The chemicals that are contributing to the decline in fertility must be banned.
Your hormones have been hijacked.
Your body's astonishing, finely calibrated signal system – a system that controls everything from your weight to your fertility to your mood – has been scrambled by loosely regulated chemicals manufacturers use in a myriad of ways including in consumer products.
These hijackers – known to scientists as "endocrine-disrupting chemicals" – are threatening our existence as a species. Driving this problem are chemical companies focused only on cheap plastics and regulators unwilling to do anything about it.
I know that sounds dramatic. I wish it weren't true. But thousands of rigorous research projects costing hundreds of millions of dollars over the past two decades has made it clear.
Male fertility is dropping precipitously, and it is clear that these chemicals are at the heart of it. I'm half the man my grandfather was, and my grandsons will be half the man I am. In some countries, half of all couples seeking pregnancy require medical intervention.
This is what's so important about a ground-breaking book on fertility, "Count Down," published this week by Shanna Swan, my good friend and a pioneering reproductive epidemiologist at Mount Sinai's Icahn School of Medicine. She lays out, in vivid detail, the environmental factors contributing to dropping fertility rates worldwide.
Grounded in irrefutable science and laced with dry, engaging wit, this epic book asks monumental questions. If you dream of children, grandchildren and generations beyond, you must read it.
But the problems with endocrine-disrupting chemicals do not stop at our bodies.
The web of life on which we depend is also at risk, as these chemicals work their way through sensitive and complex ecosystems. For example, insect populations are collapsing worldwide, and the science shows that these chemicals are playing a significant role in this. When combined with climate change and habitat destruction, the pressures are enormous.
We also know that early exposure to endocrine-disrupting chemicals reduces IQ. To paraphrase another scientist, we may not be smart enough to solve this problem before we realize how bad it is.
Our hospitals are full of patients whose chronic diseases are triggered and/or worsened by endocrine-disrupting chemical's, including diabetes, obesity, and cancer. Setting aside for the moment the astonishing emotional cost of not being able to conceive or being saddled with chronic, debilitating illnesses, the impact on our national health, productivity and health care costs is clearly in the hundreds of billions of dollars.
My granddaughter, now 2 years old, was born in Alta Bates Hospital in Oakland, California, two months premature. The plastics in the devices that were used to save her life were essential. Yet I'd bet a year's salary that the reason she was born prematurely is that my daughter was living in San Francisco during the fires in Paradise, California, of early November 2018, when thousands of pounds of plastics burned for days and coated the Bay Area with their smoke. [For more, watch the short video below.]
We need different materials. We need to test those that we use now. Not a single plastic molecule now in our environment has been fully tested for endocrine-disrupting properties. Not a single one.
At Environmental Health Sciences, we've been working to reform regulatory science for decades. We know that the Food and Drug Administration is using inaccurate standards for testing derived from 16th century science. We know that tiny amounts of these chemicals can corrupt hormonal responses. The high dose testing used by the FDA are utterly incapable of detecting these low dose effects. Hence federal regulatory standards—what is safe and what is not—are laughable and irrelevant to human health.
We need all sectors of our economy and society involved in this. Every single victory we've had in this work has included demand for safer materials and better products from the end consumer. It is an absurd situation that we live in this First World economy, where any number of conveniences and products are available, yet we remain awash with endocrine-disrupting chemicals that are hijacking our most sensitive and essential human functions.
Please excuse my scientific jargon - but that's just nuts. Dr. Swan's book shows how high the stakes are.
Pete Myers is the founder and chief scientist of Environmental Health Sciences, publisher of EHN.org and DailyClimate.org.
Banner photo credit: Scott Maxwell/flickr
On fertility, we are running out of time.
And the growing number of plastics in our lives are accelerating the crunch.
That's the core message in a pair of webinars this week on humanity's infertility crisis, centered around Tuesday's publication of "Count Down," by reproductive health expert Dr. Shanna Swan.
Worldwide, sperm counts have declined 50 percent in males the past 50 years, Swan noted. Other key aspects of human fertility – miscarriages, testosterone levels, premature egg depletion, difficulty conceiving – are all changing at a similar rate.
The data worldwide are so clear and so consistent, Swan noted on a webinar hosted by Plastic Pollution Coalition Wednesday, that the trend is unmistakable: by 2045 median sperm counts in men are headed toward zero.
"This means that half the men would have zero" viable sperm, Swan said, "and the rest would have very close to zero."
"We want to push this curve in a direction that keeps it from hitting zero."
This rise in infertility, Swan said, is the fault not of genetics – "this is too fast for genetic change" – but of our environment: Specifically hormone-hijacking compounds known as "endocrine-disrupting chemicals" found in everyday plastics used throughout the modern world.
These chemicals, particularly a family of EDCs called phthalates, are virtually inescapable, said Carnegie Mellon University chemist Terry Collins Tuesday on a webinar hosted by the Collaborative on Health and the Environment.
"Nothing you do – hardly anything – no, I think maybe nothing you do, from when you get up in the morning to when you go to sleep, is not permeated by chemicals that chemists have made," Collins said.
Nor is the infertility crisis limited to humans. Life worldwide faces similar or higher exposures to these pollutants. Scientists are seeing feminization in fish and gender blurring in frogs exposed to endocrine-disrupting compounds.
"We are now the canaries in the coalmine," said Pete Myers, founder of Environmental Health Sciences, publisher of EHN.org, during Wednesday's Plastic Pollution Coalition webinar. "We have to take the warnings from people and begin to ask, 'What should we be doing to protect the rest of life on Earth, along with people.' "
Those solutions aren't easy, panelists on both webinars agreed.
"While it's true we cannot shop ourselves out of this crisis, we can reduce our daily exposure," Swan said.
A few tips identified in "Count Down" and by panelists:
Many chemicals found in plastics can have adverse effects on human health, including increased risk of infertility.
But what's really needed, panelists agreed, is education and policy change "at every level."
"Every aspect of government and of course regulatory agencies have to change," Collins said. "Advocacy and the media has to change. This is our challenge. We have almost no time."
Watch the Collaborative on Health and Environment webinar here.
The Plastic Pollution Coalition webinar on whether humanity will survive plastic pollution will be available here in about a week, according to organizers.
Editor's note: Dr. Shanna Swan is an adjunct scientist with Environmental Health Sciences, publisher of EHN.org and DailyClimate.org.
Editor's note: The following is an excerpt from the book "Count Down: How Our Modern World Is Threatening Sperm Counts, Altering Male and Female Reproductive Development, and Imperiling the Future of the Human Race" by EHS adjunct scientist Shanna Swan, PhD.
The book is available for sale through most major retailers.
In late July 2017, it seemed as if every media outlet around the globe had become obsessed with the state of human sperm counts. Psychology Today cried, "Going, Going, Gone? Human Sperm Counts Are Plunging," while the BBC declared, "Sperm Count Drop Could Make Humans Extinct," and the Financial Times announced, "Urgent Wake-Up Call' for Male Health as Sperm Counts Plummet." A month later, Newsweek published a major cover story on the same subject: "Who's Killing America's Sperm?"
By the end of the year, my scientific paper "Temporal Trends in Sperm Count: A Systematic Review and Meta-Regression Analysis," which sparked these stories—and hundreds of others around the world— was ranked number 26 among all referenced scientific papers published worldwide, according to Altmetric's 2017 report. This truly was the drop heard round the world.
These days, the world as we've known it feels as though it's changing at warp speed. The same could be said for the status of the human race. It's not only that sperm counts have plummeted by 50 percent in the last forty years; it's also that this alarming rate of decline could mean the human race will be unable to reproduce itself if the trend continues. As my study collaborator Hagai Levine, MD, asks, "What will happen in the future—will sperm count reach zero? Is there a chance that this decline would lead to extinction of the human species? Given the extinction of multiple species, often associated with man-made environmental disruption, this is certainly possible. Even if there is low probability for such a scenario, given the horrific implications, we have to do our best to prevent it."
This is especially worrisome because the sperm-count decline that's occurring in Western countries is unabating; it's steep, significant, and continuing, with no signs of tapering off. As Danish researcher and clinician Niels Skakkebaek, MD, who was the first person to alert the scientific community to the role of environmental factors in sperm decline, said, "It's an inconvenient message, but the species is under threat, and that should be a wake-up call to all of us. If this doesn't change in a generation, it is going to be an enormously different society for our grandchildren and their children."
Indeed, if the decline continues at the same rate, by 2050 many couples will need to turn to technology— such as assisted reproduction, frozen embryos, even eggs and sperm that were recreated from other cells in the laboratory (yes, this is actually being one)—to reproduce.
Some of what we've been thinking of as fiction, from stories such as The Handmaid's Tale and Children of Men, is rapidly becoming reality. In the winter of 2017, I presented my sperm-decline findings at the One Health, One Planet conference, which focused on the interconnected health of different species on the planet, the damage being inflicted by our mad "industrialization" of the environment, and its devastating effects on frogs, birds, polar bears, and other species. After presenting the results of our analysis, which were shocking enough to the audience, I spoke for the first time about what sperm decline could mean for Homo Sapiens. That night, I awoke from a dream, feeling incredibly anxious as I suddenly realized the full implications of the story I'd put together— that given the declines in sperm count and testosterone levels and the increases in hormonally active chemicals that are being spewed into the environment, we really are in a dangerous situation for mankind and world fertility.
This was no longer only a matter of scientific study for me. I felt and remain genuinely scared by these findings on a personal level.
In some ways, the picture looks even worse when you delve deeper because it's not just an issue for men. Women, children, and other species are also having their reproductive development and function commandeered in a dysfunctional direction. In some countries throughout the world, including the United States, a massive sexual slump is underway, due to declines in people's sex drives and interest in sexual activity; men, including younger guys, are also experiencing greater rates of erectile dysfunction. In animals, there have been changes in mating behavior, with more reports of male turtles humping other male turtles, and female fish and frogs becoming masculinized after being exposed to certain chemicals.
Taken together, these trends are causing scientists and environmentalists to wonder, how and why could this be happening? The answer is complicated.
Author Shanna Swan (Credit: Axel Dupeux)
Shanna H. Swan, Ph.D., is one of the world's leading environmental and reproductive epidemiologists and a professor of environmental medicine and public health at the Icahn School of Medicine at Mount Sinai in New York City. She is also an adjunct scientist at Environmental Health Sciences, publisher of EHN.org, DailyClimate.org and FairElex.com.
An award-winning scientist, Dr. Swan's work examines the impact of environmental exposures, including chemicals such as phthalates and Bisphenol A, on men's and women's reproductive health and the neurodevelopment of children.
For more information about Dr. Swan and her book, including where to buy it, visit Dr. Swan's website at www.shannaswan.com.
Disinfectant use has exploded during the coronavirus pandemic as people try to keep their hands and surfaces clean. But one family of cleaning chemicals is receiving scrutiny for potential health concerns.
Quats, or quaternary ammonium compounds, are charged molecules that can kill bacteria, fungi, and viruses. Quats are effective disinfectants, but some researchers are raising alarm given recent research on the compounds' possible human health and environmental effects, including fertility issues, endocrine disruption, occupational asthma, marine toxicity, and potential to spur antibiotic-resistant bacteria.
And, while industry defends quats as safe, some states are taking notice and looking into regulations.
Bacteria sample inside petri dish. (Credit: IRRI Photos/flickr)
The pandemic has increased demand for products like Lysol wipes that use quats as active ingredients: sales of Lysol wipes were up nearly 50 percent in spring of 2020 compared to 2019. Other cleaning products are also in high demand — aerosol disinfectant sales as a whole have doubled in 2020 in the U.S., a large fraction of which also contain quats.
All those additional sales mean quats are becoming more present in the environment. "We're in an era now where the concentration [of quats] is certainly higher than ever before," William Arnold, an environmental engineer at the University of Minnesota, told EHN. He published a paper in June that revealed an increased load of quats may be ending up in wastewater plants, with some worrisome implications. Quats can end up in wastewater plants after they're flushed down the drain — at the levels of use during the pandemic, some plants can't keep up, so quats have the potential to pollute waterways. There, they might disrupt marine food chains, as quats have been found to be toxic to small invertebrates like plankton in lakes.
The ingredients also may be spurring antibiotic-resistant germs, Arnold said.
Bacteria are constantly working to shore up their defenses against the antiseptics we use. "We've had an 80- or 90-year head start, but we really need to keep innovating" to stay ahead of microbial evolution, Kevin Minbiole, a Villanova University chemist who studies how quats affect bacteria and viruses, told EHN.
Quats work like spears, penetrating the shell on the outside of a bacteria or virus. But some bacteria are getting better at recognizing quats and getting rid of them, or becoming resistant, said Minbiole. He and his collaborator, Emory University chemist William Wuest, are experimenting with new antimicrobial ingredients and recently patented their own quats that can mount multiple attacks on a single microbe. These quats are likely even more effective antiseptics than current quats on the market, but the new chemicals haven't yet been tested for safety, so it's not clear how their health or environmental impacts might differ, or not, from current quats, according to Wuest.
Chemistry Professor Kevin Minbiole and his students discuss their research. (Credit: villanova.edu)
But the germs may be one step ahead. As they encounter quats and other antiseptics, bacteria can develop broad, rather than specific, resistance. These new bacterial shields, which evolved to block attacks by antiseptics, might also protect them against other threats, including the antibiotic medications doctors prescribe to help fight serious infections.
It's called cross resistance: when changes bacteria make to get around one threat make them better suited to survive other threats, too. "Those changes make bacteria capable of surviving different compounds, different chemicals that it hasn't seen before," Beatriz Pereira, a recent graduate student in microbiology from University of California, Davis, told EHN.
In lab experiments, Pereira has seen bacteria develop resistance to certain quats, even when she only exposes them to low concentrations of the chemicals. The bacteria shore up their defenses, strengthening their outer membrane — a good way to develop cross resistance to other chemicals as well. It's not clear whether bacteria are yet developing resistance in the wild in response to current levels of quat pollution, or even how much quat pollution currently exists. But to Pereira, these lab experiments alongside a growing body of evidence suggest that the best way to respond to the problem of antibiotic resistance may be not to develop new quats, which might cause the same problem of antibiotic resistance eventually, but to reconsider whether we should be using them at all, at least in some products.
Theresa Hrubec, a biologist at Virginia Tech and the Edward Via College of Osteopathic Medicine, has also been publishing work on the potential risks of quats — work that started by accident. While she was using mice to study potential side effects of medications, she noticed that some mice in her control group, the mice that weren't exposed to any medication, were developing birth defects. After ruling out the possibility that she had switched the groups, she found a potential explanation: the facility had recently started using quats to disinfect her lab. The floors were mopped daily, the walls wiped down weekly, and anytime a box of mice was opened, it was wiped down with disinfectant. The mice were all being unintentionally dosed with quats, Hrubec told EHN. And she wasn't the only researcher who had seen problems with mice and quat disinfectants: Patricia Hunt, a researcher at Washington State University, had seen similar problems with her mice.
Hrubec and Hunt have since published several studies that link quats to health problems in mice, from birth defects to decreases in fertility. For each of the studies, mice were fed a mixture of two common quat disinfectants at high doses for several weeks before being examined for either fetal birth defects or signs of decreased fertility.
Mice that were exposed to quats were more likely to develop neural tube defects, an early-stage birth defect. And doses of quats decreased the number and size of litters born as well.
How exactly quats might cause birth defects is still unknown, according to Hrubec. She has a few theories. Endocrine disruption might be to blame — Gino Cortopassi, who collaborated with Hrubec, found that one quat, although not the same chemical Hrubec used in her research, can bind to hormone receptors. The same lab also found that quats appear to affect how mitochondria function, which can cause a litany of problems in cells.
Inflammation might be another possible explanation. Quats are suspected to cause occupational asthma — exposure to a toxic or irritating chemical that results in lung inflammation. Japanese researchers found in 2010 that mice exposed to quats at high concentrations by inhalation saw cell death and increased levels of inflammation. However, human studies observing quat exposure and occupational asthma have had mixed results, with some researchers arguing that quat exposure hasn't been definitively linked with lung problems.
Most of the research by Hrubec and her collaborators is done in mice, so quats may not have the same effects on humans. Figuring out how quats might be impacting humans is a much more complicated job. In a pre-print, published last year but not yet reviewed by outside experts for accuracy, Hrubec and her collaborators performed a monitoring study of a small group, 43 people. They detected quats in 80 percent of the study participants, and quat levels in the blood were associated with higher levels of inflammation and decreased mitochondrial function. The results are still preliminary, but it is among the first research to attempt monitoring quat levels in humans.
Applying disinfectant onto wipe for cleaning headphones. (Credit: Marco Verch Professional Photographer/flickr)
Not everyone agrees about how the research is being done. In a letter to the editor in response to one of Hrubec's early studies, Keith Hostetler, an industry representative, raised concerns about the experiment's design. One critique was the dose level — according to Hostetler, the level of disinfectant fed to the mice would be the equivalent of a 155-pound adult drinking about 1.5 quarts of disinfecting solution daily.
But toxicology studies are pretty typically performed with high doses at first, before being extrapolated down to more realistic doses, according to Heather Patisaul, a biologist at North Carolina State University who studies toxicological effects of hormone-disrupting compounds. She was not involved in Hrubec's studies.
"Complaining that the dose is too high and the sample size is too low is a common industry response," Patisaul told EHN via email. In this case, she said the dosage was particularly high for some groups. However, Patisaul also notes that Hrubec saw birth defects in fetuses when the father was fed less than 1/15 the dose Hostetler mentioned, which she said is more compelling evidence that quats might cause harm.
Still, "neither [dose] is anywhere near a human-relevant range," Patisaul said, so the results do not definitively show that quats could harm human health with normal levels of use.
The doses were high in order to determine whether quats warrant more research, said Hrubec, adding that many mice that were not fed quats, but were merely present in rooms where quats were used, were also found to develop birth defects. To her, this suggests that the disinfectants present in the lab from regular disinfecting were still enough to trigger health problems.
MTA New York City Transit sanitizes stations and subway cars. (Credit: Metropolitan Transportation Authority of the State of New York)
Janitor disinfects elementary classroom. (Credit: Alliance for Excellent Education/flickr)
Hrubec has been a constant figure at regulatory meetings on quats. She presented her research during a March 2020 meeting with California's Biomonitoring Program. During the meeting, other researchers also presented data on quat's potential for causing occupational asthma and endocrine disruption.
After considering data from researchers and industry, the advisory panel for Biomonitoring California voted unanimously to add quats to the list of chemicals that could be considered for biomonitoring studies, and they plan to discuss quats as potential high-priority chemicals in March 2021, according to Shoba Iyer, a toxicologist for the California Office of Environmental Health Hazard Assessment who works with the biomonitoring program.
The program's board does not have the authority to ban quats — the purpose of adding quats to the monitoring list and completing biomonitoring studies is to learn more about chemical exposures and inform public health policies and regulations, Iyer told EHN.
Officials from one agency in Massachusetts also have their eye on quats — and they say the pandemic and the resulting increase in disinfectant use has caused them to examine the chemicals more closely. "That's why we finally decided to take up [quats], because people are using it constantly to try to keep themselves and their workers and customers safe," Liz Harriman, Deputy Director of the Toxics Use Reduction Institute (TURI) in Massachusetts, told EHN.
Massachusetts state law requires companies that manufacture certain chemicals, or use them to make products, to report use levels of the chemicals and submit plans for safe use. The Scientific Advisory Board for TURI makes recommendations to state agencies on which chemicals to examine, and they are focusing on two classes of quats, both of which are used in surface cleaners, according to Heather Tenney, who heads the board.
In January, the advisory board discussed several categories of research on quats, including birth defects and respiratory conditions like asthma, as well as environmental effects of quats like the potential for microbial resistance. The board did not reach a vote, and will reconvene in March to continue discussing potential action on quats.
Hostetler, the industry representative who has published letters challenging Hrubec's research, also presented at both the March Biomonitoring California presentation and the TURI meeting in January. At the TURI board meeting, he emphasized that the U.S. Environmental Protection Agency has independently concluded that quats do not have effects on developmental or reproductive health, based on tests that follow agency guidelines.
Manufacturers maintain that their disinfecting products available for purchase have been tested extensively. "They've done a lot of research on their formulations. What they put on the market, they know to be safe and efficacious," James Kim, a Vice President of the American Cleaning Institute, a trade organization that represents manufacturers, told EHN.
Despite increased attention from states, quats will likely remain available on the market in surface disinfectants for the foreseeable future. But for consumers looking to avoid quats in their cleaning supplies, alternatives are available.
"Given the huge concern for reproductive toxicity and birth defects in humans, it really makes sense to take a precautionary approach," Samara Geller, a research analyst for Environmental Working Group (EWG), an advocacy organization that pushes for regulation of chemicals in consumer products, told EHN.
While a large portion of disinfectants on the market include either quats or bleach as their main ingredient, there are other options available. Geller said EWG recommends products that contain citric acid, lactic acid, or hydrogen peroxide as their main ingredients. EWG also publishes a guide to cleaning products that aggregates safety data where consumers can check for options.
Consumers can reference the EPA's list of disinfectants that are expected to be effective against coronavirus, which lists products by active ingredient.
Liz Harriman, the Massachusetts TURI official, said she also urges the public to consider alternative products to those that contain quats. "It's not so much that we're dead set against quats," said Harriman, "But if there are safer alternatives you can use to accomplish the same thing, why wouldn't you use those?"
Banner photo: Delta airline employees disinfect the surfaces of the cabin. (Credit: Delta News Hub/flickr)
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