Plastic (41 page)

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even very small amounts
: See L. Øie, L. G. Hersoug, and J. O. Madsen, "Residential Exposure to Plasticizers and Its Possible Role in the Pathogenesis of Asthma,"
Environmental Health Perspectives
105 (1997): 972–78, cited in Wargo et al., "Plastics That May Be Harmful," 41–45.

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The effects in rats are mirrored
: Author interviews with Swan; Joel Tickner, University of Massachusetts at Lowell, Center for Sustainable Production, October 2009; Russ Hauser, physician/researcher at Harvard School for Public Health, October 2009; Rebecca Sutton, senior scientist, Environmental Working Group, September 2009. See also Leonard Paulozzi, "International Trends in Rates of Hypospadias and Cryptorchidism,"
Environmental Health Perspectives
107 (April 1999): 297–302. Danish researchers have argued that such symptoms are connected, part of a condition they called testicular dysgenesis syndrome, which they traced to errors in the development of fetal testes, caused by either genetic defects or environmental factors, such as exposure to hormone-disrupting chemicals. In a paper published in 2001, they contended the syndrome is fairly common, estimating that as many as one in twenty Danish men have at least one or two symptoms. N. E. Skakkebæk et al., "Testicular Dysgenesis Syndrome: An Increasingly Common Developmental Disorder with Environmental Aspects,"
Human Reproduction
16 (May 2001): 972–78.

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at least 80 percent of Americans
: B. Blount et al., "Levels of Seven Urinary Phthalate Metabolites in a Human Reference Population,"
Environmental Health Perspectives
108 (October 2000): 979–82; M. Silva et al., "Urinary Levels of Seven Phthalate Metabolites in the U.S. Population from the National Health and Nutrition Examination Survey (NHANES) 1999–2000,"
Environmental Health Perspectives
112 (March 2004): 331–38. In fact, some studies suggest that just about every American carries at least one phthalate in his or her system, but until recently the CDC was able to test for only a few of the chemicals' metabolites.

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Researchers have detected phthalates
: Wargo et al., "Plastics That May Be Harmful," 39; U.S. EPA, "Action Plan on Phthalates," 2009. It's also been shown that the chemicals can cross the placental barrier.

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None of us are exposed
: It's estimated most of us are taking in 1 to 30 micrograms per kilogram of body weight every day, which is a daily exposure of about 70 to 2,100 micrograms for someone weighing 155 pounds. CERHR, "Monograph," 1.

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many of us are taking in more
: German researchers found that nearly one-third of the men and women in the study were exceeding the daily-intake limit established by the EPA. In plastic-happy Taiwan, the percentage was 85 percent. The oral threshold set by the EPA in 1986 is 0.02 mg/kg/day, based on the potential for effects to the liver. Wargo et al., "Plastics That May Be Harmful," 40–46.

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people with the highest levels
: Blount et al., "Levels of Seven"; D. B. Barr et al., "Assessing Human Exposure to Phthalates Using Monoesters and Their Oxidized Metabolites as Biomarkers,"
Environmental Health Perspectives
111 (July 2003): 1148–51.

99
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Splish-Splash Jesus
: Author interview with Swan.

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Such findings
: CERHR, "Monograph."

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the group that seems to be at greatest risk
: Interview with Hauser. For more background on NICU babies' exposure, see Ronald Green et al., "Use of Di(2-ethylhexyl) Phthalate-Containing Medical Products and Urinary Levels of Mono(2-ethylhexyl) Phthalate in Neonatal Intensive Care Unit Infants,"
Environmental Health Perspectives
113 (September 2005): 1122–25. CERHR, "Monograph"; Julia Barrett, "NTP Draft Brief on DEHP,"
Environmental Health Perspectives
114 (October 2006): A580–81.

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A really sick baby
: Luban et al., "I Want to Say," 504.

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people of any age undergoing procedures
: CERHR, "Monograph," 2.

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newborns are underdeveloped
: Many scientists consider fetuses, infants, and young children in general to be especially vulnerable to harm from chemicals because their organ systems, metabolic pathways, and hormonal systems are all still developing. Young children also breathe more air and consume more food and drink per pound of body weight, which increases their relative exposure to chemicals in the environment. The National Academy of Sciences in 1993 recognized the special susceptibility of the very young to industrial chemicals in a report on pesticides. Wargo et al., "Plastics That May Be Harmful," 9–10.

100
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We may all be a little plastic
: In an interview with the author, physician/researcher Russ Hauser described the difficulty of drawing practical conclusions from the knowledge that a patient is exposed to phthalates. He has done epidemiological studies showing a correlation between phthalate levels and male infertility. Yet he said the nature of that connection is still too uncertain to be of use in his clinical practice, where he works with infertile couples. While he tests their levels of phthalates and other chemicals used in plastics, he rarely shares the results with them because they are difficult to interpret. It's not like dealing with a known risk such as mercury, he said. If one of his patients had high mercury levels, he could tell him or her how that will affect health and how to avoid mercury in the diet. But with phthalates, he said, "I can't even interpret the level in their urine. If they're forty or eighty or a hundred and twenty parts per billion—does that really impart differences in risks? There's just not enough data [to know.]" Plus, he added, "We don't want to make someone who's anxious about having a child even more anxious about completely changing their lifestyle."

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she measured phthalate levels
: Author interview with Swan; Shanna Swan et al., "Decrease in Anogenital Distance Among Male Infants with Prenatal Phthalate Exposure,"
Environmental Health Perspectives
113 (August 2005): 1056–61.

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Swan then decided to look at
: Author interview with Swan; Swan et al., "Prenatal Phthalate Exposure and Reduced Masculine Play in Boys,"
International Journal of Androgyny
33 (April 2010): 259–69.

102
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Other epidemiological findings
: For overviews of some of those findings, see Wargo et al., "Plastics That May Be Harmful"; John Meeker et al., "Phthalates and Other Additives in Plastics: Human Exposure and Associated Health Outcomes,"
Philosophical Transactions of the Royal Society B
364 (July 2009): 2097–113; Russ Hauser et al., "Phthalates and Human Health,"
Occupational Environmental Medicine
62 (November 2005): 808–18.

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girls may also be affected
: A study of Puerto Rican girls found high levels of DEHP in more than two-thirds of the girls with premature sexual development and early breast development compared with only about one in five of the subjects with normal puberty. This study has been criticized for possible failure to control laboratory contribution of DEHP to reported tissue concentrations. I. Colón et al., "Identification of Phthalate Esters in the Serum of Young Puerto Rican Girls with Premature Breast Development,"
Environmental Health Perspectives
108 (September 2000): 895–900. Women with endometriosis had higher blood levels of DEHP in studies from Italy and India; see L. Cobellis et al., "High Plasma Concentrations of Di-(2-ethylhexyl)-phthalate in Women with Endometriosis,"
Human Reproduction
18 (July 2003): 1512–15; and B. S. Reddy et al., "Association of Phthalate Esters with Endometriosis in Indian Women,"
BJOG
113 (May 2006): 515–20. Another Italian study also found associations between phthalate levels and uterine fibroids; see'S. Luisi et al., "Low Serum Concentrations of Di-(2-ethylhexyl)phthalate in Women with Uterine Fibromatosis,"
Gynecological Endocrinology
22 (February 2006): 92–95.

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A 2010 study suggested
: Mike Verespej, "Study Says Phthalates May Harm Newborns' Immune Systems,"
Plastics News,
July 22, 2010.

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German researchers showed
: H. von Rettberg et al., "Use of Di(2-Ethylhexyl)Phthalate-Containing Infusion Systems Increases the Risk for Cholestasis,"
Pediatrics
124 (August 2009): 710–16.

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studies involving young marmosets
: Author interview with Schettler. See C. Mc­Kinnell et al., "Effect of Fetal or Neonatal Exposure to Monobutyl Phthalate (MBP) on Testicular Development and Function in the Marmoset,"
Human Reproduction
24 (September 2009): 2244–54. See also CERHR, "Monograph."

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Researchers are still debating
: The same inconsistencies arise in bisphenol A studies, where the results can be wildly different depending on, for instance, the strain of lab rat that is used. Some are more estrogen-sensitive than others and thus more likely to show response to the chemical. Critics say that's one factor accounting for the huge difference between industry-sponsored studies and those by independent researchers. The animals used in industry-funded studies have been twenty-five thousand to a hundred thousand times less sensitive to estrogen than other species, according to a 2005 study. That same report found that 94 out of 104 studies funded by the government reported significant effects to bisphenol A exposure, while not one of the 11 industry-funded studies found an effect. Frederick vom Saal et al., "Extensive New Literature."

103
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They did a small pilot study
: K. Rais-Bahrami et al., "Follow-up Study of Adolescents Exposed to Di(2-Ethylhexyl) Phthalate (DEHP) as Neonates on Extracorporeal Membrane Oxygenation (ECMO) Support,"
Environmental Health Perspectives
112 (September 2004): 1339–40.

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a study by the organization
:Environmental Working Group, "Body Burden—The Pollution in Newborns," July 14, 2005. Accessed at
http://www.ewg.org/reports/bodyburden2/execsumm.php
.

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Gray ... tested mixtures
: Author interview with Earl Gray, October 2009.

104
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The American Chemistry Council's position
: Marion Stanley, ACC, quoted in response to FDA public health notification. Also, author interview with Chris Bryant, Phthalate Esters Group, ACC, October 2008. See also CERHR, "Monograph," which contains comments submitted by the ACC in 2005.

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the ACC draws on a standing set of criticisms
: Wargo, "Pervasive Plastics." See also phthalates-related press releases listed on the ACC's website at
http://www.americanchemistry.com/s_acc/sec_newsroom.asp?CID=206&DID=555
.

105
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strategy taken straight from the tobacco industry
: David Michaels, "Doubt Is Their Product,"
Scientific American
(June 2005): 96.

106
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The EPA ... recently announced
: EPA, "Phthalate Action Plan," 2009.

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The FDA's only action
: Food and Drug Administration, "FDA Public Health Notification: PVC Devices Containing the Plasticizer DEHP," July 2002. Accessed at
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealth Notifications/UCM062182
.

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base their safety assessments
: Author interview with Schettler. See also Health Care Without Harm,"Aggregate Exposures to Phthalates in Humans," July 2002. Accessed at
http://www.noharm.org/lib/downloads/pvc/Agg_Exposures_to_Phthalates.pdf
.

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"
a scientifically improbable smoking gun
": Schapiro,
Exposed,
52.

107
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"
nearly all chemicals in commerce
": Wargo, "Pervasive Plastics." An expanded version of his analysis can be found in his book
Green Intelligence: Creating Environments That Protect Human Health
New Haven, CT: Yale University Press, 2009).

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at least sixteen thousand
: The estimate was made by the EPA and cited in Michael Wilson and Megan Schwarzman, "Toward a New U.S. Chemicals Policy: Rebuilding the Foundation to Advance New Science, Green Chemistry, and Environmental Health,"
Environmental Health Perspectives
117 (August 2009): 1202–9. The 70 percent estimate was cited by Joel Tickner in an e-mail to the author, October 2010.

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European regulators "act on the principle of preventing
": Schapiro,
Exposed,
52.

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Europeans began limiting DEHP
: In 2001, the EU classified DEHP as "toxic" and also barred its use in cosmetics and in all children's products. Starting in 1998, American toy manufacturers voluntarily removed DEHP from teethers, rattlers, and other toys that could be mouthed by children under the age of three. Yet that doesn't prevent importation of toys containing phthalates, which is significant, since 80 percent of toys sold in the United States are produced in and imported from China, where there's no restriction on the use of DEHP.

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The agency charged
: Health Care Without Harm, "The Weight of the Evidence on DEHP." Accessed at
http://www.noharm.org/lib/downloads/pvc/Weight_of_Evidence_DEHP.pdf
.

108
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approach taken by Massachusetts
: Author interviews with Liz Harriman, Pam Eliason, and Greg Morose of the Toxics Use Reduction Institute, the organization established to educate companies about nontoxic alternatives and help them comply with the state law, October 2009.

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national "plastics control law
": Wargo, "Pervasive Plastics."

109
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Safreed was a nurse
: Author interview with Paula Safreed, former nurse in NICU at Brigham and Women's Hospital, September 2009. Also, author interview with Julianne Mazzawi, assistant manager of the neonatal intensive care unit at Brigham and Women's Hospital, September 2009.