What’s the fuss about toxic household cleaners, endocrine-disrupting compounds in sunscreen and non-stick cookware?
Episode 47 Transcript: Toxic Exposures in the home: Tips for a healthy family
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Dr. Wendy: Every new year I decide I’m going to start over and make my home healthier. I plan to replace my household cleaners with less toxic ones and only buy recycled paper toilet rolls and paper towels. And I never do it, because I don’t know which products to get, and when I do look for less toxic cleaners, they are more expensive and harder to find. Plus I’m not totally convinced its really that important to make these changes for the health of my family’s environment. I have plenty of reasons to go back to the same products I’ve been using for 20 years.
But last year, I did make one change. I was volunteering as a State Government Affairs representative from my local pediatrics chapter. Our job was to review new bills that were being proposed to the state legislature and advocate on behalf of children for any proposed legislation that would potentially affect kids – because they can’t vote. This one bill came up about per- and polyfluoroalkyl substances (PFAS) also known as “forever chemicals” they are a group of man-made chemical compounds that repel water, dirt, oil, and grease- found in food packaging, and water resistant clothing.
I had to review the bill and present it to the group. And of course I could’t pronounce PFAS at the time. But as I reviewed the science behind this, I was not thinking about how they would affect kids’ health. You know what I was thinking about? My kitchen pots and pans. They are all non-stick, and at least 12 years old, and scratched. And they are covered in PFAS – teflon. How much PFAS was I eating every day?
So I researched pots and pans and replaced my pans with ceramic pans. I don’t know if my family is being exposed to less of these chemicals. But I do feel smug. And the bills banning these substances in some textiles and other uses passed in CA.
Then, this year I was asked by a freelance journalist for Architectural Digest to make recommendations about the best crib mattresses from the perspective of a pediatrician. And I was thinking about their weight, fluffiness, etc. But I spent some time in the scientific literature on crib mattresses. And guess what? there are toxic chemicals in crib mattresses for crib’s sake! Are we being poisoned everywhere? Should we all be more thoughtful about the products we bring into our homes?
The answer is yes. This issue was not on my radar, but it is now. I’m going to share with you what I’ve learned and which products you need to be careful about in your home. And why.
This is not a political statement, there is now a lot of scientific evidence that a large number of chemicals known as endocrine-disrupting compounds or EDCs have significant effects on human health. These are chemicals found in food, water, household and beauty products that disrupt our hormone system. And if you don’t know what the hormone system is, it is a system of chemicals in our body that tell our organs what to do, the messengers of the body. They are responsible for growing, reproduction, metabolism, sleep and our immune responses. And EDCs are substances that can make our bodies make more of some hormones, less of others, interfere with their ability to send signals. And research shows us undeniably that they are causing long-term health effects.
They first got attention not because they were causing problems in humans, but they were causing problems with development and reproduction of fish, and birds.
That’s a long story and this is a total aside, but one of my patient’s fathers is an elephant trainer and told me that they weren’t successfully breeding rhinos at his zoo – I guess the rhino guys talk to the elephant guys – the rhino’s feed had so much soy in it and was disrupting their fertility from the estrogenic compounds in the feed. They swapped out the feed to not contain so much soy, and now they have a rhino baby boom. There’s some theory that plants evolved to have compounds that made fewer animals be born that eat the plant. Anyway, this was a naturally-occuring phenomenon. But we are being exposed to a number of compounds from the products we use everyday that are interrupting everything including our fertility.
Early studies of animal diseases related to toxic environmental exposures were dismissed for not being relative to humans. There are tons of examples of wildlife exposures leading to population decline and birth defects in populations as well as diseases in animals as wide ranging as alligators, birds, polar bears and orcas. The idea that these animal findings don’t apply to human disease now has been debunked. And guess which humans are most affected by these chemicals? Kids. They have a smaller body size, larger skin to body ratio, are closer to the ground and they put things in their mouth that adults don’t chew on. That’s why we should be even more concerned about our kids’ exposure to EDCs.
EDCs include a huge number of different substances – you’ve likely heard of bisphenol A or “BPA” found in plastics and phthalates.
We are exposed to them in every way – by eating them, in dust and water, inhaled gases and particles in the air, through skin contact and across the placenta and even in breast milk.
So you can’t get away from them – the only thing we can do is try to get them out of the environment.
The National Health and Nutrition Examination Survey (NHANES) by the CDC in 2004 found BPA in 93% of urine samples from people over age 6. One problem is that many of these substances are lipophilic – meaning they like fat and accumulate in fat tissues and release into the blood slowly over time. And these chemicals work together to cause problems. Combinations of different EDCs seem to have intensified effects in human breast tissue, ovaries and prostate cells according to studies.
There are also concerns about these chemicals in sunscreens. The chemicals we put on our skin that act as ultraviolet filters are absorbed into our skin and there is evidence of effects on brain and breast tissues in animal models, though human data is not available yet. For now, mineral-based sunscreens containing titanium dioxide and zinc oxide are recommended instead because they aren’t absorbed.
I don’t want to scare you too much – but there are so many research studies that show a connection between EDCs and human diseases, its’ overwhelming.
There was a lot of concern about BPA especially in kids because before it was banned it was in baby bottles, pacifiers, food packaging and children’s toys. Animal studies suggest BPA is associated with ovarian cysts, and cancers. Studies are ongoing and animal studies suggest a connection with PCOS, endometriosis, fibroids, altered reproduction in men, testicular cancer, prostate cancer, obesity, diabetes, autism and ADHD. Basically everything.
It’s too much data to summarize. The takeaway here is that there is enough information to show that we need to get these substances away from our children.
BPA has largely been banned from products that your children will come into contact with. But there is a new focus on a class of chemical compounds called PFAS.
As I said before, PFAS are a group of human-made chemicals known as “forever chemicals” because they don’t break down in the environment. They have a strong bond between the fluorine and carbon atoms that give them their very helpful ability to be stain resistant and make products non-stick when they are covered in these chemicals. That also means they resist degradation, so they migrate through our soil and into groundwater and our drinking water sources.
Dr. Jamie DeWitt is an Assoc professor of pharmacology and toxicology at East Carolina University, she researches these chemicals – here she explains more:
Dr. DeWitt: PFAS is actually an acronym for a class of close to 10,000 individual substances that are defined as per and poly floral alkyl substances. They are used in a phenomenal amount of products and processes, mostly as surfactants or as raw materials for agents that confer nonstick staying grease and water repellent properties.
Dr. Wendy: I mentioned a very long list of diseases that might be linked with these chemical compounds and obviously the problem is that there are 10s of thousands of these chemicals, they are everywhere in our environment and they have combined effects in the human body. So how do researchers know which of these chemicals are a problem? One way is by looking at groups who have known exposures, like in the military or firefighters who have worn fireproof turnout gear containing PFAS. Dr. DeWitt explains the ways that researchers study these chemicals:
Dr. DeWitt: One way is by performing epidemiological studies of people who have been exposed through their jobs, where they live, or even through everyday activities, and then asking is their exposure linked to health effects? Another way that we can ask questions about the potential effects of PFS exposure on human health is by performing studies with laboratory models. And through these studies with laboratory models, we can ask questions about individual pee fast and very specific types of health effects such as effects on the immune system, or effects on development or effects on the heart, for example. And when we tie all this information together, we start to develop an overall picture of what health effects really look like following P fast exposure. And from studies of people and studies of experimental models. We now have pretty good evidence linking PFS exposure to high cholesterol, a suppressed immune system effects on development effects on liver health effects on thyroid function and other endocrine functions, effects on pregnancy and people’s ability to get pregnant, as well as some effects on ulcerative colitis or auto immune endpoints. emerging data suggests that there might be a whole bunch of other health effects, which is one reason we call P fast multi system toxicants.
Dr. Wendy: Well that is a very long and scary list. Studies show that over 98% of Americans have detectable PFAS in their blood and body tissues. So, that’s all of us.
There’s another type of exposure that we need to be aware of inside our homes and this is from something called “off-gassing”. If you’ve ever noticed that new scent coming from your carpet, car interior, or crib mattress. That smell is off-gassing. It’s what happens when an object releases volatile organic chemicals (VOCs) into the air.
You might even be familiar with these chemicals because you have smelled them from cleaning products. There is even some evidence that crib mattresses release these chemicals and can cause problems for your baby. One study links these chemicals that go into the air from crib mattresses to cases of SIDS, though that hasn’t been confirmed. But just the theory of this connection makes me recommend being thoughtful about the crib mattress you choose. The release of these chemicals increase when the mattress gets warmer while the child is sleeping on it. So, I recommend mattresses without these harmful chemicals. Crib mattresses will specify they are non-toxic or are made with natural materials. There is a link to a good choice in the show notes.
What else can you do to prevent exposure to these chemicals in your daily life? That’s next.
Dr. Wendy: Products designed to be used by kids like kids’ pajamas, car seats, furniture, baby wipes, teething rings and art supplies all have historically contained toxic chemicals. Manufacturers are generally much more careful about the materials in their products now, and in a number of cases, federal and state laws have addressed the issue. For example lead has been removed from everything, flame retardants have been banned from children’s sleepwear, and bisphenol A or BPA has been removed from baby bottles and formula cans – but only recently. However, phthalates are still common in children’s changing table pads, bumper pads and soft toys. Volatile organic compounds (VOCs) are in art supplies like glues and markers, crib mattresses and now the safety of artificial turf fields is under investigation. They use recycled tires to cushion the field and they definitely off-gas. Another place to be careful is at gymnastic centers – the foam blocks have high levels of flame retardants.
Some states have focused on chemicals in kids’ products and have developed lists of high concern chemicals. Washington State developed a retailer and manufacturer document that lists products that contain chemicals of concern.
I mentioned that I want to swap out my household cleaners. There are just too many products out there with many different claims to even sort through. The best case example of concern in this category, and the chemical that has been studied the most is triclosan. It first appeared in hospital disinfectants and then moved into household cleaners. It is known to interfere with estrogen and thyroid hormone function, and there is strong evidence it increases the likelihood that a human will have an allergy in their airway and more likely to have asthma after exposure to triclosan.
So when you are looking for household cleaners, choose ones without triclosan and triclocarban as well as artificial fragrances, so read ingredients and don’t buy ones that list perfume or “parfum” on the label.
When you are choosing household cleaners and even make-up products and air fresheners, look for labels that say non-toxic, biodegradable, phthalate-free and fragrance free. That’s the best way to avoid these chemicals that we know cause health problems.
Besides finding cleaning brands that don’t contain these chemicals, you can limit your exposure by reducing the total number of cleaning products you use, this will reduce the range of chemicals you may be exposed to. For day to day cleaning you only need water and a mild soap. You can even make your own cleaners with ingredients like vinegar, lemon juice, baking soda, and Castile soap.
Next you want to make sure your water is safe. You can check your local water authority. Some states, but not all, require testing for the presence of several PFAS and they have to report elevated levels. However, not all states do this. If your local level is high, buy PFAS free bottled water for drinking and mixing baby formula. I’d recommend buying bottled water that contains fluoride to protect your kids teeth or talk to your dentist or pediatrician about fluoride treatment.
You can also get a water filter for your home. Reverse osmosis filters remove these chemicals.
But kids also use products that aren’t designed specifically for them like sunscreen, but even baby sunscreen is not regulated and can contain known endocrine disruptors like oxybenzone. Similarly, insect repellants, toothpaste and soaps can contain these chemicals.
In terms of indoor environmental exposures, paint can be a source of exposure and manufacturers now make VOC-free paints. Studies of children in recently painted homes show an increase in respiratory infections.
Be aware of new shower curtains that can off-gas phthalates and air freshener sprays that contain stabilizers and fragrance chemicals of which most are chemicals that are on the lists of potentially concerning but don’t yet have enough human studies to ban them.
The other concern is that complications during pregnancy have increased over the past few decades and many scientists explain that exposure to these kinds of chemicals is one of the potential contributors to this problem.
Dr. DeWitt at East Carolina University works with PFAS chemicals in her lab and is careful to not release the byproducts of her research into the environment. Here’s what she said when asked about how she avoids them in her own life:
Dr. DeWitt: I also tried to educate myself about where my water comes from. I know that my water comes from the Tar River, and I can look up information for my utility company about the last time they measured pee fast in water from the power river so I can find out what pee fast and what amounts are in my drinking water. I also tried to educate myself about companies that have really made a commitment to phase pee fast out of their products and processes. And I try to purchase products from those companies so that I can support their environmental stewardship and their their moves towards sustainability.
Dr. Wendy: When you’re bathing, you don’t need an alternative water source because the chemicals aren’t absorbed through the skin.
PFAS is found in house dust, that’s why kids who are on the floor more than adults are more at risk. So use a wet mop to limit household dust. and consider changing your heating duct filters to HEPA filters.
Watch for non-stick fast food containers and microwave popcorn packaging that is non-stick inside. Most brands don’t use these chemicals, but it hasn’t been completely removed.
Replace your old or cracked nonstick cookware with cast iron or stainless steel. Or search for ceramic cookware without PFAS. Read the information about the materials that pans are made from. Brands like Caraway are non-stick ceramic and specify they don’t contain these harmful chemicals.
Instead of plastic toys, look for wood or cotton toys.
It’s really the responsibility of the government to make sure we are protected and for us to be aware of legislation in our state about these chemicals. The problem is the sheer variety of products that have EDCs in them. The other issue is that we don’t really know who is responsible for regulating these chemicals. Is it the responsibility of the Food and Drug Administration? The Environmental Protection Agency? The Department of Agriculture or the Defense Department? They all play a role. And the National Defense Authorization Act for 2023 does have provisions to reduce use of and cleanup PFAS pollution.
Some individual states are banning chemicals that aren’t banned by the federal government. And just so you know, nothing has been done about sunscreen ingredients, and many other products our families use. So it’s up to us to minimize our exposure
It is possible to test for PFAS, but testing isn’t widely available and can be expensive. And the truth is, you should assume your child has been exposed and do what you can to limit further exposure. There really isn’t any treatment to reduce what’s already in your body anyway.
The long-term cumulative effects of exposure to PFAS, phthalates, and other endocrine disrupting compounds in consumer products are subtle and may be missed because they are what we call “the fetal basis of adult disease” which means our exposures even as early as when we are in the womb lead to disorders much later in life.
The American Academy of Pediatrics has said the regulation of chemicals under the Toxic Substances Control Act is ineffective in protecting children, pregnant women and the general population from hazardous chemicals”.
The government has been slow to act to protect us, largely because the regulatory methods in place take a long time, so it’s really up to you as an individual to buy products thoughtfully and to share this information.
Our purchasing power is our voice.
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