[Pharmwaste] article about endocrine disruptors and reproductive disorders
Tenace, Laurie
Laurie.Tenace@dep.state.fl.us
Tue, 26 Jul 2005 09:46:17 -0400
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http://www.timesonline.co.uk/printFriendly/0,,1-100-1707787,00.html
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July 26, 2005=20
'Is my baby a boy? Is it a girl?' No one could tell me
by Steve Boggan
The number of male babies born with reproductive disorders is rising =
rapidly,
and some scientists blame a group of chemicals that are around us
=20
AS ALL mothers do, Sue Green remembers vividly the moment that her first =
baby
was born, but not for the usual reasons. "The midwife was smiling, then =
her
face fell," recalls Sue. " 'Congratulations,' she said. 'It's a . . . ' =
And
then there was silence."=20
The silence continued for some time. Doctors looked at the child. So did
nurses. And, over the next few hours, medical students. But none of them =
said
anything. With mounting anxiety, the exhausted mother asked what was =
wrong.
"You're not telling me something!" she remembers screaming. "Is it a boy =
or a
girl?" But they couldn't tell her.=20
Sue and her husband John had just become parents to a beautiful child =
that
looked like a boy, but his sexual organs were terribly deformed.The baby =
had
been born with a condition called hypospadias, a malformation whereby =
the
opening in the penis through which urine is passed is in the wrong =
place. In
mild cases it is slightly off centre, but in more severe cases it might =
be at
the base of the penis or even beneath the scrotum.=20
In the case of their son, Mark, they couldn't find an opening at all. =
Nor
could they identify a penis; it was somehow fused to a tiny scrotum. In =
fact,
it took four weeks of chromosome tests to establish that the baby was a =
boy.=20
This augured years of difficult times and painful surgery ahead. Taken =
as
part of a bigger picture, cases such as Mark's - corrected after six
operations over three years - are raising the alarm among medical =
scientists
across the industrialised world, because what happened to him is =
happening
more often to newborn babies in families with no history of the =
condition. It
is part of a growing incidence of genital deformities, poor fertility =
rates
and an explosion in testicular cancers that, together, are screaming out =
that
something is wrong.=20
As yet, no one can say for sure what causes the problems. However, there =
are
suspicions about chemicals in the environment - compounds that have the
potential to upset the delicate balance of hormones in the body. =
Prosaically
called "endocrine disrupters", they touch on every aspect of our lives. =
They
are found in the plastics, carpets and fabrics all around you. Tiny =
amounts
are found in your milk, vegetables and in some packaging surrounding =
your
food. They are in your make-up, perfumes, face creams and the sun =
lotions
that protect your skin. They are in the pesticides that allow your food =
to
grow - and even in the coatings of slow-release medicines. In fact, =
there is
nothing that you can do to avoid them.=20
In May, more than 120 scientists from around the world met in Prague and
issued a declaration to Western governments giving warning that =
reproductive
problems were increasing in developed nations, and calling for more =
research
into what was causing them.=20
The declaration made two points clear: first, that "there is serious =
concern
about the high prevalence of reproductive disorders in European boys and
young men", and, secondly, that endocrine disrupters may be one of the
factors responsible. Last month, scientists found the first evidence - =
which
is hotly disputed - that they could be right.=20
When Mark Green was born in 1995, his mother had never heard of =
hypospadias;
neither had many of the medical staff at Antrim Hospital in Northern =
Ireland
where he was delivered. "They were obviously very concerned because they
couldn't find a hole through which Mark could pass water," recalls Sue, =
34, a
care worker. "They rushed him to Royal Victoria Hospital for Sick =
Children in
Belfast - still without telling me what was wrong - where a specialist =
found
an opening in his scrotum. Eventually, they told my husband that Mark =
had
hypospadias, but we couldn't find any information about it anywhere.=20
"I was devastated and deeply worried. Everyone wants their baby to be
perfect, but this was something that we'd never heard of. And more than
anything, it was something that we felt we couldn't talk about. Outside =
my
immediate family, there was no one to share our worries."=20
Over a period of three years, Mark underwent six operations to separate =
his
penis from the scrotum, to construct a urinary tract and to enable him =
to
urinate normally. He is now 10 and his parents are still waiting to find =
out
whether his sexual organs will function properly in puberty. It is a =
source
of enormous concern for them.=20
Even worse, until four years ago, Sue was wrongly blaming herself for =
his
condition. She had been suffering from an illness of her own and had =
been
taking medication to alleviate the symptoms.=20
"I thought that the medication had caused Mark's problems," she says. "I =
felt
terribly guilty that that had affected him somehow. I thought that it =
was my
fault. It wasn't until we were referred to a geneticist that I was =
assured
that wasn't the case."=20
By then, medical thinking was changing. In 1993, Professor Richard =
Sharpe, of
the Medical Research Council's Human Reproductive Sciences Unit, and
Professor Niels Skakkebaek, of the Department of Growth and Reproduction =
at
Copenhagen University Hospital, published a paper in The Lancet =
suggesting
that high levels of oestrogen in the environment could be responsible =
for
damaging semen and other reproductive problems.=20
There was ample evidence in the wild that exposure to oestrogen had
demasculinised creatures, including fish and alligators in rivers that
contained the female hormone. It seemed that the synthetic oestrogen =
used in
the contraceptive pill had not been breaking down during sewage =
treatment and
was passing into the environment.=20
There was evidence, too, that certain chemicals had the ability to =
affect the
performance of hormones. These were endocrine disrupters and they were =
found
in more than 40 groups of chemicals, ranging from pesticides to paints. =
One
substance, tributyl tin (TBT), had been used to coat the hulls of ships =
to
prevent barnacles from growing. During the Eighties scientists =
discovered
that TBT had interfered with the reproductive systems of more than 100
species of fish, clams, shrimps, plankton and so on, devastating some =
aquatic
populations.=20
So, could this be happening to people? Many experts believe that it =
could.
Laboratory tests performed on pregnant rats and mice have found that =
exposure
to endocrine disrupters called phthalates, used to soften plastics, =
resulted
in offspring displaying the kind of reproductive problems that are now =
more
prevalent in the human population.=20
Further insight came in 2001, when a team led by Professor Skakkebaek
hypothesised that hypospadias was in fact part of a syndrome - which he
called the testicular dysgenesis syndrome (TDS) - that encompassed =
several
problems: poor semen quality, cryptorchidism (where a boy's testes fail =
to
descend during foetal development) and, in later life, a predisposition =
to
testicular cancer - boys with cryptorchidism are up to eight times more
likely to develop such cancers.=20
Their hypothesis, now widely accepted, was that something was =
interfering
with the development of the foetus during a crucial, but brief, period =
in the
womb.=20
"The evidence suggests that the conditions could be connected, and that =
they
might be caused by environmental factors in some cases," says Professor
Skakkebaek. "I believe that the situation is much more serious than we =
would
like to think. Many people point to social factors as being the main =
cause of
low fertility rates - obesity, women waiting later in life to have =
children
and so on.=20
"But we should also suspect that lifestyle and environmental factors,
including endocrine disrupters in very small concentrations, could also =
play
a role in the extremely low European fertility rates."=20
Professor Skakkebaek and his team from Denmark are at the forefront of
international research because symptoms of TDS are more prevalent in =
that
country than anywhere else in Europe. He has found that almost 1 per =
cent of
all young Danish men are treated for testicular cancer, 40 per cent have
subnormal sperm counts and 4.5 per cent are born with some degree of
hypospadias - 1 per cent with "severe" forms of the condition.=20
In the UK accurate figures are difficult to come by, not least because =
the
conditions can be easily misdiagnosed. Also, according to the Office for
National Statistics, there is currently no legal requirement for =
hospitals
and doctors to report hypospadias or cryptorchidism. Official figures =
show no
significant change - 458 cases of hypospadias in 2003 compared with 484 =
in
1995 - but, anecdotally, scientists, doctors and medical support groups =
have
told The Times that they are dealing with many more cases of =
infertility,
cryptorchidism and hypospadias than in the past. Whereas parents used to =
be
told that the rate of hypospadias was about one in 350, doctors in some =
parts
of the UK now estimate it to be about one in 150.=20
Professor Sharpe says: "Cryptorchidism and hypospadias are two of the =
most
prevalent congenital malformations in newborn children, yet we don't =
even
have accurate figures that can tell us exactly how common they are =
because of
variations in diagnosis and the current lack of requirement even to =
formally
report them.=20
"All we know is that across Europe the conditions are on the increase, =
sperm
counts may have dropped substantially and over the past 60 years the
incidence of testicular cancer has increased by 600 per cent. Given that =
we
now believe these are all connected, forming the testicular dysgenesis
syndrome, there is quite clearly something affecting the hormonal =
development
of foetuses in the womb.=20
"It is premature to say exactly what the cause is - it would be
counterproductive to jump to conclusions. There are clearly some =
lifestyle
factors, but the evidence is also slowly pointing towards endocrine
disrupters."=20
Professor Sharpe believes that something could be affecting the ability =
of
testosterone, the male sex hormone, to perform its key roles in =
masculinising
the developing male foetus.=20
Phthalates, the compounds that have been coming under the most scrutiny
recently, are used in a huge number of plastic products and cosmetics. =
At the
end of May, Shanna Swan, a professor in obstetrics and gynaecology at =
the
University of Rochester School of Medicine and Dentistry in the United
States, published research that she claims provides the first real =
evidence
that certain phthalates in pregnant women have a direct impact on the
development of boys in the womb.=20
In laboratory rats, exposure to phthalates was known to reduce the =
length of
the perineum, or "anogenital distance" (AGD), in newborn males. Given =
that
males have a longer AGD than females, this was evidence of interference.
Professor Swan's team measured the AGDs of baby boys while, separately, =
urine
taken from their mothers during pregnancy was analysed for phthalates. =
The
boys with the shortest AGDs had mothers with the highest levels of =
phthalates
in their urine.=20
So is this definitive proof that phthalates are responsible? "No," says
Professor Swan. "This is just one piece of research that needs to be
reproduced and examined by others. Until now, however, some people had =
been
saying, 'Well, the effects are only in animals.' This is the first time =
that
there is evidence of a possible effect in humans. There needs to be much =
more
research, but I do think that the evidence is slowly pointing to the
chemicals in our environment."=20
The chemical industry rejects Professor Swan's findings and methodology,
pointing out that under EU testing regulations phthalates have been =
examined
rigorously over the past decade and been given the all-clear.=20
Dr David Cadogan, of the European Council of Plasticisers and =
Intermediates,
says: "In general, the phthalates that have been risk- assessed are not
showing any risk to humans. There have been similar tests to Professor =
Swan's
that contradict her findings."=20
Nevertheless, parents of children with hypospadias, adult sufferers and =
the
surgeons who treat them remain suspicious. They would like to see more
government money being spent on research, accurate statistic-gathering =
and
lifelong help for victims.=20
The European Parliament is so concerned about the potential damaging =
effects
of phthalates that on July 5 it voted to ban three types of the =
plasticisers
from children's toys.=20
Jane Clarke, a community paediatric nurse, runs the Hypospadias Support =
Group
from her home in Warrington. She says: "I set up the group seven years =
ago to
help parents; there was so much anxiety and very little information out
there. But I've never been busier than I am now - I'm inundated, =
particularly
with calls from people asking for advice about corrective surgery. There =
is a
lot of confusion out there."=20
Indeed there is. Aivar Bracka, a consultant genito-urethral plastic =
surgeon
at Russells Hall Hospital in Dudley, is regarded as the country's best =
at
correcting hypospadias. Yet because there are no NHS rules on which type =
of
surgeon - general paediatric, paediatric urologist, plastic surgeon - =
should
operate, 30 per cent of all his work involves correcting the mistakes of
others, what he describes as "salvage work ".=20
For now, that is where this story ends; in mystery and confusion. And =
for the
thousands of silent sufferers in the community, that isn't good enough. =
One
of them, William, 58, a hypospadias victim, sums up the frustration. "I =
was
delivered by my grandfather, a doctor, and my own father was a doctor, =
but I
was over 30 years old before I even heard the word hypospadias," he =
says.=20
"I went through childhood in ignorance; the first I knew that there was
something wrong was in the showers at school. Then I realised that I was
different and the teasing began; it was a nightmare.=20
"I, like all hypospadias sufferers, avoided sexual relations until very =
late.
I got no help, no advice and no information. When surgeons do get =
involved
they are often the wrong surgeons - I had no corrective surgery.=20
"And no thought is given to the psychosexual aspect of the condition. =
This is
a huge problem, an enormous secret wrapped in shame, a secret that =
thousands
of people carry with them through life, never discussing it with =
anyone."=20
Now, given that all the evidence suggests such problems are on the =
increase,
perhaps this is a secret that should finally be shared.=20
Some names have been changed.=20
* Hypospadias Support Group: www.hypospadias.co.uk
<http://www.hypospadias.co.uk> =20
* Concerned parents group: www.groups.yahoo.com/group/hypospadias
<http://www.groups.yahoo.com/group/hypospadias> =20
* Phthalates Information Centre: www.phthalates.org
<http://www.phthalates.org> =20
Hard to avoid
ENDOCRINE disrupters and toxic chemicals such as some phthalates, =
biphenyl A
(BPA), brominated BPA and polycarbonated biphenyls (PCBs) are present in
plastics, furnishings, cosmetics and some food and drink containers. =
They can
be directly absorbed through the skin, or by drinking or eating products =
that
have been contaminated through the food chain.=20
There is little that you can do to avoid them, although some experts
recommend eating organic meat, fruit and vegetables and drinking only =
from
glass bottles (although the chemicals industry argues that plastic =
bottles
are perfectly safe).=20
Some also advise against letting children wear T-shirts bearing plastic
pictures or logos. Greenpeace lists household products that it believes =
are
safer than others; visit www.greenpeace.org.uk
<http://www.greenpeace.org.uk/> =20
=20
=20
Laurie J. Tenace
Environmental Specialist
Florida Department of Environmental Protection
2600 Blair Stone Road, MS 4555
Tallahassee, Florida 32399-2400
PH: (850) 245-8759
FAX: (850) 245-8811
Laurie.Tenace@dep.state.fl.us
=20
view our mercury web pages at:=20
http://www.dep.state.fl.us/waste/categories/mercury/default.htm
=20
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<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'><a
href=3D"http://www.timesonline.co.uk/printFriendly/0,,1-100-1707787,00.ht=
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a></span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'> </span></font></p>
<table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 =
width=3D400
style=3D'width:240.0pt'>
<tr>
<td style=3D'padding:0in 0in 0in 0in'>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'> </span></font></p>
<table class=3DMsoNormalTable border=3D0 cellspacing=3D0 =
cellpadding=3D0 width=3D400
style=3D'width:240.0pt'>
<tr>
<td valign=3Dtop style=3D'padding:0in 0in 0in 0in'>
<p class=3DMsoNormal><font size=3D1 color=3D"#333333" =
face=3DVerdana><span
style=3D'font-size:6.0pt;font-family:Verdana;color:#333333'>July 26, =
2005</span></font><font
size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:12.0pt;font-family:
"Times New Roman"'> <br>
<br>
</span></font></p>
<p class=3DMsoNormal><b><font size=3D3 color=3D"#333333" =
face=3DArial><span
style=3D'font-size:12.0pt;color:#333333;font-weight:bold'>‘Is =
my baby a
boy? Is it a girl?’ No one could tell =
me</span></font></b><font
size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:12.0pt;font-family:
"Times New Roman"'><br>
</span></font><font size=3D1 color=3D"#660000"><span =
style=3D'font-size:6.5pt;
font-variant:small-caps;color:#660000'>by Steve =
Boggan</span></font><font
size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:12.0pt;font-family:
"Times New Roman"'><br>
</span></font><b><font size=3D1 color=3D"#666666"><span =
style=3D'font-size:8.0pt;
color:#666666;font-weight:bold'>The number of male babies born with
reproductive disorders is rising rapidly, and some scientists blame =
a group
of chemicals that are around us</span></font></b></p>
</td>
</tr>
</table>
<p class=3DMsoNormal></p>
</td>
</tr>
<tr height=3D5 style=3D'height:3.0pt'>
<td height=3D5 style=3D'padding:0in 0in 0in 0in;height:3.0pt'>
<p class=3DMsoNormal><font size=3D3 face=3D"Times New Roman"><span
style=3D'font-size:12.0pt;font-family:"Times New Roman"'><img =
border=3D0 width=3D1
height=3D5 =
src=3D"cid:image001.gif@01C591C6.E833D3F0"></span></font></p>
</td>
</tr>
<tr>
<td style=3D'padding:0in 0in 0in 0in'>
<table class=3DMsoNormalTable border=3D0 cellspacing=3D0 =
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<td valign=3Dtop style=3D'padding:0in 0in 0in 0in'>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>AS ALL =
mothers do, Sue
Green remembers vividly the moment that her first baby was born, but =
not
for the usual reasons. “The midwife was smiling, then her face
fell,” recalls Sue. “ ‘Congratulations,’ she =
said.
‘It’s a . . . ’ And then there was silence.” =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>The silence =
continued
for some time. Doctors looked at the child. So did nurses. And, over =
the
next few hours, medical students. But none of them said anything. =
With
mounting anxiety, the exhausted mother asked what was wrong.
“You’re not telling me something!” she remembers
screaming. “Is it a boy or a girl?” But they =
couldn’t
tell her. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Sue and her =
husband
John had just become parents to a beautiful child that looked like a =
boy,
but his sexual organs were terribly deformed.The baby had been born =
with a
condition called hypospadias, a malformation whereby the opening in =
the
penis through which urine is passed is in the wrong place. In mild =
cases it
is slightly off centre, but in more severe cases it might be at the =
base of
the penis or even beneath the scrotum. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>In the case =
of their
son, Mark, they couldn’t find an opening at all. Nor could =
they
identify a penis; it was somehow fused to a tiny scrotum. In fact, =
it took
four weeks of chromosome tests to establish that the baby was a boy. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>This =
augured years of
difficult times and painful surgery ahead. Taken as part of a bigger
picture, cases such as Mark’s — corrected after six =
operations
over three years — are raising the alarm among medical =
scientists
across the industrialised world, because what happened to him is =
happening
more often to newborn babies in families with no history of the =
condition.
It is part of a growing incidence of genital deformities, poor =
fertility
rates and an explosion in testicular cancers that, together, are =
screaming
out that something is wrong. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>As yet, no =
one can say
for sure what causes the problems. However, there are suspicions =
about
chemicals in the environment — compounds that have the =
potential to
upset the delicate balance of hormones in the body. Prosaically =
called
“endocrine disrupters”, they touch on every aspect of =
our
lives. They are found in the plastics, carpets and fabrics all =
around you.
Tiny amounts are found in your milk, vegetables and in some =
packaging
surrounding your food. They are in your make-up, perfumes, face =
creams and
the sun lotions that protect your skin. They are in the pesticides =
that
allow your food to grow — and even in the coatings of =
slow-release
medicines. In fact, there is nothing that you can do to avoid them. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>In May, =
more than 120
scientists from around the world met in Prague and issued a =
declaration to
Western governments giving warning that reproductive problems were
increasing in developed nations, and calling for more research into =
what
was causing them. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>The =
declaration made
two points clear: first, that “there is serious concern about =
the
high prevalence of reproductive disorders in European boys and young
men”, and, secondly, that endocrine disrupters may be one of =
the
factors responsible. Last month, scientists found the first evidence
— which is hotly disputed — that they could be right. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>When Mark =
Green was
born in 1995, his mother had never heard of hypospadias; neither had =
many
of the medical staff at Antrim Hospital in Northern Ireland where he =
was
delivered. “They were obviously very concerned because they
couldn’t find a hole through which Mark could pass =
water,”
recalls Sue, 34, a care worker. “They rushed him to Royal =
Victoria Hospital for Sick Children in Belfast — still without =
telling me what was
wrong — where a specialist found an opening in his scrotum.
Eventually, they told my husband that Mark had hypospadias, but we
couldn’t find any information about it anywhere. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“I =
was
devastated and deeply worried. Everyone wants their baby to be =
perfect, but
this was something that we’d never heard of. And more than =
anything,
it was something that we felt we couldn’t talk about. Outside =
my
immediate family, there was no one to share our worries.” =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Over a =
period of three
years, Mark underwent six operations to separate his penis from the
scrotum, to construct a urinary tract and to enable him to urinate
normally. He is now 10 and his parents are still waiting to find out
whether his sexual organs will function properly in puberty. It is a =
source
of enormous concern for them. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Even worse, =
until four
years ago, Sue was wrongly blaming herself for his condition. She =
had been
suffering from an illness of her own and had been taking medication =
to
alleviate the symptoms. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“I =
thought that
the medication had caused Mark’s problems,” she says. =
“I
felt terribly guilty that that had affected him somehow. I thought =
that it
was my fault. It wasn’t until we were referred to a geneticist =
that I
was assured that wasn’t the case.” </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>By then, =
medical
thinking was changing. In 1993, Professor Richard Sharpe, of the =
Medical
Research Council’s Human Reproductive Sciences Unit, and =
Professor
Niels Skakkebaek, of the Department of Growth and Reproduction at
Copenhagen University Hospital, published a paper in <i><span
style=3D'font-style:italic'>The Lancet</span></i> suggesting that =
high levels
of oestrogen in the environment could be responsible for damaging =
semen and
other reproductive problems. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>There was =
ample
evidence in the wild that exposure to oestrogen had demasculinised
creatures, including fish and alligators in rivers that contained =
the
female hormone. It seemed that the synthetic oestrogen used in the =
contraceptive
pill had not been breaking down during sewage treatment and was =
passing
into the environment. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>There was =
evidence,
too, that certain chemicals had the ability to affect the =
performance of
hormones. These were endocrine disrupters and they were found in =
more than
40 groups of chemicals, ranging from pesticides to paints. One =
substance,
tributyl tin (TBT), had been used to coat the hulls of ships to =
prevent
barnacles from growing. During the Eighties scientists discovered =
that TBT
had interfered with the reproductive systems of more than 100 =
species of
fish, clams, shrimps, plankton and so on, devastating some aquatic
populations. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>So, could =
this be
happening to people? Many experts believe that it could. Laboratory =
tests
performed on pregnant rats and mice have found that exposure to =
endocrine
disrupters called phthalates, used to soften plastics, resulted in
offspring displaying the kind of reproductive problems that are now =
more
prevalent in the human population. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Further =
insight came
in 2001, when a team led by Professor Skakkebaek hypothesised that
hypospadias was in fact part of a syndrome — which he called =
the
testicular dysgenesis syndrome (TDS) — that encompassed =
several
problems: poor semen quality, cryptorchidism (where a boy’s =
testes
fail to descend during foetal development) and, in later life, a
predisposition to testicular cancer — boys with cryptorchidism =
are up
to eight times more likely to develop such cancers. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Their =
hypothesis, now
widely accepted, was that something was interfering with the =
development of
the foetus during a crucial, but brief, period in the womb. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“The =
evidence
suggests that the conditions could be connected, and that they might =
be
caused by environmental factors in some cases,” says Professor
Skakkebaek. “I believe that the situation is much more serious =
than
we would like to think. Many people point to social factors as being =
the
main cause of low fertility rates — obesity, women waiting =
later in
life to have children and so on. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“But =
we should
also suspect that lifestyle and environmental factors, including =
endocrine
disrupters in very small concentrations, could also play a role in =
the
extremely low European fertility rates.” </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Professor =
Skakkebaek
and his team from Denmark are at the forefront of international =
research
because symptoms of TDS are more prevalent in that country than =
anywhere
else in Europe. He has found that almost 1 per cent of all young =
Danish men
are treated for testicular cancer, 40 per cent have subnormal sperm =
counts
and 4.5 per cent are born with some degree of hypospadias — 1 =
per
cent with “severe” forms of the condition. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>In the UK =
accurate figures are difficult to come by, not least because the =
conditions can be
easily misdiagnosed. Also, according to the Office for National =
Statistics,
there is currently no legal requirement for hospitals and doctors to =
report
hypospadias or cryptorchidism. Official figures show no significant =
change
— 458 cases of hypospadias in 2003 compared with 484 in 1995 =
—
but, anecdotally, scientists, doctors and medical support groups =
have told <i><span
style=3D'font-style:italic'>The Times</span></i> that they are =
dealing with
many more cases of infertility, cryptorchidism and hypospadias than =
in the
past. Whereas parents used to be told that the rate of hypospadias =
was
about one in 350, doctors in some parts of the UK now estimate it to =
be
about one in 150. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Professor =
Sharpe says:
“Cryptorchidism and hypospadias are two of the most prevalent
congenital malformations in newborn children, yet we don’t =
even have
accurate figures that can tell us exactly how common they are =
because of
variations in diagnosis and the current lack of requirement even to
formally report them. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“All =
we know is
that across Europe the conditions are on the increase, sperm counts =
may
have dropped substantially and over the past 60 years the incidence =
of
testicular cancer has increased by 600 per cent. Given that we now =
believe
these are all connected, forming the testicular dysgenesis syndrome, =
there
is quite clearly something affecting the hormonal development of =
foetuses
in the womb. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“It =
is premature
to say exactly what the cause is — it would be =
counterproductive to
jump to conclusions. There are clearly some lifestyle factors, but =
the
evidence is also slowly pointing towards endocrine =
disrupters.” </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Professor =
Sharpe
believes that something could be affecting the ability of =
testosterone, the
male sex hormone, to perform its key roles in masculinising the =
developing
male foetus. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Phthalates, =
the
compounds that have been coming under the most scrutiny recently, =
are used
in a huge number of plastic products and cosmetics. At the end of =
May,
Shanna Swan, a professor in obstetrics and gynaecology at the =
University of
Rochester School of Medicine and Dentistry in the United States, =
published research that she claims provides the first real evidence that
certain phthalates in pregnant women have a direct impact on the
development of boys in the womb. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>In =
laboratory rats,
exposure to phthalates was known to reduce the length of the =
perineum, or
“anogenital distance” (AGD), in newborn males. Given =
that males
have a longer AGD than females, this was evidence of interference.
Professor Swan’s team measured the AGDs of baby boys while,
separately, urine taken from their mothers during pregnancy was =
analysed
for phthalates. The boys with the shortest AGDs had mothers with the
highest levels of phthalates in their urine. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>So is this =
definitive
proof that phthalates are responsible? “No,” says =
Professor
Swan. “This is just one piece of research that needs to be =
reproduced
and examined by others. Until now, however, some people had been =
saying,
‘Well, the effects are only in animals.’ This is the =
first time
that there is evidence of a possible effect in humans. There needs =
to be
much more research, but I do think that the evidence is slowly =
pointing to
the chemicals in our environment.” </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>The =
chemical industry
rejects Professor Swan’s findings and methodology, pointing =
out that
under EU testing regulations phthalates have been examined =
rigorously over
the past decade and been given the all-clear. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Dr David =
Cadogan, of
the European Council of Plasticisers and Intermediates, says: =
“In
general, the phthalates that have been risk- assessed are not =
showing any
risk to humans. There have been similar tests to Professor =
Swan’s
that contradict her findings.” </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span =
style=3D'font-size:8.0pt;color:black'>Nevertheless, parents
of children with hypospadias, adult sufferers and the surgeons who =
treat
them remain suspicious. They would like to see more government money =
being
spent on research, accurate statistic-gathering and lifelong help =
for
victims. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>The =
European Parliament
is so concerned about the potential damaging effects of phthalates =
that on
July 5 it voted to ban three types of the plasticisers from
children’s toys. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Jane =
Clarke, a
community paediatric nurse, runs the Hypospadias Support Group from =
her
home in Warrington. She says: “I set up the group seven years =
ago to
help parents; there was so much anxiety and very little information =
out
there. But I’ve never been busier than I am now — =
I’m
inundated, particularly with calls from people asking for advice =
about
corrective surgery. There is a lot of confusion out there.” =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Indeed =
there is. Aivar
Bracka, a consultant genito-urethral plastic surgeon at Russells =
Hall Hospital in Dudley, is regarded as the country’s best at =
correcting
hypospadias. Yet because there are no NHS rules on which type of =
surgeon
— general paediatric, paediatric urologist, plastic surgeon =
—
should operate, 30 per cent of all his work involves correcting the
mistakes of others, what he describes as “salvage work =
”. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>For now, =
that is where
this story ends; in mystery and confusion. And for the thousands of =
silent
sufferers in the community, that isn’t good enough. One of =
them,
William, 58, a hypospadias victim, sums up the frustration. “I =
was
delivered by my grandfather, a doctor, and my own father was a =
doctor, but
I was over 30 years old before I even heard the word =
hypospadias,” he
says. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“I =
went through
childhood in ignorance; the first I knew that there was something =
wrong was
in the showers at school. Then I realised that I was different and =
the
teasing began; it was a nightmare. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“I, =
like all
hypospadias sufferers, avoided sexual relations until very late. I =
got no
help, no advice and no information. When surgeons do get involved =
they are
often the wrong surgeons — I had no corrective surgery. =
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>“And =
no thought
is given to the psychosexual aspect of the condition. This is a huge
problem, an enormous secret wrapped in shame, a secret that =
thousands of
people carry with them through life, never discussing it with =
anyone.”
</span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Now, given =
that all
the evidence suggests such problems are on the increase, perhaps =
this is a
secret that should finally be shared. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><i><font size=3D1 =
color=3Dblack
face=3DArial><span =
style=3D'font-size:8.0pt;color:black;font-style:italic'>Some
names have been changed.</span></font></i><font size=3D1 =
color=3Dblack><span
style=3D'font-size:8.0pt;color:black'> </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DSymbol><span =
style=3D'font-size:8.0pt;font-family:Symbol;color:black'>·</span><=
/font><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black'> </span></font><i><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black;font-style:
italic'>Hypospadias Support Group: </span></font></i><font size=3D1
color=3Dblack><span style=3D'font-size:8.0pt;color:black'><a
href=3D"http://www.hypospadias.co.uk"><i><span =
style=3D'font-style:italic'>www.hypospadias.co.uk</span></i></a><i><span
style=3D'font-style:italic'> </span></i></span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DSymbol><span =
style=3D'font-size:8.0pt;font-family:Symbol;color:black'>·</span><=
/font><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black'> </span></font><i><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black;font-style:
italic'>Concerned parents group: </span></font></i><font size=3D1
color=3Dblack><span style=3D'font-size:8.0pt;color:black'><a
href=3D"http://www.groups.yahoo.com/group/hypospadias"><i><span
=
style=3D'font-style:italic'>www.groups.yahoo.com/group/hypospadias</span>=
</i></a><i><span
style=3D'font-style:italic'> </span></i></span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DSymbol><span =
style=3D'font-size:8.0pt;font-family:Symbol;color:black'>·</span><=
/font><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black'> </span></font><i><font
size=3D1 color=3Dblack><span =
style=3D'font-size:8.0pt;color:black;font-style:
italic'>Phthalates Information Centre: </span></font></i><font =
size=3D1
color=3Dblack><span style=3D'font-size:8.0pt;color:black'><a
href=3D"http://www.phthalates.org"><i><span =
style=3D'font-style:italic'>www.phthalates.org</span></i></a><i><span
style=3D'font-style:italic'> </span></i></span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><b><font size=3D1 =
color=3Dblack
face=3DArial><span =
style=3D'font-size:8.0pt;color:black;font-weight:bold'>Hard
to avoid</span></font></b></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>ENDOCRINE =
disrupters
and toxic chemicals such as some phthalates, biphenyl A (BPA), =
brominated
BPA and polycarbonated biphenyls (PCBs) are present in plastics,
furnishings, cosmetics and some food and drink containers. They can =
be
directly absorbed through the skin, or by drinking or eating =
products that
have been contaminated through the food chain. </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>There is =
little that
you can do to avoid them, although some experts recommend eating =
organic
meat, fruit and vegetables and drinking only from glass bottles =
(although
the chemicals industry argues that plastic bottles are perfectly =
safe). </span></font></p>
<p class=3DMsoNormal style=3D'line-height:9.0pt'><font size=3D1 =
color=3Dblack
face=3DArial><span style=3D'font-size:8.0pt;color:black'>Some also =
advise
against letting children wear T-shirts bearing plastic pictures or =
logos.
Greenpeace lists household products that it believes are safer than =
others;
visit <a =
href=3D"http://www.greenpeace.org.uk/">www.greenpeace.org.uk</a> =
</span></font></p>
</td>
</tr>
</table>
<p class=3DMsoNormal></p>
</td>
</tr>
</table>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'> </span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'> </span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>Laurie
J. Tenace</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>Environmental
Specialist</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>Florida
Department of Environmental Protection</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>2600</span></font><font
size=3D2><span style=3D'font-size:10.0pt'> Blair Stone Road, =
MS</span></font><font
size=3D2><span style=3D'font-size:10.0pt'> 4555</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>Tallahassee</span></font><font
size=3D2><span style=3D'font-size:10.0pt'>, Florida =
32399-2400</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>PH:
(850) 245-8759</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>FAX:
(850) 245-8811</span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'><a
href=3D"mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.=
us</a></span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:11.0pt'> </span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'>view
our mercury web pages at: </span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt'><a
href=3D"http://www.dep.state.fl.us/waste/categories/mercury/default.htm">=
http://www.dep.state.fl.us/waste/categories/mercury/default.htm</a></span=
></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
style=3D'font-size:11.0pt'> </span></font></p>
<p class=3DMsoNormal><font size=3D2 face=3DArial><span =
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