By: Dr. Leonardo Trasande, MD, MPP

When I began my pediatric residency 20 years ago, environmental health questions had not yet found their way into board certification exams. We did learn about the effects of childhood lead exposure on the developing brain and of air pollution in children with asthma. We had heard of the toxic effects of the pesticide DDT. Thalidomide and diethylstilbestrol were pulled out of medical practice after their devastating effects were recognized.

But we thought these were “mistake chemicals” - a rare consequence of “better living through chemistry.” Only in 2009 did the medical community realize that synthetic chemicals commonly used in furniture, agriculture, cookware, food packaging materials, cosmetics and personal care products could impair hormones in our bodies and have serious and lifelong consequences for all of us.  Even now, a decade later, awareness is still lagging despite other reports from the World Health Organization, United Nations Environment Program, the International Federation of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Over 1000 synthetic chemicals are known to have serious consequences. The effects are best known for the following:

• Flame retardants used in electronics and furniture
• Pesticides used in agriculture
• Phthalates used in personal care products, cosmetics and food packaging
• Bisphenols used in can linings and thermal paper receipts 
• Perfluoroalkylsubstances (PFA) used in nonstick cooking and oil-and-water-resistant clothing

Hormones are crucial for all sorts of bodily functions, like maintaining a healthy body temperature, good metabolism, salt, sugar and even sex. We’re talking about cognitive deficits, even autism and attention deficit disorder. Obesity and diabetes are now understood not simply to be a byproduct of caloric imbalance – synthetic chemicals can scramble metabolic systems, leading to fat deposition even after successful weight loss through a successful diet and exercise regimen.

These chemicals also mess with sex hormones, both male and female.  A serious concern about phthalates and lower testosterone (T) levels is that low T affects 40% of men over the age of 45.  Low T doesn’t just matter from a lifestyle perspective, with impotence and low sperm count.  We found that 10,000 adult men die each year in the US because phthalates reduce testosterone levels and contribute to heart attacks and stroke.

Bisphenol A, or BPA, has gotten a lot of attention because it was banned by the FDA in baby bottles and sippy cups to protect children, but it’s a synthetic estrogen. And, BPA is particularly toxic to the adult ovary. Synthetic chemicals have also been linked to endometriosis, fibroids and breast cancer. 

“Bisphenols used as replacements for BPA can be just as estrogenic, toxic to embryos and persistent in the environment.  That’s why we call these chemicals “artists formerly known as BPA.”” 

This sounds scary, as it should. And it costs our economy too, to the tune of $340 billion each year in the US alone. That’s 2.3% of GDP.

But there’s much to be hopeful about. Each of us has power to be the change we seek.  Companies listen and change their ways when consumers literally speak with their pocketbooks and wallets. The ban on BPA was driven in part by science, but would not have occurred without consumer attention that drove companies to run to the FDA and insist on a ban. More recently, it took only five buffet-style food packages with PFAS to make two major supermarket chains to literally push aside all their existing supply, and insist on their producers to change their manufacturing to eliminate these chemicals.  

In the meantime, there’s so much you can do at home to reduce your exposure.  And it neither requires a PhD in chemistry, nor has to break the bank.  

1. Studies suggest that stopping canned food consumption can decrease bisphenol levels in urine as much as 90% or more.  
2. Say no to paper receipts. Most supermarkets are switching to electronic receipts that can avoid contact with the coating that contains BPA. 
3. You should also be careful with your cosmetics. Look at the ingredient label and avoid products with “fragrance” or phthalates. A recent study found that choosing personal care products that are labeled to be free of phthalates, parabens and other endocrine disrupting chemicals can reduce exposure by as much as a third or more.
4. You can also limit phthalates and other problematic chemical exposures by looking at the recycling number on plastic bottles. Avoid the numbers 3, 6 and 7. You should also avoid washing plastic in the dishwasher, and hand wash with mild soap and water instead. If plastic food containers are etching or fraying, it’s time to throw them away as it increases the odds of leaching. 
5. A good option is swapping out your plastic dinnerware or storage containers with glass or stainless steel. 
6. Finally, eating organic reduces your exposure to pesticides. Studies have proven this across the income spectrum. The cost margins for organic versus conventional foods are narrowing such that big-box stores are even carrying organic fruits, vegetables and meats now. In particular, keep in mind EWG’s Dirty Dozen – a group of fruits and veggies that are especially vulnerable to absorbing chemicals and therefore pose a greater risk when you buy “conventional” rather than organic produce.

We also need policy change.  It doesn’t all have to come from the federal government. States have led the way, as we just saw with California banning 24 toxic ingredients from personal care products and cosmetics, and getting PFAS out of firefighting foam. Europe has led the way in regulating these chemicals as well, and many companies have changed their practices worldwide in response.

“This all sounds scary, as it should. But there’s much to be hopeful about. Each of us has power to be the change we seek. The next generations also give me great hope.”  

Their enthusiastic call to action in fighting climate change has opened public awareness to environmental exposures. And, climate change and endocrine disruption share fossil fuels as a common origin. It’s no secret that plastics use byproducts of fossil fuels as raw materials. Don’t forget the attention ocean plastics and their ecological effects have gotten as well. It’s this growing energy that gives me hope and keeps me optimistic every day!

Dr. Leonardo Trasande is a Jim G. Hendrick MD Professor, Director of the Division of Environmental Pediatrics and Vice Chair for Research in the Department of Pediatrics at NYU School of Medicine. He also serves on the faculty of the NYU Wagner School of Public Service and the NYU College of Global Public Health.

Dr. Trasande is an internationally renowned leader in environmental health. His research focuses on the impacts of chemicals on hormones in our bodies. He also has led the way in documenting the economic costs for policy makers of failing to prevent diseases of environmental origin proactively.

He is perhaps best known for a series of studies published in Lancet Diabetes and Endocrinology and the Journal of Clinical Endocrinology and Metabolism that document disease costs due to endocrine disrupting chemicals in the US and Europe of $340 billion and €163 billion annually, respectively.

SOURCES:

The American Academy of Pediatrics: Use glass or stainless steel when possible

EWG’s Dirty Dozen

California bans 24 toxic chemicals from personal care products and cosmetics

Europe’s chemical regulations

Endocrine disrupting chemicals

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