STUDY: Environmental Risks for Cancer in Kids

JOURNAL: Environmental Protection Agency

AUTHORS: Ramona Trovato

ABSTRACT: Children under 2 years of age have a much greater chance of getting cancer from exposure to certain chemicals than do adults, the Environmental Protection Agency concludes in a new risk assessment.

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COMMENTARY: According to the analysis, which focused chemicals that cause damage to genes, the risk of a future cancer is 10 times greater for a child under age 2 than for an adult who is similarly exposed.

Children from 3 to 15 years of age face a risk at least three times greater than adults when exposed to these chemicals, the proposed EPA guidance said.

The analysis was confined to so-called mutagenic chemicals that cause damage to genes thereby making a person more susceptible to getting cancer later in life.

But EPA scientists said children may well be more vulnerable when exposed to other types of cancer-causing chemicals as well, although the scientific data is not yet sufficient to make any conclusions on that.

Nevertheless, the proposed guidance would represents a major change in how cancer risk to children is viewed by EPA regulators. Currently the agency assumes in when assessing a chemical that children are no more vulnerable to cancer than adults if exposed to the substance.

"This (new assessment) is really a significant step forward in understanding how environmental exposure affects our children," said Ramona Trovato, an EPA official who has spent the last five years studying environmental pollution and children.

The proposed guidelines on children is to be reviewed by the EPA science advisory board, probably in May, with a final guidance likely to be issued this summer, said Bill Farland, the EPA's acting assistant administrator for science.

"We think this guidance on assessing children's cancer risk is going to evolve for a number of classes of compounds ... as we get more information. "We have long talked about the need to assure that we're protecting sensitive sub-populations and sensitive life stages."

The EPA assessment notes that children generally are expected to have exposures to chemicals that are different from adults because differences in their size, physiology and behavior. Children and adults exposed to the same concentrations of a chemical also may receive different internal doses because of differences in intake and absorption rates, the assessment said.

The EPA assessment was based mainly on a review of animal studies involving five mutagenic compounds and from data collected in studies of survivors of atomic bomb blasts in Japan at the end of World War II, said James Cogliano, an EPA scientist.

Most of the chemicals that were studied involve industrial applications, ones to which infants would not likely be easily exposed, said Farland.

One of them, benzopyrene, is a carcinogen found in cigarette smoke and auto exhausts; another, benzidine is used in the manufacture of dyes, while a third, vinyl chloride, is used in making plastics.

But the findings suggest, when more studies come in, the same disparity on risk between adults and the very young may well be observed although in existing studies "you see mixed results," said Cogliano. "Sometimes there was a higher cancer risk, sometimes there was not."

Environmentalists embraced the new focus on children.

"We're very happy that they've recognized that children under 2 years of age are really very susceptible," said Jennifer Sass, a scientist in the public health program at the Natural Resources Defense Council.

EPA officials said the new guidelines will more accurately reflect cancer risks than methods now in use.

STUDY: Procedure detects change in structure of blood protein

JOURNAL: Ischemia Technologies

AUTHORS: FDA

ABSTRACT: Doctors have won federal approval of a new blood test to help them tell which patients suffering chest pain aren’t really having a heart attack.

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COMMENTARY: The FDA approved a simple blood test that, when added to heart checks, could greatly improve doctors’ ability to rule out a heart attack and send those patients home sooner. The $30 test, made by Ischemia Technologies Inc. of Denver, uses the metal cobalt to hunt changes in a blood protein that occur during a heart attack.

Today, two tests are standard for heart-attack detection: an EKG to measure the heart’s electrical activity, and a blood test that detects troponin, a protein present in the blood after a heart attack.



In a study of 200 patients, doctors were 50 percent accurate in ruling out a heart attack using just an EKG and troponin test. But when they added the new test, doctors accurately ruled out a heart attack 70 percent of the time, FDA said.

A blood protein called albumin undergoes changes in its structure during a heart attack and certain other illnesses. In 1995, a Denver emergency room physician discovered that when cobalt was added to a blood sample, more of the metal would bind to normal albumin than to the changed albumin of a heart-attack victim.

The company created a way to measure that cobalt-albumin reaction using chemical-analyzing equipment standard in hospital laboratories.

But the new test must be used with standard heart-attack tests. It’s far from perfect, so using it alone could prove deadly, FDA’s Gutman said.

STUDY: Increases the activity of brain acetylcholine and choline acetyltransferase

JOURNAL: 28th International Stroke Conference: Abstract P327. Presented Feb. 14, 2003.

AUTHORS: Jinzhou Tian, MD

ABSTRACT: Ginseng may help improve memory in patients with mild dementia following a stroke, according to the results of a randomized pilot study reported at the American Stroke Association's 28th International Stroke Conference.

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COMMENTARY: Chinese ginseng has been used for centuries in China to treat disease and aging.

Chinese ginseng strikingly improves learning and memory following transient cerebral ischemia in rats. It increases the activity of brain acetylcholine and choline acetyltransferase in aged mice, while reducing the activity of acetylcholinesterase in the cerebral cortex and hippocampus.

In this randomized, double-blind, controlled clinical trial, 40 patients with mild and moderate dementia after ischemic stroke (26 men and 14 women) received one tablet of compound Chinese ginseng (n = 25) or one 40-mg tablet of almitrine + raubasine (n = 15), three times daily for 12 weeks.

The ginseng compound was extracted from Chinese ginseng roots, leaves, and panax notoginseng. The combination of almitrine and raubasine is thought to increase oxygenation in brain tissue.

After treatment with Chinese ginseng, mean scores on the HVLT and total memory scores increased significantly (P < .05 and P < .001, respectively).

Improvements in episodic memory function assessing immediate and delayed story recall, delayed word recall, verbal learning and verbal recognition, and visual recognition were greater in the ginseng group than in the almitrine + raubasine group.

"There is currently great interest in studying herbs used in traditional forms of medicines, and the problem of dementia after stroke is a significant one," says Robert J. Adams, MD, chairman of the Stroke Council of the American Heart Association. "This work showing that ginseng may improve memory after stroke needs to be further studied, with larger sample sizes. A placebo-controlled study would also be the next step.

STUDY: Conditions in the womb, which can influence birth size, might also influence the risk of breast cancer later in life.

JOURNAL: BMJ 2003;326:248-251.

AUTHORS: Dr. Valerie McCormack

ABSTRACT: Birth size, as determined by birth length and head circumference, is directly related to the risk of developing premenopausal breast cancer.

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COMMENTARY: However, the link between birth size and breast cancer was not seen among women older than 50 years of age, lead author Dr. Valerie McCormack, from the London School of Hygiene and Tropical Medicine.

Dr. McCormack said that the current study was undertaken to investigate how conditions in the womb, which can influence birth size, might also influence the risk of breast cancer later in life.

Based on the findings, Dr. McCormack suggested that larger infants may have been exposed to different levels of growth hormones in the womb, and that the in utero environment may have played a role in determining breast cancer risk.

In the study, the researchers reviewed information from 5358 singleton females born between 1915 and 1929. Data from the Swedish Cancer Registry were analyzed to determine which subjects developed breast cancer.

The researchers found that 359 of the subjects developed breast cancer, with a median age at diagnosis of 62 years.

Women who weighed at least 4000 g at birth were 3.5 times more likely to develop breast cancer than were women with birth weights below 3000 g.

Although birth weight was related to breast cancer later in life, the link was no longer significant after accounting for birth length and head circumference. In contrast, birth length and head circumference remained significant predictors of future disease even after adjusting for birth weight.

Among infants of similar birth size, the researchers found that the gestational age at birth was inversely related to the risk of breast cancer.

These findings suggest that the hormones that influence body length and head circumference also play an important role in later cancer risk.

STUDY:

JOURNAL: Ann Intern Med 2003;138.

AUTHORS: Dr. Bent

ABSTRACT: Compared with other herbal products, ephedra is far more likely to cause adverse effects.

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COMMENTARY: Based on an analysis of reports to the American Association of Poison Control Centers, Dr. Stephen Bent and his colleagues discovered that products with ephedra accounted for 64% of the herb-related adverse reactions in 2001.

This finding is remarkable, the authors note, given that less than 1% of herbal products sold that year contained ephedra.

Although awareness of the potential dangers of ephedra is growing among consumers, many still purchase ephedra-containing products.

Using data from case reports alone, it has been difficult to definitively link ephedra with various adverse effects, Dr. Bent said. But the finding that ephedra is linked to far more side effects than other herbs adds support to the theory that the substance can be dangerous, he said.

How ephedra stacked up against other products varied from herb to herb, Dr. Bent and his colleagues note -- but in all cases, it outnumbered other products in adverse reactions.

Overall, there were 1178 adverse reactions reported for ephedra, compared with 28 for ginkgo biloba, 31 for St. John's wort and 69 for Echinacea, among others.

My Comment is that Ephedra has always been the whipping boy of the herbal industry. Used properly I have never had a problem with it. It is the abuse of it that causes the issue.

Like everything else I don't see alcohol or tobacco being banned and these two items cause far greater adverse outcomes.