Food Contaminants Found in the Modern American Diets of Children and their Effects on Child Health

Attention all parents and guardians!  Caretakers of America’s youth play a significant role in determining the future health of this nation. It has become increasingly important to recognize the public health threats posed by microbes, synthetic toxins, hormones, and synthetic compounds utilized in American farm and animal agriculture, food production, and packaging today.  The susceptibility of children to exposures to food contaminants has become one of the most pressing public health issues of today.

WHY ARE CHILDREN A SPECIAL CONCERN?

The potential for adverse health effects in infants and children is especially paramount since organ development occurs most rapidly within the first months and years of life.  A child’s developing nervous system is especially vulnerable as it is less capable of repairing any structural damage caused by toxins in the environment. There are substantial qualitative differences in the capacity for the absorption, metabolism, detoxification, and excretion between children and adults as size, weight, body composition, and physiological functioning all affect pharmacokinetic and pharmacodynamic processes (Alcorn & McManara, 2003)( Jacob, Krishnan, & Venkatesan, 2004).  Infants and children generally absorb and metabolize at a more rapid rate and are less able to detoxify and excrete synthetic compounds due to the immaturity of the kidneys and liver (World Health Organization, 2007).  The manifestation of latent diseases such as cancer, neurodevelopmental impairment, and immune dysfunction is a special concern as many environmentally related diseases develop over prolonged periods of time.  Exposures in childhood may contribute to the presence of disease well into adulthood.

THE EMERGENCE OF MORE TOXIC PESTICIDES

While scientific and technological developments in the agricultural sector have increased rates of food production over the past five decades, the application of agrochemicals such as pesticides has stimulated public health concerns.  Increased pest resistance has led to the emergence of more toxic, ecologically hazardous pesticides, rising operational costs, and higher volumes of overall pesticide usage (Pimentel, 2004).  According to the CDC, approximately 40 organophosphorous insecticides are registered for use in the United States by the EPA and an estimated 73 million pounds (70% of all insecticides) were used in 2001 (2011).  The application of organophosphates, organochlorines, and carbamates by conventional agricultural operations leaves substantial pesticide residues on the produce that children frequently consume.  Dietary risks compound with those of the environment through increased contact with the floor, lawns, and outdoor playing fields.  Despite a long history of pesticide use, the potential for acute and subchronic neurotoxicity, developmental neurotoxicity, and endocrine disfunction still requires systematic review.  The National Cancer Institute has documented an increase in the incidence of all forms of invasive cancer among children over the past 20 years, from 11.5 cases per 100,000 in 1975 to 14.8 per 100,000 in 2004 (2008).  The association of cancer with pesticide residues on food has resulted in a hotbed of controversy among farmers, consumers, scientists, health practitioners, and legislators. 

MICROBIAL FOOD PATHOGENS AND ANTIBIOTIC RESISTANCE

The infiltration of foodborne microbial pathogens poses a plethora of public health challenges to the agricultural, food production, food service, and medical industries.  Antimicrobials such as amoxicillin, ampicillin, erythromycin, neomycin, penicillin, and tetracycline are added to the water and feeds of livestock in “subtherapeutic” levels to promote faster growth and reduce disease-driven losses (Goforth & Goforth, 2000).  Over time, microbes in livestock can become antibiotic-resistant.  As a matter of fact, the reporting of outbreaks due to antibiotic-resistant bacteria has increased each decade since the 1970s and rose by 40% in the last decade ” (DeWaal, Roberts, and Catella, 2011).  The emergence of antibiotic-resistant infections caused by Salmonella typhimureum, Campylobacter, Staphylococcus aureus, and Escherichia coli 0157:H7 increase the potential for disease outbreaks from eating or handling foods contaminated with pathogens in schools, daycare facilities, restaurants, and the home.  The consumption of raw fruits and vegetables increases the risk for infant and child exposures to bacterial and viral pathogens including Listeria monocytogenes, Toxoplasma Gondii, Hepatitis A, Rotaviruses, Enteroviruses, Adenoviruses (CSPI, 2006).  The toll on children’s health attributed to unsafe agricultural, food production, and food handling practices can result in permanent morbidity or mortality.

THE LINK BETWEEN SYNTHETIC CHEMICALS AND ADHD

The ingestion of synthetic chemicals used to enhance the appearance, flavor, and shelf life of food is yet another area of concern.  Artificial flavor enhancers, colors, dyes, ripening agents, sweeteners, and preservatives that are commonly found in the modern American diets of children have been linked to Attention Deficit Hyperactivity Disorder (McCann, et al, 2007).  A study conducted by the University of Southhampton found that artificial colors and sodium benzoate preservatives in the diet resulted in increased hyperactivity in 3-year-old and 8/9-year-old children (McCann et al., 2007).  The detection of plastic pollutants (phthalates) such as Bisphenol A (BPA) in the manufacturing of baby bottles, reusable cups, and lining of food and beverage containers poses further concern (HHS, 2012) (EPA, 2007).  Phthalates have been detected in foods that children most frequently consume such as milk, cheese, meat, margarine, eggs, cereal, baby food, and infant formula (EPA, 2007).  The phthalates, diethylhexyl phthalate (DEHP), dibutyl phthalate (DBP), and butyl benzyl phthalate (BBP), have been closely associated with adverse developmental and reproductive health effects (Fabjan, Hulzebos, Mennes, & Piersma, 2006).

INCREASED USAGE OF HORMONES AND ANTIBIOTICS

The growing demand for affordable meat and dairy products in America has led to the utilization of hormones and antibiotics to produce meat, eggs, and milk as rapidly and cheaply as possible.  The FDA approves a number of steroid hormones to increase the growth rate in growing cattle and sheep as well as Recombinant Bovine Growth Hormone (rBGH) to increase milk production in dairy cattle.  While the association of hormones with the early onset of puberty and cancer has yet to be scientifically proven, the uncertainty has prompted the banning of rBGH in Japan, Canada, Australia, and New Zealand and the use of all hormones in beef by the European Union.  Approximately 70% of all antibiotics used in the United States are administered to healthy livestock at low doses to promote faster growth and to mitigate for unsanitary living conditions, especially in Concentrated Animal Feeding Operations (CAFOs), (NRC, 2007).  This practice has contributed to an epidemic of antibiotic-resistant infections in America. The CDC estimates that 2 million antibiotic-resistant infections and 90,000 deaths occur annually (Pew Commission on Industrial Farm Animal Production, 2008).  Children are especially vulnerable to this health risk.

THE RISE OF OBESITY AND DISEASE IN AMERICAN CHILDREN

Pesticides, growth hormones, and other various chemicals that are commonly found in America’s conventionally raised meats, fruits, and vegetables contain obesogens that disrupt normal functioning of the endocrine system, causing weight gain.  According to data from the National Health and Examination Survey (NHANES), “approximately 17% (or 12.5 million) of children and adolescents aged 2—19 years are obese” (CDC, 2011).  Sadly, the prevalence of obesity among children and adolescents has nearly tripled since 1980 (CDC, 2011).  The principal causes of sickness, disability, and death in children in the United States today are chronic illnesses and rates of many of these diseases are high and rising (Landrigen & Goldman, 2011). “Toxic chemicals in the environment are making important contributions to these disease trends” (Landrigen & Goldman, 2011).

THE ROLE OF PARENTS IDENTIFIED

The foundation for a healthy diet is framed at a young age and developed through the learned behaviors and role modeling of parents and siblings.  Since children can experience great difficulty comprehending the impact of future negative health effects, interventions should begin in the home environment.  The education of parents and guardians is therefore imperative so as to increase overall awareness for food-related health risks and to augment informed purchasing, handling, and preparation of food and packaging.  Improving the modern diets of children will augment efforts to reduce the prevalence of foodborne infections, obesity, and acute and chronic diseases in America today and in the years to come.

References

Alcorn, J & McNamara, P.J. (2003). Pharmokinetics in the newborn. Advanced Drug Delivery Reviews, 55 (2003) 667–686 Retrieved from http://144.206.159.178/ft/18/595546/12296298.pdf

The Centers for Disease Control and Prevention. (2011). US obesity trends. Atlanta: GA. Retrieved from http://www.cdc.gov/obesity/data/trends.html

Retrieved from http://envirocancer.cornell.edu/factsheet/diet/fs37.hormones.cfm Center for Science in the Public Interest. (2006). Fear of Fresh: How to Avoid Foodborne Illness from Fruits and Vegetables. Nutrition Action Healthletter, Retrieved from http://www.cspinet.org/nah/12_06/fearoffresh.pdf

DeWaal, C.S. Roberts, C.R. & Catella, C.C. (2011). Antibiotic resistance in foodborne pathogens: evidence for the need of a risk management strategy. Center for Science in the Public Interest. Retrieved from http://cspinet.org/new/pdf/abrfoodbornepathogenswhitepaper.pdf

Fabjan, E., Hulzebos E., Mennes, W.  & Piersma, A. (2006). A category approach forreproductive effects of phthalates. Critical Reviews in Toxicology, 36(9), 695-726. Retrieved from http://rivm.openrepository.com/rivm/bitstream/10029/6730/1/fabjan.pdf

Goforth, R.L. & Goforth, C.R. (2000). Appropriate regulations of antibiotics in animal feed.Boston College Environmental Affairs, 28(1) 39-78. Retrieved from http://www.bc.edu/bc_org/avp/law/lwsch/journals/bcealr/28_1/02_FMS.htm

Jacob, R., Krishnan, B., and Venkatesan, T. (2004). Pharmacokinetcs and pharmacodynamics of anaesthetic drugs in paediatrics. Indian Journal of Anaesthesia, 48(5) 340-346. Retrieved from http://medind.nic.in/iad/t04/i5/iadt04i5p340.pdf

Landrigan, P.J.& Goldman, L.R. &  Goldman, L.R. (2011). Children’s vulnerability to toxic chemicals: a challenge and opportunity to strengthen health and environmental policy. Health Affairs, 30:5842-850. doi:10.1377/hlthaff.2011.0151.  Retrieved from http://www.gasdrillingtechnotes.org/uploads/7/5/7/4/7574658/assembly_air_health_landrigan_childrens_vulnerability_to_toxic_chemicals__a_challenge_and_opportunity_to.pdf

McCann, D., Barrett, A., Cooper, A., Crumpler, D, Dalen, L., Grimshaw, K. & Stevenson, J.  (2007). Food additives and hyperactive behavior in 3-year-old and 8/9-year-old children in the community: A randomized, double-blinded, placebo-controlled trial. The Lancet, 370(9598), 1560-1567. doi:10.1016/S0140-6736(07)61306-3

National Resources Defense Council. (2011, May 25). Superbug suit: groups sue FDA over risky use of human antibiotics in animal feed. [Press Release]. New York: NY. Retrieved from http://www.nrdc.org/media/2011/110525.asp

Pew Commission on Industrial Farm Animal Production. (2008). Putting meat on the table: industrial farm animal production in America. Retrieved from http://www.ncifap.org/bin/e/j/PCIFAPFin.pdf

Pimentel, D. (2004). Environmental and economic costs of the application of pesticides primarily in the United States. Environment, Development and Sustainability, 7(1), 229-252. doi: 10.1007/s10668-005-7314-2. Retrieved from http://www.beyondpesticides.org/documents/pimentel.pesticides.2005update.pdf

United States Department of Health & Human Services. (2012). Bisphenol A (BPA) Information for Parents. Retrieved from http://www.hhs.gov/safety/bpa/

United States Environmental Protection Agency (EPA). (2007). Phthalates: TEACH chemical summary. Washington: DC. Retrieved from http://www.epa.gov/teach/chem_summ/phthalates_summary.pdf

World Health Organization. (2007). Promoting safety of medicines for children. (ISBN: 978-924-156343-7). Retrieved from http://www.who.int/medicines/publications/essentialmedicines/Promotion_safe_med_childrens.pdf

 

Should We Regulate the Usage of Mobile Sources of Air Pollution?

While the idea of regulating the amount of usage of mobile sources of air pollution seems promising, it is very unrealistic.  Americans take great pride in their cars and restricting their usage would not be well received.  Also, regulations would also be extremely difficult to enforce.  How are we to enforce the usage of leaf blowers?  Do we start placing usage meters on mobile equipment?  Do we establish a municipal police force solely dedicated to mobile source pollution?  What would this do to our taxes?  What rights would this type of “force” have to enter the property of one’s home without the appropriate warrant?  This would be an overly-bureaucratic government!

We are a mobile populace who relies heavily on our cars and other forms of mobile transportation to get us to a wide variety of environments from the workplace to vacation destinations.  Limiting their use would inflict further wound to a suffering American economy. Now let me be clear, I am not advocating a public free-for-all.  Instead, I propose that we regulate the vehicles and equipment themselves.

Some of you may be thinking, “What about heavily polluted areas?!”  To this I must ask, “How many leaf blowers have you seen being operated in New York City?”  Also, many people do not own cars because there isn’t a compelling need for one.  My brother is one of them.  He sold his car when he moved to Manhattan.  Of course, he always takes mine when he comes home but that is an entirely different topic!  You would also be hard-pressed to find any lawn mowers operating in the City as well.

I am sure many of you have been squeezed into a subway at one point or another.  I cannot help but wonder how much air pollution is actually prevented through use of public transportation in NYC.  My efforts to find research quantifying this has unfortunately failed.  Understandably, this is very difficult to estimate.  However, I did find that gasoline consumption in NYC is at the same rate the national average was in the 1920s (Jervey, 2006).  In fact, NYC’s dense population and low automobile dependence help make New York among the most energy efficient in all of the United States (Owens, 2004).

My point is there must be a balance achieved between usage and toxic emissions of mobile sources of air pollution which can be most efficiently achieved through pragmatic, enforceable regulations.  Examples include improving fuel economy and minimizing emissions through idling policies.  Most states have adopted the latter.  It is also up to the consumer to minimize emissions.  Driving fewer miles and purchasing more fuel efficient cars can indeed save Americans a lot of money.  With the prices of gas expected to soar this summer, these options can be advocated for their advantages to both the consumer and the environment.

Fortunately, the government is doing something to regulate mobile sources of air pollution.  The EPA finalized a rule in February 2007 to reduce hazardous air pollutants from mobile sources by limiting the content of benzene in gasoline and reducing toxic emissions from passenger vehicles and gas cans (EPA, 2012).  Since mobile sources are responsible for the majority of benzene emissions, this is a step in the right direction.  According to EPA estimations, this rule would “reduce total emissions of mobile source air toxics by 330,000 tons and VOC emissions (precursors to ozone and PM2.5) by over 1 million tons” by 2030 (EPA, 2012).  This is a considerable improvement.  The EPA also regulates emissions from highway vehicles and nonroad equipment and controls emissions of hydrocarbons, particulate matter, and nitrogen oxides to significantly reduce toxic emissions (EPA, 2012).  In addition, the EPA is currently developing programs to provide further control of emissions from nonroad gasoline engines and diesel locomotive and marine engines (EPA, 2012).  To reduce the overall risks to communities, the EPA has developed several programs including Clean School Bus USA, the Voluntary Diesel Retrofit Program, and National Clean Diesel Campaign (EPA, 2012).

We have indeed come a long way in controlling mobile sources of air pollution.  As a more informed and environmentally conscious American population continues to emerge, I predict that it will become progressively easier to address the problems of air pollution in the future.  Continued regulation of the automobile manufacturing industry will also continue to modify and adapt its cars to be more fuel efficient and less toxic to the environment.  While I think that the use of electric cars by everyone is a long way off, it is an inevitable possibility we must all are prepare for.

References

Jervey, B. (2006). The Big Green Apple: Your guide to eco-friendly living in New York City. Globe Pequot Press. ISBN 0762738359.

Owen, D. (2004, October 18). Green Manhattan: Everywhere should be more like New York. The New Yorker. http://www.newyorker.com/archive/2004/10/18/041018fa_fact_owen

U.S. Environmental Protection Agency. (2012). Mobile Source Air Toxics. Retrieved from http://www.epa.gov/oms/toxics.htm#epamsat

CONSUMERS BEWARE: The Dangers of Endocrine Disruptors (EDCs) & Pharmaceuticals in Personal Care Products

Just when you thought it was safe to drink the water, look no further than your medicine cabinet.  Concerns continue to  build over the public health impact of our water supply.

What are common chemicals/classes of EDCs?

According to the National Institute of Environmental Health Sciences (NIEHS), chemicals/classes of endocrine disruptors include “pharmaceuticals, dioxin and dioxin-like compounds, polychlorinated biphenyls, DDT and other pesticides, and plasticizers such as bisphenols (2011).”  Disturbingly, endocrine disrupting chemicals (EDCs) can be found in literally thousands of common products including plastic bottles, metal food cans, detergents, flame retardants, food, toys, cosmetics, and pesticides (NIEHS, 2011).  The broad presence of EDCs in everyday products increases the likelihood for interference with the body’s endocrine system to produce a number of adverse developmental, reproductive, neurological, and immune effects (NIEHS, 2011).  While the field of endocrine disruption is fairly new, studies are being conducted to confirm whether endocrine disruptor exposure may reduce fertility and increase the incidence of endometriosis and some cancers (NIEHS, 2011).  The future of this field will undoubtedly yield some extraordinary findings to ultimately increase the public’s awareness and impact future manufacturing processes.

How do EDCs get into receiving water bodies?

Endocrine disruptors infiltrate receiving waterways via personal, pharmaceutical, and agricultural applications.  Human activity, residues from pharmaceutical manufacturing and hospitals, illicit drugs, and veterinary drugs contribute a variety of pharmaceuticals and personal care products (PPCPS) to receiving waters in the form of prescription and OTC therapeutic drugs, veterinary medicines, fragrances, cosmetics, sun-screen products, diagnostic agents, and vitamins (EPA, 2010).  Agricultural applications also supply receiving waters with a plethora of chemicals suspected of acting as endocrine disruptors including insecticides, herbicides, fumigants and fungicides (NRDC, 1998).  Individuals supply wastewater treatment plants with PPCPs through excretion, bathing, and disposal of medications into the sewer system and trash (EPA, 2010).  Discarding unused medications and personal care products into the toilet is an irresponsible yet common practice that exacerbates the problem.  Since PPCPs do not easily dissolve or evaporate at typical temperatures and pressures, they can infiltrate soils and aquatic environments with ease (EPA, 2010).  PPCPs that are not broken down and processed by the body or degraded by the environment enter domestic sewers and remain untreated.  PPCPs also have the capacity to penetrate soil and aquatics via sewage, biosolid applications, and irrigation with reclaimed water (EPA, 2010).

Endocrine disruptors are also introduced through spray-drifts, runoff from livestock and pesticides, and leachate from municipal landfills and septic systems (Center for Biological Diversity, n.d.).  The widespread use of steroid hormones in confined animal feeding operations (CAFOs) is of particular concern for the introduction of  endogenous steroids, exogenous compounds,  pharmaceuticals, and anabolic growth promoters like trenbolone and melengestrol  into receiving waters (Kolodziej, n.d).  The potential for CAFOs to elevate the concentration of steroids in watersheds is considerably higher with the occurrence of extreme precipitation.  The presence of synthetic steroid hormones such as trenbolone, melengestrol, and zeranol, used to promote rapid livestock growth, increases when the accumulation of animal wastes is not controlled and a direct pathway for wastes to reach surface waters exists (Kolodziej, n.d.).

Why are EDCs of particular concern to regulators?

Since municipal sewage treatment plants are not equipped for the removal of PPCPs and other unregulated contaminants, the presence of endocrine disrupting chemicals (EDCs) in the watershed poses a number of public health concerns.  While the measure of health risks has yet to be quantified, growing evidence suggests that EDCs can produce adverse health effects in humans, wildlife, fish, or birds including developmental, reproductive, neural, and immune problems (EPA, 2010).  This can adversely affect fish ecology and threaten the survivability of species.  A panel of experts convened by the NIEHS and the National Toxicology Program (NTP) found ‘credible evidence’ for the effect of hormone-like chemicals on test animals’ bodily functions at levels below the ‘no effect levels’ established by traditional testing (EPA, 2010).  There is also substantial research in experimental animals and wildlife associating EDCs with reduced male fertility and number of males born, male organ defects, female reproductive diseases, and increases in mammary, ovarian, and prostate cancers (EPA, 2010).  The storage of endocrine disruptors in fat cells can also have long-term negative health consequences.  Exposures to Bisphenol A and other EDCs with estrogenic activities increase the detrimental health effects of cancer and obesity (EPA, 2010).  The transgenerational effects of EDCs is also a focus of study as NIEHS research has found that fertility defects have been passed to subsequent generations (EPA, 2010).    

With the omnipresence of Bisphenol A (BPA), Di (2-ethylhexyl) phthalate, and phytoestrogens in many common, everyday products, the simultaneous exposure to multiple EDCs elevates concerns (EPA, 2010).  As of 2007, over 100 individual PPCPs have been identified in addition to antibiotics and steroids that have been found in both environmental samples and drinking water.  Simultaneous exposure occurs through one’s diet and the medications and cosmetics used.  Studies are now focusing on the association between EDCs and resistance to antibiotic drugs as well as special scenarios involving fetal exposures (EPA, 2010).  Further studies are warranted to investigate the acute and long term effects of EDCs as it remains a pressing and highly controversial public health issue.

Considerations for regulating EDCs in wastewater and/or receiving water bodies

Prior to designing regulations, policy-makers must consider scientific uncertainties associated with EDCs and their potential health effects in animals and humans.  Stringent regulations must rely on a definitive classification system for endocrine disrupting chemicals so as to implement appropriate restrictive measures.  The regulation process necessitates further research to identify conclusive evidence to considerably minimize the controversy that surrounds this issue.  This will require the expertise of a broad variety of experienced medical scientists and environmental health specialists along with substantial research investment capital and time for further research completion.  The implementation of appropriate regulations should reflect a close collaboration between policy makers, field experts, and the public at large.

Policy makers must also consider the level of vulnerability of the population exposed to EDCs and their potential impacts when implementing regulations.  This can be based on a variety of factors including the average age, diet, occupation, and prevalence of obesity, cancers, and metabolic diseases.  Other factors include the presence of major industries within a relevant geographical area.  Infants, young children, and the elderly are special populations who exhibit increased susceptibility to EDCs due to inferior immune systems.  Special considerations must also be considered for pregnant women and individuals with immune disorders/diseases such as AIDS.  Obese individuals and people suffering from cancer are of particular concern as increased EDCs exposure can manifest or exacerbate symptoms associated with endocrine system abnormalities.  One’s occupation is also a critical factor as manual laborers face increased frequencies and durations of EDC exposure.  The presence of industries and the type of manufacturing processes and chemicals used are especially pertinent when initiating regulatory legislation to decrease the overall prevalence of EDC exposures among workers and citizens in the environment in which they live.  Regulations should therefore reflect all of these factors to minimize the overall risk to any given population.

The potential impacts on businesses should also be considered.  In a fragile American economy, the development of new restrictions would pose increased financial and administrative burdens, threatening the survivability of businesses.  The alteration of manufacturing and agricultural processes to incorporate new raw materials to eliminate or reduce the release of EDCs could pose considerable financial losses.  Similarly, provisions that necessitate wastewater treatment to improve levels of EDCs in effluent discharges or measures to decrease employee exposure could prove to be exceedingly costly.  Also, company management plans for the monitoring of EDCs would necessitate comprehensive recordkeeping and reporting, requiring additional manpower and staff.

References

Kolodziej, Edward. (n.d.) University of Nevada, Reno. Occurrence, fate, and transport of steroid hormones. Retrieved from http://www.unr.edu/cee/homepages/kolodziej/research.html

Miller, Jeff. Center for Biological Diversity. (n.d.). Endocrine disruptors. Retrieved from http://www.biologicaldiversity.org/campaigns/pesticides_reduction/endocrine_disruptors/index.html

National Institute of Environmental Health Sciences (NIEHS) (n.d.). Endocrine disruptors. Retrieved from http://nymc.mrooms.org/file.php/264/Session_15_Readings/Endocrine_Disruptors_-_intro.pdf

National Institute of Environmental Health Sciences (NIEHS) – National Institutes of Health.(2011). Endocrine disruptors. Retrieved from http://www.niehs.nih.gov/health/topics/agents/endocrine/index.cfm

National Resources Defense Council (NRDC). (1998). Endocrine disruptors. Retrieved from http://www.nrdc.org/health/effects/qendoc.asp