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The lack of environmental health education in medicine contributes to lost opportunities for physicians to prevent or intervene early in environmentally-related diseases. Despite the importance of environmental exposures on disease morbidity (the WHO estimates that 13% of total disease burden in the United States is related to the environmental risk factors), medical students receive very little training on how to recognize and manage environmentally-related diseases.[1] On average, medical students receive seven hours of environmental health training in 4 years of medical school; approximately one-third of graduating medical students believe that their EH training was “inadequate.”[2], [3] Continue Reading »

Agrichemicals in surface water and birth defects in the United States. Significant association was found between the season of elevated agrichemicals and birth defects. Conclusion: Elevated concentrations of agrichemicals in surface water in April–July coincided with higher risk of birth defects in live births

This report has shown that during the period from 1996 to 2002 women in the United States with LMPs in April–July (i.e. the time of conception) were significantly more likely to have a live birth with a birth defect than in other months. The report further demonstrates, using NAWQA surface water samples that concentrations of atrazine, nitrates and other pesticides also were higher in the months of April–July. The correlation between birth defects, pesticides and nitrates was statistically significant.

Paul D Winchester (paul.winchester@ssfhs.org)1, Jordan Huskins2, Jun Ying3 Section of Neonatal Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA 2.Indiana University School of Medicine, Indianapolis, IN, USA .Institute for the Study of Health, University of Cincinnati, Cincinnati, OH, USA

 

Objectives: To investigate if live births conceived in months when surface water agrichemicals are highest are at greater risk for birth defects.

Methods: Monthly concentrations during 1996–2002 of nitrates, atrazine and other pesticides were calculated using United States Geological Survey’s National Water Quality Assessment data. Monthly United States birth defect rates were calculated for live births from 1996 to 2002 using United States Centers for Disease Control and Prevention natality data sets. Birth defect rates by month of last menstrual period (LMP) were then compared to pesticide/nitrate means using logistical regression models.

Results:. A significant association was found between the season of elevated agrichemicals and birth defects. Conclusion: Elevated concentrations of agrichemicals in surface water in April–July coincided with higher risk of birth defects in live births.

While a causal link between agrichemicals and birth defects cannot be proven from this study an association might provide clues to common factors shared by both variables. NAWQA) study provides the most comprehensive national-scale analysis of pesticide occurrence and concen- trations in streams and ground water. In the NAWQA study, pesticide concentrations were measured in water samples from 186 stream sites representing 51 hydrological systems from 1991 to 2002. The NAWQA study units account for 70% of total water use and 50% of the United States drink- ing water. Pesticides were found to be present in most stream water samples and over half of the ground water samples. Seasonal patterns of pesticide concentrations were found with the highest monthly concentrations in May and June (8). The study also found that 90% of pesticide exposure is to mixtures versus individual pesticides.

The USGS indicated a strong relationship between pesti- cide occurrence in water samples and their use each year. Studies of pesticide occurrence in humans also correlated with pesticide applications and peaked in the spring months (9–11).

The present study relies on the general findings by USGS, the Environmental Protection Agency (EPA) and other agencies indicating that seasonal variations in nitrates, atrazine and other pesticides may serve as markers for an- nual agricultural and urban pest-control activities. In the present investigation we sought to answer a qualitative ques- tion; are annual peaks in pesticides and nitrates (typically from April to July) correlated with greater risk to pregnan- cies conceived in those months? If no increase in birth de- fects were found in April–July conceptions it might be in- ferred that the contaminant peaks pose little threat to human reproductive success.

Abbreviations

LMP, first day of last menstrual period; NAWQA, National Water Quality Assessment Programme; USGS, The United States Geo- logical Survey; CDC, Centers for Disease Control; OR, odds ra- tio; mg/L, milligrams per litre; μg/L, micrograms per litre; Anen, anencephalus; Spina, spina bifida/meningocele; Hydro, hydro- cephalus; Micro, microcephalus; Nervous, other central nervous system anomalies; Heart, heart malformations; Circul, other cir- culatory/respiratory anomalies; Rectal, rectal atresia/stenosis; Omphalo, omphalocele/gastroschisis; Gastro, other gastroin- testinal anomalies; Genital, malformed genitalia; Renalage, re- nal agenesis; Urogen, other urogenital anomalies; Cleftlp, cleft lip/palate; Adactyly polydactyly, syndactyly, adactyly; Clubfoot, club foot; Hernia, diaphragmatic hernia; Downs, Down syn- drome; Chromo, other chromosomal anomalies; Musco, mus- culoskeletal; Othercon, other congenital anomalies; Tracheo, tracheoesophageal fistula; NHANES, National Health and Nu- trition Examination Survey; NHEXAS, National Human Expo- sure Assessment Study; AM, atrazine.

METHODS Surface water nitrates, atrazine and all other measured pesti- cide concentrations (agrichemicals) were obtained monthly for each year between 1996 and 2002 from the USGS NAWQA database. Monthly pregnancy and birth outcome data were obtained from the Centers for Disease Control (CDC) natality database for the same years 1996–2002. Year of delivery, month of last menstrual period (LMP), presence of any birth defect and category of birth defect were recorded for each live birth. Maternal risk factors and demograph- ics including alcohol use, tobacco use, diabetes, age, race and metropolitan or non-metropolitan residence were also recorded. Mother’s month of LMP was used as a proxy for the time of conception and all birth defect rates were calcu- lated based on cases per 100 000 live births for each LMP month. Stillbirths and abortion data were not used.

Measures, predictors and factors Primary measures of interest are (i) dichotomous variables of total birth defects and individual birth defects and (ii) nu- merical variables of concentrations of agrichemicals includ- ing atrazine, nitrate and other pesticides. The major factor of interest is the monthly or seasonal factor, that is the months April–July versus other months. Other predictors/factors in- clude maternal risk factors, maternal demographics and year of birth.

Statistical methods We performed three major analyses in this study. First, dichotomous variables such as total and individual birth de- fects were assessed for their associations with the seasonal factor (a two-level factor of ‘peak’ season in months April– July and ‘off-peak’ season of other months) in a multivariate logistic regression model adjusting for other covariates such as maternal risk factors, maternal demographics and year. Second, agrichemicals were modelled with the seasonal factor using multivariate regression models, adjusting for years. Agrichemicals were log-transformed before performing mul- tivariate regression analyses since their distributions were right skewed. Third, relationships between birth defects and agrichemicals were assessed using multiple logistic regres- sion models, adjusting for maternal risk factors, maternal demographics and years. Both simple and multiple models were considered in this approach. The simple model used only one agrichemical as the major predictor of interest while the multiple models used all three agrichemicals as the predictor. All statistical analyses were performed using statistical software package SAS version 9.2 (Gary, NC). p-value <0.05 was considered statistically significant.

RESULTS Baseline characteristics A total of 30.11 million births were studied between 1996 and 2002. Table 1 shows women between ages 20 and 35 accounted for over 65% of total births, non-Hispanic whites over 59% and residents in rural areas less than 18%. One percent reported using alcohol during pregnancy, less than 13% using tobacco and less than 3% reported gestational diabetes.

Birth defects Our study included 22 birth defect categories with the over- all birth defect rate defined as any one birth defect. Table 1 and Figure 1 show the mean birth defect rates for each maternal LMP month. Birth defect rates were higher when mother’s LMP was April–July. Table 2 shows that birth de- fect rates for April–July LMPs were significantly higher than birth defect rates for other LMP months (1621/100000 vs. 1573/100 000 live births p < 0.01). Birth defects were positively associated to the maternal risk factors. Higher birth defects were found among mothers who had alcohol,

⃝DISCUSSION

This report has shown that during the period from 1996 to 2002 women in the United States with LMPs in April–July (i.e. the time of conception) were significantly more likely to have a live birth with a birth defect than in other months. The report further demonstrates, using NAWQA surface water samples that concentrations of atrazine, nitrates and other pesticides also were higher in the months of April–July. The correlation between birth defects, pesticides and nitrates was statistically significant.

Pesticides and nitrates, separately and in combination, have been linked to embryo toxicity and to untoward out- comes of pregnancy (12,13). Women’s pesticide exposures through household gardening, professional application or living in close proximity to agricultural crops were associ- ated with increased risks of offspring having neural tube defects and limb anomalies (14). Garry et al. found that in western Minnesota the rate of specific birth defects was elevated in pesticide applicators as well as the general pop- ulation of western Minnesotans and that this risk was most pronounced for infants conceived in the spring (15). Spe- cific birth defect categories showing significant increased risk in Garry’s study were circulatory/respiratory, urogeni- tal and musculoskeletal/integumental which are similar to the categories found in our study. Schreinemachers et al. found that infants in four wheat-producing states conceived in April–June, the time of herbicide application, were more likely to have circulatory/respiratory (excluding heart) mal- formations compared with births conceived during other months. She also found that counties with high wheat

 Nitrates and pesticides occur as mixtures in most water samples  Recent observations in frogs, rats and other animals have demonstrated that individual chemicals at environmentally relevant concentrations may show little or no toxicity but when added together the effects are significantly more toxic or disruptive of vital endocrine functions (12,18,19). It is likely that other contaminants not specifically measured by the NAWQA study could also peak in April–July including air pollutants (20). Thus, the period of increased risk might not be associated solely with pesticides and nitrates.

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A Top Five (5) List of Precautionary Principles to protect children from environmental exposure to toxins while their endocrine system is developing.

We must protect children from environmental exposure to toxins while their endocrine system is developing. The Precautionary Principle, is an approach which is characterized by minimizing potential hazards to children health, at the onset of an activity, rather than accepting a level of harm. Continue Reading »

“First do no harm,” expressed an apparently frustrated scientist linked to the US FDA. “When we know something is a toxin, it should not be given to people, particularly healthy people.

http://www.greenmedinfo.com/blog/new-autoimmunity-syndrome-linked-aluminum-vaccines
Leading immunologists at International Congress on Autoimmunity link aluminum in vaccines to a new post-vaccine syndrome
While “anti-vaxxers” are being smeared in public campaigns as backward and unscientific fear-mongers, a growing body of cutting edge research is emerging from the top echelons of medical immunology to confirm what the cranks have been saying for years about the devastating effects of vaccine ingredients. Continue Reading »

Crop Pollination Exposes Honey Bees to Pesticides Which Alters Their Susceptibility to the Gut Pathogen Nosema ceranae by Jeffery S. Pettis, Elinor M. Lichtenberg, Michael Andree, Jennie Stitzinger, Robyn Rose, Dennis van Engelsdorp . Published: July 24, 2013DOI: 10.1371/journal.pone.0070182

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0070182#authcontrib

Recent declines in honey bee populations and increasing demand for insect-pollinated crops raise concerns about pollinator shortages. Pesticide exposure and pathogens may interact to have strong negative effects on managed honey bee colonies. Such findings are of great concern given the large numbers and high levels of pesticides found in honey bee colonies. Thus it is crucial to determine how field-relevant combinations and loads of pesticides affect bee health. Continue Reading »

Scientists are extremely concerned about the hazards of GMOs to biodiversity, food safety, human and animal health, and demand a moratorium on environmental releases in accordance with the precautionary principle.
They are opposed to GM crops that will intensify corporate monopoly, exacerbate inequality and prevent the essential shift to sustainable agriculture that can provide food security and health around the world.
They call for a ban on patents of life-forms and living processes which threaten food security, sanction biopiracy of indigenous knowledge and genetic resources and violate basic human rights and dignity.
They want more support on research and development of non-corporate, sustainable agriculture that can benefit family farmers all over the world. Continue Reading »

Department of Health Flyer on Pesticides and Your Health
Read, Print and Share. Education is the key!

http://www.sarasotahealth.org/Documents/Env/pesticides_and_your_health.pdf

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