epidemiology

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Bugs And Kids: Indoor Insecticide Use Linked To Childhood Cancers, Study Finds

(Tom Simpson/Flickr)

(Tom Simpson/Flickr)

I just threw out my spray can of Raid for flying insects. With kids in the house, I never did like the idea of spewing toxic stuff around, and only ever used it when a bug was driving me to feral insanity. Now, after reading the paper just out in this week’s issue of the journal Pediatrics, I’ll stick with the flypaper and swatter no matter how intense my irritation.

The paper concludes that the sum of previous research suggests a significant link between indoor pesticide use and childhood cancer.

To be more exact, senior author Chensheng Lu says the results “suggest that when kids are exposed to pesticides — especially a group of pesticides we call insecticides — in the indoor residential environment, kids have 43 to 47 percent more chance of having childhood cancers, specifically leukemia and lymphoma.”

Dr. Lu is an associate professor of environmental exposure biology at the Harvard T.H. Chan School of Public Health. He acknowledges the study’s limitations, in particular that it could find only 16 relevant previous papers to analyze. But, he says, it showed “consistent results in terms of the positive correlation between exposure to insecticide indoors and childhood cancer.”

The study does not aim to “cause fear in parents,” Lu says. “But it’s to give you a precautionary principle that those exposures can be prevented, can be mitigated or can be completely removed.”

Of course, these findings only heighten the dilemma for households or schools that are tormented by pests, with infestations too fierce to be dented by anything but the big toxic guns. Are we supposed to just let the roaches and mosquitoes run wild?

Dr. Lu points out that preventive measures like window screens and hole-plugging can help, and among pesticides, some applications are safer than others — for example, “bait houses” that try to attract the pest inside a box-like structure to be poisoned.

“The worst-case scenario in terms of indoor pesticide use and human exposure it to use some kind of fogger,” he says. “Also, some kind of open-air application, a broadcast application, a spray can. Those are bound to significant exposures.” Continue reading

Boston’s Health, By T Stop: Neighborhoods Near But ‘Health Worlds Apart’

BPHC data posted in Dr. Sandro Galea’s “Dean’s Note” on Boston health disparities.

BPHC data posted in Dr. Sandro Galea’s “Dean’s Note” on Boston health disparities.

If you went on a little T ride with Dr. Sandro Galea, the new dean of the Boston University School of Public Health, the urban landscape would never look quite the same to you, I bet. You wouldn’t just see neighborhoods, anymore; you would see health neighborhoods.

In his latest “Dean’s Note” post, Dr. Galea uses images like the one above to illustrate the yawning gaps in health statistics among Boston’s neighborhoods. (Get off at Dudley Square, the diabetes rate is 11 percent; get off at Arlington, it’s just 3 percent.) He also posts T-stop numbers on low birth weight, physical activity and homicide, among other health-related stats. And he writes:

Inured as we are to inequalities in health, we might well shrug off these health differences as ones between far-apart worlds. But are they? In fact, the geographic space we are talking about here is remarkably small. We are dealing with geographic differences of roughly four miles, or about an hour’s walk. In many respects, it is remarkable that areas so close to one another should have such dramatically different health indicators—“health worlds apart” that are simply down the street from one another.

Those health worlds may be far apart indeed. A new “Child Opportunity Index” suggests that Boston may be the worst city in the country for Hispanic kids in terms of healthy development.

Developed by researchers at Brandeis University’s Heller School for Social Policy and Management and Ohio State University’s Kirwan Institute for the Study of Race and Ethnicity, the index finds that 58 percent of Hispanic children in Boston live in neighborhoods with the lowest level of access to “healthy development resources,” from parks to high-quality child care.

The index also found Boston to be the sixth-worst metro area in the country for African-American children.

From the press release, headlined, “Boston has the Highest Concentration Nationally of Hispanic Children Living in the Worst Neighborhoods for Healthy Development:” Continue reading

So Much For The Killer Bra: Study Finds No Link With Breast Cancer

(canonsnapper via Compfight)

(canonsnapper via Compfight)

If you’re a bra-wearing woman, maybe you know this feeling: You exhale with relief as you unhook your band at the end of a long day. Looking over your shoulder into the mirror, you see the slight indentation the elastic has left on your torso, and think: “Constriction like this just can’t be good.”

That intuition resonates with popular theorizing that bras can lead to breast cancer by blocking the healthy drainage of waste products from the breast area. Hence the higher breast cancer rates in developed countries.

But give me good hard data over feelings and pop theories every time. A big new study, funded by the National Cancer Institute, finds no link at all between bras and breast cancer.

The study, published in the journal “Cancer Epidemiology, Biomarkers & Prevention,” found that whether women wear bras just a few hours a day or more than 16, whether they wear underwires or wireless, whether they have big cups or small cups, brassieres are guiltless: They just do not seem to be linked to the two most common forms of breast cancer.

The research involved hundreds of postmenopausal women: 454 with invasive ductal carcinoma, 590 with invasive lobular carcinoma, and 469 without breast cancer, who served as controls. Each woman answered questions about everything from her pregnancy history to the age at which she started wearing a bra, whether it had an underwire, cup size, band size and how many hours a day she wore it.

Bottom line: It looks like your bra won’t kill you unless someone strangles you with it. Which contradicts a 1995 book that added gallons of fuel to the theory that bras are harmful: “Dressed To Kill: The Link Between Breast Cancer and Bras.”

The new paper’s senior author, Dr. Christopher Li, head of the Translational Research Program at the Fred Hutchinson Cancer Research Center, says “Dressed To Kill” provided some of the impetus for the study. Our conversation, lightly edited:

Why did you think this study was worth doing?

The whole theory about bra-wearing and breast cancer came to my attention years ago, when there was this book published called “Dressed to Kill.” The whole premise of the book was that bra-wearing is the primary culprit for breast cancer in the world. Being a breast cancer researcher, I had never heard of this theory, and people, friends of mine who had seen it, were saying, ‘What’s going on with this?’ Continue reading

Hidden Price Of That Succulent Lobster: Health Woes Of Stoic Lobstermen

Longtime Maine lobsterman Jon Rogers (Jesse Costa/WBUR)

Longtime Maine lobsterman Jon Rogers (Jesse Costa/WBUR)

By Richard Knox

Mainer Jon Rogers started lobstering 47 years ago at the age of 10, when he’d go out on his grandfather’s boat.

Ask him about his health and he says, “No worse than anyone else who uses his body in his work. My hips are sore, my knees are sore, my shoulders are sore, my back is sore. I get up every day and it takes me awhile to get going. I hurt every day.”

But Rogers, who lives on a skinny, south-pointing finger of land in Casco Bay called Orr’s Island, doesn’t go to the doctor much. “I never really complained about too much unless I was really hurting,” he says.

“I’d schedule a doctor’s appointment with all the intentions of going,” Rogers says. “But if there was an opportunity to haul traps for a few days, I’d set aside the doctor’s appointment and go haul traps.” This summer he’s running 800 traps, which means his days starts around 5:30 a.m.

Rogers appears to be pretty typical of Maine’s 5,000 lobstermen, and of all 9,000 people who work in the state’s fishing industry.

“They work really hard and have a lot of chronic diseases,” says Miranda Jo Rogers, Jon’s daughter. “These people have a stoic mentality — they don’t seek health [care] until they really need it. So there are no really positive role models on how to be proactive and keep healthy.”

Lobsterman Jon Rogers with med-student daughter Meredith Jo Rogers, who is studying the health of lobster harvesters. (Courtesy)

Lobsterman Jon Rogers with med-student daughter Miranda Jo Rogers. (Courtesy)

Miranda Rogers aims to do something about that. Although she’s still a Tufts Medical School student, she’s taken on a project she expects will take her to graduation and beyond — maybe decades beyond.

“I am happily indebted to the community that raised me, and I wish to make a long-lasting difference in Maine,” she wrote recently to the state’s lobster harvesters, asking them to fill out a 24-page questionnaire on their health.

It will be the most complete look ever at the health of a difficult-to-reach population with special health care needs, low rates of health insurance and high skepticism of outsiders.

“Up and down the coast, the commercial fisherman is very talkative on his own turf, but it’s a very secretive bunch and not that trusting,” Jon Rogers says. Continue reading

Is The Autism ‘Epidemic’ Over?

By Karen Weintraub
Guest Contributor

It’s common knowledge that we’re in the midst of an autism epidemic, right?

Well, maybe not. Boston University professor Hershel Jick published a paper today in the BMJ suggesting that there was an autism epidemic in the 1990s, but it may be over.

He and his colleagues used what he says is the only database in the world with reliable, consistent data over the last 23 years – from the United Kingdom. And Jick says the trend is clear. Autism increased fivefold between 1990 and 2000, but has held steady since 2004, at least in the U.K.

What might cause such a precipitous rise and then a flat line? “It’s a complete mystery,” says Jick, who has been studying the epidemiology of disease since the mid-1960s and has never seen a similar trend.

“You tell me what there could be out there that increased the risk dramatically for 10 years and then stopped? There has to be something out there,” he says. But what it is? “I haven’t a clue.”

(Autism Speaks)

(Autism Speaks)

One of the biggest debates in autism in recent years has been genes versus environment. People who develop autism need a genetic vulnerability to the condition, but if it’s truly rising, there must be an environmental trigger, too, because genes can’t change quickly. Continue reading

Nutrition Researcher: ‘One Little Thing At A Time Never Makes A Difference’

fruits

Among all my weekend media-reading, here’s the bit that keeps echoing in my mind:

In a long Boston Globe Magazine feature titled “Walter Willett’s Food Fight,” about the famously mustachoied and outspoken (in a data-driven way, of course) Harvard researcher, way down near the end, comes a daunting vignette that rings exceedingly true.

Christopher Gardner, the director of nutrition studies at the Stanford Prevention Research Center, “confesses to suffering from a professional ‘midlife crisis.'” To wit:

He explains that what we know about nutrition so far comes from big studies like Willett’s and small targeted trials like his. Willett watches thousands of people, year after year, to see who dies and who lives. But Willett can’t prove that it was, say, the whole grains in their diet that protected them — so Gardner runs randomized trials to isolate one element and try to determine cause and effect. Here’s what he finds instead: “One little thing at a time never makes a difference.”

A few years ago, Gardner ran a National Institutes of Health-funded study on garlic. Because he must test a specific hypothesis, lest he be accused of going on a fishing expedition, he asked whether one clove per day helped lower cholesterol in people with moderately elevated levels. Six months and $1.4 million later, he found no effect. “I couldn’t even answer: Is garlic good for you?” he says.

Collectively, the work that he and Willett and others in nutrition and epidemiology have done has built a large body of knowledge, Gardner says, but they’re hitting a ceiling. “We know about 90 percent of what we’ll ever know,” he says. “And it’s not enough.”

Yes. The “garlic is good for you”-type studies are the bane of many a health reporter’s existence, because such findings flip-flop so annoyingly. (Globe Magazine reporter Neil Swidey describes the public reaction as “will-you-make-up-your-minds-already exasperation.”) So readers, if you don’t see a lot of those types of studies posted here on CommonHealth, you’ll know why…

New U.S. Map: We’re Fat By Any Measure, Though Mass. Less Fat Than Most

The latest obesity map from the CDC

The latest obesity map from the CDC

The CDC has shifted its methodology for assessing the nation’s fatness quotient, now using interviews via cellphone as well as landline. But the bottom line is the same: Very very fat. Though Massachusetts, I’m happy to report, is third-thinnest. That is, the percentage of the state’s residents who are obese is only (only?) 22.7, trailing only Colorado and Hawaii (Hawaii?). Mississippi is highest at 34.9. Full details at the CDC here. From the press release:

BACKGROUND: In 2011, rates of adult obesity remain high, with state estimates ranging from 20.7 percent in Colorado to 34.9 percent in Mississippi. No state had a prevalence of adult obesity less than 20 percent, and 12 states (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Texas, and West Virginia) had a prevalence of 30 percent or more. The South had the highest prevalence
of adult obesity (29.5 percent), followed by the Midwest (29 percent), the Northeast (25.3 percent) and the West (24.3 percent).

In 2011, several updates occurred with BRFSS that impact estimates of state-level adult obesity prevalence. First, there was an overall change in the BRFSS methodology, including the incorporation of cell-phone only households, and a new weighting process. These changes in methodology were made to ensure that the sample better represents the population in each state. Second, to generate more accurate estimates of obesity prevalence, small changes were made to the criteria used to determine which respondents are included in the data analysis.

Because of these changes in methodology, estimates of obesity prevalence from 2011 forward cannot be compared to estimates from previous years. Data collected in 2011 will provide a new baseline for obesity prevalence data collected in subsequent years.

Ticks That Carry Lyme Disease Spreading Into Canada

The classic "bullseye rash" of Lyme Disease

Now that my young son has had Lyme Disease twice, the outdoors no longer holds the same allure for me. When I see children gamboling in the woods, my mind’s eye sees tiny infected ticks creeping quietly onto their ankles. Bushes and trees have become sinister, and not even sweeping lawns look innocent anymore.

I’d been wondering if perhaps we could take an outdoor vacation so far north that we’d be beyond the Lyme bacterium’s reach, but this report just out in the Canadian newspaper Times Colonist disillusions me: The deer ticks that can carry Lyme disease have been spreading rapidly in Canada, apparently due to global warming.

From the Times Colonist:

A new study has documented the rapid growth in Canada of ticks that can cause Lyme disease, and global warming is thought to be a factor.

Ticks capable of carrying Lyme disease went from being almost non-existent in populated areas in Canada in 1990 to being currently in 18 per cent of such spots east of Saskatchewan, and this is expected to reach 80 per cent by 2020, according to the paper published in the British Ecological Society’s Journal of Applied Ecology.

Lyme Disease remains exceedingly rare in Canada compared to the United States, but my paranoia remains broad enough that I’m leaning toward Western Canada if we take a trip.

The study did show that warmer areas are seeing more rapid growth in ticks. Continue reading