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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal><span style='color:#1F497D'>Hi Jen and all,<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Jen, that is fascinating, and yes I like Dalma’s quote, too. This is contrary to what was taught when I was in immunology years ago—antibodies and hormones are two totally different proteins with different functions. An antibody is theoretically very specific to the antigen it locks onto—making the antibody/antigen complex effective at protecting the body from disease or other foreign elements. I’m sure our knowledge has advanced remarkably since I was an undergrad, to the point where antibody proteins have been fully decoded, etc. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Another interesting aspect of pharmaceuticals is the doses that are prescribed are thousands of times higher than necessary. Think of it, we take a milligram dose that translates to a microgram, nanogram or picogram concentration in the body. The rest is primarily excreted. The drug/receptor interaction is not nearly as exacting as the antigen/antibody complex. As Jim Lazorachek, an EPA water scientist said, we are essentially overdosed every time we take a medication. I’ve found for the few medications I take, a much smaller dose than prescribed is often very effective. I try to be conscious of what I am excreting. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Some of the solution to the extraordinary overdosing and excretion is to combine the drug with an antibody making it specific to a cellular protein. Of course this is expensive. But it would go a long way in accurate dosing and minimizing aquatic impacts. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><p class=MsoNormal><span style='color:#1F497D'>Very truly yours,<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Catherine Zimmer, MS, BSMT<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Zimmer Environmental Improvement, LLC<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt;font-family:Pristina;color:#00B050'>Reducing and managing healthcare related waste and costs for fifteen years. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>St. Paul, MN <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Ph: 651.645.7509<o:p></o:p></span></p><p class=MsoNormal><span style='color:#00B050'><a href="mailto:zenllc@usfamily.net"><span style='color:#00B050'>zenllc@usfamily.net</span></a><o:p></o:p></span></p></div><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Volkman, Jennifer (MPCA)<br><b>Sent:</b> Friday, October 30, 2015 6:19 PM<br><b>To:</b> pharmwaste@lists.dep.state.fl.us<br><b>Subject:</b> RE: [Pharmwaste] Testing chemical risk in MN lakes, scientists shrink to the cell level<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='color:#1F497D'>My favorite quote from one of Dalma’s presentations is “the estrogen receptor is very promiscuous” <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>I listened to a presentation from Mark Ferrey last week on the studies he’s done. Very interesting, like how they thought they had a “control lake” that was nearly inaccessible in the middle of nowhere in far northern MN, but it had just as many hits for chemicals as lakes in very populated areas with houses all around them. Another was that contrast dyes commonly showed up, how many people have to drink those? Airborne deposition vs. sewering is another interesting concept. I believe he is next going to work on comparing airborne toxics data with is found in surface water…<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>I’m not a fan of the common analogies used to help people get a picture of what a ppm or ppt is. I think saying one drop in an Olympic size pool just tells people it isn’t enough to worry about. I’ve been wondering if a chart exists that shows the level of drugs in our blood system—what the effective dose computes to in our blood stream. He had a chart! It is attached and I think you may find it a more useful way to communicate ppm/b/t. <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>I think the easiest analogy to understand is that a person taking a (typical) 20 ug dose of ethinyl estradiol results in it being present at a level of 250 ppt in a woman’s body--and it is enough to keep her from getting pregnant. It also includes some non-pharmaceuticals. I couldn’t find a source for the table in the PowerPoint I took this from, sorry.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Mark also said that Mayo doctors were very interested in his data and he asked them if they believed these parts per trillion could have much impact on humans. A doctor told him the difference in the level of estrogen in a woman’s body pre and post menopause is a reduction from 10 ppt to 7 ppt.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>JV<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a> [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>] <b>On Behalf Of </b>Tenace, Laurie<br><b>Sent:</b> Tuesday, October 27, 2015 8:12 AM<br><b>To:</b> <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br><b>Subject:</b> [Pharmwaste] Testing chemical risk in MN lakes, scientists shrink to the cell level<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal style='margin-bottom:8.05pt'><span style='font-size:21.0pt;font-family:"ITCFranklinGothicW01-Dm 812677"'>Testing chemical risk in MN lakes, scientists shrink to the cell level<o:p></o:p></span></p><p class=MsoNormal style='margin-bottom:8.05pt'><a href="http://www.mprnews.org/story/2015/10/26/testing-risk-in-minnesota-lakes"><span style='font-size:12.0pt;font-family:"ITCFranklinGothicW01-Dm 812677"'>http://www.mprnews.org/story/2015/10/26/testing-risk-in-minnesota-lakes</span></a><span style='font-size:12.0pt;font-family:"ITCFranklinGothicW01-Dm 812677"'><o:p></o:p></span></p><p class=MsoNormal style='margin-bottom:8.05pt'><span style='font-size:21.0pt;font-family:"ITCFranklinGothicW01-Dm 812677"'><o:p> </o:p></span></p><p class=MsoNormal><a href="http://www.mprnews.org/environment"><span style='font-size:10.5pt;font-family:"Helvetica Neue";color:#00334E;text-decoration:none'>Environment</span></a><span style='font-size:10.5pt;font-family:"Helvetica Neue";color:#999999'> </span><a href="http://minnesota.publicradio.org/about/people/mpr_people_display.php?aut_id=25"><span style='font-size:10.5pt;font-family:"Helvetica Neue";color:#00334E;text-decoration:none'>Dan Gunderson </span></a><span style='font-size:10.5pt;font-family:"Helvetica Neue";color:#999999'>· Moorhead, Minn. · Oct 26, 2015 <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Scientists have found pharmaceuticals and other chemicals in lakes across Minnesota, including one in Voyageurs National Park in northern Minnesota. New genetic testing tools are helping researchers determine what risk those chemicals pose to the environment. Courtesy of Voyageurs National Park file <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Dalma Martinovic uses many tools to analyze the potential effects of environmental pollutants in Minnesota lakes. But there's none better than her firefly experiment.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>To test for chemicals affecting hormone production, Martinovic uses breast cancer cells with a firefly gene. When the cells are exposed to certain chemicals, they glow like a firefly. The more intense the cell reaction to the chemicals, the brighter the light.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"It's really cool actually," said Martinovic, a researcher at the University of St. Thomas.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>It's more than cool. Researchers for years documented low levels of chemicals — from antidepressants to insect repellent — in Minnesota lakes, but they had a hard time answering the question: What's the risk?<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Martinovic is working now with the Minnesota Pollution Control Agency and the federal Environmental Protection Agency on techniques to help find answers. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>The new tools can assess risk from chemicals found in water at levels as low as a few parts per trillion. In a swimming pool the size of a football field — and four stories deep — a single drop of water would be about one part per trillion.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Digging into the effects of chemicals at the genetic level is a big change for scientists. In the past, a researcher might expose a fish to chemicals and observe what happened. In some cases </span><a href="http://www.mprnews.org/story/2010/11/01/male-fish-study"><span style='font-size:10.5pt;font-family:"Arial","sans-serif";color:#00334E'>male fish took on female traits</span></a><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'> after exposure. In other studies </span><a href="http://www.mprnews.org/story/2013/02/20/environment/new-study-shows-chemicals-can-reduce-fish-survival"><span style='font-size:10.5pt;font-family:"Arial","sans-serif";color:#00334E'>fish behavior changed</span></a><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Why those things happened wasn't always clear.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Those studies are still used, but now instead of only observing fish response to chemicals, Martinovic zooms in on individual genes. Are they turned on or off by chemical exposure? Genes create proteins that in turn influence what happens to cells and organs in a fish or human body.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>The earliest studies of contaminants involved hormones. Scientists observed reproductive changes in fish exposed to chemicals that interfere with hormone production.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>But that was like seeing a blurry photo. Now, by examining how individual genes react to chemicals, the picture is slowly coming into focus.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Early genetic work by Martinovic found fish genes that regulate immune response often changed in response to the chemicals. Genes that regulate hormones nearly always changed when exposed to low levels of chemicals that interact or interfere with hormones. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Because there are many chemicals in water it's also important to understand the cumulative effect. Sometimes more than one chemical will stimulate the same gene to produce a protein. In other cases one chemical will turn on a gene while </span><a href="http://www.mprnews.org/story/2011/03/11/wastewater-pharmaceuticals-streams"><span style='font-size:10.5pt;font-family:"Arial","sans-serif";color:#00334E'>another has the opposite effect</span></a><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"When we talk about genes we say, 'Oh, genes are so important," she said. "Well in a sense, protein is the expression of the gene. It tells you if this gene is turned on it's going to make some protein or it's not going to make some protein. In a sense proteins are the expression of the state of your body." <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Another new tool to identify risk is data mining. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>The EPA has created a large database of genetic response to a variety of chemicals. It brings together research from around the world. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"We can go to the database and say, I have these four chemicals please list all of the genes that would be impacted by these chemicals. And then we can say, 'OK, what do these processes mean?" Martinovic said. "We can actually then predict what might be happening." <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>That's the ideal scenario for risk assessment. The problem is there are thousands of chemicals that still need to be tested and added to the database.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Still, genetic risk assessment is helping target research by helping rank chemicals by the potential effects of genetic change they may cause.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>That will allow MPCA to decide which chemicals to test for in the environment, and avoid expensive tests for chemicals with limited risk potential, said MPCA scientist Mark Ferrey.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>The techniques may provide a better picture the risk to the environment or human health, said Ferrey, who first reported on the widespread discovery of chemicals in Minnesota lakes back in 2009 but confessed he's lost sleep over the question of the risk the chemicals posed.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"Some people will say it's terrible and very frightening that we can have medications in our surface water. And other people will say these chemicals are at such low concentrations it can't possibly make a difference," Ferrey said. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"This is a way to say this is why these things matter to us," he added. "How can we mitigate exposure in the environment? How can we treat them more effectively in treatment plants? How can we remove them from the waste stream?" <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Ferrey and Martinovic are using these techniques to prioritize the risk for contaminants in water collected at 10 sites around Minnesota. The findings will be published early next year.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>Martinovic is optimistic that within 15 years chemical risk assessment will be much quicker and more detailed.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:10.5pt;font-family:"Arial","sans-serif"'>"It's complex. It's not simple," she said. "But all of this holds great promise."<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Laurie Tenace<o:p></o:p></p><p class=MsoNormal>Environmental Specialist<o:p></o:p></p><p class=MsoNormal>Waste Reduction Section<o:p></o:p></p><p class=MsoNormal>Florida Department of Environmental Protection<o:p></o:p></p><p class=MsoNormal>2600 Blair Stone Road, MS 4555<o:p></o:p></p><p class=MsoNormal>Tallahassee, FL 32399-2400<o:p></o:p></p><p class=MsoNormal>850.245.8759<o:p></o:p></p><p class=MsoNormal><a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a><o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p></div></body></html>