Household Hazards

 Recently, the Centers for Disease Control reported an alarming outbreak of bone marrow toxicity in multiple U.S. States, primarily in the southwest. The potentially life-threatening problem manifest as a paucity of infection-fighting white blood cells, a condition called agranulocytosis. This is a common and expected side-effect of cancer chemotherapy and can also occur following the use of certain prescription medications

We are learning once again that imported Chinese toys mean risky playthings and that the "watchdog" agency meant to protect U.S. consumers seems to have been curled up asleep, oblivious to the public health trespass.

Health

Bhopal, 1984 – West Virginia near-miss, 2008

Paul D. Blanc M.D., M.S.P.H. on December 23, 2009

December 3, 2009 marked the 25th anniversary of the 1984 chemical disaster in Bhopal, India. The event was marked by local protests in India and by worldwide media notice. Commentators emphasized the death toll (at least 10,000, with many estimates higher after taking into account delayed mortality) and Union Carbide-Dow Chemical corporate culpability (there is still an Indian arrest warrant out for the former Union Carbide chief executive officer). But most reports ignored the fate of the Institute West Virginia facility that also handled the same chemical that caused the Bhopal damage.

December 3, 2009 marked the 25th anniversary of the 1984 chemical disaster in Bhopal, India. The event was marked by local protests in India and by worldwide media notice. Commentators emphasized the death toll (at least 10,000, with many estimates higher after taking into account delayed mortality) and Union Carbide-Dow Chemical corporate culpability (there is still an Indian arrest warrant out for the former Union Carbide chief executive officer). But most reports ignored the fate of the Institute West Virginia facility that also handled the same chemical that caused the Bhopal damage.

In medical toxicology referrals, I regularly encounter patients who are worried about an environmental overexposure because a test battery of multiple substances showed one or another elevation. Typically the test was ordered with no specific toxin in mind, but rather as part of a "shot-gun" approach to making a diagnosis - not usually a good idea, as watching any episode of House will make clear. One of the environmental tests most likely to go awry is a hair analysis for metal toxins. 

The seamier side of global toxics trade has received much needed scrutiny in the light of a particularly egregious episode of environmental contamination. In August 2006, various neighborhoods of Abidjan (capital of the Ivory Coast) were turned into ad hoc toxic dump sites. This Summer of Muck happening was made possible through hazardous waste off-loaded from the tanker Probo Koala, which had sailed a circuitous route to Africa from North America via Europe. Having arrived at Abidjan, Probo Koala’s liquid was pumped out into trucks and then simply spread around town, dumping it in ditches and on roadsides.

A few months ago, I consulted on the medical case of a young man with an extremely low platelet blood cell count. The problem, which could have caused life-threatening bleeding, was suspected to be a medication side-effect. The patient had been diagnosed with inflammatory bowel disease and recently started on a standard and widely-used medication for that condition. But the issue was not so straightforward. At the same time that the treating doctors prescribed the drug, the patient also began self-medicating with a Chinese, multi-herbal preparation. 

As we gear up for a potential new round of H1N1, aka swine flu, it is worth noting some of the other health complications of human-pig encounters.  

This summer, new international rules spelled out the end of the short-lived polyurethane swimsuit era in competitive sports. Amid all media splash (what does Michael Phelps think?), one ripple-effect that went unnoticed was the likely benefit of fewer factory workers coming down with asthma from making this high-tech gear.  

The week following my last posting on lead hazards in artificial turf, the California State Attorney General, Jerry Brown, announced a major legal settlement with the manufacturers of AstroTurf.

In previous postings, I addressed emerging adverse health issues related to two metals: zinc and manganese. Lead, unlike those substances, is a hazard so well known and so widely recognized that most people reasonably assume the problem has long since been addressed. 

My last posting dealt with zinc, a vital nutrient that can also be toxic. I focus here on manganese, another nutrient that also can also do harm. Inorganic manganese has had longstanding commercial applications, with known hazards for those who work with the metal. Now scientific innovation has managed to produce an entirely new class of manganese-based organic chemicals, signaling a new health threat and a potential environmental disaster. 

On June 16 2009, the U.S. Food and Drug Administration (FDA) FedEx'd a warning letter to Matrixx Initiatives, Inc concerning a new homeopathic hazard. The FDA rarely concerns itself with homeopathic over-the counter products, but this case involved a heavily promoted and very widely used class of cold remedies.