Staying Healthy in a Toxic World

BODY TOXINS

Chemicals have worked their way into our blood-streams, our cells, and our brains--and they're here to stay. Here's what you should know.

On a bright morning last December, I drove along the coast north of San Francisco. The sky was crystal-blue, scrubbed clear by the brisk ocean winds. To the west stretched the vast expanse of the Pacific; to the east, miles of empty rolling hills. I was on my way to Bolinas, a tiny town filled with refugees from Bay Area sprawl, to visit Sharyle Patton and her husband, who moved there more than 20 years ago. Despite decades of green living, Patton, 59, recently learned her body is full of industrial pollutants.

A health activist, Patton had agreed to be tested as part of an experiment. The analysis of her blood and urine showed traces of 105 chemicals, pollutants, and pesticides, including solvents, PCBs, lead, and mercury. Most Shocking: Her levels of dioxin (a toxin emitted by incinerators) were nearly as high as those of people living in the most polluted industrial areas in America.

Like Patton, every one of us has a body loaded with chemicals. Where are they coming from? What effect are they having on our health? And, perhaps most important, what can we do about it?

CHEMICALS ENTER OUR BODIES INVISIBLY
Our lives are permeated by products brewed up in chemistry labs--more than 9,000 are in active use, in detergents, brake linings, and carpet pads, plastics, shampoos, and cold creams. Many these products make our lives easier and better. But most, critics charge, have not been subjected to adequate health and safety testing. The chemicals enter our bodies through the air, the soil, our foods, and things we touch. Some pass through quickly; others, like the compounds in flame retardants, can accumulate in fatty tissue, where they persist for months or years. We even harbor vestiges of compounds that have been retired or banned. (Thirty years after the pesticide DDT was outlawed in the United States, wisps are still being detected, even in people born after the ban.) Experts call that chemical load the body burden. Even newborns have one.

Last year, the Centers for Disease Control and Prevention in Atlanta released the most extensive body-burden study to date. Researchers tested the blood and urine samples of 2,500 people across the country and found traces of all 116 chemicals they looked for. (A similar test for 27 chemicals was published in 2001, and the agency plans to release a new report with a growing roster of chemicals every two years.) Meanwhile, the Mount Sinai School of Medicine in New York City, in collaboration with the Environmental Working Group, an advocacy organization in Washington D.C., and Commonweal, a West Coast health and environmental research institute, conducted an intensive analysis of the chemical burden in nine people, including Patton. Participants were scanned for 210 substances. The average number each harbored? Ninety-one.

EXPOSURE IS LINKED TO A RANGE OF HEALTH PROBLEMS
Sounds creepy, but what does that mean? Is having traces of dioxin in my blood any more of a risk to my health than the years I smoked cigarettes or the fact that my father dropped dead of a heart attack at 63? It's awful to think that I've passed on even minute amounts of pollutants to my three children. But is their body burden a more pressing concern than making sure they steer clear of junk food, get enough exercise, and always wear seat belts? Much of the evidence is circumstantial. Several of the participants in the EWG study do have significant health problems; Patton, for instance, was never able to have children. Andrea Martin, another participant, had already survived two bouts of breast cancer when she took part in the study, and she died soon after of a brain tumor. Martin was convinced the traces of 59 carcinogens found in her body contributed to her dismal health history, but as with the other participants' illnesses, there is no direct proof.

However, recent laboratory and epidemiological studies do point to a link between the growing number of chemicals we've been exposed to in the past 50 years and the rising incidence of health problems, including asthma, autism, various cancers, diabetes, premature births, Parkinson's disease, heart disease, infertility, and learning and attention-deficit disorders. Chemicals could even be a factor in rising obesity rates: One study found that rats exposed in utero to bisphenol A, a component of polycarbonate plastics, were significantly heavier than unexposed rats. "We certainly don't know everything about these chemicals--that's a big problem--but there's no question there are causal connections between chronic diseases and chemical exposure," says Philip Landrigan, M.D., a pediatrician and expert in environmental health at Mount Sinai.

It sounds precise to say that someone is carrying 1.79 picograms of a PCB, but the measurement tells you little. It doesn't tell you, for example, when or where or how an exposure took place. The EWG report revealed an exhaustive list of products containing the chemicals found in the volunteers' bodies--the C's alone are instructive, including: car waxes, carbon cleaners, carpet, caulking compounds, ceramics, child-proof wall finishes, chipping paint in older homes, colognes, computers, contact cements, contact lens cleaning solution, cosmetics, crystal tableware--but in most cases it's impossible to track a pollutant exactly to its source. Even when you know a product contains chemicals, finding out which ones it has is still tough. As I discovered when I began pulling out the cleaning supplies under my sink to see what I'd been unthinkingly spritzing around the house, manufacturers often don't list the chemical ingredients of their products. (The information is considered proprietary.)

What's more, body-burden tests can check for only a tiny fraction of the chemicals we're exposed to. The CDC, which has among the best testing facilities in the world, still hasn't perfected a way to detect perfluorinated compounds, one of the chemical families that most worry many experts. Abundant, persistent in the environment, and likely to accumulate in the body, these grease- and water-repelling compounds are used to make fabrics stainproof and paper cartons such as pizza boxes leakproof, and they appear, not surprisingly, to be biodegradable-proof. Most important, the results of a body-burden test can't tell you how the chemicals will interact with one another or how those combinations may affect your health. So far, few studies of such mixtures have been done.

MOST TROUBLING, TOXINS MAY AFFECT YOUR HORMONES
Though we've long known the hazards of certain chemicals, recent research suggests many may affect our health in a particularly insidious way--by disrupting our bodies' hormonal signals. To find out more about these "endocrine disrupters," I call John Peterson Myers, a zoologist who cowrote an influential book on the subject, titled Our Stolen Future. "What we need to worry about is not just cancer; it's not just mutations," he says. "It's changes in how we function, how our brain works, how well we can resist disease, how fertile we are."

Traditional toxicology focuses on the effects of high doses of toxins, when a cell's defenses are overwhelmed and the cell dies or its DNA is damaged, which can lead to cancer. But it turns out endocrine-disrupters can have devastating effects in low doses. They can "hijack control of development," says Myers, and alter the biochemical messages that determine when particular genes are turned on or off. That can have a disastrous impact during critical periods, such as when a baby's brain is developing or a preteen girl is maturing.

Toxicologists have always believed that the poison is in the dose, that if a high dose has no effect, there will be none at a low dose. But that's not true in the case of endocrine disrupters: The poison is often in the timing. Take bisphenol A, a building block of polycarbonate plastic that is used to coat the inside of aluminum cans and to make products such as Nalgene water bottles. It showed no ill effects in adult rats at high doses and seemed to be safe at 5 milligrams per day or less. Yet several newer studies have found that fetal mice exposed to doses 1,000 times lower suffer a slew of delayed reproductive effects. (When washed by hand in warm water with mild detergent, Nalgene bottles do seem to be safe for human use.)

Those at greatest risk from endocrine disrupters are not adults, but preteens, infants, and fetuses. "A tiny dose of exposure during pregnancy can have much more severe effects on health than exposure during adult life," says Landrigan. The classic example is DES, an estrogen-mimicking drug and endocrine disrupter that doctors began dispensing in the 1940s to prevent miscarriages. Thirty years later, the FDA issued an advisory when the daughters of those women began turning up with vaginal cancer. (And DES sons are showing higher-than-normal rates of testicular cancer.) Many industrial chemicals, such as dioxin (found in everything from milk to fish to baby food), are equally potent estrogen mimics. Recent animal studies have suggested prenatal exposure to dioxin can change breast tissue in such a way that tumors more easily develop decades later.

Women are hit by endocrine disrupters in particular ways. As major estrogen carriers, we're vulnerable to the many substances that mimic that hormone's actions. Women are also exposed to a raft of chemicals at work--think of the toxic substances used by manicurists, housecleaners, and even nurses--and in the personal products we use. In 2000, for instance, CDC researchers found that women between the ages of 20 and 40 had the highest levels of one member of a widely used chemical family called phthalates--a disturbing discovery because some phthalates have been found to disrupt fetal development. Why are young women's levels so high? The answer's likely to be found in the average lipstick or nail polish; phthalates are a common ingredient in cosmetics.

It's hard to talk conclusively about the effects of endocrine disrupters on people because the research has been largely on wildlife in polluted areas or on lab rats and mice, and extrapolating data across species is challenging. Critics also point out that data on the health effects are conflicting. And some toxicologists take issue with the theory that health can be affected at low doses, but not high ones. Why? Because the theory "flies in the face of generally recognized and long-standing principles of toxicology," says Richard Becker, Ph.D., a toxicologist with the American Chemistry Council. So far, he says, "the theory falls short of meeting scientific standards."

However, several major studies are under way to answer some of the most pressing questions about chemical risk. The CDC is collaborating with NASA and the EPA to form a national health-tracking network to chart links between environmental hazards and disease. The National Center for Toxicogenomics is sponsoring research into the interplay between pollutants and genes. The National Institutes of Health is also gearing up the largest longitudinal study to date on the risks of chemical exposure. Researchers hope to follow 100,000 children from inception to age 21; both they and their mothers will be tested for 100-plus chemicals and their health closely monitored.

SMALL CHANGES WILL HELP PROTECT YOU
In talking with experts--activists, scientists, and policy wonks--I asked them what they personally did about their body burden. No one thought it worth bothering to try to get rid of the chemicals already in our bodies. No one was eager to get tested, either, not least because it's extremely expensive and, for a comprehensive test, available only with participation in a scientific study. Instead, most people's suggestions were basic and easy to put into practice.

Eat low on the food chain (less fatty meat and high-fat dairy).
Stick with organic produce when possible. A study found that children who ate only organic produce had one-sixth the level of pesticides in their bodies as those who ate conventionally grown fruits and vegetables.
Vary the fish and shellfish you eat to lower your exposure to mercury. Pregnant women should eat no more than 12 ounces a week of cold-water fish, such as tuna, and should avoid shark, swordfish, and king mackerel altogether.
Use a water filter.
Air out dry-cleaning before bringing it into the house.
Don't microwave food in plastic containers.
Vacuum often, and use a machine that has a HEPA filter because contaminants often cling to household dust.
Steer clear of carpets and furniture treated with stain repellents.
Avoid pesticides and get rid of chemically laced household cleaners in favor of plain soap and water. When I asked Landrigan whether that could leave you vulnerable to bacterial contaminants, he scoffed. "Counters are not operating rooms; they don't have to be sterile."
Such measures sound minor, but because, as Patton puts it, "we all live in the same chemical neighborhood," for now they are the best--and most realistic--way to deal with the problem. Davis Baltz, another of the EWG study participants, admits that he takes care to avoid inhaling anything nasty. "If I smell something like diesel fumes, I will immediately hold my breath and look around to see how I can get away before I have to take another breath," he says.

And there's the rub: None of us can hold our breath that long. Ultimately, body burden is not an individual problem, but a social one. "You can make personal lifestyle choices, and that's going to be helpful," says Sharyle Patton. "And you can avoid exposure where you can--that will be helpful. But mostly what you need to do is work at a policy level. We all have to find ways to get the world to think more carefully about how it uses chemicals."

Who's at the top of the food chain? Your baby.
What could be more disturbing than the idea of a nursing mother downloading industrial chemicals into her baby? Yet research has shown that breast milk is laced with pesticides and other pollutants. "Babies nurse at the top of the food chain," says Sandra Steingraber, Ph.D., an ecologist and author of Having Faith: An Ecologist's Journey to Motherhood. "They feed one rung higher than we do, so certain contaminants in our diet are at maximum concentrations in human milk."

A proposed law in California calls for the state to test breast-milk samples, as well as blood and urine, for various contaminants. If the law passes, it will create the first such bio-monitoring program in the country. "This is a way to make toxic pollution real," says Jeanne Rizzo, executive director of the Breast Cancer Fund. "When breast milk talks, people listen."

Still, no one is urging mothers to quit breast-feeding. "However contaminated breast milk may be, it is the best food for babies," says Steingraber. Breast-fed babies are generally healthier, less prone to diarrhea and ear infections, and also less likely to develop diseases that have been linked to chemical exposures, such as asthma, diabetes, and certain childhood cancers. Studies that have followed babies exposed to chemicals in utero have found those who are breast-fed suffer fewer ill effects. "Breast-feeding counterbalances the effect of pollutants" says Gina Solomon, M.D., a, senior scientist with the Natural Resources Defense Council. "If they are able, I'm absolutely convinced women should breast-feed."

What's being done
Fifty countries have ratified the Stockholm Convention, an international agreement that would ban 12 of the most notorious and persistent pesticides and chemicals in use. But the United States is not among them. In order for us to be included in next year's conference, the Senate must ratify the bill before May 17, 2004. Go to senate.gov to send an e-mail.

In countries that have paid greater attention to the dangers of chemicals, that awareness is making a difference. In Sweden, for instance, scientists have been analyzing breast milk for contaminants. In the mid-1990s, researchers noticed the growing presence of polybrominated fire retardants in the samples. These compounds are routinely added to thousands of products, including furniture, computers, and cars, to reduce fire injuries; they appear to disrupt fetal development. Some European companies agreed to stop using the two most common compounds in the mid-1980s (the European Union has since instituted a ban that goes into effect August 1, 2004). Since then, Swedish levels have declined.

HOW DO I JOIN A STUDY?
Signing up for studies is the best way to get free, comprehensive testing-unfortunately, volunteers are rarely taken. Check the National Health and Nutrition Examination Survey (www.cdc.gov/nchs/nhanes.htm) or the National Children's Study (nationalchildrensstudy.gov). Another resource is your state's environmental health office; it can inform you of any alerts or studies. Remember, the presence of chemicals doesn't always indicate illness.

In one study, the participants' bodies harbored an average of 91 industrial chemicals.

PHOTO (COLOR): It's often impossible to track a pollutant to its source.

PHOTO (COLOR): Your cosmetics could contribute to the chemical load in your body.

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By Susan Freinkel

PHOTOGRAPH BY Holly Lindem

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