A new study by researchers at UCLA and Brigham and Women’s Hospital in Boston suggests that improvements in air quality over the past decade have resulted in fewer cases of ear infections in children.

Ear infections are one of the most common illnesses among children, with annual direct and indirect costs of $3 billion to $5 billion in the United States.

“We believe these findings, which demonstrate a direct correlation between air quality and ear infections, have both medical and political significance,” said study co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and an associate professor of surgery at the David Geffen School of Medicine at UCLA. “The results validate the benefits of the revised Clean Air Act of 1990, which gave the Environmental Protection Agency more authority to implement and enforce regulations reducing air-pollutant emissions. It also shows that the improvements may have direct benefit on health-quality measures.”

The research appears in the February issue of Otolaryngology–Head and Neck Surgery, the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation.

The researchers reviewed National Health Interview Survey data for 120,060 children between the years of 1997 and 2006 and measured the number of instances of three disease conditions for each year — frequent ear infections (three or more within a year), respiratory allergy and seizure activity, which is not influenced by air quality but was included as a control condition.

These numbers were then cross-referenced with the EPA’s air-quality data on pollutants, including carbon monoxide, nitrous dioxide, sulfur dioxide and particulate matter, for the same time period. The study authors discovered that as air quality steadily improved, the number of cases of frequent ear infections significantly decreased.

The results also showed that there was not an association between improved air quality and improved rates of pediatric respiratory allergy, possibly due to the fact that allergens are not pollutants.

Reference: UCLA, Amy Albin,  Improved air quality linked to fewer pediatric ear infections, January 27, 2010

A new study led by Mount Sinai researchers in collaboration with scientists from Cornell University and the U.S. Centers for Disease Control and Prevention, has found higher prenatal exposure to phthalates—manmade chemicals that interfere with hormonal messaging—to be connected with disruptive and problem behaviors in children between the ages of 4 and 9 years. The study, which is the first to examine the effects of prenatal phthalate exposure on child neurobehavioral development, will be published January 28, on the Environmental Health Perspectives website.

“There is increasing evidence that phthalate exposure is harmful to children at all stages of development,” said Stephanie Engel, PhD, lead study author and Associate Professor of Preventive Medicine at Mount Sinai School of Medicine. “We found a striking pattern of associations between low molecular weight phthalates – which are commonly found in personal care products – and disruptive childhood behaviors, such as aggressiveness and other conduct issues, and problems with attention. These same behavioral problems are commonly found in children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder, or Conduct Disorder.”

Phthalates are part of a group of chemicals known as endocrine disruptors, that interfere with the body’s endocrine, or hormone system. They are a family of compounds found in a wide range of consumer products such as nail polishes, to increase their durability and reduce chips, and in cosmetics, perfumes, lotions and shampoos, to carry fragrance. Other phthalates are used to increase the flexibility and durability of plastics such as PVC, or included as coatings on medications or nutritional supplements to make them timed-release.

“Recently, the government instituted regulations limiting certain phthalates in things like child care articles or toys that a young child might put in their mouth,” continued Dr. Engel. “But it’s their mother’s contact with phthalate-containing products that causes prenatal exposure. The phthalates that we found most strongly related to neurodevelopment were those commonly found in cosmetics, perfumes, lotions and shampoos. Current US regulations do not address these kinds of phthalates.”

For the study, phthalate metabolite levels were analyzed in prenatal urine samples of a multiethnic group of 404 women who were pregnant for the first time. The women were invited to participate in follow-up interviews when their children were between the ages of 4 and 9. The mothers were not informed of their phthalate metabolite levels and the researchers were unaware of their exposures when testing the children.

Follow-up visits were completed by 188 of the women and their children. At each follow-up visit, the mothers completed validated questionnaires designed to assess their behavior and executive functions. The researchers found that mothers with higher concentrations of low molecular weight phthalates consistently reported poorer behavioral profiles in their children. The strongest trends were in the categories of conduct and externalizing problems, characteristics typically associated with Oppositional Defiant Disorder, Conduct Disorder and ADHD.

“These are high level, chronic exposures that start before the child is even born, but continue throughout their life. More research is needed to examine the effects of cumulative exposure to phthalates on child development. But what this study suggests is that it’s not enough to regulate childhood exposure to these chemicals. The regulations need to include products that moms use,” said Dr. Engel.

Reference: The Mount Sinai Hospital / Mount Sinai School of Medicine, Mount Sinai finds prenatal exposure to certain chemicals affects childhood neurodevelopment, Jan. 28, 2010

Postage stamps with aroma could affect the health of sensitive people

On January 7th, German Minister of Finance, Dr.Schaeuble, presented the new charity postage stamps to Federal President Horst Koehler and Ms. Donata Freifrau Schenck zu Schweinsberg, President of the Bundesarbeitsgemeinschaft der Freien Wohlfahrtspflege (a federal association of welfare organizations). The unique feature of these stamps for this year is: They are fruit scented – blueberry, strawberry, lemon and apple. The scenting agents are micro-encapsulated and are not supposed to be released until they are rubbed.

The perfumed stamps release a scent even without being rubbed

CSN wanted to know whether the stamps really do not smell until being rubbed and arranged to get samples of the scented stamps. As we asked to buy the new charity stamps, the lady behind the post office counter pulled out an extra folder and remarked almost devoutly, “Oh yes, this are the new perfumy stamps.” She took out a sheet of stamps which showed blueberries and delightedly announced: “Wow, these really can be smelled without rubbing!”

Two welfare stamps were purchased by CSN and examined carefully. Both stamps give off a smell without being rubbed with the finger. Strictly speaking, the strawberry-stamp emits the smell of a cheap toothpaste with strawberry flavor, and the odor of the lemon stamps are a reminder of a toilet cleaner with an artificial lemon aroma. It smells nothing like a natural fruit aroma. The lemon scent grew stronger after the stamp was left at room temperature for a short while. CSN refused to activate the odor by rubbing. It can be assumed that the smell of the stamps will grow by the inevitable friction of the letters during transport and by running them through the sorting system at the postal hubs. Therefore it is quite possible that the perfumed stamps will contaminate other mail.

CSN would like to know if the applied scents were tested for their health compatibility, and which safety criteria and methods they used for the tests. Was their safety criteria the tolerable toxic load for an average healthy adult or was it the tolerable toxic load for the weakest, i.e. for an embryo? Did they test the plain aroma agents or the printing ink equipped with the aroma? Has the material of the stamp an effect on the compatibility? The information of the Bundesdruckerei (German federal printing press) suggests that first amounts of the scents were emitted before even the printing process was completed.

People with asthma, allergy to scents, sensitivities to chemicals, and persons who respond severely to scents could be affected by this advertising stunt.

As an answer, at January 11, CSN wrote the following open letter:

Perfumed Postage Stamps Constrain People with Disabilities

Dear Mr. Federal President Dr. Horst Koehler,

Dear Ms. Frau Donata Freifrau Schenck zu Schweinsberg,

Dear Dr. Wolfgang Schaeuble,

On January 7th, you shared the presentation of the new charity stamps issued by the Ministry of Finance, which emit scents of apple, strawberry, blueberry and lemon when rubbed. We want you to think about that at first glance simpatico idea, and we politely request you Dr. Schaeuble, to withdraw these postage stamps from circulation as Minister of Finance, because there are groups of people with certain disabilities and health disorders, who would be at risk if exposed to these scents.

Wouldn’t it be ironic, if some of those people who should benefit from these charity stamps will be harmed, by putting them in circulation? Do you realize the critical position of the German Federal Environmental Agency (UBA/Umweltbundesamt) regarding scents? The UBA points out that scented products should be avoided in public areas. The German coalition for allergies and asthma the DAAB (Deutscher Allergie- und Asthmabund e.V.) assumes about 11 percent of general population, that was actually a good nine million cases, affected by olfactory hypersensitivity for scents (according to Meggs et al. 1996). They postulate warning signs for scented rooms.

Is it appropriate to characterize those as people with disabilities who respond to scents with health troubles?

According to the ‘Americans with Disabilities Act’ (ADA), an individual with a disability is defined as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.

The ‘Convention on the Rights of Persons with Disabilities’ (UN-convention) which was signed by the German government on March 30, 2007, defines persons with disabilities as those, who have long-term physical, mental, intellectual or sensory impairments which may hinder their full and effective participation in society on an equal basis with others.

Perfumed postage stamps limit the lifestyle of allergic, asthmatic, chemically diseased and other sensitive persons in an unreasonable way. This violates the UN-convention and does not meet the protection criteria set out for people with disabilities as outlined by the ADA. Severe sensitive cases and those who suffer from contact allergies caused by scents don’t even need to smell traces of those contaminants. Unsuspecting they will contaminate their living space which often is prepared safe from toxins under difficult financial conditions.

Thus far, people with health impairments from scents were able to at least receive and open their mail without help from others. This autonomy and normality of life is taken away from them. If someone encounters physical reactions by being exposed to scents, he/she will become unable to receive mail any longer and has to depend on other people to sort this type of ‘mail bomb’ out. Possibly a whole delivery is lost because one single letter with a perfumed postage stamp has contaminated all other mail.

During the Christmas season of 2004 there was a similar campaign with perfumed scratch stickers. Contrary to the statement of a German mail service personnel, the scents are not securely locked in the ink. None can be sure that somebody rubs the stamps on the dispatch or mechanical interaction will release these substances. At that time when the mail arrived it was already fragrant and it will be again this time.

Potentially such deliveries could sensitize people who have not suffered from an allergy yet. Have the applied scents adequately been tested for that risk? Would you bet your life on their harmlessness? Did you know that most of the scents used in Germany are not tested for tolerance? According to the “Special Report on Allergies, 2000″ (“Spezialbericht Allergien, 2000″) by the German Federal Government, there are about 15 to 25 percent of general population affected by an atopic disease, that was over 20 million cases, and one-third are sensitized for allergies, that was about 27 million. Should not everything be done, to keep this data from growing?

Scents trigger a variety of physical reactions for people with this sensitivity. Depending on disease and state of health, they range from harmless irritations to life threatening conditions. The following troubles can be caused individually or in combinations:

Tiredness, sneezing, irritated eyes, redness, itching, blisters, inflammations, swelling and burning of the lips, nasal mucosa burning, burning of the tongue, toothache, cough, voice failure, labored breathing, vertigo, sickness, headache, migraine, speech disorder, disturbance of memory, permanent painful vomiting, cardialgia, tachycardia, state of shock, absence, coma.

Often, such an incident increases the sensitivity for other substances or undoes a recovery which was hardly achieved by a strategy of avoidance and healthy living over a long period.

If nothing else, artificial scents could disturb the aesthetic perception of healthy ones and never reach the sensuality of their prototypes. Lay some apples from an organic farmer in your bedroom and compare it with the odor from these stamps.

Considering all of the above, we request, that the health damage which may be expected for those people in the general population who are sensitized by scents be recognized and, as under the terms of the Convention on the Rights of Persons with Disabilities, that the circulation of these perfumed postage stamps be immediately stopped.

Kind regards,

Silvia K. Mueller, Bruno Zacke

CSN – Chemical Sensitivity Network

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We thank Christi and Jim for translation help.

If your baby were suffering from colic, would you treat him with artificially dyed and sweetened simethicone (the chemical in drugs such as Mylanta and Mylicon) or first try an emulsion of fennel seed oil?  If your young daughter developed a persistent rash, would you prefer the doctor to prescribe antihistamines or a diet rich in omega fatty acids?

More and more, it’s likely you’d give the second choice a try. The big news is that mind-body pediatrics has come of age over the past generation. It’s a trend that seems very appropriate for a generation of parents looking for foods without pesticides and cosmetics without solvents.

A major symptom of its acceptance is the publication of the first textbook book on Integrative Pediatrics, edited by the avuncular and reassuring Dr. Andrew Weil, the U.S.’s best known non-conventional medicine practitioner and spokesperson.   The august National Institutes of Health has set up a center devoted to its study while the American Academy of Pediatrics has formed a practitioners’ Section.  And you can now find pediatricians across the nation who will use integrative practices to care for your children (click on hyperlink to members, select Section on Complementary and Alternative, for a listing by zip code; also www.aaemonline.org).

This kind of medical care works to keep children well by instilling a long-life pattern of healthy living and by treating simple problems such as ear aches without resorting to the overuse of drugs.  It particularly lends itself to caring for children with chronic illnesses, such as cancer, juvenile arthritis, obesity, asthma and developmental disorders such as autism and ADHD, where conventional medicine hasn’t a great track record of cures.  In fact, there’s been a major increase in the number of prescription medications used to treat symptoms of childhood chronic illnesses, despite the absence of data that they are effective in curing the underlying problems.

If the incidence of chronic childhood illnesses continues the upward climb it has taken over the past two decades, and as more families understand the link between prevention and treatment, integrative pediatrics may very well become the standard practice of the future.

Probably only grandmothers like me remember when revered New York Times journalist James Reston, returning from a 1972 reporting trip to China with President Nixon, wrote about his surprising experience in undergoing an emergency appendectomy with acupuncture as the only sedative.  That launched our nation’s first timid and by now vast interest in alternative medicine, from acupuncture to meditation, massage and body manipulation, biofeedback, exercise, nutrition and the use of botanically-based supplements.

Now that these techniques are no longer “alternative” to conventional western medicine but have become pretty much an accepted part of it, they are called “integrative” (meaning they’re integrated into standard practice) or “holistic” or “complementary” or “environmental” (a term especially acknowledging the effect of toxic exposures).

In my interviews with integrative pediatricians, they explain, first and foremost, that the power in holistic practice is their relationship with the child and her family, that healing is inexorably bound to the connection between practitioner and patient.

To create that connection, they spend lots of time meeting and talking and educating.  They build a team with the parents; the pediatrician acts like a quarterback helping the parents navigate the health care system.  In the first months of a child’s life, they focus on frequent well-baby care where they also design individualized schedules for vaccinations and treat problems that may arise, such as colic. These conversations with parents and patient continue as the child grows, so different from the usual harried, cookie-cutter 15-minute consultation.

If you visit Dr. Lawrence Rosen, a 43-year-old MIT grad and Mt Sinai-trained integrative pediatrician, you’ll find his pleasant office in New Jersey a paragon of green construction – the flooring, cabinetry and paint were chosen as the safest, least toxic (his website offers resources on green pediatrics construction based on his research and experiences). Even the staff’s dishware is either glass or nontoxic plastic made from recycled materials. Dr. Rosen explains that “the build-up of low-level toxic exposures is responsible for more illnesses than one-time higher exposure.”  He’s given him practice a name: The Whole Child Center, and he blogs when he can about natural parenting practices.

One of his patients is a ten-year-old girl (let’s call her Jenny) with asthma so severe she was using several different inhalers and several different allergy medications every day. Some of the steroid-based drugs were affecting her appetite and causing weight gain, while their continued use could have threatened her long-term development. Yet she still found it hard to participate in school sports. Jenny also had eczema and food allergies. “Rather than prescribing more medicines to suppress her symptoms, I looked for ways to balance her immune system response,” Dr. Rosen explained. He didn’t remove her from her medications immediately, to avoid an attack, but slowly over time worked with Jenny to integrate complementary therapies.

He started her on a daily probioitic, –which are supplements or foods like yogurt, rich in beneficial live microorganisms such as lactic acid bacteria.  He told her mom to ensure her diet included lots of fruits and vegetables with their healing antioxidants as well as foods with high levels of omega-3 fatty acids. Jenny was encouraged to build up her physical strength by swimming and walks outdoors in nature.  Dr. Rosen also worked with her on relaxation techniques including guided imagery and breathing (“Everyday Blessings: The Inner Work of Mindful Parenting,” by Jon Kabat-Zinn.and his wife, Myla). After careful monitoring, she’s now mostly weaned from her prescription meds, uses an inhaler infrequently, and has achieved her dream of participating in sports. Whereas last year she had missed 40 days of school, this year it was down to five.

A young patient with cancer in remission might be treated with similar practices, to support his immune system and his body’s overall strength and resilience.

“Conventional Western medicine is about fixing disease, mainly acute illnesses. It’s oriented around disease labeling and treatment,” Dr. Rosen says. Integrative pediatricians focus on wellness and innate balance of health.

Author: Alice Shabecoff for CSN – Chemical Sensitivity Network, January 9, 2010

Alice Shabecoff is the co-author with her husband Philip of Poisoned Profits: The Toxic Assault on our Children, published by Random House last year.  See their website, www.poisonedprofits.com

Related article from Alice Shabecoff:

• Our planet, our children – How are your children doing?
• My mother made me fat

Information Sources:

• A membership association of environmental physicians: American Academy of Environmental Medicine
• For families and practitioners; has a member directory: Holistic Pediatrics Association
• A practitioner group: Integrative Practitioner

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To my readers: I’m working on a related article that will focus on the way that nutrition can heal developmental disorders such as ADHD and autism.  And another article on how today’s health care system impedes the use of integrative pediatrics.

New York State (NYS) employees who responded to the World Trade Center (WTC) disaster on or after 11 September 2001 potentially experienced exposures that might have caused persistent respiratory effects. NYS responders represent a more moderately exposed population than typical first responders. 

To assess whether NYS employees who were WTC responders were more likely than controls to report lower respiratory symptoms (LRS) or a diagnosis of asthma 5 years post-9/11, persistence and severity of symptoms were also evaluated. 

Participants were initially mailed self-administered questionnaires (initial, Year 1, Year 2) and then completed a telephone interview in Year 3. Data were analysed using Poisson’s regression models. 

WTC exposure was associated with LRS, including cough symptoms suggestive of chronic bronchitis, 5 years post-9/11. When exposure was characterized using an exposure assessment method, the magnitude of effect was greater in those with exposure scores above the mean. WTC exposure was associated with persistence of LRS over the 3 year study period. Results also suggest that participants with the highest exposures were more likely to experience increased severity of their asthma condition and/or LRS. 

The findings suggest that even in a moderately exposed responder population, lower respiratory effects were a persistent problem 5 years post-9/11, indicating that some WTC responders require ongoing monitoring.  

Literature: Mauer MP, Cummings KR, Hoen R., Long-term respiratory symptoms in World Trade Center responders, Bureau of Occupational Health, Center for Environmental Health, New York State Department of Health, Occup Med (Lond). 2009 Dec 24.