“Concerning” disparities in HP vaccine uptake among US adults, with men and Hispanic people among those least protected

In a national sample of 27-45 year olds, nearly 85% had not been vaccinated against the virus – highlighting an “urgent need” to address uptake disparities

TAYLOR & FRANCIS GROUP

An analysis of data from a nationwide health survey reveals “concerning” disparities in human papillomavirus (HPV) vaccine uptake among US adults aged 27 to 45 years. 
 

More than 84% of the 9,440 people involved in a national sample had yet to be vaccinated for this common virus which can cause cancers later in life such as cervical, oropharyngeal (throat), anal, penile, vaginal and vulvar. 
 
Low uptake in the vaccine was observed among men, as well as people of Hispanic heritage, and those with lower educational levels. 

 

Publishing their findings in the peer-reviewed journal Human Vaccines & Immunotherapeutics, the expert team state the results highlight an “urgent need” to address and mitigate disparities in HPV vaccine uptake in this age group and raise awareness of the importance of the vaccine – especially for men who were more than three times less likely to be vaccinated.   
 
“The overall low uptake of the HPV vaccine in this age group, raises concerns regarding cancer prevention efforts,” states lead author Dr. Nosayaba Osazuwa-Peters, who is a  head and neck cancer epidemiologist at Duke University School of Medicine’s and the Duke Cancer Institute, in North Carolina.  
 
“Given the importance of the HPV vaccine in cancer prevention, it is critical that these disparities are addressed and mitigated. 
 

“Addressing disparities and improving access to vaccination services are crucial steps in preventing HPV-associated cancers and improving public health outcomes for all.” 

 

Dr, Osazuwa-Peters adds: “Males are in particular need of increased knowledge of the vaccine, in light of the increasing incidence of both anal and oropharyngeal cancers, which are known to originate from the HPV virus. 

 

“When the HPV vaccine was first approved in the US in 2006, it was approved for only girls, and with a focus on cervical cancer; so, males have literally been playing catch-up the whole time. Interestingly, as of now, oropharyngeal cancer, 75% of which are in males, have overtaken cervical cancer, for which the vaccine was originally developed.” 

 

With nearly 36,000 people diagnosed with an HPV-associated cancer each year in the US, HPV vaccination offers a critical opportunity for cancer prevention, potentially preventing more than 90% of these cancers. 

 

While routine HPV vaccination was initially recommended for children aged 11 to 12 years, with catch-up vaccination through to age 26 years, the US Food and Drug Administration (FDA) expanded the age range for eligibility to adults aged 27 to 45 years in 2018. However, there is little currently known about the uptake of the vaccine within this age group. 

 

This research analyzed data from the 2019 National Health Interview Survey, which collects cross-sectional health data from a nationally representative sample of the US population. It is the first study since the FDA age expansion to exclusively examine differential HPV vaccine uptake in a diverse sample of 27- to 45-year-old adults from across the US population. 
 
Results reveal that a significant proportion (84.5%) of participants had not yet been vaccinated against HPV. 

 
The outcomes also unveil disparities in HPV vaccine uptake based on demographic and socioeconomic factors: 

 

• Females had over three times greater odds of vaccine uptake compared to males. 

• Non-Hispanic Blacks were 36% more likely, while Hispanics were 27% less likely, to receive the vaccine compared to non-Hispanic Whites. 

• Individuals without a usual place of care and those with lower educational levels had lower odds of vaccine uptake. 

 

Dr. Osazuwa-Peters, who led a team of specialists from institutions across the US, adds: “For oropharyngeal cancer, about 75% of new cases are in males. As oral HPV is the primary cause of HPV-associated oropharyngeal cancer, providing the HPV vaccine to middle-aged individuals is undoubtedly an important strategy to decreasing risk of infection, persistence, and eventual HPV-associated oropharyngeal malignancy.  
 
“While the population benefit of the HPV vaccines in preventing oropharyngeal cancer may not be realized until years later, there are ongoing clinical trials to definitely establish that the current vaccines are effective in the prevention of oral HPV infection.”  
 
Of particular concern, too, is the lower likelihood of HPV vaccine uptake among Hispanic adults, they authors add, emphasizing the need for targeted interventions to increase awareness and access to vaccination.  

 

Overall, the expert team state their findings should “serve as a call to action for policymakers, healthcare providers, and community leaders to intensify efforts to promote HPV vaccination among adults aged 27 to 45 years”. 

 

A key strength of this study lies in its analysis of a nationally representative sample of data. However, its limitations include a reliance on self-reported data and the inability to determine the exact age of HPV vaccination among participants.

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JOURNAL

Human Vaccines & Immunotherapeutics

DOI

10.1080/21645515.2024.2313249 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Racial and ethnic disparities in human papillomavirus (HPV) vaccine uptake among United States adults, aged 27–45 years

ARTICLE PUBLICATION DATE

28-Mar-2024

You are never too old for an STI – more older adults being diagnosed with STIs such as gonorrhea and syphilis

Infectious disease expert addresses how to manage the rise in sexually transmitted infections in older adults

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

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• Infectious disease expert addresses how to manage the rise in sexually transmitted infections in older adults.
• STIs in Americans aged 55 to 64 years have more than doubled over the past decade; in England the number of over 45s diagnosed with gonorrhoea and syphilis doubled between 2015 and 2019.
• Availability of sildenafil (Viagra) in late 1990s had an impact on STIs in older men.
• Sexual health campaigns overlook the needs and experiences of the baby boom generation.
• Health professionals must be proactive in discussing sexual concerns and making sexual health a routine part of general health care for older adults.

**Note: the release below is a special early release from the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024, Barcelona, Spain, 27-30 April). Please credit the congress if you use this story**

A new research review presented at a pre-congress day for this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024, Barcelona, 27-30 April) will look at how to manage the rise in sexually transmitted infections (STIs) in older people, such as gonorrhoea, syphilis, and genital warts. It will focus on the importance of sex, intimacy, and sexual health to the Baby Boomer generation, especially given that 1 in 6 individuals worldwide will be aged 60 and older by 2030. The presentation will be given by Professor Justyna Kowalska from the Medical University of Warsaw, Hospital for Infectious Diseases in Warsaw, Poland—who will highlight the need for conversations around older people and sexual health to be normalised.

Data from the US Centers for Disease Control and Prevention (CDC) indicate that rates of chlamydia, gonorrhoea, and syphilis among US adults aged 55 and older have more than doubled over the past 10 years. For example, rates of gonorrhoea among those aged 55 to 64 years rose from around 15 cases per 100,000 people in 2015 to 57 per 100,000 in 2019 [1]. In England, 31,902 new STIs were recorded in the over 45s in 2015, which rose to 37,692 in 2019 – an increase of 18%, with the majority of new diagnoses in men who have sex with men [2]. High STI prevalence estimates have also been reported more broadly in older adults around the world, including China, Korea, Kenya, and Botswana.

“Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over 50s”, explains Professor Kowalska. “These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.”

Compounding the problem are the many misconceptions around sexuality and sexual activity in older adults, and the importance of sex and intimacy to older people’s happiness and wellbeing. As Professor Kowalska explains, “People do not become asexual with age. In fact, with preventive medicine and improved lifestyles people are enjoying a healthy life and sex life for longer. Older people often find greater satisfaction in their sex lives due to experience and known expectations. We need more role models like Samantha Jones in the TV show Sex and the City to challenge stereotypes around older sexuality.”

Although the frequency of sexual activity tends to decline with age, older adults are still having lots of sex. In a study in England, half of men and almost a third of women aged 70 and over reported being sexually active. Similarly, in a Swedish study, 46% of individuals aged 60 years and older reported being sexually active, as did 10% of those aged 90 years or older [3].

Studies show higher levels of sexual desire, greater sexual frequency, and more sexual partners among older men than women. A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women. And the effects in men were larger after sildenafil (Viagra), the first phosphodiesterase type 5 inhibitor (PDE5 inhibitor), hit the market. Professor Kowalska says, “These findings indicate that sexual risk taking is common among older adults, particularly men. Given that the number of people aged 60 years and older is set to double worldwide by 2050 and the widespread availability of drugs to enhance sexual activity, health professionals must be proactive in discussing sexual concerns and making sexual health a routine part of general health care for older adults.”

Although the incidence of STIs among the over 50s is small compared to younger age groups, it is rising, and Prof Kowalska will call for raising awareness about sexual health in older adults, explaining that they came of age at a time when sex education in school did not exist. “Sexual health campaigns are focused on young people and overlook the needs and experiences of those aged 50 and older”, she says. “Health promotion messages give the impression that condoms and concerns about STIs only apply to young people. But the dangers of undiagnosed and untreated STIs such as HPV-related cancers and onwards transmission are very real, particularly in this age group who are more likely to have underlying conditions such as heart disease and stroke.”

Prof Kowalska will also highlight the lack of evidence for using communication to promote positive behaviours to reduce the spread of STIs in older adults, particularly outside the USA and for infections other than HIV. “Increasing older adults’ knowledge of the risk of STIs and how to engage in safer sex is crucial to tackling record levels of STIs”, says Professor Kowalska. “Tailoring education programmes to the over 50s and including peer support and ensuring they are located within existing community settings is vital to their success.” Ultimately she says, “Older people have a right to good sexual health, so let’s normalise conversations around sex and older people, and change the narrative on ageing.”

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ARTICLE PUBLICATION DATE

27-Mar-2024

 

Around half of people living with HIV in developed countries are now aged 50 years and over and at higher risk of becoming frail and having multiple comorbidities

Older people with HIV are more likely to have comorbidities, and the risk increases the longer they have lived with HIV

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

A new research review to be presented at a pre-congress day for this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2024) will focus on the growing prevalence of HIV in older adults, with, using England as an example, half of adults accessing care aged now 50 years and older, and around 1 in 11 aged 65 years and older. Similar trends exist in Italy and other countries of Western Europe.  Older adults with HIV in all countries are also more likely to have comorbidities and become ‘frail’ early compared with older adults without HIV.

Presenter Professor Giovanni Guaraldi, University of Modena and Reggio Emilia, Modena, Italy, will also discuss the problem of more older people being diagnosed with HIV (one in 5 new diagnoses in those aged 50 and over) and late diagnosis in those older people, with (again using the example of England) around half of those cases newly diagnoses in the over-50s presenting with white blood cell CD4 count below 350 cells per mm³ of blood within 3 months of diagnosis, increasing their risk of mortality in the following year by 5-fold.*

Despite the challenges, Prof Guaraldi will also highlight the progress made, with the difference in remaining life expectancy comparing those people living with HIV and those without HIV infection aged 21 years decreasing from 22 years in 2003-06 down to 9 years in 2014-2016. Yet across that same period, there was no change in the difference of years lived without developing other conditions (multimorbidity) with those living with HIV living 15 fewer years without multimorbidity compared with those not infected. Today, in another sign of progress, a young person diagnosed with HIV promptly can expect the same life expectancy as those not living with HIV.

By age 65 years, around 70% of those living with HIV for 20 years or more are living with multiple other conditions, compared with around 50% for those infected for less than 20 years and close to 40% for those not living without HIV. These figures steadily increase as those with HIV age, but the gap narrows between those with and without HIV (see graph in presentation). A similar trend is shown for polypharmacy (taking multiple prescribed drugs) in those living with HIV.

Prof Guaraldi will also discuss the hidden phenomenon of accelerated ageing or ‘early frailty’ in those living with HIV. Frailty is a clinical syndrome based on presence of specific signs and symptoms, including weight-loss, exhaustion, lack of physical activity, decreasing grip strength, and walking speed. He will review a study showing frailty levels higher in people living with HIV compared with those not living with HIV, across all age groups from age 50 years and up, with rates some five times higher in those aged 65+. Another study shows older adults living with HIV twice as likely to become frail as their HIV negative peers.

He will discuss that frailty and poor outcomes are not inevitable, and ways of avoiding this include early diagnosis of HIV and initiation of antiretroviral treatment (to avoid risk of rapid progression and cognitive impairment), but also a careful analysis of all their other medications and taking people off them (deprescribing) where possible.  He will also cover drugs that should be avoided in older people with HIV where possible, due to drug-drug interactions and also drugs that increase the risks of frailty. Examples in this extensive list include the alfalitics drug class used for treating high blood pressure, and benzodiazepines that can increase the risk of falls. 

Finally, he will refer to the social and care challenges faced by older people living with HIV, explored in the recent paper he co-authored in The Lancet HIV, discussing, among other issues, the problems that they can face entering long-term aged care facilities and opening up about their diagnosis to new doctors and people that they are not familiar with – and an array of other problems, including exacerbated challenges of daily living, mental health problems including ‘survivor guilt’ and stigma, and the increasing isolation caused by the COVID-19 pandemic.

They explain: “Ageism can enhance several HIV-related issues, including self-inflicted stigma, and loneliness. At-risk communities are particularly susceptible to experiencing these aspects. Ageism can be considered the last pillar of the stigma cascade affecting older people living with HIV, and also the most important barrier to achieving healthy ageing in people living with HIV.”

Among the many recommendations, Prof Guaraldi and colleagues recommend “Clinical care systems need to be reshaped to meet the needs of older people living with HIV, including geriatric syndrome screening, integrated care, and support and referral systems that include provision of adequate time for medical visits with a focus on improving wellness and functional status” and that “HIV doctors and clinicians should receive training on how to provide comprehensive care for older people living with HIV”.

They say: “The model of care for older people living with HIV needs to extend beyond virological success by adopting a geriatric mindset, which is attentive to the challenge of ageism and is proactive in promoting a comprehensive approach for the ageing population.”

Prof Guaraldi will also emphasise that with the advances in care and treatment, people living with HIV can age healthily with the right support. He will refer to the first ever known patient with HIV to reach age 100 years, The ‘Lisbon Patient’ Miguel, who died in August 2019 months after celebrating his 100th birthday. He did not have multiple other conditions or polypharmacy, and lived alone and independently, and had never in his life been admitted to hospital. Prof Guaraldi concludes: “We are now in an entirely new era where living into your 70s, 80s and even 90s with HIV is now possible and becoming more and more common,” he concludes. “We must make sure that we do everything we can, socially, physically and medically, to ensure people living with HIV live as healthy a life as possible as they reach their later years.”

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ARTICLE PUBLICATION DATE

27-Mar-2024

 

Olympics not likely to swallow up skateboarding’s subversive nature into its corporate spectacle, study says

UNIVERSITY OF EXETER

 

The subversive nature of skateboarding is not likely to be affected by its continuing place in the corporate world of the Olympics, experts have predicted.

The inclusion of the street sport – which happened for the first time in Tokyo 2020 – could help to promote pacifism and egalitarianism and help to combat sexism, homophobia and racism, research suggests.

Some had suggested the subversive sport and its links to rebellion, pools, ramps, and skateparks, as well as less typical type of competition, would not fit easily into a world of sponsors and broadcast deals.

The study, by Brian Glenney, from Norwich University, and Paul O’Connor, from the University of Exeter, says the inclusion of skateboarding can help the Olympics keep pace with the modern world.

Dr O’Connor said: “Skateboarding is mainstream and yet there remains an irony that skateboarders can now win an Olympic gold medal in a stadium for acts that are deemed illegal in the streets outside it. To emphasize this contrast, it would be like graffiti vandalism becoming an Olympic event.

“Skateboarding’s inclusion in the games is the final rung on the sportification ladder that has been evolving since the late 90’s ESPN X Games and 2010’s Street League. Yet skateboarding remains stubbornly moored to its anti-sport subversive ethos of cooperative fun defined by use of illegal street locations. And though the inclusion of skateboarding in the Olympics is made possible by commodifying international sport conglomerates like VF Corp. and Nike, Inc, core elements of skateboarding’s messaging remain anti-corporate.

“It is tempting to suggest that both skateboarding and the Olympics will benefit most by remaining non-overlapping activities after this collision of worlds; skateboarding will retain its subcultural and niche style, and the Olympics will become more open and accessible to activities that emphasize play, lifestyle, unity, and fun.”

Dr Glenney said: “The modern Olympics has become so aligned with the economics of broadcast rights that the IOC is dependent on expanding its waning viewership; skateboarding is one opportunity to capture a lucrative youthful demographic of viewers. But can the Olympic myth survive in a globalized media-rich era? Can it absorb these media enriched lifestyle sport myths unfettered and often antagonistic to nationalism, corporatism, and politics, capturing the public imagination with their own unique and diverse narratives of individualism, authenticity, and transcendent defining moments?

“The skateboarding myth holds no such restrictions and largely answers to the culture rather than a corporate board. This appears to be a key reason why the Olympics have sought to include lifestyle activities like surfing, skateboarding, and most recently, break-dancing in its games.

“What remains to be seen is how the Olympic myth can move beyond its reductive nationalist frame and be a more authentic source for pacifism and human egalitarianism. Here we are hopeful that skateboarding might be able to offer its humble contribution. While it is far from devoid of sexist, homophobic, and racist elements, it has proven to be remarkably open and fertile in addressing these changes above and beyond other sports.”

 

What progress has China made in agriculture green development over the past five years？

HIGHER EDUCATION PRESS

 

IMAGE: 

GRAPHICAL ABSTRACT

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CREDIT: JIANBO SHEN, QICHAO ZHU, YONG HOU, WEN-FENG CONG, WEN XU, JIULIANG XU, ZHICHAO AN, XIAOQIANG JIAO, KAI ZHANG, TIANXIANG YU, LIN MA, OENE OENEMA, WILLIAM J. DAVIES, FUSUO ZHANG

Reconciling the tasks of producing adequate amounts of nutritious food for the increasing global population while preserving the environment and natural ecosystems simultaneously is an enormous challenge. The concept of agriculture green development (AGD) was detailed in 2017 and the necessary governmental policies were developed to address the aforementioned challenge in China and to help achieve the related global sustainable development goals. AGD emphasizes the synergy between green and development; current agriculture has to transform from the intensive farming with high inputs, high environmental impacts and low resource-use efficiency to a more sustainable agriculture, in order to ensure an adequate supply of nutritious food while delivering environmental integrity, improved economic profitability, and social equity. The AGD special plan distinguishes three main systems, including the natural system, the food system, and the human and social system. The food system has four subsystems: (1) green crop production, (2) green integrated crop-animal production, (3) green food and industry, and (4) green ecological environment and ecosystem services.

Prof. Fusuo Zhang and Jianbo Shen from China agricultural university and their team present the progress of AGD that has been made over the past 5 years and makes recommendations for more research and development, in order to better deliver agricultural green and sustainable development on national and international scales. The AGD research program was established as a collaboration between several universities, governments and the private sector in China, under the guidance of China Agricultural University in Beijing. Also, international universities are involved; for example, there is an ongoing joint PhD research program between Wageningen University and China Agricultural University involving 90 PhD students over a period of 7 years (2019−2025). The four research themes of the AGD research program each receive roughly similar financial research support.

In the past five years, the AGD research program has made innovative developments in the theory and practice of the four research themes. The research theme of Green Crop Production focuses on developing innovative crop production methods and technologies for producing adequate amounts of healthy and nutritious plant-based food with reduced agrochemical inputs and lower environmental impacts. The research has three key and interlinked foci: (1) green cropping systems with high resource use efficiency, (2) healthy soil systems which deliver multiple ecosystem functions and which have a high resilience, and (3) soil-crop system management with green intelligent fertilizers. The theme of Green Integrated Crop-Animal Production aims at exploring ways to better integrate crop and animal production systems for improved nutrient cycling, enhanced feed production and feed use efficiency, and increased animal productivity. The theme of Green Food and Industries aims at adding value to food products for both consumers and producers, at lowering the environmental footprint of food products and at boosting and transforming food industries. The theme of Green Ecological Environment and Ecosystem Services focuses on quantifying and minimizing the overall impact of food production and consumption on the environment, and on developing landscapes and measures to improve biodiversity and ecosystem services. A green eco-environment necessitates the implementation of green practices throughout the whole food production-consumption chain.

At the same time, the group has acquired a series of new understandings in all four themes, which have important implications for the implementation of AGD in practice. AGD requires a multistakeholder approach, fueled by innovative and interdisciplinary research. Synergistic realization of multiple goals is a key requirement for AGD, Interactions and coupling mechanisms within systems require more attention. Joint actions have to be taken by governments, farmers, supply industries, consumers, educators, extension services and researchers to support AGD. This requires strong coordination and public awareness campaigns. The additional perspective is that international and regional cooperation, knowledge sharing, technology transfer, talent training and consultation are essential for AGD. China is ready to work with other countries to deepen cooperation, help more countries and more people share the benefits of development, and make new and greater contributions to building a community with a shared future for humankind without poverty and with common development goals.

This study has been published on the Journal of Frontiers of Agricultural Science and Engineering in Volume 11, Issue 1, 2024, DOI：10.15302/J-FASE-2024535.

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JOURNAL

Frontiers of Agricultural Science and Engineering

DOI

10.15302/J-FASE-2024535 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Agriculture green development in China: insights and advances

 

Parental avoidance of toxic exposures could help prevent autism, ADHD in children, new study shows

Researchers suggest screening to determine risk

Peer-Reviewed Publication

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO

SAN ANTONIO, March 27, 2024 – Autism and attention deficit hyperactivity disorder (ADHD) may be preventable if parents avoid toxic exposures and adopt interventions such as environmental house calls, according to a published study led by researchers from The University of Texas Health Science Center at San Antonio (UT Health San Antonio).

Using a validated, self-administered questionnaire now used worldwide to identify individuals with chemical intolerance – the Quick Environmental Exposure and Sensitivity Inventory (QEESI©) – parents and practitioners can determine the risk for each family and learn which exposures to avoid in their own homes where most people spend most of their day, the researchers said.

A population-based survey of nearly 8,000 U.S. adults, using QEESI, found that parents with chemical intolerance scores in the top tenth percentile were 5.7 times as likely to report a child with autism and 2.1 times as likely with ADHD compared with parents in the bottom tenth percentile. The findings build on a 2015 study by UT Health San Antonio that first linked chemical intolerance in patients with the risk of their children developing autism and ADHD.

“This is the first-ever article in the medical literature showing that chemical intolerance in parents can predict the risk of autism and ADHD in their children, and suggests that reducing exposures prior to and during pregnancy could help prevention,” said Claudia S. Miller, MD, MS, professor emeritus with the Department of Family and Community Medicine at UT Health San Antonio. “Up to now, most interventions have been behavioral or medical, after a child is diagnosed.”

Miller is senior author of the study, titled, “Assessing Chemical Intolerance in Parents Predicts the Risk of Autism and ADHD in Their Children,” published March 1 in the Journal of Xenobiotics, a leading toxicology publication, for its special issue on autism. Co-authors include Raymond F. Palmer, PhD, and Rodolfo Rincon, MD and specialist, both with the Department of Family and Community Medicine at UT Health San Antonio; and David Kattari, a statistician with the Marilyn Brachman Hoffman Foundation in Fort Worth, Texas.

The researchers note that the study is observational, and further research is needed using controlled trials to confirm causality and further explore the proposed mechanism behind chemical intolerance.

Still, they wrote, “The implications of this study, if confirmed, could be significant for preventive measures and early intervention strategies in families with parental chemical intolerance. We recommend that all prospective parents be assessed for chemical intolerance at an early age.”

Mast cells and autism

Physician-researcher Miller in 1996 first proposed a two-stage disease process of initiation by exposure and then triggering of symptoms called TILT, for Toxicant-Induced Loss of Tolerance, as the mechanism behind chemical intolerance. She has served as a physician/environmental consultant on exposures. And her published papers have explored the impact of pesticides, the Gulf War, breast and other implants, 9/11, toxic molds, combustion products from fires, and indoor air pollutants in so-called “sick” homes, schools and workplaces, including the EPA’s own headquarters building in Washington, D.C.

The new study comes amid a backdrop of a 317% increase in the prevalence of autism since 2000, now occurring in one of every 36 children in the country, the researchers note, citing data originating from the Centers for Disease Control and Prevention. And the prevalence of ADHD has risen to one in eight children, also according to the CDC.

Miller and colleagues in 2021 discovered a strong association between chemical intolerance and “mast cells,” considered the immune system’s first responders that originate in the bone marrow and migrate to the interface between tissues and the external environment where they then reside.

When exposed to “xenobiotics,” foreign substances like chemicals and viruses, they can release thousands of inflammatory molecules called mediators. This response results in allergic-like reactions, some very severe. These cells can be sensitized by a single acute exposure to xenobiotics, or by repeated lower-level exposures. Thereafter, even low levels of those and other unrelated substances can cause the mast cells to release the mediators that can lead to inflammation and illness.

In their latest study, the researchers determined that the high chemical intolerance scores among parents of children with autism, coupled with the 2021 finding of mast-cell activation as a plausible biomechanism for chemical intolerance, suggest that:

• The QEESI can identify individuals at increased risk.
• Environmental counseling, such as personalized environmental house calls to assess risks at home, may reduce personal exposures to possible triggers such as pesticides, fragrances and tobacco smoke, particularly during pregnancy and childhood.
• The global rise in autism and ADHD may be due to fossil-fuel-derived and biogenic toxicants epigenetically “turning on” or “turning off” critical mast cell genes that can be transmitted trans-generationally.

The researchers conclude that once mast cells are sensitized, diverse xenobiotics that never bothered the person previously and do not bother most people trigger multisystem symptoms that wax and wane over time. And they believe that persistent activation and triggering of mast cells may underlie the brain inflammation in autism.

“The potential role of environmental toxicants in influencing epigenetics and mast cell function is a complex and emerging area of research,” they wrote. “Acknowledging the need for further evidence, we hope this study contributes to an improved understanding of the potential role of environmental factors in the global rise of autism and ADHD.”

The authors created tools for patients, practitioners and researchers, described in their “TILT Tutorial on Chemical Intolerance, Autism, and ADHD”, available along with other resources at https://TILTresearch.org.

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Assessing Chemical Intolerance in Parents Predicts the Risk of Autism and ADHD in Their Children

Raymond F. Palmer, Rodolfo Rincon, David Kattari, Claudia S. Miller

First published: March 1, 2024, Journal of Xenobiotics

https://www.mdpi.com/2039-4713/14/1/22

 

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

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JOURNAL

Journal of Xenobiotics

DOI

10.3390/jox14010022 

METHOD OF RESEARCH

Observational study

ARTICLE TITLE

Assessing Chemical Intolerance in Parents Predicts the Risk of Autism and ADHD in Their Children

ADHD stimulants may increase risk of heart damage in young adults

While likelihood of cardiomyopathy grows over time, the overall risk remains low

AMERICAN COLLEGE OF CARDIOLOGY

Young adults who were prescribed stimulant medications for attention-deficit/hyperactivity disorder (ADHD) were significantly more likely to develop cardiomyopathy (weakened heart muscle) compared with those who were not prescribed stimulants, in a study presented at the American College of Cardiology’s Annual Scientific Session.

The study found that people prescribed stimulants such as Adderall and Ritalin were 17% more likely to have cardiomyopathy at one year and 57% more likely to have cardiomyopathy at eight years compared with those who were not taking these medications. Cardiomyopathy involves structural changes in the heart muscle that weaken its pumping ability. It can cause a person to tire easily and limit their ability to perform daily tasks, and it often worsens over time.

However, researchers said that the overall risk of cardiomyopathy remained relatively low even when stimulants were used long-term. They said the findings do not necessarily point to a need for clinicians to change their approach to screening patients or prescribing stimulants.

“The longer you leave patients on these medications, the more likely they are to develop cardiomyopathy, but the risk of that is very low,” said Pauline Gerard, a second-year medical student at the University of Colorado School of Medicine in Aurora, Colorado, and the study’s lead author. “I don’t think this is a reason to stop prescribing these medications. There’s very little increased risk of these medications over the long term; it’s a real risk, but it’s small.”

ADHD is one of the most common neurodevelopmental disorders in children, affecting about 1 out of 10 American children aged 3 to 17, and can continue into adulthood. It is typically treated with behavioral therapy initially, which may be combined with stimulant or non-stimulant medications to help control behaviors that interfere with daily life and relationships. Stimulant medications can elevate blood pressure by causing the heart to beat faster and with greater force.

Most previous studies assessing the safety of stimulant medications have focused on the first year or two of use and found no evidence of harm to the heart. Since many patients are prescribed these medications in early childhood and continue taking them into adulthood, this new study was designed to assess their potential to cause harm over a longer period of time, Gerard said.

Using the TriNetX research database that includes information from about 80 hospitals across the U.S., researchers analyzed data from people diagnosed with ADHD between 20-40 years of age. Individuals with the presence or absence of a prescription for stimulant medications along with rates of cardiomyopathy that could potentially be linked to stimulant use were included. Those with heart damage caused by other known factors, such as cancer treatments, were excluded.

For the analysis, the researchers paired each person who had been prescribed stimulants with an individual who had not been prescribed stimulants but was as similar as possible in all other respects, such as age, sex and other health conditions. Overall, 12,759 pairs were created and were followed for at least 10 years. Of these pairs, people prescribed stimulants were found to be significantly more likely to develop cardiomyopathy throughout the 10-year follow-up period, with the gap growing larger each year except the last two, when it narrowed slightly.

Despite the significant gap, the overall prevalence of cardiomyopathy was still quite low in both groups. After being prescribed stimulants for 10 years, 0.72% (less than three-quarters of one percent) of patients developed cardiomyopathy, compared with 0.53% (a little over half of one percent) among those who were not prescribed stimulants.

To put the numbers into context, Gerard said, “You can have almost 2,000 patients on these medications for a year and you might only cause one of them to have a cardiomyopathy that they otherwise would not have had, but if you leave them on it for 10 years, 1 in 500 will have that happen.”

At these levels, researchers said the study does not suggest that aggressive testing for cardiovascular risk is warranted before prescribing stimulants, given that the potential benefits of testing must be balanced against the risks and costs. They suggest that further studies could help to identify subgroups of patients at greater risk who may benefit from future screening approaches.

Gerard said that it could also be helpful to study potential differences among different types of ADHD medications and different types of cardiomyopathies.

Gerard will present the study, “ADHD Stimulant Use Associated with Increased Risk of Cardiomyopathy in Young Adults,” on Sunday, April 7, at 2:15 p.m. ET / 18:15 UTC in Hall B4-5.

ACC.24 will take place April 6-8, 2024, in Atlanta, bringing together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention. Follow @ACCinTouch, @ACCMediaCenter and #ACC24 for the latest news from the meeting.

The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at ACC.org.

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Open waste burning linked to air pollution in Northwestern Greenland

HOKKAIDO UNIVERSITY

 

VIDEO: 

OPEN WASTE BURNING IN QAANAAQ. (TEPPEI J. YASUNARI, ET AL. ATMOSPHERIC SCIENCE LETTERS. MARCH 26, 2024)

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CREDIT: TEPPEI J. YASUNARI, ET AL. ATMOSPHERIC SCIENCE LETTERS. MARCH 26, 2024

A case study on the effects of open waste burning on air quality in Northwestern Greenland calls attention to the importance of no-one-left-behind sustainable air quality monitoring in the Arctic region.

To better understand the air quality risks faced by remote Arctic communities, an international team monitored aerial pollutants at a community in Northwestern Greenland. Their findings, published in Atmospheric Science Letters, reveal that open waste burning elevates the concern of health risks to the community.

The study focused on Qaanaaq, a small village in Northwestern Greenland with a population of approximately 600. During the summer of 2022, the team conducted the first-time measurement of particulate matter (PM2.5) in the ambient air there and identified an increase in PM2.5 pollution. PM2.5 refers to tiny particles with a diameter of 2.5 micrometers or less, such as dust and smoke.

PM2.5 pollution is closely linked with severe air pollution and is particularly harmful to human health; PM2.5 exposures are correlated with a spectrum of health problems, including respiratory ailments such as asthma and bronchitis, cardiovascular diseases, and even premature death.

Monitoring PM2.5 levels is important for assessing air quality and protecting public health. However, compared to the mid-latitudes, the PM2.5 observations in high-latitude regions are relatively left behind (i.e., fewer PM2.5 observations) in terms of the SDG’s mission statement.

The research team, which included researchers from Hokkaido University, the University of Tsukuba, Nagoya University, and NASA, and was led by Associate Professor & Distinguished Researcher Teppei J. Yasunari at the Arctic Research Center, used commercially available advanced PM2.5 measurement systems for cold regions, which was updated from their previous research, to collect continuous PM2.5 data spanning the period from July 20 to August 13, 2022. Their analysis uncovered multiple instances of heightened PM2.5 levels, particularly notable from August 8 onwards. These increases were attributed to local open waste burning activities, as evidenced by the visible black smoke emitted from the Qaanaaq dump site on the same day with combined data analyses using NASA’s re-analysis data and NOAA’s HYSPLIT model online simulations.

Although further investigation indicated that pollutants originating from sources outside of the study area may have also contributed some during the early stages of the study, the analyses indicated these contributions were minimal, highlighting the significant impact of local pollution sources on air quality in Qaanaaq. The hourly mean PM2.5 concentrations did not reach alarming levels during the measurement period. However, additional analysis based on the NOAA HYSPLIT online dispersion simulations also implied that there were likely particulate matter depositions from the open waste burning to the nearby sea areas, including Baffin Bay, suggesting important research targets in environmental science in the future. 

“This is the first time we've studied PM2.5 in a small Arctic residential area of Northwestern Greenland where we didn't know the air quality before. We found out how much pollution increases with PM2.5 during local open waste burning,” Yasunari said. “Now, Qaanaaq uses an incinerator, stopping open waste burning. But, continuous air quality monitoring is crucial because pollution doesn't choose timing or stop at borders.” He emphasizes the need for healthy air for everyone, Arctic residents included, underlining continuous monitoring as essential for long-term health, in line with the SDGs.

Tomoki Kajikawa, co-author of the study, installing the PM2.5 measurement system at the site in Qaanaaq (Photo provided by Tomoki Kajikawa)

CREDIT

Tomoki Kajikawa

Visible smoke from open waste burning in Qaanaaq on August 8, 2022, and days of continuously increased PM2.5 from that day onwards. (Teppei J. Yasunari, et al. Atmospheric Science Letters. March 26, 2024)

CREDIT

Teppei J. Yasunari, et al. Atmospheric Science Letters. March 26, 2024

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JOURNAL

Atmospheric Science Letters

DOI

10.1002/asl.1231 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

ncreased atmospheric PM2.5 events due to open waste burning in Qaanaaq, Greenland, summer of 2022

ARTICLE PUBLICATION DATE

26-Mar-2024