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Friday, September 19, 2008

Children's Health

Worries in a Bottle





Are commonly used plastics
and medicines harming human health?

IT IS a family nightmare. New parents try to eliminate potential hazards from their children’s lives, but what if hidden dangers lurk in the use of everyday objects and familiar substances, like plastics or medicines? Just imagine if baby-feeding bottles harmed infants’ health, or if a painkiller widely administered to children ended up doing more harm than good.
Activists have long raised concerns about the poorly understood links between the environment and health. Some worry about toxins in the air and the overuse of plastics, while others fret that children are overmedicated. Regulators and industry officials have pooh-poohed such talk, but several studies released this week may lead them to reconsider.

A frequent cause for concern has been bisphenol-A (BPA), a commonly used plastic. The Work Group for Safe Markets, a coalition of American charities and lobbying groups, earlier this year issued a report called “Baby’s Toxic Bottle” that suggested BPA leaches into milk when bottles are heated. Others worry that adults have been harmed by this plastic too, since it is often used to line the inside of drink cans.
Such worries were easily dismissed because they were not backed by scientific evidence—at least until now. A study published this week in the Journal of the American Medical Association analyses the most comprehensive set of data that tracks both a variety of health indicators and concentrations of BPA in urine. The latter matters because when this plastic is absorbed, it quickly passes through the body.
The researchers, led by Iain Lang of Peninsula Medical School at Exeter in south-west England, found that higher urinary concentrations of BPA were associated with heart problems, diabetes and liver complications. They did not find such a correlation with other diseases. Although the study did not include infants, parents using BPA bottles are unlikely to be reassured by these findings.
A separate study in the Lancet will also come as little comfort. A team led by Richard Beasley of the Medical Research Institute of New Zealand studied the link between the use of paracetamol, a painkiller frequently used for young children, and asthma. After scrutinising the health data for children aged six and seven participating in the International Study of Asthma and Allergies in Childhood, they draw a sobering conclusion: use of this drug to tame fevers in children under the age of one is associated with an increased risk of their having asthma when they are six.
So, is this all doom and gloom for parents? Not necessarily. For one thing, these studies are not the final word on a very complex subject. The authors of the paper on paracetamol, for example, admit that “causality cannot be established” from a statistical study such as theirs; to determine whether the link is coincidence or causation, they recommend randomised control trials that look carefully into the long-term effects of paracetamol use. The BPA paper also acknowledges that independent replication and follow-up studies are needed. Another complication is that even a link between asthma and paracetamol needs to be put into the proper context. Any demonstrable harm caused by the use of plastics and painkillers has to be weighed against the benefits they bring, such as reliability and efficacy. They also need to be weighed against the costs and benefits of alternatives.
Simply abandoning two familiar tools of parenthood in a panic might make matters worse: suppose, say, BPA were replaced with new materials that eventually turned out to have even more worrying properties. This week’s studies, although not definitive, do provide enough reason for researchers to redouble their efforts to understand the complex links between a child’s early life and its later health.

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