The Global Fool

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Global Threats: Children’s Exposure to Toxic Pesticides
May17

Global Threats: Children’s Exposure to Toxic Pesticides

By Roberta Attanasio In 2012, the American Academy of Pediatrics (AAP) released a policy statement to outline the harmful effects of pesticides in children, and to make recommendations on how to reduce exposure. According to the statement, prenatal and early childhood exposure to pesticides is associated with pediatric cancers, decreased cognitive function, and behavioral problems. In addition, the statement pointed out that recognizing and reducing children’s exposure to pesticides requires improved medical training, public health tracking, and regulatory approaches, and made recommendations on specific actions that should be taken to decrease such exposure. Despite the recognition of the dangers associated with pesticide use, and the AAP recommendations on limiting children’s exposure, not much has been done since 2012 — indeed, it’s likely going to get worse before it gets better. The AAP recommended that pediatricians should ask parents about pesticide use around the home and yard, offer guidance about safe storage, and recommend parents choose lowest-harm approaches when considering pest control. Are pediatricians following these recommendations? At this time, let’s say this is an open-ended question — although we may guess what the correct answer is. Let’s now move from the local (the American Academy of Pediatrics – AAP) to the global (the Food and Agricultural Organization of the United Nations – FAO). According to the International Labour Organization (ILO), nearly 100 million boys and girls between 5 and 17 years old are engaged in child labor in agriculture. Many are directly exposed to toxic chemicals while working on the farm — however, children are also exposed when they help with family chores or play, and through the food they eat and the water they drink. Exposure can result in acute poisoning and sickness immediately after contact. But often, it also has longer-term, chronic impacts on their health and development. Children are particularly vulnerable to pesticide exposure for various biological and behavioral reasons. They breathe in more air than adults and so take in more dust, toxic vapors, and droplets of spray. Relative to their body weight, children need to eat and drink more than adults, and if food is contaminated, they absorb more toxins. The surface area of a child’s skin per unit of body mass is greater than that of an adult, and their skin is more delicate. All these factors can lead to greater absorption of chemicals, and children’s organs are less able to detoxify pesticides because they are not yet fully developed. Now, recognizing that education is crucial to limit exposure to pesticides (as stated by the AAP in 2012), FAO and ILO extension workers in Africa and elsewhere are engaging with rural communities to reduce...

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Dante’s Fainting: A Medical Enigma from the Middle Ages
May15

Dante’s Fainting: A Medical Enigma from the Middle Ages

A guest post by Michele A. Riva 2015 is the 750th anniversary of the birth of the Italian poet Dante Alighieri (1265-1321), the author of the literature masterpiece the Divine Comedy. Written between 1304 and 1321, the Divine Comedy is an epic poem that describes Dante’s imaginative and allegorical journey through Hell, Purgatory, and Heaven. The poem has inspired not only the creative efforts of illustrious authors such as William Shakespeare, Geoffrey Chaucer and John Milton, but also an ongoing debate on the “medical conditions” that are so frequently depicted in it. During his Hell-Purgatory-Heaven journey, Dante frequently experiences symptoms such as loss of consciousness, hallucinations and fainting, which he relates to love and passion, fear and anguish, and mysticism. However, a few medical scholars think these symptoms could be mirroring a real pathological condition that affected Dante since childhood. So, for these medical scholars, the question is: what is the most likely pathological condition that was causing Dante’s symptoms? Narcolepsy is one of the possible answers. Narcolepsy is a disorder characterized by excessive sleepiness, associated with hallucinations, episodes of muscle weakness and subsequent falls, which are always triggered by strong emotions. So, all the Divine Comedy could be interpreted as a result of hallucinations in a subject afflicted by a sleep disorder. Emotional syncope might also explain Dante’s loss of consciousness. This condition, one of the most common causes of fainting, causes a sudden drop in heart rate and blood pressure. It occurs in response to triggers such as scary, embarrassing or uncomfortable situations, as well as instances of high stress or trauma, similar to those that Dante experiences during his journey. Finally, another possible, and even more intriguing explanation of Dante’s fainting is related to food/drink depletion. According to the poet, his journey in Hell starts on the night of April 8, 1300, and ends in Paradise one week later, on April 15. During the whole passage through Hell, which lasts about 48 hours, he keeps walking, and he neither eats, nor drinks. Ditto for his journey through Purgatory. Thus, for five days, he goes with no water, and no food — at the same time, he is experiencing heavy emotional distress. After his last collapse in Purgatory, his guide Beatrice throws him into the Lethe river — Dante drinks for the first time in his long journey. He does not faint anymore. But, what about the high temperatures he has to endure while walking in Hell? This is certainly another factor that might have contributed to his distress and caused the multiple syncopes he experiences there. We’re attempting to diagnose potential disorders that affected Dante’s health....

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Clean Air: The Effects of U.S. Power Plant Carbon Standards on Human Health
May04

Clean Air: The Effects of U.S. Power Plant Carbon Standards on Human Health

By Roberta Attanasio A little more than a year ago, the World Health Organization (WHO) reported that in 2012 around 7 million people died — accounting for one in eight of total global deaths — as a result of exposure to air pollution. These estimates more than doubled the previous ones, and confirmed that air pollution is now the world’s largest single environmental health risk. The WHO concluded that reducing air pollution globally could save millions of lives. But, what policy changes would be most effective at saving lives? The answer comes from a new study published in the journal Nature Climate Change (May 4, 2015.) The study, (US power plant carbon standards and clean air and health co-benefits), was based on data from the Census Bureau as well as detailed maps of the more than 2,400 fossil-fuel-fired power plants operating across the U.S. It outlines how changes in carbon dioxide emissions could lead to considerable health benefits for the U.S population. According to the WHO, the diseases caused by air pollution include ischemic heart disease (40%), stroke (40%), chronic obstructive pulmonary disease (11%), lung cancer (6%), and acute lower respiratory infections in children (3%). For the new study, the researchers analyzed three possible policy options for power plant carbon standards. The policy option leading to the biggest health benefits was the one that included changes proposed by the U.S. Environmental Protection Agency (EPA) on June 2, 2014, in the Clean Power Plan. Modeling analysis indicated that this option could prevent an expected 3,500 premature deaths in the U.S. every year, and avert more than a thousand heart attacks and hospitalizations annually from air pollution-related illness. Thus, according to the study, the formula presented in the draft Clean Power Plan is on the right track to provide large health benefits, and these health benefits depend entirely on critical policy choices that will be made by the EPA in the final Clean Power Plan expected in July. The Plan is the nation’s first attempt to establish standards for carbon dioxide emissions from power plants. It is also viewed as an important signal of U.S. leadership in the run-up to international climate negotiations in Paris in December. Jonathan Buonocore, one of the researchers involved in the study, said in a press release: “If EPA sets strong carbon standards, we can expect large public health benefits from cleaner air almost immediately after the standards are implemented.” Power plants are the nation’s largest source of carbon dioxide emissions that contribute to climate change. However, they release not only carbon dioxide, but also other pollutants such as sulfur dioxide, nitrogen oxides and particulate matter — precursors to smog and...

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Prenatal Exposure to Air Pollutants: Links to Attention Deficit Hyperactivity Disorder
Apr11

Prenatal Exposure to Air Pollutants: Links to Attention Deficit Hyperactivity Disorder

By Roberta Attanasio PHAs — short for polycyclic aromatic hydrocarbons — are bad actors: they’re toxic, ubiquitous pollutants that readily cross the placenta, causing damage to the fetal brain. Now, results from a new study show that PHA-induced fetal brain damage may lead to severe behavioral problems during early childhood, including aggression and attention deficit hyperactivity disorder (ADHD). The deleterious effects of air pollution — greater risk of stroke, heart attacks and cognitive deterioration — are widely recognized. However, the new study assessed prenatal exposure and identified specific physical damage in the brain. The researchers used magnetic resonance imaging to measure the brains of 40 children from a cohort consisting of more than 600 mother-baby pairs. The mothers were either Latina (Dominican) or African American nonsmoking women from minority communities in New York City, aged 18 to 35 years. During the third trimester of pregnancy, the women carried personal backpack monitors that measured exposure to eight common PAHs over 48 hours. Such exposure occurred by breathing contaminated air. PHAs — common components of air pollution — are often found together in groups of two or more and persist in the environment for long periods of time. They’re generated by motor vehicles, waste incineration, wildfires and agricultural burning, and oil and coal burning for heat and electricity. Cooking (especially charred foods), tobacco smoke, and space heaters are indoor sources of PHAs. Low-income, urban, and minority communities are disproportionately exposed to these air pollutants. The researchers had previously demonstrated that exposure of the pregnant women from the same cohort to airborne PAHs was associated with multiple neuro-developmental disturbances. Results form the new study indicate that such disturbances have a biological root in the altered architecture of the brain. Specifically, PHA exposure was linked to reductions of the white matter surface in later childhood. These reductions were confined almost exclusively to the left hemisphere of the brain, and involved almost its entire surface. The researchers don’t know why the left side seemed to be affected more, but they suspect the compounds interfere with an early biochemical process that helps the fetal brain divide into slightly asymmetrical hemispheres. Results from the study also show that postnatal PAH exposure correlates with white matter surface measures in other regions of the brain, the dorsal prefrontal regions. Thus, the children involved in the study were exposed to “a double hit”, first as developing fetuses, and then at an early age. Indeed, Bradley Peterson, lead author of the study, told the Los Angeles Times: “It’s a double hit. They have the abnormality from prenatal life throughout the left hemisphere and then on top of that they have...

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The Global Travels of Chikungunya Virus: Is it Coming to You?
Mar30

The Global Travels of Chikungunya Virus: Is it Coming to You?

By Roberta Attanasio Chikungunya virus is spreading fast — worldwide. First described during an outbreak in southern Tanzania in 1952, it caused sporadic illness in Africa and large urban outbreaks in Thailand and India in the 1960s and 1970s. As of now, it has been identified in over 60 countries in Asia, Africa, Europe and Americas. The virus, which causes fever and severe joint pain, is transmitted to humans by the bites of infected female mosquitoes, most commonly by Aedes aegypti and Aedes albopictus — two species that can also transmit other mosquito-borne viruses, including dengue. There is no vaccine and no specific treatment for the infection. Gemma Handy aptly describes the onset of the disease in an Antiguan patient: “The acute ache started in her ankles before quickly spreading through her body, crippling her muscles, pounding her joints and leaving her hands and feet severely swollen.” The patient said: “”I was fine when I went to bed, but when I woke up in the morning and tried to get up my ankles hurt so much I couldn’t stand. It was very scary. After that I started getting different pains all over my body. Soon my hands were so swollen I couldn’t hold anything.” Indeed, “chikungunya” derives from a word in the Kimakonde language, which is spoken by the Makonde, an ethnic group in southeast Tanzania and northern Mozambique — it means “to become contorted”, and describes the stooped appearance of sufferers with joint pain. Most patients recover fully, but in some cases joint pain may persist for several months, or years — and even become a cause of chronic pain and disability. In 2007, disease transmission was reported for the first time in a localized outbreak in north-eastern Italy. Outbreaks have since been recorded in France and Croatia. According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Chikungunya virus in the Americas was identified in Caribbean countries and territories in late 2013 — local transmission means that mosquitoes in the area have been infected with the virus and are spreading it to people. Beginning in 2014, Chikungunya virus disease cases were reported among U.S. travelers returning from affected areas in the Americas and local transmission was identified in Florida, Puerto Rico, and the U.S. Virgin Islands. The current numbers of people infected with the virus within the Americas are staggering: the Pan-American Health Organization reports that, as of the end of February 2015, the initial handful of cases had exploded to 1,247,400 suspected and confirmed cases, affecting almost every country in the hemisphere. After the first locally acquired case of Chikungunya was reported...

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