Chemicals and COVID-19, Part Two

A few months ago I wrote a post summarizing some of what was then known about the chemical connection to COVID-19. I talked about the link between the disease (cases, hospitalizations, and deaths) and fine particulate matter in the air. I also mentioned chemical connections to some of the risk factors like asthma and heart disease. Some new, potentially important information has come to light since then, so it’s time for an update.

Forever Chemicals

The most significant new information concerns compounds that have come to be known as “forever chemicals” because they’re so persistent. These chemicals are in a class once known as PFCs (perfluorinated chemicals) and now generally called PFAS (per- and polyfluoroalkyl substances). PFAS are currently in the spotlight, due at least in part, I believe, to the excellent movie Dark Waters, which brought them into the public consciousness. 

PFAS have already been linked to a wide range of negative health effects, but it appears we can add something new to the list. They may make COVID-19 worse.  A very recent study, still undergoing peer review, found that people infected with coronavirus who had elevated levels of one particular PFAS chemical had more than twice the risk of experiencing severe illness. What’s especially disturbing is that the particular substance, PFBA (aren’t these acronyms fun?), has been promoted as being safer than others in the class because it leaves the bloodstream more rapidly. Unfortunately, it accumulates in the lungs, which may explain the finding.

The Harvard researcher who found the connection also worries about something else. Previous research has found that people exposed to PFAS had reduced antibody concentrations after receiving tetanus and diphtheria vaccinations. In other words, the chemicals apparently reduced vaccine effectiveness. Will the chemicals also interfere with a COVID vaccine? As he notes, “At this stage we don’t know if it will impact a corona vaccination, but it’s a risk. We would have to cross our fingers and hope for the best.”

Unfortunately, PFAS are even harder to avoid than we previously thought. They’re handy for making things non-stick and waterproof, so an obvious place to start lowering your load is by avoiding products with those sorts of coatings. Seven years ago, when they were still called PFCs, I wrote a post noting that “it seems ironic that PFCs are generally used for their anti-stick properties given the fact that they’re very ‘sticky’ and persistent in the environment and in our bodies.”

Avoiding obviously non-stick products isn’t enough, though. A group of researchers recently attempted to determine just how widespread the use of PFAS has become, and said this: “What we found is deeply disturbing. PFAS are used in almost all industry branches and in a much wider range of consumer products than we expected. Altogether, we found PFAS in more than 200 use categories.” They note that some uses were already known, such as in fast-food containers, carpets, waterproof fabrics, ski waxes, batteries, muffin tins, popcorn bags, dental floss, and fire-fighting foams, but that many weren’t. They found the chemicals in hand sanitizers, mobile phones, a wide variety of cosmetic products, artificial turf, guitar strings, piano keys, pesticides, printer ink, and many more surprising places. PFAS frequently show up in the water supply, and have also been found in food as diverse as meat, leafy greens, and chocolate cake with icing.

Gas Appliances

As I noted in my previous post, the state of the air we breathe (particularly the amount of particulate matter in it) has been linked to the number and severity of COVID cases. Now it appears that long-term exposure to high NO2 (Nitrogen Dioxide) is more dangerous than exposure to particulate matter or ozone and correlates with a higher risk of death from the disease. An article reporting on the finding notes that NO2 is a primary pollutant produced by natural gas-burning stoves and furnaces.

Cleaners and Disinfectants

Last month I wrote an entire post on disinfectants, so I won’t repeat it all here, but I’ll point out that we now know much more clearly than we did at the beginning of the pandemic how the virus spreads, and that knowledge changes the risk/benefit equation of using disinfectant chemicals.  A New York Times article published after I wrote my post was aptly headlined:  “The Coronavirus Is Airborne Indoors. Why Are We Still Scrubbing Surfaces?” It points out that “disinfecting sprays are often made from toxic chemicals that can significantly affect indoor air quality and human health.”

A recent piece in the Washington Post makes the same point and notes that there’s not a single documented case of COVID-19 being transmitted through a contaminated surface. The authors (three professors) give the analogy of cleaning countertops and doorknobs to try to protect yourself from the effects of cigarette smoke in the air. They add that “the use of all of these extra cleaning products releases chemicals into the air that can be harmful to our health.”

Long-haulers

A growing number of “long-haulers” who have persistent symptoms after being infected with the virus are reporting increased sensitivity to everyday chemicals. Many of us with MCS (Multiple Chemical Sensitivity) find familiarity in the story.  All people alive carry a load of manmade and biological toxins inside, and when the load gets too high, sometimes the body turns on a warning system to keep us from being injured further. 

An article headlined “Why Are COVID-19 Long-Haulers Developing Fragrance Allergies?” points out that the main way to cope is to avoid triggers, but acknowledges that it’s difficult to do. Indeed it is. Let’s help ourselves and each other by being very intentional about the products we buy and use.

From my Heart to Yours

On this date three years ago, my husband's heart stopped beating. He was in his 50s, seemingly healthy and robust, and most people were genuinely shocked at his death. I didn't wake up that March morning believing that my husband would die that day, but in a general sense I was less shocked than many others seemed to be. That was partly due to life experiences (my mother died when I was young, so I grew up understanding the unpredictability of death) and partly due to understanding some of his risk factors.

I'm going to mark this anniversary by writing about heart disease and talking about some lesser known causes. At some point I'm going to talk about a risk factor or two that I wish Dan would have taken more seriously. I imagine that last sentence put some of you on edge. Believe me, I spent a lot of time debating whether or not to write this post, but I decided to do so for multiple reasons, including that I'd like to think that Dan would want me to.

Heart disease is the leading cause of death in the United States. The Centers for Disease Control notes that it causes one out of every four American deaths. Risk factors listed by the CDC include high blood pressure, high cholesterol, smoking, diabetes, excess weight, poor diet, physical inactivity, and excessive alcohol use. I believe these are fairly well known by the general population. There are many other risk factors, however, that are less understood.

This is by no means an exhaustive list, but some of the lesser known contributors to heart disease include the following:

Air pollution - Air pollution is a broad term, but in general, fine particulates in the air, such as from industrial and traffic fumes, are associated with higher rates of heart disease. The American Heart Association reports research showing increases in death and hospitalizations when there are higher rates of smog. ABC News reports on a study finding that being stuck in traffic more than triples the risk of having a heart attack.

Non-stick chemicals - As I've noted many times, chemicals in our consumer products are generally not tested for safety, so the health effects often remain unknown. Some, however, have been linked to heart disease, including a family of chemicals used in products such as non-stick pans and stain resistant coatings. A 2012 study found that people who had the highest rates of the chemical PFOA in their blood were twice as likely to experience heart disease, heart attack, or stroke as those with the lowest levels. Because of the bad press, PFOA is being replaced by other similar chemicals, but many health experts warn that there is no reason to believe that the newer versions are any less problematic.

Chemicals found in food and beverage containers - A 2014 study in the International Journal of Environmental Research and Public Health concluded that the chemical BPA, found in many places, including plastic bottles and in the lining of food cans, was associated with heart disease in both acute and chronic low-dose exposure situations. As with PFOA, the bad press about BPA has led to some changes, but a 2016 study found it present in 67% of cans tested.

Heavy metals - University Health News reports that researchers have implicated at least four heavy metals associated with clogging arteries: lead, mercury, cadmium, and arsenic.

Mold and other toxins found in water damaged buildings - Water damaged buildings, or those with high indoor humidity levels, tend to be breeding grounds for a multitude of organisms, including a wide variety of fungi and bacteria. Exposure can lead to chronic inflammation, which can contribute to heart disease. A study in the Internet Journal of Toxicology found an association between exposure to molds in damp buildings and high cholesterol levels.

Sleep apnea - The American Heart Association notes that sleep apnea is associated with high blood pressure, arrhythmia, stroke, and heart failure. I'm almost certain that Dan had sleep apnea, and I wish I had been successful at convincing him to get tested.

Sugar consumption - This is the big one that I worried about for years. Dr. Mark Hyman's summary of the research notes that people with the highest sugar consumption have a 400% higher risk of experiencing a heart attack than those who consume the least. Sugar (in all its various forms) is not just a problem because of its "empty calories," adding to weight without contributing nutrition, but because it is inflammatory and dangerous in and of itself.

Americans eat a lot of sugar, and the amount continues to climb. A Huffington Post article reports that the American Heart Association recommends that women cap their consumption at six teaspoons a day and men at nine, but that the average American consumes 30 teaspoons daily. There are a number of reasons for this. One is simply that American food manufacturers sweeten almost everything. I remember returning to the United States after living overseas and being astonished to find sugar in canned kidney beans. Dr. Hyman notes, "Most of us don’t know that a serving of tomato sauce has more sugar than a serving of Oreo cookies, or that fruit yogurt has more sugar than a Coke, or that most breakfast cereals — even those made with whole grain — are 75% sugar. That’s not breakfast, it’s dessert!"

Americans also eat a lot of sugar because we're addicted to it. I don't use that term lightly. Sugar affects the same reward centers of the brain that other drugs do, and produces tolerance in the same manner. People find themselves needing more and more of it to satisfy their sweet tooth and may experience withdrawal symptoms when they don't consume it at regular intervals. To quote Dr. Hyman again, " Recent and mounting scientific evidence clearly proves that sugar — and flour, which raises blood sugar even more than table sugar — is biologically addictive. In fact, it’s as much as eight times more addictive than cocaine." A 2007 rodent study reported that 94% of the animals chose sugar (or an artificial sweetener) over cocaine when given the choice.

Drug abuse is a serious and growing personal and societal problem that I don't want to trivialize in any way. An Associated Press article reports that almost 13,000 people died of a heroin overdose in 2015 and prescription painkillers killed over 17,500 people. A 2015 LA Times story reports another serious statistic: sugary drinks are linked to 25,000 deaths in the United States each year.

It seems likely that many, if not most Americans are addicted to sugar to some degree. I believe I was, until my health forced me to radically change my diet. I believe Dan was. We talked about it some through the years, and he never quite denied it, but he never quite addressed it, either. About a year before he died, he developed a persistent itchy rash that doctors had trouble diagnosing. At some point I sent him an article which suggested giving up sugar for two weeks in the case of mystery skin ailments. Not long afterwards, he remarked to me that he had decided that he wouldn't cut sugar out completely, but that maybe he would try to cut down.

I remember that conversation clearly. Dan was itchy and miserable, but not fully willing, for a a brief two weeks, to trade sugar for the possibility of relief. The basic definition of addiction is continuing to engage in a behavior despite negative consequences, and I remember feeling a wave of deep sadness and thinking, "This is a strong addiction. It could kill him." I thought there was a good possibility that his heart would cause him major problems some day, but I didn't know how soon the day would come. I think my vague thought of what might happen was that he might have a heart attack in his 60s, and that, if we were lucky, he would live through it and then maybe get serious about changing his diet.

Obviously, I don't know that sugar consumption had anything to do with Dan's sudden death. He had plenty of other risk factors, including genetic ones, and had a period of high work stress in the time period before he died, which could well have been the final straw. I'm also certainly not unaware that my own health limitations added a significant degree of stress to Dan's life. (On the flip side, I think my need to live a low-toxicity life was protective for him in some ways, as well.) I can't point to sugar and say that I know it killed my husband, but the research is clear that it is, in fact, a killer.

I'm very sensitive to "blame the victim" messages and absolutely don't want this to come across that way. This isn't blaming, but warning. It's remembering the events of this day three years ago and deeply and sincerely wanting to spare other people a similar experience. Sometimes people take things more seriously when they know people who have been affected, which is my sole motivation for sharing personal stories.

As I was debating whether or not to write this post, I ran across Leviticus 5:1, which says "If you are called to testify about something you have seen or that you know about, it is sinful to refuse to testify." Yes, it's Old Testament and no, it wasn't written about blog posts, but it convinced me. What I can offer the world these days is limited, but I can testify about things I have seen and know about.

I imagine I've made a lot of people mad by this point. To those who are mad because they loved Dan and are angry that I wrote some negative things about him, I'll simply say that I loved him, too, and miss him greatly. I've cried every day this month so far. I'll also remind you that I wrote a very different sort of post about him three years ago.

To those who are mad because in addition to harping about chemicals, I'm now harping about a very prevalent food choice which is a source of comfort and pleasure, I'll simply say that I get it. Those of us who became addicted to sugar were simply eating the standard American diet or found ourselves eating more sugar because we were avoiding fat and dietary cholesterol like the experts recommended. The sugar industry manipulated studies and public policy just like the chemical industry does today. It's easy to understand how we ended up in this place, but now that we're here, it's time to accept that there are real consequences.

I write because I care about you. Whether I know you personally or not, you matter to me simply because you've taken the time to read this post. I know other people care about you, too, and we all want your heart to keep beating for a very long time.

Non-Toxic Oven Cleaning

Thanksgiving weekend has come to a close, and for those who hosted guests, it’s time to put things back in order. If this means cleaning an oven from the effects of cooking a Thanksgiving feast, there are some things to keep in mind, including the following:

• Commercial oven cleaners are generally very toxic. The Environmental Working Group (EWG) rated 12 oven cleaners on their safety. Of the 12, one product received a “C” grade and 11 received an “F.”

• Self-cleaning ovens aren’t a non-toxic option, either. Self-cleaning ovens are generally coated with Teflon or similar chemicals. See the previous post titled “Sticky Chemicals” for more information on the dangers of PFCs. The burning of food particles during the self-cleaning cycle may also release small amounts of carbon monoxide and there may be fumes released from the oven’s insulation, including formaldehyde. Most oven manufacturers recommend opening windows, running ventilation fans, and/or leaving the house while the self-cleaning function is operating. Many also recommend removing pets from the home. In a Healthy Home Tip article, the EWG noted that the flu-like symptoms that people often get from heated Teflon-like chemicals are so common that they have been given a name by scientists: “Polymer fume fever.”

• It’s possible to clean an oven safely. There are many “recipes” that have been used successfully. Some people just use baking soda and water. Others use baking soda and vinegar. One blogger posted her recipe for using baking soda and dish soap, which is similar to what I usually do, except that I use a fragrance-free dish soap made by Seventh Generation. Other methods that have been recommended are to use a pumice stick or citrus peels.

Here's what works for me.

In the evening I make a paste of baking soda, water, and fragrance-free dish soap. I apply this to the oven interior. I then boil a pot of water on the stove. When it’s boiling nicely, I remove it from the stove, stick it in the oven, and close the oven door. This allows the oven to fill with steam. I leave everything alone until morning, at which time I wipe away all the gunk. After everything looks clean, I go over everything again with water or vinegar just to make sure I’ve removed all the residue. That’s it. It almost always works. Occasionally there’s a stubborn spot that remains, but some combination of baking soda, water, and time always removes it.

The chemical industry wants us to believe that our choices are harsh chemicals, filth, or exhausting work. It isn’t true. Let’s show them we know better.

Chemicals and Conception

Celebrating Mother's Day yesterday reminded me again of what a blessing it is to be the mother of two amazing young men. As I ponder the gift of motherhood, I can't help but think of a number of people I know who would very much like to be parents, but have found that goal difficult to achieve. There are many possible reasons for infertility, but a factor that may be overlooked, and that can be controlled to an extent, is exposure to chemical toxins. (How did you know I was going to say that?)

Earlier this year, the journal Environmental Health Perspectives published a study that examined "persistent pollutants" and the time to pregnancy of couples wishing to conceive. The study and a report of it published in E Magazine noted the following:

• Couples exposed to toxins known as persistent organic pollutants took longer to become pregnant.

• Men’s chemical exposures were more important to the equation than their partners'.

• The concentration of chemicals found to delay conception was lower than the average found in the U.S. population.

An online article entitled "Toxins and Fertility" notes that only about 5 percent of the almost 80,000 chemicals used in the US today have been tested for their reproductive effects. Despite that, we do know that certain chemicals may cause problems for couples wishing to become parents. The article and a fact sheet produced by Safer Chemicals, Healthy Families list the following chemicals that may affect reproduction:

• Phthalates, which are widely used and may be found in nail polish, shampoo, conditioner, lotion, antiperspirant, sunscreen, gum, candy, medications, and many other places

• Parabens, added to a wide range of household products, including bath products and cosmetics

• Bisphenol A (BPA), which can be found in polycarbonate plastic and some food and beverage can linings

• Perfluorinated compounds (PFCs), commonly used in stain-proof and non-stick products

• Cadmium, a metal used in pigments, metal coatings, plastics, and batteries

• Fluoride, added to many municipal water supplies

• Common pesticides and fungicides, including Vinclozolinis, Kepone, DBCP, ethylene dibromide, and Methoxychlor (MCX)

• Triclosan (Microban),found in anti-bacterial soaps, dental products, cosmetics, deodorant, first aid products, kitchenware, appliances, toys, and more

The chemicals listed are linked to a wide range of other health effects as well. Avoiding them benefits us all.

Sticky Chemicals

Last month, the journal Environmental Health Perspectives reported on a study of common household chemicals called PFCs. The lead study author, quoted in a WebMD article, noted that the study found "a clear and strong association between exposure to [these] compounds and osteoarthritis, which is a very painful chronic disease.“ Osteoarthritis is the most common form of arthritis and involves irreversible deterioration of joint cartilage.

PFCs are often used to make products slicker and more repellent. Some of the many places they may be found include:

• Nonstick cookware

• Grease-resistant food packaging, such as microwave popcorn bags, pizza boxes, and fast food sandwich wrappers

• Paper plates

• Carpeting

• Stain-resistant upholstered furniture

• Some clothing items, including those made of Gore-Tex and other fabrics treated for water or stain resistance

• Shoes

• Luggage

• Camping and sporting equipment

• Certain cosmetic and personal care products, including shampoo, dental floss, denture cleaners, nail polish, eye make-up, pressed powder, shaving cream, and lotion

PFCs have been previously linked to other negative health effects. These include higher levels of "bad" LDL cholesterol, skewed thyroid hormone levels, premature onset of menopause in women, liver inflammation, reduced vaccine effectiveness in children, smaller birth size of babies, and weakening of the immune system. They cause cancer in laboratory animals and are likely human carcinogens.

It seems ironic that PFCs are generally used for their anti-stick properties given the fact that they’re very “sticky” and persistent in the environment and in our bodies. It takes a human body 4 years to expel half of a dose of one of the two most common PFCs and more than 8 years to process half a dose of the other. Some varieties of the chemicals have been removed from the market, but others have taken their place. The Environmental Working Group notes that "companies that manufacture PFCs have agreed to phase out one variety, called PFOA, by 2015. Unfortunately, there’s no evidence that the chemicals being used to replace it are any safer."

Tips for avoiding PFCs include the following:

• Avoid use of Teflon-type non-stick cookware. Safer alternatives are stainless steel, cast iron, ceramic, or enamel. Remember that it isn't just pans that may be coated with PFCs, but muffin tins, cookie sheets, and other bakeware.

• Decline optional stain-protection treatment when buying furniture. Some health experts recommend covering any treated furniture already owned with a heavy slipcover to impede migration of the chemicals from the furniture into your body.

• Carpeting should be avoided for many reasons. (See this previous post.) Adding treatment for stain resistance makes a bad product worse.

• Avoid clothing treated for water or stain repellency. In most situations, the benefits are not worth the risk. Tightly-woven non-treated fabrics are often an acceptable alternative.

• Minimize consumption of food packaged in PFC-coated containers. Pop popcorn on the stove, in an air-popper, or in a plain brown bag in the microwave. Use glass or ceramic for microwave cooking and for storing leftovers. Avoid paper plates.

• When buying cosmetics and personal care products, read the labels and look for PTFE and for ingredients that start with "fluoro" or "perfluoro." These are PFCs and should be avoided.

I know it’s discouraging to constantly read of the extent of the chemical problem and the ramifications of using the products that surround us. I find it discouraging, too. We simply must educate ourselves, though, and do what we can to protect ourselves and our fellow human beings. Seemingly small decisions can matter more than we imagine.