Tag Archives: toxicology

Name Your Poisoner

There seems to be a newfound fondness for the Russian government on the part of Trump’s followers, both in the government and the population at large. Several officials have been less than forthright about their connections with Russian government officials or moneyed oligarchs. Attorney General Jeff Sessions has recused from the investigation of Russian interference in our election. Mike Flynn was fired after only three weeks on the job due to his failure to divulge his connections to Russia. Paul Manafort, who was Trump’s campaign manager was fired after it was revealed that he had multi-million dollar contracts with certain Russian oligarchs. Other examples abound.

There seems to be a consensus on both sides of the political aisle that the Russian government or associated criminal elements tried to affect the outcome of our election, and would like to see further destabilization of democracy in America. This is the usual stuff of “cloak and dagger” behavior reminiscent of the cold war. The Russian government also has a much darker side.

Early in the twentieth century, Russia developed a lab to test poisons to be used by various agents and spies. Poisoning is a common method for dealing with both foreigners and Russian dissidents. One of the more famous events occurred during the cold war. Georgi Markov was an anti-communist Bulgarian writer who lived in exile in London. While crossing a bridge to catch a bus in 1978, he was poked in the buttocks with a umbrella. Later in the day he went to a hospital with flu-like symptoms. Three days later he was dead. On autopsy, a small hollow pellet was discovered at the site of the poke. Chemical analysis showed that he had been intentionally poisoned with ricin, an extremely potent toxin made form castor beans.

Victor Yushchenko ran in 2004 for president of Ukraine on a policy of aligning his country with the west rather than Russia. Shortly after his election he met with Ukraine officials who favored an alliance with Russia. Later he came down with what was initially diagnosed as acute pancreatitis. Later still he developed extreme chloracne, a condition only seen in individuals exposed to certain chlorinated hydrocarbons. In Yushchenko’s case it was determined that he was exposed to TCDD, a toxic bi-product of the manufacture of Agent Orange. Although he survive he was ill for months and remains disfigured from the chloracne.

Another dissident, Alexander Litvinenko fled Russia for asylum in the UK. In 2006 he became ill in the evening after having lunch with two Russian officials. He was diagnosed with acute radiation poisoning from Polonium-210. Three weeks later he was dead. It is thought that only a few drops of a Polonium solution in a bowl of soup would produce a lethal effect. This synthetic element can only be had from reprocessing waste from a nuclear reactor.

Surely the luckiest Russian poisoning victim is Vladamir Kara-Murza. Mr. Kara-Murza describes himself as a Russian democracy campaigner. In May 2015 he became ill for unknown causes. Blood works showed elevated levels of heavy metals but no known toxins were found. Although sophisticated chemical analysis can detect the most minute amounts of toxin, it only works if you know what to look for. Last February he became inexplicably ill again. He was in critical condition for weeks but is now recovering. It can’t be said for sure if Kara-Murza was poisoned – twice – but surely he is a target of the Kremlin and Russian leaders have a long-standing monstrous tradition of poisoning political opponents.

Cell Phones and Cancer, Again

Like the Phoenix rising from ashes, so is the “cell phones cause cancer” meme. The current claim is based on a study done with rats exposed full body for nine hours a day for several months. The result was a statistically significant increase in two types of tumors, gliomas and schwannomas. Gliomas are tumors in glial cells of the brain and are rare, the incidence in 2008 was less than 7 per 100,000. In this study the schwannomas were found in heart cells and are even rarer. Important also was the fact that there was a dose-response relationship. Higher intensity cell phone radiation produced a greater incidence of tumors.

So is it time to keep that phone on speaker and never, never carry it around in your bra? Maybe not, at least the bra part. Where as there were increased tumors observed in male rats, there was no increase in tumors in females regardless of the dose (intensity of radiation.) That in itself is a problem as both male and female rats have glial and schwann cells so why were only the males affected?

The bigger problem with a link between cell phones and cancer is the fact that it is biologically implausible. Cell phones utilize radio waves as do WiFi, TV, microwaves and others. This is the lower energy form of electromagnetic radiation that does not cause ionization and therefore doesn’t cause chemical reactions. A chemical reaction is required to cause a mutation in DNA and hence initiate cancer. Higher energy radiation known as ionizing is a well know cause cancer. Too much ultraviolet (UV) radiation from the sun is the most common cause of cancer. X-rays are also a known cause of cancer.

The history of cell phones and cancer is somewhat odd. In 1989 Susan Reynard , 31, was diagnosed with an astrocytoma, a tumor of the astrocytes which is another type of brain cell. The tumor, in the eyes of her husband resembled the outline of a cell phone – just like she held it to her head. She died in 1992 and her husband sued the phone manufacturer and service provider claiming a causal link between her cell phone use and the tumor which killed her. He lost the suit.

A number of studies with laboratory animals and epidemiological studies with humans have been been conducted over the years with variable outcomes. Studies with animals always suffer from the fact that there may be physiological differences between us and other animals, hence risk factors will be different.

Even without a controlled study the connection between brain cancer and cell phone use seems sketchy. Whereas the incidence of brain cancer has remained relatively steady over the past few decades, use of cell phones has increased several hundred fold. It is estimated that 91% of adults in the US use cell phones.

Epidemiological studies look at the relationship between disease and human population factors. The most accurate are prospective studies where a group a people are followed over a long time span to see if there is a correlation with a disease and their exposure. A prospective study concluded in 2011 confirmed this lack of a relationship. Thousands of participants across 13 countries were followed for close to a decade. The was no discernible relationship whatsoever between cell phone use and cancer.

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Arsenic Anyone?

A popular talk show doctor recently had several brands of Apple juice tested and claimed to have found Arsenic. Whereas nobody wants poison in her food, the question of the amount and its relevance is important. First a little background on Arsenic.

One of the first things that come to mind in association with Arsenic is poison. And indeed it is poisonous. It has been used as a pesticide because it is generally poisonous to all forms of life, rats, cockroaches, even some fungi succumb to it. Ironically it is also known to be an essential trace element for some organisms and possibly humans in tiny, tiny amounts.
 
Arsenic has been known since antiquity and is poisonous to varying degrees depending on its form. As important as the potency of a poison is the amount of the poison. A seventeenth century physician-chemist by the name of Paracelsus famously proclaimed “everything is poisonous, nothing is poisonous, the dose makes the poison”. One example is lima beans which naturally contain toxic cyanide ion, but lima beans aren’t toxic as the dose of cyanide is too small.
 
Arsenic has historically been a component of intrigue. In 15th century Italy the Borgia family waxed powerful. Lucrezia and Cesare were among the children of Cardinal Rodrigo Borgia (who became Pope Alexander VI- obviously things in the church were different in those days!) Lucrezia was said to be a very effective poisoner as she had learned how to concoct lethal Arsenic potions which were undetectable in food or drink. Arsenic-laden wallpaper
 
Napoleon may have been done in by Arsenic, but not by an intentional poisoning. His villa on the island of St Helena had wallpaper colored with Sheele’s Green, a pigment made from Arsenic. In moist air a mold can grow on the wallpaper and convert the Arsenic to a volatile form. It appears at least for Napoleon that not the butler but rather the wallpaper did it. Another Arsenic pigment called Emerald Green may have impaired the health of Cezanne, Van Gogh, and Monet among others.

Emerald Green Paint Pigment

Emerald Green Paint Pigment


 
Some women in the Victorian era would eat small amounts of Arsenic to produce a pale complexion. Tanned skin in those days indicated that one worked in the fields and was therefore of a lower class.
Now back to Apple juice. Any Arsenic in juice is an issue if for no other reason that juice is a mainstay of many children. Two questions come to mind. Where did the arsenic come from and is there enough Arsenic in the right form to be a risk to health?

 Generally speaking the Arsenic is coming from the soil in which the fruit is grown. It can be in the soil naturally or due to use of Arsenical pesticides applied to the soil. Lead Arsenate was used in the United States until the seventies. Arsenic is very stable and could persist in soils for many years. Another source may be China, where environmental regulations are lax at best. Over half of the Apple juice sold in the United States now comes from China.

The amount of Arsenic measured recently in some of the juice samples does exceed the World Health Organisation’s suggested limit for safety. However the method of measurement included both toxic inorganic and relatively nontoxic organic Arsenic. When only the toxic form is considered the level appears to be safe. The FDA has been monitoring arsenic in Apple juice for decades and sees no threat to public safety based on these findings.

tablet

Worried Sick- the Nocebo Effect

A synthetic form of thyroxine called Eltroxin, chemically and biologically identical to natural thyroxine, has been in use for over forty years. It is used effectively to treat hypothyroidism which if left untreated can result in a range of symptoms up to and including heart disease. In 2007 GlaxoSmithKline moved its manufacture from Canada to Germany. At the same time they updated the actual tablet, changing its physical form but leaving the active ingredient the same.

Shortly thereafter in New Zealand a trickle of reports of adverse side effects not seen before were received by a health monitoring organization. After the new side effects began to show up in the press, reports of the new symptoms skyrocketed over a thousand fold even though the only difference was the appearance of the pills, not the chemistry.

A study by a team of Italian gastroenterologists involved patients who were lactose intolerant and a control group who weren’t. The subjects were told that the study involved examining the effects of lactose on the gut. Even though the subjects were given only a glucose tablet which can not cause symptoms, forty four percent of those intolerant and and 26 percent of those tolerant, reported gastrointestinal problems.

Many here in the US and overseas suffer from a so called WiFi syndrome. A range of symptoms including nausea, head aches, joint pain etc. occur when they know they are exposed to electromagnetic fields, but only if they know they are exposed. There is absolutely no evidence that the EMF can cause these symptoms.

These examples are only three of hundreds of examples of what is know as the nocebo effect, from latin for “I shall harm”. In years past this may have been referred to as a form of mass hysteria, now more benignly called a psychogenic illness. In some cases it has been shown that the mere suggestion of a possible symptom or side effect can cause a biochemical change in the body which results in the symptom, but only from the suggestion.

This was shown elegantly in an animal model using rats. They were trained by classical Pavlovian training to become asthmatic. First the experimenters gave the rats a natural substance, histamine, which causes an asthma reaction and paired that with the ringing of a bell. In subsequent trials just the bell ringing would cause the rats to release excess histamine into their blood, thus triggering an asthma attack. If rats can be trained to become asthmatic, shouldn’t it be true that people who have asthma reactions could be trained to not react?

The nocebo effect is the evil twin of the better known placebo effect, latin for “I shall please”.

nocebo and placebo

nocebo and placebo

Any benefits of homeopathic medicine, and much folk medicine are a result of the placebo effect, including modern day agents associated with Traditional Chinese Medicine, acupuncture, much of chiropractic, and over the counter medications called nutritional supplements.

The question as to whether society should allow profit from the sale of placebos is a moral one. Should some one make money by suggesting that a nostrum will do something, even if it only works for believers? It sure works for Madison Avenue. Ca-ching.

Global Warming, Fossil Fuels, Air Quality, and Health

Everybody wants to be healthy, and we go to considerable lengths to achieve the same. Preventive care, diet and exercise all contribute to good health. There are factors however which are beyond our individual capacity to control. Global warming is one of those things that we have to address collectively. It comes about due to the release of certain air pollutants. Reducing these pollutants will not only help mitigate the direct environmental damage but also improve our health.

Air pollution has been linked to several of the leading causes of death in the United States. Asthma, chronic bronchitis, emphysema, lung cancer, myocardial infarction, congestive heart failure, and stroke have all been shown to be linked in multiple peer reviewed articles in major medical journals. Even conditions as diverse as Type II diabetes and Alzheimer’s’ disease have shown correlations with air pollution levels.

Chronic exposure to gasses such as ozone and nitrogen oxides and fine particulate matter

particulate matter

particulate matter

cause an inflammatory reaction in sensitive tissues and contribute to poor health. The source of the pollutants is a result of our quest for the cheapest possible energy sources to power our lives. There is a deal with the devil in cheap energy sources, mostly fossil fuels. Burning coal and oil and to a lesser extent natural gas result in the production of these unhealthy pollutants.

That good news is that the USEPA through the Clean Air Act regulates these pollutants and constantly reviews the scientific data supporting limitations of pollutant release. The act was passed in 1963 and has been significantly amended several times to tighten air quality standards. Enforcement of the act has led to considerable improvement of air quality, but currently something like one third of Americans live in counties which are out of containment.OzoneFormationDiagram

In 1990 Congress directed the EPA to conduct occasional scientific reviews as to the costs and benefits of air quality regulations. A 2009 study by the National Research Council finds that the cost for health care from one coal fired power plant is 156 million dollars per year. Collectively 62 billion dollars a year is spent as a result of burning coal to make electricity. This is due to the health effects of pollutants at currently allowed levels. Another study showed that over 20 years of clean air act regulations, one dollar spent on air quality protection resulted in a savings of 44 dollars in health care costs. The EPA estimates that the investment of 65 billion dollars in 2020 will save a total of 2 trillion dollars in health care.

One argument to revitalize the economy is to cut regulations, thus lowering the cost of doing business. Lowering air quality standards may save business and the consumer money on energy production but will greatly increase health care costs- out of proportion with the savings on energy costs. This is not the time to try to save money limiting the actions of the EPA, regardless of the budget cutting fervor in congress. We can pay a little for air quality but overall save a lot by supporting strict air quality standards, even if it means abandoning coal fired electricity production.

There is no question that somewhere in the future we will stop burning fossil fuels to produce energy, whether it is due to depletion of the resources or our recognition of the harmful effects to health and the environment. Any and all programs which get us away from fossil fuel consumption will benefit society. Ultimately we need clean sustainable energy sources such as wind and solar which release no air pollutants.

poison ivy

Poison Ivy

The old adage “leaves of three, let it be” helps to identify and therefore avoid poison ivy. The plant is polymorphic, growing as ground cover, small shrubs up to two or three feet high, or a climbing vine. It is often confused with virginia creeper which has five leaves. Formally named Toxicodendron radicans, it and other related plants contain urushiol (oo-rush-ee-ol) . The substance is present in all parts of the plant; leaves, stems, roots, and berries. Poison ivy, poison oak, and poison sumac are known to cause the characteristic itchy, blistering rash.

Virginia-Creeper

Virginia-Creeper

Other plants such as cashews also have urushiol when raw and must be properly processed, shelled and roasted, to remove the plant oil. Lacquer, the stuff that produces the beautiful shiny finish in furniture, contains small amounts of urushiol and can affect hypersensitive individuals. The name urushiol comes from the Japanese name for Lacquer, urushi.

The first time, or first few times one is exposed there usually isn’t a reaction. Only after being exposed does one become sensitized and on second exposure develop the itchy rash. This is because urushiol is an allergen, something which causes an allergic reaction , and and the allergy has to be “learned” by exposure.

Actually it is a bit more complex. Only proteins, very large molecules, can cause an allergic reaction. Much of our bodies are protein so our immune system must be able to distinguish our proteins and foreign proteins. Antibodies develop as a method to rid the body of foreign protein. A whole cascade of chemical reactions occur once the immune system identifies a foreign protein. Urushiol is not a protein but a substance know as a hapten. Haptens are small molecules which can chemically react with protein. Once a protein, for example the keratin of our skin, has reacted reacted with urushiol our bodies no longer recognize the protein as “self” but rather as foreign.

Urushiol is a fat soluble oleoresin, which means that it can penetrate the skin within an hour or two. There it reacts, “labels” the protein, and sets the allergic reaction in motion, the rash occurring several hours after exposure. Heavier exposures result in a faster reaction.

This has lead to the misconception that the allergen may be carried through the blood. For example heavy exposure to the back of the hand and only slight exposure to the upper arm means that the rash will show up on the hand first and arm only later.

Another misconception is that the fluid present in the blisters contains the poison. Once the blisters form, the poison is long gone. You can’t get a reaction just by coming in contact with someone else’s rash. You can be exposed by secondary contact however. There is a fairly wide variation is sensitivity so exposure and subsequent reaction can occur when a sensitive person handles the clothes of a less sensitive person.

In extreme cases, people are exposed by inhaling smoke particulates from burning poison ivy. This can be dangerous as the rash occurs in the throat and even in the lungs.