechnology, chemistry, and computer science to target biological processes that may be disrupted. The combined information helps prioritize chemicals based on potential human health risks. Computational toxicology research allows for thousands of chemicals to be evaluated for potential risk at a small cost in a condensed time frame. Another comforting concept is dose – acknowledged, though veiled in Jenkin’s comments about tobacco’s impact being cumulative, long lasting and frequently, in the case of cancer slow to reveal itself. While cancer researchers might take exception to the comment that “smoking a single cigarette never killed anyone”, the idea that exposure equals consumption or absorption (and internalization; i.e., dose) is not accurate. Exposure does not equal dose. The dose makes the poison is a basic principle of toxicology. It is credited to Paracelsus (1493-1591) who expressed the classic toxicology maxim “All things are poison and nothing is without poison; only the dose makes a thing not a poison.” This is often condensed to: “The dose makes the poison”. It means that a substance can produce the harmful effect associated with its toxic properties only if it reaches a susceptible biological system within the body in a high enough concentration (i.e., dose). The principle relies on the finding that all chemicals—even water and oxygen—can be toxic if too much is eaten, drunk, or absorbed. Most readers appreciate the difference between taking two aspirins for a headache and what might result from ingesting the entire bottle. Or that consuming an entire shaker of table salt (NaCl) would have different health effects than sprinkling a few granules on your food. Perhaps perplexing to the public, but of dose-related importance is the CDC’s National Biomonitoring Program (NBP) which currently measures and monitors 300 chemicals in human tissues and fluids (http://www.cdc.gov/biomonitoring/about.html). Reducing contaminant exposures when they present in air, water, food, soil, dust and consumer products reduce the risk of adverse health risks. Jenkins suggests appropriate lifestyle changes to reduce exposures, but it should be noted, one can only reduce risks, not eliminate them.
Kenneth Portier, a Cech’ reference, supported the idea of reducing exposures, but noted that prioritizations are in order. This is supportable – why worry about phthalates when you put 7000 chemicals in your body with a cigarette or drive without your seat belt? He presents the unique population of children. Lesliam Quiro-Alcala adds the essential considerations attributed to that group. A significant reality not expressed is that children will probably be exposed for longer periods of time because they usually live longer than the adults they share exposures with. Quiro-Alcala concludes with the comment “We’re exposed to a soup of chemicals every day”. Mixtures are an incredibly complex and significant environmental health challenge that defines the reality of the “toxic world”. For the most part, the information scientists have is for one chemical, not normally in the presence of others. Mixtures can enhance toxicological responses in an additive manner, a greater than additive (synergism) or actually compete for and reduce adverse health effects. TV advertisements for pharmaceuticals emphasize this concept when they conclude with “Tell your doctor if you take…, ….., or ….. Each time a chemical is added to the mix, the results may change. This is another area where the computer may prove invaluable in unlocking the mysteries associated with mixtures.
Regulation is worthy of greater note. While reducing personal exposures and becoming more aware of the complex science may benefit individuals, populations will benefit from the products of the federal agencies that protect human health. Politicians that call for the end of the US EPA or other regulatory agencies because they are expensive and cost industry jobs, should be rigorously vetted. Federal agencies are not really “lax” in their responsibilities but handcuffed by limited budgets and other resource needs. In the long run, human health or lack thereof is more costly than reducing emissions and making all environments safer.
Cech seems to focus on cancer, but other significant adverse health outcomes are potentially attributable to household chemicals. Chemicals associated with developmental and reproductive toxicology through endocrine disrupting mechanisms are equally important as are those associated with neurological or any other organ system toxicities.
Her article and Jenkin’s book are appropriate continuations to the public’s growing awareness of the environment’s contribution to adverse human health outcomes. It is hoped those with little previous knowledge of the problem will be motivated to learn more and take action. However, for those who have been professionally associated with the problem, this is not ground breaking or novel information. The more people that appreciate the problem, the greater the chance that some good will result; beginning perhaps in the home by reducing or addressing those dangers and expanding to benefit global health outcomes.
Author: Dr. Russ Savage, TERA Center Fellow