Long-term exposure to air pollution may raise risk of depression later in life, study says | CNN



CNN
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Exposure to air pollution may be tied to the risk of developing depression later in life, a large new study finds.

Scientists are finding more and more evidence that people who live in polluted areas have a higher risk of depression than those who live with cleaner air. But this study published Friday in JAMA Network Open is one of the first to examine the associations between long-term exposure and the risk of depression diagnosed after age 64.

Depression itself is a serious health condition. When it develops in an older adult, it can also contribute to problems with the ability to think clearly, studies show, as well as physical problems and even death.

Previous research has found that a new diagnosis of depression is less common among older adults than in younger populations.

“That’s one of the biggest reason we wanted to conduct this analysis,” said Dr. Xinye Qiu, co-author of the new study, published Friday in JAMA Network Open. Qiu is a postdoctoral research fellow in the Department of Environmental Health at Harvard T.H. Chan School of Public Health. “Surprisingly, we saw a large number of late-onset depression diagnoses in this study.”

The researchers looked at information on more than 8.9 million people who got their health insurance through Medicare and found that more than 1.52 million were diagnosed with depression later in life during the study period of 2005 to 2016. But the number is probably an undercount; studies show that late-in-life depression is often underdiagnosed.

To determine the study participants’ pollution exposure, Qiu and her co-authors looked at where each of the people diagnosed with depression lived and created models to determine the exposure to pollution at each ZIP code, averaged across a year.

The researchers looked at the study participants’ exposure to three kinds of air pollution: fine particulate matter, also known as PM2.5 or particle pollution; nitrogen dioxide; and ozone.

Particle pollution is the mix of solid and liquid droplets floating in the air. It can come in the form of dirt, dust, soot or smoke. Coal- and natural gas-fired power plants create it, as do cars, agriculture, unpaved roads, construction sites and wildfires.

PM2.5 is so tiny – 1/20th of a width of a human hair – that it can travel past your body’s usual defenses.

Instead of being carried out when you exhale, it can get stuck in your lungs or go into your bloodstream. The particles cause irritation and inflammation and may lead to respiratory problems. Exposure can cause cancer, stroke or heart attack; it could also aggravate asthma, and it has long been associated with a higher risk of depression and anxiety.

Nitrogen dioxide pollution is most commonly associated with traffic-related combustion byproducts. Nitrogen oxides are also released from traffic, as well as through the burning of oil, coal and natural gas. Exposure can increase inflammation of the airways, cause coughing or wheezing and reduce lung function.

Ozone pollution is the main ingredient in smog. It comes from cars, power plants and refineries. This particular pollution is best known for exacerbating asthma symptoms, and long-term exposure studies show a higher risk of death from respiratory diseases in people with higher exposures. The American Lung Association calls it one of the “least well-controlled pollutants in the United States,” and it’s one of the most dangerous.

In the new study, the scientists found that people who lived in areas with higher pollution levels long-term had an increased risk of a depression diagnosis. All three of the pollutants studied were associated with a higher risk of late-onset depression, even at lower pollution levels.

“So there’s no real threshold, so it means future societies will want to eliminate this pollution or reduce it as much as possible because it carries a real risk,” Qiu said.

There were greater associations between depression and exposure to particle pollution and nitrogen dioxide among socioeconomically disadvantaged groups. That may in part be because they are simultaneously exposed to social stress and these poor environmental conditions, the study says.

Older adults who had underlying problems with their heart or breathing were also more sensitive to developing late-in-life depression when exposed to nitrogen dioxide pollution, the study found.

The study has some limitations. The majority of the participants were White, and more research would be needed to see whether there would be a difference among diverse populations.

This is also a population-level study, so there is no way to pinpoint exactly why people exposed to these kinds of air pollutions would have a higher risk of depression.

Other studies have found that exposure to air pollution may affect the central nervous system, causing inflammation and damaging the body’s cells.

Some air pollution, studies show, can also cause the body to release harmful substances that can hurt the blood-brain barrier, the network of blood vessels and tissues made up of closely spaced cells that protect the brain, and that may lead to depression and anxiety.

Because aging can impair the immune response, older adults may be particularly vulnerable to the negative effects of air pollution. More research will be needed to fully understand these connections, as the neural basis for depression is not completely understood.

Another possibility may be that people who live in polluted areas develop physical problems that are associated with worsening psychiatric health, the study said.

“Late-life depression should be a geriatric issue that the public and researchers need to be paying more attention to, like on a similar level with Alzheimer’s and other neurological conditions,” Qiu said.

She is particularly concerned about the effects that climate change will have on this phenomenon. Ozone pollution will increase as the world gets warmer, and the study found that ozone pollution had a stronger association to late-onset depression than particle and nitrogen dioxide pollution.

“Because of this concerning effect we are seeing with ozone, it makes more sense for the government to put some regulation on pollution and also climate mitigation, because rising temperatures and ozone pollution are definitely linked to each other,” Qiu said.

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After a train derailment, Ohio residents are living the plot of a movie they helped make | CNN



CNN
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When Ben Ratner’s family signed up in 2021 to be extras in the movie “White Noise,” they thought it would be a fun distraction from their day-to-day life in blue-collar East Palestine, Ohio.

Ratner, 37, is in a traffic jam scene, sitting in a line of cars trying to evacuate after a freight train collided with a tanker truck, triggering an explosion that fills the air with dangerous toxins. In another scene, his father wears a trench coat and hat while people walk across an overpass to get out of town. Directors told the group they wanted them to look “forlorn and downtrodden” as they escape the environmental disaster.

The 2022 movie was shot around Ohio and is based on a novel by Don DeLillo. The book was published in 1985, shortly after a chemical disaster in Bhopal, India, that killed nearly 4,000 people. The book and film follow the fictional Gladney family – a couple and their four kids – as they flee an “airborne toxic event” and then return home and try to resume their normal lives.

Ratner tried to rewatch the movie a few days ago and found that he couldn’t finish it.

“All of a sudden, it hit too close to home,” he said.

Ratner and his family – his wife, Lindsay, and their kids, Lilly, Izzy, Simon and Brodie – are living the fiction they helped bring to the screen.

Officials ordered them to evacuate their home last week, a day after a Norfolk Southern train carrying 20 cars of hazardous materials slid off the rails and caught fire, threatening to explode. The National Transportation Safety Board is still investigating the cause of the incident.

“The first half of the movie is all almost exactly what’s going on here,” Ratner said Wednesday, four days into their evacuation.

In a way, the movie has provided a point of grim humor about the situation facing the residents of East Palestine – the joke no one wanted to make.

“Everybody’s been talking about that,” Ratner said of his friends and neighbors who are keeping in close touch through the crisis. “I actually made a meme where I superimposed my face on the poster and sent it to my friends.”

In the 2022 film

Scholars who study DeLillo’s work say they are not surprised by the collision of life and art. His work is often described as prescient, said Jesse Kavadlo, an English professor at Maryville University in St. Louis and president of the Don DeLillo Society.

“The terrible spill now is, of course, a coincidence. But it plays in our minds like life imitating art, which was imitating life, and on and on, because, as DeLillo suggests in ‘White Noise’ as well, we have unfortunately become too acquainted with the mediated language and enactment of disaster,” Kavadlo said.

The night of February 3, Ratner was watching his daughter’s basketball game at the local high school when the crash happened. He didn’t hear it over the noise of the game, but when they walked out of the building, he could see the massive blaze. He shot a few seconds of video on his cell phone.

His family returned to their house, which sits less than a mile from the crash site. Throughout the night, he said, they heard sirens but got little information. “We weren’t sure exactly what the danger was.”

While his family slept, he stayed up, nervously watching the fire and the news.

The next morning, activity around the site had picked up. “There was a lot of commotion, helicopters and people hightailing it out of town, and it was it was a little intense,” he said.

His wife and kids headed to stay with his wife’s parents, who live about 2 miles from the crash site. Ratner went to work running the coffee shop he and his wife own, LiB’s Market, in nearby Salem.

By that afternoon, an official alert warned that people needed to move even farther, beyond a 2-mile radius. Roughly half of the town’s 4,800 residents had to evacuate.

A friend offered to let them stay in their pool house. They later moved to another friend’s house next to their café.

School was canceled for the week. They got their dog out of the house, but they had to leave the pet turtle behind.

For now, they’re keeping their distance. But even after they go back, they have to decide whether they’ll stay.

East Palestine is in an economically depressed area, Ratner said, but it had been on a rebound. He and his wife had been considering opening another café there, but now they’re worried that plan is in jeopardy.

“That’s where we’ve been raising our kids, finishing college, buying a business, and that’s been our place,” he said. “In the future, are we going to have to sell the house? Is it worth any money at this point?”

Five of the tankers on the train that overturned last week were carrying liquid vinyl chloride, which is extremely combustible. Last Sunday, they became unstable and threatened to explode. First responders and emergency workers had to vent the tankers, spill the vinyl chloride into a trench, and then burn it off before it turned the train into a bomb. Authorities feared that an explosion could send shrapnel up to a mile away.

But that didn’t happen. The controlled burn worked and the evacuation order for East Palestine residents was officially lifted Wednesday after real-time air and water monitoring did not find any contaminant levels above screening limits.

“All of the readings we’ve been recording in the community have been at normal concentrations, normal backgrounds, which you find in almost any community,” James Justice, a representative of the US Environmental Protection Agency, said at a briefing Wednesday.

Support team members prepared to assess remaining hazards in East Palestine, Ohio, on February 7.

Although authorities have assured the residents that any immediate danger has passed, some residents have yet to return home. Ratner said they’re worried about longer-term risks that environmental officials are only beginning to assess.

Real-time air readings, which use handheld instruments to broadly screen for classes of contaminants like volatile organic compounds, showed that the air quality near the site was within normal limits.

The decision to lift the evacuation order was based on analysis of air monitoring data, according to Charles Rodriguez, community involvement coordinator for the EPA’s Region 5 office.

Up to this point, officials have been looking for large immediate threats: explosions or chemical levels that could make someone acutely ill.

“Under this phase, it’s been the emergency response,” Kurt Kohler of the Ohio EPA’s Office of Emergency Response said Wednesday. “As you see the emergency services go back home, off-site, Ohio EPA is going to remain involved through our other divisions that oversee the long-term cleanup of these kinds of spills.”

The cleanup and monitoring of the site, he said, could take years.

Although the explosion risk is past, Ratner said, people who live in East Palestine want to know about the chemical threats that might linger.

Fish and frogs have died in local streams. People have reported dead chickens and shared photos of dead dogs and foxes on social media. They say they smell chemical odors around town.

When asked at Wednesday’s briefing about exactly what spilled, representatives from Norfolk Southern listed butyl acrylate, vinyl chloride and a small amount of non-hazardous lube oil.

“Butyl acrylate is a lot of what we’re gathering information on,” said Scott Deutsch, a regional manager of hazardous materials at Norfolk Southern.

Butyl acrylate is a clear, colorless liquid with a strong, fruity odor that’s used to make plastics and paint. It’s possible to inhale it, ingest it or absorb it through the skin. It irritates the eyes, skin and lungs and may cause shortness of breath, according to the National Institute of Occupational Safety and Health. Repeated exposure can lead to lung damage.

Vinyl chloride, which is used to make PVC pipes, can cause dizziness, sleepiness and headaches. It has also been linked to an increased risk of cancer in the liver, brain, lungs and blood.

Although butyl acrylate easily mixes with water and will move quickly through the environment, it isn’t especially toxic to humans, said Richard Peltier, an associate professor of environmental health sciences at the University of Massachusetts at Amherst.

“Vinyl chloride, however, has a specific and important risk in that is contains a bunch of chlorine molecules, which can form some really awful combustion byproducts,” Peltier said. “These are often very toxic and often very persistent in the environment.”

Portions of a Norfolk Southern freight train that derailed February 3 were still on fire the next day.

A spokesperson for Norfolk Southern acknowledged but did not respond to CNN’s request for more information on how much of these chemicals spilled into the soil and water.

The Ohio EPA says it’s not sure yet, either.

“Initially, with most environmental spills, it is difficult to determine the exact amount of material that has been released into the air, water, and soil. The assessment phase that will occur after the emergency is over will help to determine that information,” James Lee, media relations manager for the Ohio EPA, wrote in an email to CNN.

Lee said that after his agency has assessed the site, it will work on a remediation plan.

Vinyl chloride is unstable and boils and evaporates at room temperature, giving it a very short lifespan in the environment, said Dana Barr, a professor of environmental health at Emory University’s Rollins School of Public Health.

“If you had a very small amount of vinyl chloride that was present in an area, it would evaporate within minutes to hours at the longest,” she said.

“But the problem they’re facing here is that it’s not just a small amount, and so if they can’t contain what gets into the water or what gets into the soil, they may have this continuous off-gassing of vinyl chloride that has gotten into these areas,” Barr said.

“I probably would be more concerned about the chemicals in the air over the course of the next month.”

State officials said they would continue to monitor the site for exactly that reason. They are also continuing to try to dig and remove contaminated soil.

“Right now, we have a system set up. As the data comes, it is distributed to a network of people to look at both on an immediate-phase – ‘Hey, is there anything really alarming to look at’ – and those smaller numbers that really matter to long-term health,” Kohler said at Wednesday’s briefing.

He said the local health department would test residents’ wells to make sure their drinking water is safe. Officials are also offering to test the air in residents’ homes before they come back.

Norfolk Southern is funding a phone line for residents to speak to a toxicologist with the Center for Toxicology and Environmental Health, an environmental consulting firm.

No one is quite sure whether to trust the help, though, since it’s coming mostly from the company behind the spill. Some residents have already filed a class-action lawsuit against Norfolk Southern.

“We’re definitely signing up for the air testing of the home before we get in there,” Ratner said.

The first trains to pass since the accident started rolling through again midweek, Ratner said. The roar of the trains, a sound he used to tune out, is now jarring.

Even the sounds of loud trucks are “off-putting,” he said.

Don Cheadle, left, and Adam Driver star in

Ratner said it was fun to be part of a disaster movie – a stylized, darkly comedic Netflix streamer starring Adam Driver, Greta Gerwig and Don Cheadle.

In real life, the situation has been gutting.

“Those are great actors, but it was hard to see it as a put-on,” Ratner said.

He shares the sentiments of Lenny Glavan, a local tattoo artist, who wrote a letter to Norfolk Southern CEO Alan Shaw on Tuesday to express the town’s anger and frustration over the accident.

“You just ripped from us our small-town motto ‘A place you want to be,’ ” Glavan wrote.

“It may not be beach-front property, it may not even have the highest paying jobs, or much else to offer, but in my experiences in life, the place I and most people want to be is when you need a helping hand, a shoulder to cry on, a friend to pray with, or a place to call home East Palestine has always been that place to want to be,” he said in his note, which was publicly posted on Facebook.

“With the events in which have occurred, the railroad that gave this small town life has now taken the life, the heartbeat, the unity and that security that families or individuals long for in this wild world away … possibly indefinitely.”

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Common kinds of air pollution led to changes in teens’ blood pressure, study says | CNN



CNN
 — 

Scientists know that air pollution can make it difficult to breathe and may ultimately cause serious health problems like cancer, but a new study shows that it might also have a negative impact on teens’ blood pressure.

Exposure to higher levels of nitrogen dioxide was associated with lower blood pressure in teens, according to the study, published Wednesday in the journal PLOS One. Exposure to particulate matter 2.5, also known as particle pollution, was associated with higher blood pressure.

The researchers say the impact is “considerable.”

Other studies have found a connection between blood pressure changes and pollution, but much of that work focuses on adults. Some research has also found negative associations with pollution exposure and younger children, but little has focused on teens.

Generally, low blood pressure can cause immediate problems like confusion, tiredness, blurred vision and dizziness. High blood pressure in adolescence can lead to a lifetime of health problems including a higher risk of stroke or heart attack. It’s a leading risk factor for premature death worldwide.

The study did not look at whether the teens had symptoms or health effects from the change in blood pressure.

The scientists saw this association between pollution and blood pressure in data from the Determinants of Adolescent Social Well-Being and Health study, which tracks the health of a large and ethnically diverse group of children in London over time.

The researchers took data from more than 3,200 teens and compared their records to their exposures to pollution based on annual pollution levels where they lived.

Nitrogen dioxide pollution is most commonly associated with traffic-related combustion byproducts. Nitrogen may help plants grow, but it can impair a person’s ability to breathe and may cause damage to the human respiratory tract. In this study, the nitrogen was thought to be coming predominantly from diesel traffic.

The particle pollution in the study is so tiny – 1/20th of a width of a human hair – that it can travel past the body’s usual defenses. Instead of being carried out when a person exhales, it can get stuck in the lungs or go into the bloodstream. The particles cause irritation and inflammation and may lead to a whole host of health problems.

Particle pollution can come from forest fires, wood stoves, power plants and coal fires. It can also come from traffic and construction sites.

In this study, the link between pollution exposure and changes in blood pressure was stronger in girls than in boys. The researchers can’t determine why there is a gender difference, but they found that 30% of the female participants got the least amount of exercise among the group and noted that that can have an effect on blood pressure.

“It is thus imperative that air pollution is improved in London to maximise the health benefits of physical exercise in young people,” the study says.

Although the study also can’t pinpoint why teens’ blood pressure changed with pollution exposure, others have found that exposure to air pollution may affect the central nervous system, causing inflammation and damage to the body’s cells. Additionally, exposure to particle pollution can disrupt a person’s circadian rhythms, which could affect blood pressure. Particle pollution exposure may also reduce the kidneys’ ability to excrete sodium during the day, leading to a higher nighttime blood pressure level, the study says.

When it came to nitrogen dioxide pollution, the researchers had previously done a crossover study that involved the blood pressure of 12 healthy teen participants who were exposed to nitrogen oxide from a domestic gas cooker with lit burners. Their blood pressure fell compared with participants exposed to only room air.

In the new study, the associations between pollution and blood pressure were consistent. Body size, socieoecomonic status and ethnicity didn’t change the results.

However, it looks only at teens in London, and only 8% of them were people of color. Those children were exposed to higher levels of pollution than White children, the study found.

Levels of pollution in London are also well above what World Health Organization guidelines suggest is safe for humans. However, the same could be said for most any area in the world. In 2019, 99% of the world’s population lived in places that did not meet WHO’s recommended air quality levels.

Earlier work has shown that pollution can damage a young person’s health and may put them at a higher risk for chronic diseases like heart problems later in life. Studies in adults found that exposure to air pollution can affect blood pressure even within hours of exposure.

Pollution caused 1 in 6 deaths worldwide in 2019 alone, another study found.

Some experts suggest that one way to reduce a teen’s risk of pollution-related health problems is to invest in portable air cleaners with HEPA filters that are highly effective at reducing indoor air pollution. However, the filters can’t remove all of the problem, and experts say communitywide solutions through public policy are what’s needed.

Dr. Panagis Galiatsatos, an assistant professor in pulmonary and critical care medicine at Johns Hopkins Medicine, said research like this is important to generate a hypothesis about what these pollutants are doing to people. Galiatsatos, a volunteer medical spokesperson with the American Lung Association, was not involved with the new study.

“A lot of these air pollutions tend to cluster in economically disadvantaged neighborhoods, so it’s one of the big reasons we want to always keep a close eye on this, as it disproportionately impacts certain populations more than others,” he said.

Blood pressure is an important marker to track for health because it is a surrogate to understand the more complex processes that might be happening in the body.

“My big takeaway is that these toxins clearly seem to have some physiological impact on the cardiovascular system, and any manipulation should be taken into the context of a concern,” Galiatsatos said.

Study co-author Dr. Seeromanie Harding, a professor of social epidemiology at King’s College London, said she hopes it will lead to more research on the topic.

“Given that more than 1 million under 18s live in [London] neighborhoods where air pollution is higher than the recommended health standards,” she said in a news release, “there is an urgent need for more of these studies to gain an in-depth understanding of the threats and opportunities to young people’s development.”

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Climate change is contributing to the rise of superbugs, new UN report says | CNN



CNN
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Climate change and antimicrobial resistance are two of the greatest threats to global health, according to a new report from the United Nations Environment Programme.

The report, titled “Bracing for Superbugs,” highlights the role of climate change and other environmental factors contributing to the rise of antimicrobial resistance. It was announced Tuesday at the Sixth Meeting of the Global Leaders Group on Antimicrobial Resistance in Barbados.

Antimicrobial resistance or AMR happens when germs such as bacteria, viruses and fungi develop the ability to defeat the medications designed to kill them.

“The development and spread of AMR means that antimicrobials used to prevent and treat infections in humans, animals and plants might turn ineffective, with modern medicine no longer able to treat even mild infections,” the UN Environment Programme said in a news release.

Roughly 5 million deaths worldwide were associated with antimicrobial resistance in 2019, and the annual toll is expected to increase to 10 million by 2050 if steps aren’t taken to stop the spread of antimicrobial resistance, according to the report.

In the US, there are nearly 3 million antimicrobial-resistant infections each year, and more than 35,000 people die as a result, the US Centers for Disease Control and Prevention says.

Antimicrobials are commonly used in cleaning products, plant pesticides and medications to kill and prevent the spread of germs among people, animals and crops.

Drug resistance can develop naturally, but experts say the overuse of antimicrobials in people, animals and food production has accelerated the process. The microorganisms that survive these chemicals are stronger and more powerful, and they can spread their drug-resistant genes to germs that have never been exposed to antimicrobials.

The focus so far has largely been on excessive antimicrobial use, but experts say there is growing evidence that environmental factors play a significant role in the development, transmission and spread of antimicrobial resistance.

“Climate change, pollution, changes in our weather patterns, more rainfall, more closely packed, dense cities and urban areas – all of this facilitates the spread of antibiotic resistance. And I am certain that this is only going to go up with time unless we take relatively drastic measures to curb this,” said Dr. Scott Roberts, an infectious diseases specialist at Yale School of Medicine, who was not involved with the new UN report.

The climate crisis worsens antimicrobial resistance in several ways. Research has shown that increased temperatures increase both the rate of bacterial growth and the rate of the spread of antibiotic-resistant genes between microorganisms.

“As we get a more extreme climate, especially as it warms, the gradients that drive the evolution of resistance will actually accelerate. So, by curbing temperature rises and reducing the extremity of events, we can actually then fundamentally curb the probability of evolving new resistance,” Dr. David Graham, a professor of ecosystems engineering at Newcastle University and one of the UN report’s authors, said at a news conference ahead of the report’s release.

Experts also say severe flooding as a result of climate change can lead to conditions of overcrowding, poor sanitation and increased pollution, which are known to increase infection rates and antimicrobial resistance as human waste, heavy metals and other pollutants in water create favorable conditions for bugs to develop resistance.

“The same drivers that cause environmental degradation are worsening the antimicrobial resistance problem. The impacts of antimicrobial resistance could destroy our health and food systems,” Inger Andersen, the UN Environment Programme’s executive director, said at the news conference.

Environmental pressures are creating bugs that thrive in the human body, which experts say is unusual for some species.

“There’s one hypothesis from a prominent mycologist who suggests that the reason the body’s temperature is 98.6 is because that is the temperature where fungi can’t grow that well. And so, now we’re seeing Candida auris and some of the other new microbes that have come up that really grow quite well – even at temperatures of 98.6 in the human body. And so I think climate change, really selecting for these organisms to adapt to a warmer climate, is going to increase the odds that there’s infection in humans,” Roberts said.

Such opportunistic infections jeopardize medical advancements like joint replacements, organ transplants and chemotherapy – procedures in which patients have a significant risk of infection and require effective antibiotics.

Drug-resistant infections can make treatment difficult or even impossible. Roberts says that resorting to “last-ditch treatments” is “never a good scenario from the patient level because there are reasons we don’t use them up front,” such as organ toxicity and failure.

“When somebody does present with a drug-resistant bacteria or fungus and we really need to rely on one of these last-line antibiotics, it’s usually a challenge to treat from the outset. And so the patients really don’t do as well as a result,” he said. “In rare circumstances, we run out of options entirely, and in that case, there’s really nothing we can do. Fortunately, those cases remain quite rare, but I am certain that with this growing antibiotic resistance problem, we’ll see these increasing frequency over time.”

Experts say that both climate change and antimicrobial resistance have been worsened by and can be improved by human actions. One critical step is to limit antibiotic overuse and misuse.

“Antibiotics and antifungals do not work on viruses, such as colds and the flu. These drugs save lives. But, anytime they are used, they can lead to side effects and antimicrobial resistance,” the UN report’s authors wrote.

The authors also emphasize that the health of people, animals, plants and the environment are closely linked and interdependent, and they call on governments to identify policies to limit antibiotic use in agriculture and reduce environmental pollution.

Finally, experts say, steps to reduce climate change are steps to limit antimicrobial resistance.

“Whatever we can do on an individual level to kind of reduce the impact of climate change, really, that’s kind of only worsening this problem, as well as pollution and urbanization and in dense, crowded areas. Although I know from the individual level that’s a hard thing to change,” Roberts said.

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FDA proposes new levels for lead in baby food, but critics say more action is needed | CNN



CNN
 — 

The allowable levels of lead in certain baby and toddler foods should be set at 20 parts per billion or less, according to new draft guidance issued Tuesday by the US Food and Drug Administration.

“For babies and young children who eat the foods covered in today’s draft guidance, the FDA estimates that these action levels could result in as much as a 24-27% reduction in exposure to lead from these foods,” said FDA Commissioner Dr. Robert Califf in a statement.

The

Baby foods covered by the new proposal – which is seeking public comment – include processed baby foods sold in boxes, jars, pouches and tubs for babies and young children younger than 2 years old, the agency said.

While any action on the part of the FDA is welcome, the suggested levels of lead are not low enough to move the needle, said Jane Houlihan, the national director of science and health for Healthy Babies Bright Futures, a coalition of advocates committed to reducing babies’ exposures to neurotoxic chemicals.

“Nearly all baby foods on the market already comply with what they have proposed,” said Houlihan, who authored a 2019 report that found dangerous levels of lead and other heavy metals in 95% of manufactured baby food.

That report triggered a 2021 congressional investigation, which found leading baby food manufacturers knowingly sold products with high levels of toxic metals.

“The FDA hasn’t done enough with these proposed lead limits to protect babies and young children from lead’s harmful effects. There is no known safe level of lead exposure, and children are particularly vulnerable,” Houlihan said.

The director of food policy for Consumers Reports, Brian Ronholm, also expressed concerns. In 2018, Consumer Reports analyzed 50 baby foods and found “concerning” levels of lead and other heavy metals. In fact, “15 of them would pose a risk to a child who ate one serving or less per day,” according to Consumer Reports.

“The FDA should be encouraging industry to work harder to reduce hazardous lead and other heavy metals in baby food given how vulnerable young children are to toxic exposure,” Ronholm said in a statement.

Exposure to toxic heavy metals can be harmful to the developing brain of infants and children. “It’s been linked with problems with learning, cognition, and behavior,” according to the American Academy of Pediatrics.

Lead, arsenic, cadmium and mercury are in the World Health Organization’s top 10 chemicals of concern for infants and children.

As natural elements, they are in the soil in which crops are grown and thus can’t be avoided. Some crop fields and regions, however, contain more toxic levels than others, partly due to the overuse of metal-containing pesticides and ongoing industrial pollution.

The new FDA guidance suggests manufactured baby food custards, fruits, food mixtures — including grain and meat-based blends — puddings, vegetables, yogurts, and single-ingredient meats and vegetables contain no more than 10 parts per billion of lead.

The exception to that limit is for single-ingredient root vegetables, such as carrots and sweet potatoes, which should contain no more than 20 parts per billion, according to the new guidance.

Dry cereals marketed to babies and toddlers should also not contain more than 20 parts per billion of lead, the new FDA guidance said.

However, the FDA didn’t propose any lead limit for cereal puffs and teething biscuits, Houlihan said, even though the products account for “7 of the 10 highest lead levels we’ve found in over 1,000 baby food tests we have assessed.”

The limit set for root vegetables will be helpful, Houlihan added. Because they grow underground, root vegetables can easily absorb heavy metals. For example, sweet potatoes often exceed the 20 parts per billion limit the FDA has proposed, she said.

Prior to this announcement, the FDA had only set limits for heavy metals in one baby food — infant rice cereal, Houlihan said. In 2021, the agency set a limit of 100 parts per billion for arsenic, which has been linked to adverse pregnancy outcomes and neurodevelopmental toxicity.

There is much more that can be done, according to Scott Faber, senior vice president of government affairs for the Environmental Working Group, a nonprofit environmental health organization.

“We can change where we farm and how we farm to reduce toxic metals absorbed by plants,” Faber said. “We also urge baby food manufacturers to conduct continuous testing of heavy metals in all their products and make all testing results publicly available.”

Companies can require suppliers and growers to test the soil and the foods they produce, and choose to purchase from those with the lowest levels of heavy metals, Houlihan added.

“Growers can use soil additives, different growing methods and crop varieties known to reduce lead in their products,” she said.

What can parents do to lessen their child’s exposure to toxic metals? Unfortunately, buying organic or making baby food at home isn’t going to solve the problem, as the produce purchased at the grocery store can also contain high levels of contaminants, experts say.

A 2022 report by Healthy Babies, Bright Futures found lead in 80% of homemade purees or store-bought family foods. Arsenic was found in 72% of family food either purchased or prepared at home.

The best way to lessen your child’s exposure to heavy metals, experts say, is to vary the foods eaten on a daily basis and choose mostly from foods which are likely to have the least contamination. Healthy Babies, Bright Futures created a chart of less to most contaminated foods based on their testing.

Fresh bananas, with heavy metal levels of 1.8 parts per billion, were the least contaminated of foods tested for the report. After bananas, the least contaminated foods were grits, manufactured baby food meats, butternut squash, lamb, apples, pork, eggs, oranges and watermelon, in that order.

Other foods with lower levels of contamination included green beans, peas, cucumbers and soft or pureed home-cooked meats, the report found.

The most heavily contaminated foods eaten by babies were all rice-based, the report said. Rice cakes, rice puffs, crisped rice cereals and brown rice with no cooking water removed were heavily contaminated with inorganic arsenic, the more toxic form of arsenic.

After rice-based foods, the analysis found the highest levels of heavy metals in raisins, non-rice teething crackers, granola bars with raisins and oat-ring cereals. But those were not the only foods of concern: Dried fruit, grape juice, arrowroot teething crackers and sunflower seed butter all contained high amounts of at least one toxic metal, according to the report.

While buying organic cannot reduce the levels of heavy metals in infant food, it can help avoid other toxins such as herbicides and pesticides, Dr. Leonardo Trasande, director of environmental pediatrics at NYU Langone Health told CNN previously.

“There are other benefits to eating organic food, including a reduction in synthetic pesticides that are known to be as bad for babies, if not even more problematic,” Trasande said.

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Pandemic fueled alcohol abuse, especially among women, but there are treatment options | CNN

Editor’s Note: In the final two episodes of “This Is Life With Lisa Ling,” the series explores alcoholism in America (at 9 p.m. ET Sunday) and interracial marriages (at 10 p.m. ET Sunday).



CNN
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Brook was 34 years old when her use of alcohol escalated, a way of coping with a breast cancer diagnosis.

“I just decided I’m not gonna go through this straight,” she told Lisa Lang in an episode of “This Is Life With Lisa Ling,” airing at 9 p.m. ET Sunday on CNN.

“I would drink before I went to my chemo sessions. It became more and more of a coping mechanism,” said Brook, who did not want to use her last name.

Brook survived the bout with cancer but says she became dependent on alcohol — and the pandemic only made it worse.

“When Covid started and I was home, I started drinking more and more and more,” said Brook, now 42. “I started not being able to eat, I started throwing up more often, and then I started throwing up blood.”

She recently ended up in the hospital, diagnosed with cirrhosis of the liver and a bad bleed from ulcers, which doctors said could take her life if not quickly treated.

“When they were talking to me afterwards, they said, ‘If you keep going like this, you’ll be dead in a year,’ ” Brook told Ling.

Alcohol use disorder is defined as compulsively using alcohol despite negative consequences on relationships and one’s ability to function at work, school or in the community. Over time, excessive alcohol use may even rewire the brain, making booze as desirable as natural rewards such as food or sex, experts say.

Researchers at University of California, Los Angeles showed pictures of alcoholic drinks to people who are and are not addicted while scanning their brains. Regions of the brain associated with craving, pleasure and reward lit up significantly more in those with an alcohol use disorder.

“It’s much more of a medical and brain disease than we initially thought,” Lara Ray, a clinical psychologist who runs the UCLA Addictions Lab, told Ling.

In addition, just one pint of beer or average glass of wine a day may begin to shrink the overall volume of the brain. The brains of nondrinkers who began consuming an average of one alcohol unit a day showed the equivalent of half a year of aging, according to a study published in March.

The damage worsens as the number of daily drinks rises, the study found — drinking four alcohol units a day aged a person’s brain by more than 10 years.

Alcohol use disorder is a growing problem in the United States, which experts say has been enhanced by the pandemic, especially among women.

“Last year, I took care of two women who were in their early 20s who had cirrhosis and needed liver transplants, and I’ve never seen that before in my entire career,” Dr. James Burton, medical director of liver transplantation at the University of Colorado School of Medicine in Aurora, told Ling.

A recent study found a significant increase in alcohol-associated liver disease and a 15% higher rate of waiting lists and subsequent liver transplants between 2020 and 2021 — the greatest increase occurred in young adults.

Since the pandemic’s onset, statistics show an overall 14% increase in the number of drinking days per month, but a “41% increase in heavy drinking days among women,” Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital, told CNN in January.

Why? Pre-pandemic mom wine culture, which “normalized and even glorified” drinking, is partly to blame, said Dr. Leena Mittal, chief of the women’s mental health division in the department of psychiatry at Brigham and Women’s Hospital in Boston.

In addition, “studies have shown the complexities of balancing home, work and caregiving responsibilities during the pandemic have fallen disproportionately on women,” Mittal said earlier.

Women are especially sensitive to the effects of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related problems appear sooner and at lower drinking levels than in men, said the institute, part of the US National Institutes of Health.

Women are more susceptible to alcohol-related brain damage and heart disease than men, and studies show women who have one drink a day increase their risk of breast cancer by 5% to 9% compared with those who abstain.

Pandemic lockdowns also forced many people to live and work from home — sometimes alone. A July study found drinking alone during adolescence and young adulthood can strongly increase the risk for alcohol abuse later in life, especially if you are a woman.

Victoria, who also did not want to use her last name, told Ling she began drinking as a teenager. Now 55, she still “can’t control it. It’s like a tension that builds up. And so then when I do drink, it’s like, ‘Ah! I’m drinking,’ you know, so it’s way too much, way too fast.”

Victoria says she continues to crave alcohol but goes regularly to support meetings for addiction recovery after moving in with her mother during the pandemic.

Binge drinking — defined as more than four drinks for women and five for men within a few hours — is on the rise. According to a study published in June, even older people who consider themselves moderate users of alcohol are downing multiple drinks in one sitting.

People who binged were about five times more likely to experience numerous alcohol problems, including injuries, emotional or psychological issues, and alcohol dependence at work or school or while caring for children, the study found.

“What this means is that an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner, even though their average drinking level is the same,” study coauthor Charles Holahan, professor of psychology at the University of Texas at Austin, told CNN previously.

The US Food and Drug Administration has approved only three drugs designed to reduce alcohol use since 1951: disulfiram, which causes headaches, nausea and vomiting when mixed with alcohol; acamprosate, which works on the reward centers of the brain to reduce alcohol cravings; and naltrexone, which reduces cravings and appears to help with heavy drinking.

There is help. Find it here

  • The National Institute on Alcohol Abuse and Alcoholism has a tool called the NIAA Alcohol Treatment Navigator that “helps adults find alcohol treatment for themselves or an adult loved one.” For teens, the institute recommends these resources.
  • The Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline active 24/7/ 365 days a year to provide information and treatment referrals to local treatment facilities, support groups and community-based organizations: 800-662-HELP (4357) and 800-487-4889 (TTY option).
  • All three have significant side effects that can deter people from using them consistently.

    Researchers continue to experiment with various drugs to see if they can help cure cravings without major side effects. While not FDA-approved, the anticonvulsant drug topiramate has shown promise in some clinical trials but may affect cognition and memory. Other anticonvulsant drugs, such as zonisamide and gabapentin, and a smoking cessation drug called varenicline have shown mixed results.

    At Ray’s lab at UCLA, small clinical trials have found promising results from the neuromodulator ibudilast, which hindered cravings and reduced the odds of heavy drinking for some people by 45%.

    For Billy Flores, 45, the change happened quickly.

    “In the first two days, I was upset in the stomach, but by the third day I was on it, I was off of alcohol, which is pretty amazing I thought,” he told Ling about using ibudilast.

    Bill has struggled with alcohol but says he has found hope with a clinical trial.

    Additional studies are needed to see if the benefits hold true for larger populations.

    In the meantime, there are gold standard treatments for alcohol use disorder that don’t involve medications. Those include Alcoholics Anonymous and Self-Management and Recovery Training 12-step programs, cognitive behavioral treatments and mindfulness-based approaches.

    A large 2006 clinical trial found behavioral interventions can be as effective as drugs — in fact, most of the medication clinical trials done to date have also included some form of social or behavioral treatment in combination with drugs.

    Having support is critical to keeping a positive mindset that will ultimately win the battle with alcohol, experts say.

    Brook agrees.

    “When I was doing my therapy intake for rehab, one of the questions was, ‘What made you decide to do this?’ And I said, ‘I’m better than this,’ ” she told Ling.

    “I still like to think that even with the relapses, I’m gonna still be that person who gets right back up and tries again.”

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