Black and Latino males twice as likely to have poor health

Given the inequality in healthcare in the United States, it's no surprise that some groups of people suffer far worse health outcomes than people with better resources. But if there is one group that has been especially overlooked in this equation, it's black and Latino boys. The major factor in their poor health, according to a new report by the California Endowment, is where they live. Growing up in poor and stressful neighborhoods with limited healthcare resources leads to poor health.

According to the findings in the report:

• The odds of poor health outcomes for boys and men of color are more than two times higher than for white boys and men in California.
• Latino boys are 4.1 times more likely than white boys to suffer from post-traumatic stress disorder.
• African-American boys are 2.5 times more likely.
• Latinos are 3.1 times more likely to have limited access to health care and 4.8 times more likely to lack health insurance.
• Asthma disproportionately affects children who live in poorer neighborhoods.
  Black young men have a homicide rate 16 times greater than that of young white men.
• African-American and Latino children are 3.5 times more likely to grow up in poverty compared to whites.

Poorer neighborhoods mean less access to stores selling health foods, fewer parks and safe places to run and play in and fewer social networks to promote health and safety.

The California Endowment has launched a 10-year initiative, called Building Healthy Communities, to improve the health of men and boys of color by making strategic improvements in the communities and neighborhoods in which they live. In the report, the group identifies a handful of successful programs to improve the lives of men of color already in place in the state that could be applied on a larger scale -- and why implementing these programs statewide cannot wait.
 
-- Shari Roan

Photo credit: Carlos Chavez  /  Los Angeles Times

Flame retardants alter thyroid hormone in pregnant women

High levels of common flame-retardant chemicals appear to alter thyroid hormone levels in pregnant women, according to a new study. The chemicals, called PBDEs, or polybrominated diphenyl ethers, are known to interfere with blood chemistry in animals, but this is the first large study to investigate levels of PBDEs and a sensitive thyroid hormone in pregnant women.

The link is important because the chemicals, in high enough levels, could affect the pregnancy and the health of the fetus, said one of the study's authors, Jonathan Chevrier, a researcher in epidemiology and in environmental health sciences at UC Berkeley.

"Normal maternal thyroid hormone levels are essential for normal fetal growth and brain development, so our findings could have significant public health implications," Chevrier said in a news release. "These results suggest that a closer examination between PBDEs and these outcomes is needed.”
 
The study was released Monday in the journal Environmental Health Perspectives.
 
PBDEs are found in carpets, textiles, foam furnishings, electronics and plastics. U.S. fire safety standards implemented in the 1970s led to increased use of PBDEs, which can leach out into the environment and accumulate in human fat cells. PBDEs can be found in the blood of most American residents, and levels are especially high among California residents because of the state's rigorous flammability laws. Concentrations of the chemicals in blood and breast milk have increased dramatically in the last three decades.
 
The researchers analyzed blood samples from 270 women taken around the end of their second trimester of pregnancy. The researchers measured concentrations of 10 PBDE chemicals, two types of thyroxine (T4) and thyroid-stimulating hormone (TSH). TSH is a substance that drops when the thyroid gland is producing too much hormone. The study also controlled for such factors as maternal smoking, alcohol and drug use, and exposure to lead and pesticides.

The researchers found that a 10-fold increase in each of the PBDE chemicals was associated with decreases in TSH ranging from 10.9% to 18.7%. At these levels, the women met the definition of subclinical hyperthyroidism, which indicates an early stage of thyroid malfunction.
 
"Low TSH and normal T4 levels are an indication of subclinical hyperthyroidism, which is often the first step leading toward clinical hyperthyroidism," Chevrier said. "Though the health effect of subclinical hyperthyroidism during pregnancy is not well understood, maternal clinical hyperthyroidism is linked to altered fetal neurodevelopment, increased risk of miscarriage, premature birth and intrauterine growth retardation."
 
It's not known just how the chemicals interfere with thyroid function. PBDEs could bind to thyroid receptors and alter how the hormone is released.
 
A study released earlier this year from the same research group found that women with higher exposures to flame retardants took longer to get pregnant.
 
"Our results suggest that exposure to PBDE flame retardants may have unanticipated human health risks," said Brenda Eskenazi, a professor of epidemiology and of maternal and child health at UC Berkeley.
 
-- Shari Roan

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Photo credit: Mark Boster / Los Angeles Times

Free range eggs contain a little something extra: pollutants

Here’s some disconcerting news for health-conscious eaters who favor eggs from free-range hens: A Taiwanese study found that the eggs contain much higher levels of industrial pollutants than eggs laid by caged hens.

The researchers focused on two types of pollutants, polychlorinated dibenzo-p-dioxins and dibenzofurans (known collectively as PCCD/Fs), which are released into the environment by municipal waste incinerators, factories and other industrial sources. A report from the International Program on Chemical Safety says the chemicals have caused cancer, liver damage, problems with the skin and nervous system, reproductive problems and other undesirable effects in animals.

The researchers collected 60 free range eggs from farms in southern Taiwan and compared them with 120 eggs from caged hens that were purchased throughout the country. Then they measured the levels of 17 kinds of PCCD/Fs.

For the free range eggs, the levels ranged from 6.18 to 41.3 picograms per gram of lipid, with an average value of 17.5 pg/g. Levels for the caged eggs ranged from 2.85 to 19.8 pg/g, with an average value of 7.65.

The researchers also calculated the toxic equivalency quotient (TEQ) for both kinds of eggs using a system endorsed by the World Health Organization. The levels for the free range eggs were 5.7 times higher than the levels for the caged eggs.

In addition, 17% of the free range eggs had levels that European regulators have deemed unsafe for consumption. All of the caged eggs were easily in the safe zone, the researchers found. The results were published in the latest edition of the Journal of Agricultural and Food Chemistry.

The researchers believe the free range eggs have more contaminants because they are found in the environments where free range hens roam. Studies have found the chemicals in “feedstuffs, soil, plants, worms and insects,” they wrote. Their own measurements of dirt from free range farms persuaded them that soil contamination is at least partly to blame.

The problem probably isn’t limited to Taiwan. Scientists have also found the same trend in the European Union, and one study found that about 10% of free range eggs exceeded the safety limit set by regulators there.

“The issue of contamination in free range eggs could be a global issue, and more research should be done to identify the factors from the external environment that influence and modify the PCDD/F levels in eggs from free range hens,” the authors wrote.

In case you were wondering, their research was not sponsored by the commercial egg-laying industry. The scientists had grants from the National Science Council of Taiwan and the Taiwanese Ministry of Education.

— Karen Kaplan

Photo: These free-range chickens seem to be enjoying their time outdoors, but with dioxins lurking in the environment, it may not be good for them – or us – after all. Credit: Steve Osman / Los Angeles Times

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Seem to be getting more cadmium than calcium? Here's a look at health risks

McDonald's has decided to recall a lot -- a whole heckuva lot -- of Shrek drinking glasses because they're contaminated with cadmium, a heavy metal that can do unpleasant things in, and to, the body.

And Consumer Reports announced earlier this week that an analysis of protein drinks had found that some were contaminated with, among other things, cadmium.

That followed Wal-Mart's announcement in May that it was pulling Miley Cyrus-branded kids jewelry because it was tainted with, yes, cadmium.

For a metal that most Americans would be hard-pressed to locate on the periodic table much less when it's trying to pass itself off as an innocuous everyday component of innocuous everyday objects, cadmium certainly seems to be the "it" element of the day. Obviously, it's time for a primer.

Here's one for chemistry buffs. Atomic number, 48. Symbol, Cd. Number of neutrons, 64...

Not doing it for you? Understandable. Check out this to-the-point cadmium fact sheet from the Illinois Deaprtment of Public Health.

The fact sheet begins by stating that cadmium is one of the byproducts you get when smelting some other metals, and that the stuff is found naturally in the air, water and soil. More to the point:

"Cadmium can enter your body from smoking tobacco, eating and drinking food and water containing cadmium, and inhaling it from the air. Your skin does not easily absorb cadmium so touching cadmium will not likely cause adverse health effects."

Here's the entire answer to this question: "How can cadmium affect my health?"

"Health effects caused by cadmium depend on how much has entered your body, how long you have been exposed and how your body responds.

Some workers who breathe air with high levels of cadmium over a short period of time may experience lung damage or possibly death. Breathing cadmium in air does not usually cause immediate breathing problems or any warning signs. Therefore, exposure may continue until serious lung damage has occurred. Most naturally-occurring cadmium levels found in the environment are not high enough to cause lung damage. Breathing lower levels of cadmium over several years can result in a buildup of cadmium in the kidneys and lead to kidney disease. It also can cause bones to become weaker. If you eat food or drink water that contains large amounts of cadmium, stomach irritation, vomiting and diarrhea may result.

Women exposed to cadmium in the workplace may have low birth weight babies; however exposure to cadmium at normal environmental levels is not likely to cause low birth weight infants. Rodents exposed to cadmium in air have higher rates of lung cancer, liver damage and changes in the immune system. There is no evidence that cadmium causes cancer at the low levels normally found in the environment."

The fact sheet also explains testing for exposure, reducing exposure and the like.

That's not to say that cadmium exposure isn't serious. Here's what the Occupational Safety & Health Administration has to say about the health effects of chronic cadmium exposure. The greatest risks are of lung cancer and kidney damage.

And forgive the obvious, but, no, the cadmium-calcium comparison in the headline isn't meant to be taken literally. 

Here's the McDonald's recall story and the announcement from the Consumer Product Safety Commission. 

-- Tami Dennis

Photo: A scene from "Shrek Forever," which has been the subject of a promotional tie-in with McDonald's. The fast-food chain has offered up Shrek-bedecked Happy Meals and the aforementioned drinking glasses. Credit: DreamWorks Animation

Environmental factors likely play a role in multiple sclerosis

Speculation about the cause of multiple sclerosis includes genes and environmental factors. A study published Thursday supplies strong evidence that environmental factors play a critical role.

Multiple sclerosis is a disease in which the immune system goes awry and attacks healthy tissue in the body. Researchers at UC San Francisco conducted the most advanced gene analysis ever on identical twins in which one twin has MS and the other does not. The analysis did not yield evidence for genetic differences that could explain why one sibling had the disease and the other did not. Nor did researchers find any differences in the epigenome -- mechanisms that change the way genes are expressed apart from changes in DNA -- to explain the disease in one twin.

Exactly what environmental factors contribute to causing MS is still unknown, however. The leading theory is that a virus triggers the immune system reaction that leads to the disease. Smoking and vitamin D deficiency have also been suggested as possible environmental contributors. But, "the results put us a step closer to teasing out the relative contributions of genetic and environmental factors on multiple sclerosis," the lead author of the study, Sergio Baranzini, said in a news release.

The findings do not mean genes don't play a role in the disease. When one identical twin has MS, there is 30% increased risk that the identical sibling will develop it. That compares with an increased risk of only 5% for a nonidentical twin.

The study is in the current issue of the journal Nature.

-- Shari Roan

Photo: A doctor uses a fluorescent microscope to view a brain section of a patient with MS. Credit: Julia Malakie / Associated Press

The air is sick, and so are we

We Southern Californians tend to forget that we don't breathe healthful air. More Californians live in areas that don't meet federal air quality standards than residents of any other state. Despite many efforts to improve air quality in the last two decades, the air remains polluted. People who live near freeways or inland have especially poor air quality.

Living this way has consequences. According to a report released Tuesday by the RAND Corp., air pollution in California caused more than $193 million in hospital-based medical care from 2005-07. These were costs related to cases of pneumonia and asthma triggered by poor air quality.

The report estimates that high levels of ozone and particulate matter caused nearly 30,000 emergency room visits during the study period. The biggest problem created by pollution is asthma attacks among children under age 17 -- an estimated 12,000 emergency room visits attributed to air pollution.

The report is titled "The Impact of Air Quality on Hospital Spending."

-- Shari Roan

Photo: Los Angeles skyline. Credit: Nick Ut  /  AP

No radiation danger from airport body scanners

There are two kinds of exposures to think about with regard to airport body scanners that are increasingly used to screen passengers. One is exposure to radiation. They other is just, well, exposure.

According to an editorial published Wednesday, consumers need not worry about the radiation dose from an airport scanner. The machines produce so little low intensity x-ray radiation that a person would have to undergo 1,000 to 2,000 screens to receive radiation similar to one chest x-ray.

The machines even appear safe for children and pregnant women, says the author of the piece, Dr. Mahadevappa Mahesh, of Johns Hopkins University School of Medicine. However, operators of the equipment should receive safety training to make sure they avoid inadvertent exposure.

The privacy issue is a bigger concern, Mahesh said. Scanning has  been called "a virtual strip search." But, he said, privacy concerns should be alleviated by having viewing stations at remote locations and ensuring the system cannot save images.

The machines may one day become mandatory, so it's time to start thinking about their repercussions, Mahesh said. "When considered in the context of a potential increase in security, the benefits outweigh the potential for harm," he wrote.

The editorial is published online in the British Medical Journal.

-- Shari Roan

Photo: A combination of images shows a security guard demonstrating a body scanner at London's Heathrow airport and a computer screen showing a scan of a security guard with a gun in his possession. Credit: Stringer / AFP / Getty Images

Maintaining a home that's clean and safe

Information to help people avoid harmful substances in their homes is available online or in print form thanks to an alliance of health and environmental experts at UC San Francisco.

The material includes tips on reducing exposure to metals and synthetic chemicals used in everyday life at home and work. There are also recommendations on shopping for safe products and how various substances affect men, women, pregnant women and children. Recent research has shown that exposure to chemicals may impair reproductive health and that developing fetuses and young children are especially vulnerable to contaminants.

"We've identified key areas where exposures are constant and avoidable, and a means for individuals to contact government representatives to prevent impacts of environmental contaminants on future generations," Tracey Woodruff, director of the UCSF Program on Reproductive Health and the Environment, said in a news release. "Although certain groups are most vulnerable, toxic substances in the environment affect every person, every day and are the responsibility of all of us."

The brochure and links to further resources can be found on the PRHE website. A downloadable brochure is also available.

-- Shari Roan

Photo: A sampling of "green" household products. Credit: Anne Cusack  /  Los Angeles Times