Plastics and Human Health

Oregon

Physicians for Social

Responsibility

http://www.flickr.com/photos/kfisto/364229989/

Introduction

•Chemical background:•Precaution vs. proof•Complex Interactions and vulnerability

•Concerns: •Endocrine disruptors•Dose response patterns

•Bisphenol-A•Phthalates•What you and your patients can do

OverviewIntroduction

Proven Harm

Partially Proven Harm

Not Yet Recognized Harm

Forever Unrecognized Harm

Precaution vs. Proof

http://www.flickr.com/photos/greenpeace_italia/2165953486/

Introduction

Complex Interactions

Introduction

Nutrition

Genetics

Health Outcomes

Social

Envir

onment

Toxic Exposures

Plastics As We Know Them:Safer vs. Not-So-Safe

1 - polyethylene terephthalate (new evidence)2 - high density polyethylene3 - polyvinyl chloride4 - low density polyethylene5 - polypropylene6 - polystyrene7 - other (often polycarbonate)

Plastics

Endocrine Disruptors

Alter, block, or mimic the

synthesis, transport, binding, or

metabolism of endogenous

hormones

Health

Interfere with embryonic

and postnatal endocrine

signaling, e.g. thyroid (new)

…Researchers expect more effects…

from e.hormone, at e.hormone.tulane.edu

from e.hormone, at e.hormone.tulane.edu

Potential Effects of Endocrine Disruption

• Falling age of puberty in girls– Declining conception rates (7)

• Obesity and diabetes• Heart Disease (new)• Male genital abnormalities• Regional decreases in sperm count • Cancers

– Breast– Prostate

• Neurobehavioral problems, e.g. autism, hyperactivity

Health

Does the dose make the poison?

Health

No exposure to endocrine disruptor

Very small in utero exposure

Bisphenol-A

http://www.flickr.com/photos/bframe/406051181/

BPA

Health Concerns

• Reproductive effects, male and female • Recurrent miscarriages• Insulin resistance, diabetes & obesity• Heart disease• Altered brain development (recent)• Cancers

– Prostate – Breast – Decreased antioxidant enzymes

• Altered immune function• Behavioral effects

– Alters attention, activity

Sources of BPA Exposure• Polycarbonate food and drink containers

• With heating• With repeated washing of material• With acidic or basic foods/liquids

• Maternal exposure• Breast milk • Prenatal exposure

BPA

“Significant” effects in 94 published in vivo studies (of 115)

– 90% of government-funded studies found adverse effects

– 0% of industry-funded studies found adverse effects

BPA

What You Can Do About BPA

• Avoid canned foods• Use alternatives to #7 baby bottles:

– Breast feed, glass bottles• Use alternative sippy cups:

– #2,4,5, glass• Use alternatives for storing food and water:

– glass, ceramic, safer plastics: #2,4, 5• Never heat/cook/microwave food in any

plastic

Phthalates

Health Concerns

• Endocrine system– Thyroid

– Insulin resistance • Obesity

• Diabetes

– Male reproductive problems

• Allergies, asthma

Phthalates

Potential Reproductive Effects

• High dose and low dose risk• Early puberty in females• Male reproductive effects:

– Lowered semen quality– Testes (Leydig) cells vulnerable

• Swan, et al. (2005) study on male infants:– Urine levels of mothers’ phthalate

metabolites positive correlation with shorter ano-genital distance (AGD)

– Supported by increasing male genital abnormalities http://www.flickr.com/photos/nirak/206930221/

Phthalates

In Consumer Products

• Vinyl plastic (PVC): toys, inflatable mattresses, shower curtains

• Fragrance: soap, lotion, detergent, air fresheners, etc.

• Other common products: paint, adhesive, solvent, car interiors

• Medical: time-released drugs/capsules, tubing, IV bags, gloves, bags containing plasma

Phthalates

Banned in Children’s Products

European Union 2005

San Francisco 2006

California 2009

United States 2009

Phthalates

What You Can Do About Phthalates

• Avoid using PVC (#3) – Use phthalate-free medical equipment– Toys, bottles, sippy cups

• Use fragrance-free products– Laundry– Personal care products– Cleaning– Air fresheners

Educate Your Patients About Avoiding BPA and phthalate

• Avoid using plastic containers in microwave, all cooking.– Cling wraps: beware especially in microwave or oven

• Use alternative packaging; especially with food & drink.

• Avoid plastic bottled water unless water supply questionable

• Bring your own take-home containers to restaurants• Avoid over-use of detergents or overly abrasive

cleaners for plastic items• Use alternatives to non-stick cookware, stain

resistant products

We can prevent toxic exposures to ourselves and the generations to come.

Resources• Environmental Health Perspectives

http://www.ehponline.org/• The Collaborative on Health and the Environment

http://www.healthandenvironment.org/• Environmental Working Group www.ewg.org• Agency for Toxic Substances and Disease Control

Registry www.atsdr.cdc.gov/• Oregon Department of Environmental Quality (DEQ)

http://www.oregon.gov/DEQ/• National Toxicology Program-Center for the Evaluation

of Risks to Human Reproduction (CERHR); http://cerhr.niehs.nih.gov/reports/index.html

• Our Stolen Future http://www.ourstolenfuture.org• Health Care Without Harm http://www.noharm.org• Lowell Center for Sustainable Development Chemicals

Policy Database: http://chemicalspolicy.org/uslegislationsearch.php

Types of Plastics

#1 - Polyethylene Terephthalate

• Food & beverage containers– Single-use water bottles– Microwave food trays– Food packaging films

• Clothing– Polyester, polar fleece

http://www.flickr.com/photos/brimelow/73092271/

http://www.flickr.com/photos/caobhin/194534255/

Plastics

Use one time, avoid heating or long-term storage;

Commonly recycled

#2 - High Density Polyethylene

• Opaque bottles– Milk jugs– Detergent bottles

• Gas tanks• Pipes and tubing• Plastic Lumber• Plastic bags

http://www.flickr.com/photos/tzofia/291301033/

http://www.flickr.com/photos/adamcnelson/2262436767/

http://www.flickr.com/photos/splorp/9322376/

Plastics

Use sparingly, commonly recycled

#3 - Polyvinyl Chloride (PVC)

• Teething rings• Pacifiers• Toys (inflatable)• Pipes, Tubing• Medical equipment• Shower curtains• Clothing• Synthetic leather• Window frames• Siding

http://www.flickr.com/photos/sisterdimension/540271784/

http://www.flickr.com/photos/artventuresgallery/184264587/

http://www.flickr.com/photos/ryosalem/227010700/

Plastics

Major health concerns – avoid and replace;Less commonly recycled

#4 – Low Density Polyethylene• Plastic wraps• Flexible bottles• Plastic baggies• Flexible tubing• Furniture• Dental appliances• Lab pipettes and

tipshttp://www.flickr.com/photos/sonnyandsandy/33707441/

http://www.flickr.com/photos/unprose/154829034/

Use sparingly, less commonly recycled

Plastics

#5 - Polypropylene• Trays• Food storage containers• Some baby bottles

http://www.flickr.com/photos/jdickert/2383258186/

Plastics

http://www.flickr.com/photos/seandreilinger/2450683425/

Use sparingly, less commonly recycled

#6 - Polystyrene

• Clear food containers• Styrofoam

– food trays– Disposable cups, bowls

• Packaging material• Insulation• Coolers• Lab equipment

http://www.flickr.com/photos/mr_enigma/62914044/

http://www.flickr.com/photos/crouchingdonkey/1162561710/

Plastics

http://www.flickr.com/photos/keuynish/163686563/

http://www.flickr.com/photos/tychay/1535108294/

Major health concerns - avoid use, less commonly recycled

#7 “Other” - often Polycarbonate

• Some baby bottles• Reusable drink bottles• Lining of food cans • Cutlery• Dental fillings, sealants• CDs

http://www.flickr.com/photos/iwantamonkey/127501910/

Plastics

Microsoft Clipart 2003

http://www.flickr.com/photos/reuvenim/2523549479/

Avoid use of polycarbonate (PC),less commonly recycled

Bioplasticsare also

labeled #7