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Post-publication Peer Reviews to:
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![[Read P3R]](/icons/misc/sectionDOWN.gif){kind=icon}
Redefining normal age of breast growth obscures potential environmental causes
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Devra L Davis, environmental oncologist university of Pittsburgh Graduate School of Public Health, Center for Environmental Oncology,, Chandra M. Tiwary, Maryann Donovan, Deborah Axelrod, Anne Sasco
Send letter to journal:
davisdl{at}upmc.edu Devra L Davis, et al.
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February 8, 2007, we’ve heard that private laboratory tests reveal that popular children’s shampoos and soaps can contain a known carcinogen, at levels above those allowed by the FDA. What does this mean? Fortunately, childhood cancer is rare. Unfortunately, the National Cancer Institute reports that it is less rare today than in years past. Lance Armstrong sends an incredibly inspiring message about the ability of young men to survive testicular cancer, but he also reflects a worrisome trend—Rates of this most common cancer in young men are rising throughout the industrial world. NCI reports that inherited germ line defects that are passed on from our parents, explain less than one in ten cases of cancer in young persons today. As was the case with Mr. Armstrong, we can’t explain why most cancer in young persons occurs. Clearly the things that happen to babies in utero have lasting effects on their health. Studies in pregnant rodents find that exposures to levels of plasticizers that can be found in personal care products can cause defects in the reproductive tracts of their offspring. What about us? Recent work by Professor Shanna Swann of the University of Rochester found that the greater the amount of several common phthalate plasticizers in the blood of mothers during pregnancy the greater the chance that their baby boys will have birth defects of their anus. Another study by Professor Frederica Perera of Columbia University, found that the more diesel exhaust, pesticides and other contaminants that young pregnant women inhaled walking around their neighborhoods of Harlem or the South Bronx the smaller head size and lower birth weight of their babies. Other work by the Jacobsons of Wisconsin found that intelligence of children in middle school was determined by the amount of toxic chemicals circulating through their mothers during pregnancy. As a science epidemiology, tells us about the past. In all the cases just mentioned, because studies were done on infants and children, results were produced relatively quickly. But what about what we’ve heard today? Steinman has provided disturbing analyses that have found an established carcinogen in baby shampoos and soaps. Some would tell us that this is of no concern. We don’t have proof of harmed humans. Yet. After all the levels are really too small to be of any impact. But, the reality is this: life is a mixture. We don’t get to choose the good and bad things that we breathe and drink. Children are simply not little adults. Their brains double in the first two years of life. Their immune systems and bones grow. Pound for pound they breathe faster, live closer to the tailpipe and have the potential to absorb relatively higher doses of any pollutant that is in our common environment. The soft, sweet, wonderful skin of our babies is just as sensitive as we imagine it to be. The so-called testicular barrier of an infant is actually one hundred times more absorbent. The combined effect of small amounts of hazardous chemicals on our children is a matter that merits serious concern. The absence of evidence at this point should not be construed as proof there is no problem, rather it shows how difficult it is to collect critical information on such a moving target. For many complex exposures of modern life, we simply have no control group, that is no group that is truly unexposed. Some ingredients or contaminants of shampoos, soaps and creams can get right through the skin into the bloodstream. Dr. Chandra Tiwary, who is here with us today, headed up pediatric endocrinology for the Air Force at Brooks Air Force Base, until his retirement recently. While there he reported on a disturbing pattern. Baby girls as young as one year of age had developed breasts, after their parents had applied creams that contained hormones to their scalps. When they stopped using these creams, the breasts went away. Others have provided similar observations. We don’t know why more young African American women get breast cancer than do young white women, nor do we know why girls are developing breasts at younger ages. Perhaps the two are related. Our Center for Environmental Oncology at the University of Pittsburgh Cancer Institute is releasing a pamphlet today that explains what we know and suspect about environmental risks of breast cancer for African American women. Although white women have the highest overall breast cancer incidence rates, African-American women under age 40 have a significantly higher incidence of breast cancer as well as a higher rate of death from breast cancer than do white women. Furthermore, African-Americans with breast cancer die at a younger age than women in other groups. In looking at breast cancer incidence among African-American and white women in the United States from 1975 to 2002, we reported to the American Public Health Association recently that the chances of getting breast cancer in newer generations are about 21 percent higher in whites and 41 percent higher in African- Americans than in previous generations of women. In an article published this week in the peer-reviewed journal Medical Hypothesis, Dr. Tiwary, Dr. Maryann Donovan and I explain why we think that the use of estrogen and other-containing or hormone-mimicking agents in personal care products account for some of these unexplained patterns in African American women. In light of the growing numbers of younger girls with breasts, the Lawson Wilkins Pediatric Endocrine Society—the certifying board for pediatric endocrinology—in 1999 recommended that what is normal should be redefined to include breast growth at age 6 for African Americans and age 7 for whites. We believe that this would be a dangerous move. We agree with endocrinologist Kurt Midyett and colleagues of Children’s Mercy Hospital of the University of Missouri-Kansas City: if we say that breasts at young ages are normal, we will fail to pick up serious disease that could account for this. We will also lose the chance to learn whether widely used agents in the environment, like those found in personal care products today, lay behind some of these patterns. It should not be the job of scientists to find out what contaminants or ingredients may be affecting the delicate endocrine systems of our children and grandchildren. People have a right to know whether products they use on themselves and their children contain compounds that increase their risk of disease. Without such information, we turn our children into lab rats in a vast uncontrolled experiment. I look forward to the day when the right to know will be protected far better than it is at this time. Science will advance and our children will be the better for it. References provided on request www.ehponline.org/docs/2004/6641/abstract.html www.findarticles.com/p/articles/mi_m0CYP/is_17_112/ai_n15690597 http://www.medicalnewstoday.com/medicalnews.php?newsid=56157 Medical Hypotheses Volume 68, Issue 4 , 2007, Pages 756-766 Jacobson JL, Jacobson SW, Humphrey HE. Effects of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children. J Pediatr. 1990 Jan;116(1):38–45. [PubMed] http://pediatrics.aappublications.org/cgi/content/abstract/111/1/47 Conflict of Interest:None declared |
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