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Lead, Tobacco Exposure Linked to ADHD

November 25th, 2009

Health Risks Seen in Prenatal Tobacco Smoke Exposure and Childhood Lead Exposure

From WebMD.com:

Prenatal exposure to tobacco smoke and childhood exposure to lead are linked to increased risk of attention deficit hyperactivity disorder ( ADHD) in children, a new study shows.

The study is published in the December issue of Pediatrics.

Researchers led by Tanya E. Froehlich, MD, MS, of the department of pediatrics at Cincinnati Children’s Hospital Medical Center, analyzed data of prenatal tobacco and childhood lead exposure in the 2001-2004 National Health and Nutrition Examination Survey, a representative sample of U.S. children aged 8 to 15.

Prenatal tobacco exposure was measured by reports of cigarette use during pregnancy, and childhood lead exposure was assessed by blood levels.

The researchers say they found that young people exposed prenatally to tobacco smoke were 2.4 times more likely to have ADHD, and that those with blood levels in the top third of the population had a 2.3-fold increased likelihood of ADHD diagnosis.

The combined effect from both toxicants was even greater. Children with both exposures had a more than eightfold increased chance of having ADHD, compared to youths who weren’t exposed to either, the researchers say.

The authors say their study is the first to determine the independent effects of tobacco smoke and lead on ADHD in a nationally representative sample, and contend it provides the first estimate of joint effects of the two common toxicants.

The researchers examined data on 2,588 youngsters from the National Health and Nutrition Examination Survey 2001-2004 and 8.7% met criteria for diagnosis with ADHD. “Our findings suggest that reduction of toxicant exposures may be an important avenue for ADHD prevention and they underscore the enormous burden that may be associated with continued exposure to tobacco and lead,” the researchers conclude.

4 healthy choices to change your life

August 11th, 2009

From LATimes.com:

If people would just do four things — engage in regular physical activity, eat a healthy diet, not smoke and avoid becoming obese — they could slash their risk of diabetes, heart attack, stroke or cancer by 80%, a new report has found.

But less than 10% of the 23,153 people in the multiyear study — published in Monday’s Archives of Internal Medicine — actually lived their lives this way.

“The study has such a simple straightforward focus on making the point that prevention works in preventing serious disease,” said Dr. J. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.

“What really has been difficult is trying to figure out how to get people to take notice of the message and engage in healthy behaviors.”

Researchers at the U.S. Centers for Disease Control and Prevention and in Germany examined the habits of German men and women ages 35 to 65 from 1994 and 1998. At the start of the study, the scientists measured participants’ heights and weights and asked them about their diseases, lifestyle habits and diets.

Healthy factors included never smoking; engaging in physical activity for at least 3 1/2 hours each week; eating a diet low in red meat and high in fruits and vegetables; and having a body mass index lower than 30. (A person with a BMI of 30 or above is classed as obese.)

About 9% of participants practiced all four healthy lifestyle choices.

Four percent practiced none.

Roughly 35% followed two of the healthy practices.

Researchers reviewed participants’ medical records about eight years later, on average, looking for diabetes, heart attacks, strokes or cancer. People who followed all four healthy practices were at far lower risk compared with people who followed none: 93% lower risk for diabetes, 81% for a heart attack, 50% for a stroke and 36% for cancer.

For people who had never smoked and who maintained a BMI under 30, the risk of chronic disease was reduced 72% — the most dramatic reduction of any dual combination of healthy factors.

The scientists also found that each healthy factor reduced chronic disease risk.

A BMI under 30 lowered overall disease risk most — particularly for diabetes.

Never smoking reduced heart attack risk the most of all four factors.

“All of them are important, and trying to pick one is like asking someone to pick their favorite child,” said study coauthor Dr. Earl S. Ford, a senior scientist in the CDC’s Division of Nutrition, Physical Activity and Obesity.

Dr. Vyshali S. Rao, chairwoman of cardiology at Huntington Hospital in Pasadena and an American Heart Assn. spokeswoman, said the study underscores that shifting to a healthier diet helps the heart even if a person remains overweight.

However, she said, people who alter their diets often find they lose weight as a side benefit.

“Cardiologists try to stress to their patients more and more [that] cardiovascular disease is in hands of each individual patient to change,” Rao added.

The study’s findings, which are consistent with investigations that started in the late 1990s, are likely to apply to people living in the United States as well as those in Germany.

“The strongest reductions in risk for diabetes and [heart attack] are not surprising,” said Dr. Rachel Ballard-Barbash, associate director of the National Cancer Institute’s Applied Research program. “Even within a few years’ time, we can see changes in these diseases associated with these health behaviors,” such as lowered levels of LDL cholesterol and blood pressure.

“For stroke and cancer,” she added, “most studies would suggest it would take longer to see changes.”

Heart disease, cancer and strokes are the top three causes of death in the United States, killing an estimated 1,328,643 people every year, according to the CDC. Diabetes is the sixth cause of death, killing 72,449 annually. Many additional people live constrained lives in poor health because of these illnesses.

FDA Cautions Public About Electronic Cigarettes

July 24th, 2009

From WashingtonPost.com:

The Food and Drug Administration said Wednesday that an analysis of leading brands of electronic cigarettes, a new type of “smokeless” nicotine product, detected carcinogens and a chemical used in antifreeze that is toxic to humans.

Officials at the FDA and other public health experts cautioned consumers against using the products, saying that the health effects of electronic cigarettes are unknown.

“The FDA is concerned about the safety of these products and how they are marketed to the public,” said Margaret A. Hamburg, the agency’s commissioner.

The FDA studied the ingredients in cartridges from two leading brands of electronic cigarettes. In one sample, it detected diethylene glycol, a chemical used in antifreeze. Other samples turned up carcinogens, including nitrosamines, according to the agency.

Electronic cigarettes, also called “e-cigarettes,” are battery-operated devices that generally contain cartridges filled with nicotine, flavor and other chemicals. The electronic cigarette turns nicotine, which is highly addictive, and other chemicals into a vapor that is inhaled by the user. Since they produce no smoke, they can be used in workplaces, restaurants and airports.

The products are relatively new and began appearing on the market about five years ago, sold over the Internet, in mall kiosks and in stores. They often come in candy and fruit flavors, leading critics to charge that they are being targeted toward children.

The FDA considers e-cigarettes to be drug devices and, as such, says that manufacturers must first get federal approval to market them. It has refused to allow imports of e-cigarettes.

In May, two e-cigarette suppliers filed suit against the FDA to allow the shipments, claiming that the regulatory agency has no authority over the products. The suit is pending in a District federal court.

Direct link found between smoking and brain damage

June 29th, 2009

From news-medical.net:

New research which suggests a direct link between smoking and brain damage will be published in the July issue of the Journal of Neurochemistry. Researchers, led by Debapriya Ghosh and Dr Anirban Basu from the Indian National Brain Research Center (NBRC), have found that a compound in tobacco provokes white blood cells in the central nervous system to attack healthy cells, leading to severe neurological damage.
The research centers on a compound known as NNK, which is common in tobacco. NNK is a procarinogen, a chemical substance which becomes carcinogenic when it is altered by the metabolic process of the body.

Unlike alcohol or drug abuse NNK does not appear to harm brain cells directly, however, the research team believe it may cause neuroinflamation, a condition which leads to disorders such as Multiple Sclerosis.

“Considering the extreme economical and disease burden of neuroinflammation related disorders, it is extremely important from a medical, social and economic point of view to discover if NNK in tobacco causes neuroinflammation” said Ghosh.

To prove if such a link exists the team conducted two types of tests, one outside of a living host in glass and one in laboratory mice. The team used blot analysis techniques which showed that the introduction of NNK resulted in a clear increase in proinflammatory signaling proteins, proinflammatory effector proteins and other stress related proteins. Increased levels of proinflammatory cytokines, which act as molecular messengers between cells, were also detected.

This shows that NNK provokes an exaggerated response from the brain’s immune cells, known as microglia. Microglia cells act as ‘destroyers’ for the brain by attacking damaged or unhealthy cells. However, when provoked by NNK these cells start to attack healthy brain cells rather than the unhealthy cells they are supposed to attack.

“Our findings prove that tobacco compound NNK can activate microglia significantly which subsequently harms the nerve cells,” said Basu.

While other harmful side effects of smoking, such as lung disease, usually derive from tar or smoke this research suggests damage is not confined only to smoking. NNK is present in all forms of tobacco and therefore it can also enter the body through chewing.

The study also suggests that second hand smoking may lead to the same neuroinflamation conditions. Concentrations of NNK in tobacco can vary from 20-310 nanograms in cigarettes. However, NNK is also present in the smoke itself, meaning that smoke-filled air indoors may contain up to 26 nanograms of NNK. This means that both direct and second-hand smoking can lead to substantial measures of NNK intake.

“This research sheds light on the processes that lead to nerve cell damage in those who smoke cigarettes or consume tobacco products on regular basis,” said Ghosh.

A New Cigarette Hazard: ‘Third-Hand Smoke’

January 5th, 2009

From .nytimes.com

Often open a window or turn on a fan to clear the air for their children, but experts now have identified a related threat to children’s health that isn’t as easy to get rid of: third-hand smoke.

That’s the term being used to describe the invisible yet toxic brew of gases and particles clinging to smokers’ hair and clothing, not to mention cushions and carpeting, that lingers long after second-hand smoke has cleared from a room. The residue includes heavy metals, carcinogens and even radioactive materials that young children can get on their hands and ingest, especially if they’re crawling or playing on the floor.

Doctors from MassGeneral Hospital for Children in Boston coined the term “third-hand smoke” to describe these chemicals in a new study that focused on the risks they pose to infants and children. The study was published in this month’s issue of the journal Pediatrics.

“Everyone knows that second-hand smoke is bad, but they don’t know about this,” said Dr. Jonathan P. Winickoff, the lead author of the study and an assistant professor of pediatrics at Harvard Medical School.

“When their kids are out of the house, they might smoke. Or they smoke in the car. Or they strap the kid in the car seat in the back and crack the window and smoke, and they think it’s okay because the second-hand smoke isn’t getting to their kids,” Dr. Winickoff continued. “We needed a term to describe these tobacco toxins that aren’t visible.”

Third-hand smoke is what one smells when a smoker gets in an elevator after going outside for a cigarette, he said, or in a hotel room where people were smoking. “Your nose isn’t lying,” he said. “The stuff is so toxic that your brain is telling you: ’Get away.’”

The study reported on attitudes toward smoking in 1,500 households across the United States. It found that the vast majority of both smokers and nonsmokers were aware that second-hand smoke is harmful to children. Some 95 percent of nonsmokers and 84 percent of smokers agreed with the statement that “inhaling smoke from a parent’s cigarette can harm the health of infants and children.”

But far fewer of those surveyed were aware of the risks of third-hand smoke. Since the term is so new, the researchers asked people if they agreed with the statement that “breathing air in a room today where people smoked yesterday can harm the health of infants and children.” Only 65 percent of nonsmokers and 43 percent of smokers agreed with that statement, which researchers interpreted as acknowledgement of the risks of third-hand smoke.

The belief that second-hand smoke harms children’s health was not independently associated with strict smoking bans in homes and cars, the researchers found. On the other hand, the belief that third-hand smoke was harmful greatly increased the likelihood the respondent also would enforce a strict smoking ban at home, Dr. Winickoff said.

“That tells us we’re onto an important new health message here,” he said. “What we heard in focus group after focus group was, ‘I turn on the fan and the smoke disappears.’ It made us realize how many people think about second-hand smoke — they’re telling us they know it’s bad but they’ve figured out a way to do it.”

The data was collected in a national random-digit-dial telephone survey done between September and November 2005. The sample was weighted by race and gender, based on census information.

Dr. Philip Landrigan, a pediatrician who heads the Children’s Environmental Health Center at Mount Sinai School of Medicine in New York, said the phrase third-hand smoke is a brand-new term that has implications for behavior.

“The central message here is that simply closing the kitchen door to take a smoke is not protecting the kids from the effects of that smoke,” he said. “There are carcinogens in this third-hand smoke, and they are a cancer risk for anybody of any age who comes into contact with them.”

Among the substances in third-hand smoke are hydrogen cyanide, used in chemical weapons; butane, which is used in lighter fluid; toluene, found in paint thinners; arsenic; lead; carbon monoxide; and even polonium-210, the highly radioactive carcinogen that was used to murder former Russian spy Alexander V. Litvinenko in 2006. Eleven of the compounds are highly carcinogenic.