Some Plastics Linked to Risk for Diabetes and Heart
Disease
< Sep. 17, 2008 > --
Bisphenol A (BPA), a chemical found in plastics that include baby bottles and
packaging for food and beverages, may put people at risk for heart disease and
type 2 diabetes, a new study concludes.
BPA is one of the world's highest production-volume
chemicals, with more than two million metric tons produced worldwide in 2003. It
is used in plastics in many consumer products and there has been an increase in
demand of 6 percent to 10 percent annually.
"Widespread and continuous exposure to BPA, primarily
through food but also through drinking water, dental sealants, dermal exposure,
and inhalation of household dusts, is evident from the presence of detectable
levels of BPA in more than 90 percent of the US population," say researchers in
a new journal article.
The research, published this week in the
Journal of the American Medical Association (JAMA),
was released early to coincide with a public hearing the
US Food and Drug Administration (FDA) is holding on the issue this week.
This is the first study of associations with BPA levels in
a large population, and it explores "normal" levels of BPA exposure.
Evidence of adverse effects in animals has created concern
over low-level chronic exposures in humans, but there is little data of
sufficient statistical power to detect low-dose effects.
According to one expert, the study is suggestive, but not
conclusive. "I am really torn here, because I really believe that BPA has some
concerns, but this paper does not prove that," says Dr. Hugh S. Taylor, an
associate professor in the Department of Obstetrics, Gynecology & Reproductive
Sciences at the Yale University School of Medicine.
"It's sort of classic guilt by association," Dr. Taylor
says. "The correlations are there. There is more diabetes and more heart disease
in people with more BPA, but people who are eating a lot of things out of cans
and water bottles are going to have higher BPA in their urine, and they're
probably not eating the healthiest diet, so you might expect them to have
diabetes and heart disease."
In the study, led by Dr. David Melzer, of Peninsula Medical
School, Exeter, in the United Kingdom, researchers looked at the association
between BPA and heart disease and diabetes among 1,455 adults who participated
in the 2003-2004 US National Health and Nutrition Examination Survey (NHANES).
Dr. Melzer's group found people with high levels of BPA
were more likely to have heart disease, including heart attack, or diabetes. In
fact, high levels of BPA increased the risk for these diseases by 39 percent,
the researchers report.
In addition, higher BPA concentrations were associated with
abnormal concentrations of three liver enzymes.
"There are real problems with BPA use," Dr. Taylor says.
"BPA is an estrogen-like endocrine disruptor. Clearly, from the animal data,
there is reason to believe [that] BPA is hazardous to the fetus if taken during
pregnancy. I think it's worth being cautious and at least trying to keep women
who are pregnant away from BPA," he says. "With adult exposure, it is less
certain that there is any adverse effect."
Dr. David O. Carpenter, director of the Institute for
Health and the Environment at the University at Albany in New York, notes that
he has shown that these very same diseases are associated with PCBs
[polychlorinated biphenyls], dioxins, and chlorinated pesticides.
"I have a strong suspicion that BPA is doing exactly the
same thing," he says. "I have been arguing that BPA should be banned for a long
time just on the basis of its effect on endocrine systems. The industry reports
that argue that it has no adverse effects are simply wrong," he says.
There is nobody who is not exposed to BPA, Dr. Carpenter
adds. "The problem in our society is that we are all exposed to this mixture of
chemicals, and which ones are responsible for disease is difficult to determine.
This is really an important new observation," he says.
The American Chemistry Council
thinks the link between BPA and heart disease and diabetes is tenuous. "While
scientific study continues, the public should be reassured by the FDA's
own recent review of bisphenol A," says Tiffany Harrington, the council's
director of public affairs.
BPA has been the subject of extensive scientific testing
and government reviews worldwide, Harrington says. "These reviews have
consistently concluded that human exposure levels to BPA are low and within the
safe limits set by government authorities," she says.
"While properly designed and executed statistical studies
on this and other compounds can bring valuable new insights with respect to
human health, sometimes they do not, and sometimes they merely claim false
associations that add little to and even confuse the body of science,"
Harrington adds.
Another expert, Dr. Rick Stahlhut, from the University of
Rochester Medical Center in New York, agreed this study does not provide a
causal link between BPA and heart disease and diabetes, but it is the first step
toward discovering such a link. "The findings are intriguing, but they have to
be validated," Dr. Stahlhut says.
Dr. Stahlhut says he expects the controversy to continue.
"It's just like every other environmental exposure problem. We are always two
decades behind. Ten to 20 years after the chemical is produced, suspicions start
to rise. By then, it's a multi-billion-dollar industry, and now there are forces
whose job it is to keep it going - and that is what is happening now," he says.
Until all the facts are known about BPA, Dr. Stahlhut
recommends not exposing yourself to things you do not need. Do not take it for
granted that because some "smiling guy on TV" says it is OK, it is, he says.
Always consult your physician for more information
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According to the National
Toxicology Program (NTP) at the National
Institute of Environmental Health Sciences, BPA is a high production
volume chemical used primarily in the production of polycarbonate plastics
and epoxy resins.
Polycarbonate plastics have many applications including
use in some food and drink packaging, e.g., water and infant bottles,
compact discs, impact-resistant safety equipment, and medical devices. Epoxy
resins are used as lacquers to coat metal products such as food cans, bottle
tops, and water supply pipes. Some dental sealants and composites may also
contribute to BPA exposure.
The primary source of exposure to BPA for most people
is through the diet, states the NTP. While
air, dust, and water are other possible sources of exposure, BPA in food and
beverages accounts for the majority of daily human exposure.
BPA can leach into food from the protective internal
epoxy resin lining of canned foods and from consumer products such as
polycarbonate tableware, food storage containers, water bottles, and baby
bottles. The degree to which BPA leaches from polycarbonate bottles into
liquid may depend more on the temperature of the liquid or bottle, than the
age of the container.
The NTP states that one
reason people may be concerned about BPA is because human exposure to BPA is
widespread. The 2003-2004 National Health and Nutrition Examination Survey
(NHANES) conducted by the Centers for Disease Control
and Prevention (CDC) found detectable levels of BPA in 93 percent of
2,517 urine samples from people six years and older. The
CDC NHANES data are considered representative
of exposures in the US.
Another reason for concern, especially for parents, may
be because some animal studies report effects in fetuses and newborns
exposed to BPA.
The NTP has “some
concern“ for effects on the brain, behavior, and prostate gland in fetuses,
infants, and children at current human exposures to BPA.
The NTP has “minimal
concern“ for effects on the mammary gland and an earlier age for puberty for
females, in fetuses, infants, and children at current human exposures to
BPA.
More research is clearly needed to understand exactly
how these findings relate to human health and development, but at this point
the NTP cannot dismiss the possibility that
the effects being seen in animals may occur in humans.
In the case of BPA, the NTP
expressed “some concern” for potential exposures to the fetus, infants, and
children.
There are insufficient data from studies in humans to
reach a conclusion on reproductive or developmental hazards presented by
current exposures to BPA, but there is limited evidence of developmental
changes occurring in some animal studies at doses that are experienced by
humans.
It is uncertain if similar changes would occur in
humans, but the possibility of adverse health effects cannot be dismissed.
The NTP conclusions are
based on the weight of scientific evidence, and integrate toxicity and
exposure information.
Always consult your physician for more information.
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