Monday, 16 April 2012

The increasing burden of disease from food and water contamination

By Syed Akbar

How safe is the food we eat, the water we drink and the air we breathe? 
Research studies show that with rapid urbanisation and consequent increase 
in pollution levels, the "burden of disease" has increased manifold during the 
last one decade.
Incidence of autism in children due to pollution increased 10 fold while male 
birth defects went up by two times with sperm count decreasing by one per 
cent every year. The burden of asthma in children shot up by 200 per cent 
even as acute lymphocytic leukaemia (cancer of white blood cells) recorded a 
62 per cent increase. Incidence of childhood brain cancer increased by 30 per 
cent. Preterm births recorded 23 per cent increase while infertility in couples 
went up by five to 10 per cent. Pollution is also the major factor in three to 
five per cent of birth defects in India.
The statistics are alarming. But more shocking are research reports that reveal   
that vegetables, fruits, cereals and even fish tend to accumulate heavy metals 
and dangerous chemicals from the soil. This simply means we consume a 
plethora of harmful chemicals and metals ranging from phthalate esters to 
mercury whenever we eat fruits or vegetables. These dangerous elements 
continue to accumulate in our bodies through food, water and air and cause a 
"synergetic effect", the overall result of which is disastrous to our health. The 
chemical accumulation in the food chain is because of water pollution and the 
increasing tendency to use sewage (treated or untreated) for horticulture.
The Environmental Working Group of the United States, in a chemical 
analysis of placental blood of 10 new born babies, found that on an average 
200 industrial chemicals and pollutants in the umbilical cord. The total 
number of chemicals that made their way into the blood stream of the babies 
through their mothers is a whopping 287.
Of the 287 chemicals detected in umbilical cord blood, as many as 180 cause 
cancer, 217 are poisonous to the brain and nervous system and 208 cause 
birth defects.
With pollution eating into the health, the adult mortality rate (probability of 
dying per 1,000 population between 15 and 60 years of age) for Indians by 
the World Health Organisation is as high as 275 for men and 202 for women. 
This is as against 91 and 48 respectively for Israel and 198 and 136 
respectively for Lebanon despite these two countries witnessing large-scale 
deaths in violence. If put in simple words, pollution has emerged a major 
killing factor as compared with deaths in insurgency or terrorism.
According to a National Environment and Health Action Plan report for India 
by the World Health Organisation, about 70 to 80 per cent of water borne 
diseases are caused due to contamination of surface and ground water due to 
discharge of untreated/partially treated sewage and industrial effluents into 
the water bodies.
The University of Hyderabad which conducted a study on horticultural crops 
grown on the polluted riverbed of Musi found "bioaccumulation" in a number 
of leafy vegetables, vegetables and fruits including pomegranates. Irrigation 
of agricultural fields with treated/ untreated effluent containing heavy metals 
such as chromium, lead, mercury or arsenic will also lead to absorption of 
harmful elements into plant bodies through roots.
Research by Acharya NG Ranga Agricultural University revealed pesticide 
residue in vegetables and fruits. Though most of the pesticide goes off with 
the washing, still minute portions remain and this minute quantity goes on 
accumulating in the body causing serious health problems including cancer.
Another WHO report focusing on Southeast Asia region points out that over 
40 per cent of the global burden of diseases from environmental factors falls 
upon children below five years of age. More than five million children die 
each year from environmental-related diseases.
According to the report, in India each year over three million people die 
prematurely from water-related diseases and another two million succumb to 
indoor air pollution from smoky stoves. Infants and young children top the 
list followed by women from rural households. One million die from urban 
air pollution.
Increased industrialisation and urbanisation has resulted in hundreds of 
thousands of chemicals being released into the atmosphere every day. What 
worries the health experts is that the health hazards of only a very few of 
these chemicals are known. Most commonly used chemicals like 
organochlorines can cause grave harm to the unborn or new-born child. In 
some cases the foetus is also affected.
Studies by Hyderabad-based National Institute of Nutrition have shown that 
the milk of Indian mothers contains among the highest amount of the 
insecticide HCH (Hexachlorocyclohexanes) anywhere in the world. Another 
NIN report shows that excessive administration of veterinary medicines to 
cattle is leading to pharmaceutical residues in the cattle milk. No wonder then 
that you take a bout of veterinary medical residues along with your morning 
tea or coffee. Moreover, increased absorption and storage of toxins in the 
growing organs of children and adolescents increase the chance for 
development of serious or life threatening disease throughout life.
The chemicals and metals that have made their way into our bodies through 
either the food chain or vehicular pollution include mercury (accumulates in 
seafood and harms brain development); Polyaromatic hydrocarbons (from 
burning petrol or garbage and causes cancer);  Polybrominated 
dibenzodioxins and furans (plastic production and incineration, harms 
hormone system); Perfluorinated chemicals (from products like Teflon and 
food wrap coatings, birth defects and cancer); Polychlorinated 
dibenzodioxins and furans (from PVC production, causes cancer); 
Organochlorine pesticides (DDT and other pesticides, reproductive defects); 
Polybrominated diphenyl ethers (furniture foam, computers, and televisions, 
affects thyroid); Polychlorinated Naphthalene (Wood preservatives and 
varnishes, causes liver and kidney damage); and Polychlorinated biphenyls 
(Industrial insulators, nervous system problems). 

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The Ill Effects
--------

At risk are our reproductive, immune and digestive systems. Harmful effects 
of pollution, particularly the air pollution (both indoor and outdoor), on 
human body have been well established by a series of studies in Hyderabad 
conducted by the National Institute of Nutrition, the Centre for Cellular and 
Molecular Biology, the Indian Institute of Chemical Technology, the Institute 
of Genetics and Hospital for Genetic Diseases (Osmania University), Owaisi 
Hospital and Research Centre and Mahavir Hospital among others.
Atmospheric pollution can damage male and female reproduction, immune 
system, hearing, cardiovascular (heart) system and blood, liver, skin, lungs, 
brain and nerves, kidneys, stomach and intestines, hormonal system and 
vision and cause cancer and birth defects.
"Ozone layer depletion is occurring because of pollution, which is leading to 
UV light reaching earth", says dermatologist Dr Anup Lahiry adding that 
"this in turn is leading to sensitivity to light, skin allergies and ageing of the 
skin. Pollution is also making skin more oily and acme prone".
A study on the harmful effects of vehicular pollution on children by the 
National Institute of Nutrition showed that nearly one-third of those tested in 
Hyderabad had lead levels of 15 micrograms per decilitre or more in their 
blood. This is as against the upper permissible limit of 10 microgram per 
decilitre. 
The study revealed that lead toxicity not only inhibits cognitive development 
and loss of intelligence but also causes anaemia and progressive damage to 
organs. Chronic low level exposure to lead damages organ system including 
brain, nervous system, haemoglobin synthesis and renal functions.
Automobile emissions enter lungs directly and from there into the blood 
stream. In some cases the pollutants enter bone marrow and remain there for 
as long as six years. The damage is gradual but irreversible.
Says consultant palmonologist Dr S Mallikarjun Rao, "industrial pollution 
and mainly vehicular pollution is leading to high levels of air pollution. The 
air has high levels of sulphur dioxide, carbon monoxide, oxides of nitrogen, 
suspended particular matter and other chemicals causing allergic reactions, 
recurrent cold, bronchitis, precipitate asthma, chronic obstructive pulmonary 
disease, lung cancers etc. It also leads to increase in mental stress levels. 
There is increase in the incidence of such diseases in cities like Hyderabad in 
the recent past".
Heavy metal contaminants like mercury retard normal brain development and 
lead to permanent impairment. Vinyl teethers and plastic toys commonly sold 
in the Indian markets contain chemicals such as DEHP (Di (2-ethylhexyl) 
phthalate), that leach and hamper the development of the child's reproductive 
system.
A survey by UNICEF in different parts of the country reveals that 19.3 per 
cent of under five children suffer from acute respiratory infections. 
According to WHO, indoor air pollution from solid fuels ranks fourth among 
risks to human health in developing countries and ranks higher still in India 
(third), just below malnutrition and lack of safe sanitation and drinking 
water. As many as 34,000 women die every year in the country due to 
chronic obstructive disorders.
No wonder then that the number of pollution related patients has increased in 
cities like Hyderabad, New Delhi, Mumbai, Kolkata, Bangalore and Chennai. 
"Lots of patients with respiratory allergies from simple running nose to 
severe asthmas are reporting of late due to air pollution. Constant exposure to 
noise due to vehicular traffic and blaring sounds from loud speakers can lead 
to hearing loss at an early age. Such noise can also lead to irritation. 
Prevention and protection is the best option," suggests senior ENT surgeon 
Dr Sajeet Kumar.
With the discovery of vaccines infectious diseases like polio, smallpox, 
diphtheria and rheumatic fever have declined. Surprisingly pollution-related 
health problems including asthma, autism, attention deficit and hyperactivity 
disorders, childhood brain cancer and acute lymphocytic leukaemia have 
increased in the recent past.

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Infertility
-------

Pollution and infertility. May sound strange. But studies by the Hyderabad-
based Centre for Infertility Management, Hetero Research Foundation, 
Owaisi Hospital and Research Centre show that chemical pollutants like 
phthalate esters are causing endometriosis in women. What is worrying is 
that women are also passing on infertility to their sons, besides suffering 
themselves from the painful endometriosis.
"Women with endometriosis showed significantly higher concentrations of 
Di-n-Butyl Phthalate, Butyl Benzyl Phthalate, Di-n-Octy phthalate and 
diethyl Hexyl phthalate," points out fertility expert Dr Roya Rozati 
concluding that phthalate esters are instrumental in the aetiology of 
endometriosis. As many as 49 infertile women were studied for the purpose 
in Hyderabad.
Carbon monoxide from burning of fossil fuels combines with haemoglobin in 
the blood to form carboxyhemoglobin reducing the oxygen carrying capacity 
of the blood. This poisonous gas also contributes to adverse pregnancy 
outcomes, including miscarriage, stillbirth, low birth weight, and early infant 
mortality.
"Environmental pollution is directly related to malfunction of testes leading 
to male infertility. It is also related to failures in treatment in reproductive 
units (test tube baby centres). It can also cause ovarian dysfunction, resulting 
in female infertility," warns Dr Meera Rajagopal a fertility specialist at 
Akshaya Fertility Centre.
Pollution is also stated to be the cause of undescended testis in infants. This 
is a common birth defect with two to five per cent of babies born having 
undescended testis. But with increasing levels of pollution, the percentage of 
children suffering from the problem has increased greatly even in developed 
countries like the USA. Pollution prevents testicles from completely 
descending into the scrotum during pregnancy. Children born with this defect 
are at higher risk for testicular cancer and breast cancer.
Five to 10 per cent of couples suffer from infertility-related problems. About 
50 per cent of pregnancies end in abortions and three to five per cent of 
babies are born with defects.
Health experts have found significant regional differences in sperm count 
that cannot be explained by differences in genetic factors. Pollution is also 
related to increasing incidence of hypospadias (deformed penis). Average 
sperm counts in industrialised countries appear to be declining at a rate of 
about one percent each year.

====
Cancers
====
Incidence of cancers particularly of lung, breast, uterus, testicular, prostate 
and gastrointestinal tract. Exposure to chemicals like dioxin during foetal 
development has been found to cause endocrine-related cancers like breast 
and uterine cancers in women. Dioxin in men even in minute quantities (0.02 
to 10 parts per billion) will change the testosterone levels and cause diabetes 
and also changes the sex ratio of children i.e. a man with this much little 
quantity of dioxine in the blood will father twice as many girls as boys.
"Environmental pollution has several deleterious effects on diseases of 
kidney and urinary bladder. Some specific agents when exposed for a long 
time can also cause bladder cancer. Water pollution in relation to kidney 
stones is under investigation," says senior urologist Dr V Raja Gopal.
Childhood cancer cases increased by 27.1 per cent while brain and nervous 
systems cancers increased by 56.5 per cent. The incidence of testicular cancer 
also went up to 66 per cent. The effect of pollution on cancers can be gauged 
from the fact that only 10 per cent of cancers are related to genetic factors 
and the rest to environment pollution.
Pollution is being projected as a major factor for increase in breast cancer. A 
report by US Environmental Protection Agency points out that among girls 
born today, one in seven is expected to get breast cancer and one in 30 is 
expected to die from it. Among those 65 and younger, breast cancer 
incidence rose 1.2 per cent per year, corresponding to a doubling every two 
generations (58 years).
Consultant dietician Sunita Sapur says the gastrointestinal tract may get 
affected due to adulterated food. "The microvilli in the GI tract which 
produce enzymes for digestion also get affected which leads to digestive 
disorders and mal-absorption of essential nutrients. To remove toxic 
substances certain organs like liver, kidneys have to stretch their 
performance. Adulterated food can also cause cancers of the stomach, liver 
damage and kidney problems," she adds.
An EPA reports says the incidence of testicular cancer is doubling about 
every one and a half generations or 39 years. Testicular cancer is now the 
most common cancer in men in the age group of 15 to 35 years. Prostate 
cancer has emerged as the most common cancer among men and the second 
most lethal among all cancers.
"Tobacco and smoke cause environmental pollution and lead to lung cancers, 
laryngeal cancers, oesophageal cancers etc.," says medical oncologist Dr 
SVVS Prasad. Coloured agents in food are suspected to lead to cancers. 
Pickled foods containing nitrites and nitrates can cause stomach cancers. Soft 
foods without fibre can cause colon cancers. Pollution because of pesticides 
can cause cancers like non-Hodgkin’s lymphoma. "Environmental pollution 
with radiation like radon gas emitted from concrete buildings can lead to 
cancers like leukaemia. Asbestos pollution can cause lung cancers. Radiation 
from X rays and atomic energy plants can also cause cancers," he observes.

----
The Pollutants
----

A number of environmental chemicals are potentially ototoxic or capable of 
damaging hearing or equilibrium. They include trichloroethylene used in 
household spot removers, rug cleaning solutions, paints, waxes, pesticides, 
adhesives and lubricants.
Solvents with neurotoxicity like Xylene used in paints, varnishes and 
thinners, can affect hearing by injuring the brain. Styrene, used in plastics, 
resins, synthetic rubber and insulation, disrupts the ability of the brain to 
process speech and other complex sound. Hexane, used in shoe factories, 
damages the hearing nerve pathways in the brain.
Carbon disulphide, an insecticide, causes hearing loss. Another chemical 
toluene can damage the hearing whether inhaled or absorbed by contact with 
the liquid form. Carbon monoxide poisoning can cause injury to the delicate 
nervous system.
Butyl nitrate, used in room fresheners, causes loss of hearing.
Mercury poisoning causes unsteady walking, weakness, visual and sensory 
disturbances. Organic tin compounds used in the manufacture of 
polyurethane foam, silicone rubber and polyvinyl chloride causes severe 
health problems.
An exposure to methyl mercury to foetus will cause measurable damage to 
the functioning of the brain. A study by ZM Patel and RA Adhia of the 
Genetic Research Centre, National Institute for Research in Reproductive 
Health, Mumbai, on 17653 new-born babies revealed 294 (1.6 per cent) had 
major malformations and 1400 (7.92 per cent had minor malformations, 328 
(1.8 per cent) were stillbirths. Polygenic traits accounted for 45.1 per cent 
while chromosomal aetiology was found in four per cent. A genetic basis was 
found in 65.4 per cent of cases.

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What To Do
----------

There is no shortcut route to escape from the harmful effects of pollutants 
and chemicals that have made their way into our food chain. The US 
Environmental Protection Agency suggests that people should stay indoors as 
much as they can during days when pollution levels are high.
"Many pollutants have lower levels indoors than outdoors. If you must go 
outside, limit outside activity to the early morning hours or wait until after 
sunset. This is important in high ozone conditions because sunshine increases 
ozone levels," an EPA report points out.
Other steps suggested by EPA are: Don't exercise or exert yourself outdoors 
when air-quality reports indicate unhealthy conditions. The faster you 
breathe, the more pollution you take into your lungs. However, if you live or 
work close to a known pollution source, or if you have a chronic heart or 
lung problem, talk with your doctor about other ways to protect yourself from 
air pollution.
Though Ayurvedic doctors prescribe Panchakarma therapy to "detoxify" the 
body, unfortunately real and effective systems that detoxify and excrete 
industrial chemicals are not available. Ayurvedic doctors claim that 
panchakarma will eliminate environmentally toxic substances like 
polycholorinated biphenyl and pesticides through natural purification 
methods.
To protect from the pollution of radiation, one should wear good quality 
sunglasses. "Pollution leads to increase in the incidence of dry eye syndrome, 
which is a chronic problem in itself. One should wear glasses to reduce the 
problem," says Dr Shikha Fogla, consultant ophthalmologist. 

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