---- forwarded message ----
Date: Wed, 08 Oct 2003 16:35:25 -0600
From: Teresa Binstock <[EMAIL PROTECTED]>
Subject: Testing people for pollutants: when breast milk talks, people listen
Testing people for pollutants
A study looking for environmental toxins in breast-milk
samples puts California at the forefront of the biomonitoring movement.
By Shari Roan LATimes Staff Writer
October 6, 2003
http://www.latimes.com/features/health/la-he-biomonitoring6oct06,1,1246713.story
Torrance is home to a hazardous waste site; the Central Valley uses copious
amounts of pesticides; and Marin County has an unusually high, and puzzling,
rate of breast cancer. For scientists and environmental activists, these
disparate locations are the ideal proving ground for a new theory. They believe
that environmental pollutants may play a role in various diseases, such as
breast cancer. To prove their hypothesis, they have begun collecting breast milk
from new mothers in all three locations.
In doing so, they've placed California in the vanguard of a national
biomonitoring movement.
Biomonitoring involves looking for "pollution in people" ? testing bodily
substances, usually blood and urine, for the presence of harmful substances,
such as dioxins, polychlorinated biphenyls, or PCBs, and DDT. Traditionally,
estimates of human exposure to toxic substances have been based on measurements
of chemicals found in food, soil, air and water.
Because many chemicals accumulate in the fat cells of the breasts, the milk of
new mothers ? particularly during the first few weeks of nursing ? contains a
high concentration of chemicals. Testing the milk could offer insight into any
possible connection between pollution and disease.
"Biomonitoring is telling us what's in our bodies and are [the levels of those
toxic substances] going up or down ? are there things we need to worry about?"
says Kim Hooper, a state scientist who is co-directing the breast-milk
biomonitoring study in Torrance, the Central Valley and Marin County. That
study, of 120 women, is conducted by the Environmental Protection Agency and is
already underway.
Activists in the field of breast cancer, frustrated that genetics and diet only
partly explain the dramatic rise in rates of the disease in the past 50 years,
are pushing to expand biomonitoring even further. They want a statewide program
that will focus on possible causes of breast cancer as well as other diseases.
Legislation sponsored by the Breast Cancer Fund, a nonprofit health advocacy
group, would ? among other things ? make California the first state in the
nation to regularly test mothers' milk for dangerous chemicals.
"It became very clear to us that what is not being addressed is the unexplained
risk factors in breast cancer," says Jeanne Rizzo, executive director of the
group. "We saw more and more science connecting synthetic chemicals with breast
cancer."
But efforts to use the relatively new science of biomonitoring is not without
criticism. Some experts say that information from biological samples could be
used by insurance companies or in hiring to discriminate against people or
communities. Other experts worry that a detailed accounting of what's in breast
milk could cause some women to stop nursing their babies. Focusing on chemicals
in breast milk, they say, might inadvertently suggest that breast-feeding is not
safe.
Regardless, biomonitoring's time seems to have come. Technological advances have
made it possible to detect a wider array of chemicals in the body at much lower
levels than before. The federal Centers for Disease Control and Prevention
launched a study two years ago to examine blood samples from 5,000 Americans,
citing evidence that chemicals may be influencing rates of cancer, asthma,
autism, birth defects and Parkinson's disease.
Such advances coincide with mounting concern about environmental links to breast
cancer, in particular. Studies suggest that fewer than half of breast-cancer
cases can be explained by known risk factors, such as genetic traits and
reproductive patterns. American women today have a one in eight chance of
developing the disease, up from one in 22 in the 1940s.
Leading cancer researchers have endorsed breast-milk biomonitoring as an
important new direction in breast cancer research.
More than 85,000 synthetic chemicals have been introduced in the last 50 years
for industrial, farming and other uses, yet more than 90% of them have not been
tested for their effects on human health. However, studies have linked 46
chemicals to mammary tumors in animals, according to the National Toxicology
Program.
Previous breast-milk biomonitoring studies, performed mostly in Europe, have
detected more than 200 toxic substances in breast milk, including dioxins
(industrial byproducts), DDT (a pesticide) and PCBs (chemicals used to make an
array of products).
Two recent breast-milk biomonitoring studies showed high amounts of
flame-retardant chemicals ? called polybrominated diphenyl ethers ? in U.S.
women. Those relatively small-scale studies were conducted by the Environmental
Working Group, a nonprofit organization, and the University of Texas, Houston.
Health activists in communities with known environmental hazards have long
sought to draw attention to the potential risks of living in such areas, says
Cynthia Babich, a longtime environmental activist. She once lived near the
federally designated Del Amo Toxic Waste Site in Torrance, a Superfund site
contaminated with DDT, a cancer-causing chemical that is now banned in the U.S.
Her house and others were razed several years ago in order to clean up the
contamination.
While biomonitoring may turn up bad news, the information is important to
safeguard the community, says Babich, who is helping to coordinate the EPA study
in Torrance. The idea that even the very youngest members of the neighborhood ?
newborns ? could be affected by environmental contamination might make people
sit up and take notice.
"I think it's important for science to understand what our body burdens are,"
she says. "People act like it doesn't matter that we have DDT in our blood.
Maybe breast-milk biomonitoring will be something that will make people pay
attention."
Scientists caution that biomonitoring can only contribute preliminary
information about cancer and toxic exposure. While biomonitoring almost always
yields evidence of some chemical exposure, what that exposure means to human
health may require years of study.
"If a chemical accumulates in breast fat and it is a carcinogen, I would want to
look at it very closely. But we have to be careful. We can't assume everything
in breast milk is related to breast cancer," says Dr. Gina Solomon, a senior
scientist at the Natural Resources Defense Council, an environmental group that
sponsors a Web site to promote both breast-feeding and biomonitoring.
And, says Patricia Buffler, an epidemiologist at the UC Berkeley School of
Public Health, the principal investigator of last year's conference: "The theory
is that breast milk is better than other bodily fluids in telling the story of
environmental exposure because chemicals are stored in fatty tissue. But we
don't know if that is true."
The purpose of the proposed state biomonitoring legislation is not to uncover a
smoking gun, backers say. Instead, the program, which would include collecting
blood and urine samples, would attempt to point out trends in chemical
exposures, identify disproportionately affected communities, link exposures to
disease, assess the effectiveness of current regulations and set priorities for
research and legislation.
The bill, SB 689, proposing this two-year program, was introduced by Sen.
Deborah Ortiz (D-Sacramento) and passed a Senate committee before stalling. The
bill will be reviewed in January.
The bill has garnered widespread ? although not unanimous ? support.
Like any research involving donated biological samples, unethical or sloppy
research could result in the misuse of that information. For example, detection
of a particular pollutant that causes cancer, at least theoretically, could be
used by health insurers to deny coverage or for other forms of discrimination,
says James Hodge, deputy director of the Center for Law and the Public's Health
at Johns Hopkins Bloomberg School of Public Health in Baltimore. If individuals
in a community were found to be carrying high levels of a harmful substance,
entire communities could be branded with that information.
"This is a new type of health surveillance involving sensitive health data,"
Hodge says. "Any time we're testing any individual through any bodily sample,
there are privacy concerns at the core."
However, much like the EPA-funded study already underway, a state program would
be voluntary. Individual results would be confidential and study subjects would
be counseled about the findings ? a way to address fears over privacy invasion
and misuse of the data, proponents say.
The $150,000 EPA study was funded in part to demonstrate how researchers can
conduct biomonitoring in a particular community without alienating its
residents, Hooper says. The major scientific goal of that study is to look for
evidence of flame-retardant chemicals in breast milk.
But information gleaned from breast-milk biomonitoring may undermine a different
health objective. Several health groups say they fear biomonitoring will
frighten women from nursing their infants.
Leaders of La Leche League, an international breast-feeding education
organization, view breast-milk biomonitoring with trepidation.
"Yes, we have to clean up the environment, but don't use breast milk as the call
to arms. It will get attention but it will have a very negative effect," says
Marian Tompson, one of the organization's founders. "I know well-educated women
who have been scared away from breast-feeding because they have read about
contaminants in breast milk."
Traditionally, American women have been far less likely to breast-feed compared
with other cultures, despite the many health and economic advantages associated
with nursing. However, researchers reported in December that 69.5% of mothers
now breast-feed in the early postpartum period ? the highest levels in at least
half a century in this country ? and rates are rising by 2% per year.
Barbara Brenner, executive director of Breast Cancer Action, a San
Francisco-based breast-cancer advocacy organization, says her group withdrew its
support for the biomonitoring legislation after becoming concerned about the
potential impact of the studies on breast-feeding.
"We were hearing increasingly from people working with new mothers about the
challenges, particularly in the United States, with getting people to
breast-feed at all," Brenner says. "We are concerned that an emphasis on
breast-milk biomonitoring is going to make that problem worse, not better."
Dozens of studies point to the benefits of breast-feeding. For babies,
breast-feeding has been linked to enhanced immunity; resistance to infection and
allergies; a lowered risk of obesity, diabetes and several childhood diseases,
and higher intelligence.
Breast-feeding appears to be good for mothers too. Studies show that
breast-feeding for one year or longer can reduce the risk of breast cancer.
Biomonitoring proponents say the studies can be accomplished without affecting
breast-feeding rates. For example, the state Senate bill would include funding
for public education to explain that breast-feeding ? even with contaminated
milk ? is still the best choice for infant nutrition.
It's even possible that the nutritious components in human breast milk help
protect a baby from exposure to pollutants. Any substances in a mother's body is
likely be transferred to a fetus via the bloodstream, experts say.
Breast-feeding, though it can transfer toxic substances, is considered such an
ideal food for babies that it may help fight cell damage caused by in utero
chemical exposure.
"The little we do know is it looks like any damage [from pollutants] happens to
the fetus in utero and breast-feeding tends to reverse that damage," Hooper
says.
Rizzo, of the Breast Cancer Fund, notes that biomonitoring has not caused a
decline in breast-feeding in Sweden. Yet the discovery of toxic flame-retardant
chemicals in breast milk led to a swift ban on the chemicals in that nation.
"They said: You know what? Flame retardants shouldn't be in breast milk ?
whether there is a link to breast cancer or not," Rizzo says. "When breast milk
talks, people listen."
*
(BEGIN TEXT OF INFOBOX)
Monitoring breast milk
Testing breast milk can detect chemicals that accumulate in the body. These
substances are released when a new mother
nurses, providing a snapshot of chemical exposures over time. Some of these
chemicals include:
? Dioxins: These industrial byproducts have been linked to cancer as well as
reproductive problems and the disruption of
hormones.
? Organochlorine pesticides: These chemicals, used on crops, are sometimes
called endocrine-disruptors because they
mimic the female hormone estradiol, causing breast cells to proliferate.
? Polybrominated diphenyl ethers: This class of widely used flame retardants
has only recently been recognized as
potentially harmful to infant brain development.
? Polychlorinated biphenyls: PCBs are banned but remain in the environment.
They were used to make adhesives, paints,
lubricants, coolants and many other products. High levels of exposure have been
linked to problems in infants, such as low
birth weight.
Copyright 2003 Los Angeles Times
*
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