Saturday, August 27, 2016

ScienceBlogs Channel : Physical Science

ScienceBlogs Channel : Physical Science


E-cigarettes emit a range of harmful chemicals, some known human carcinogens [The Pump Handle]

Posted: 26 Aug 2016 08:00 PM PDT

The verdict on whether electronic cigarettes are safer than traditional cigarettes is still very much out. However, a recent study found e-cigarette emissions contain a variety of concerning chemicals, including some considered to be probable carcinogens.

In a study published in July in Environmental Science & Technology, researchers found significant levels of 31 harmful chemical compounds in e-cigarette vapors, including two that had yet to be detected: propylene oxide and glycidol, both of which health researchers have described as reasonably anticipated to be human carcinogens. Researchers also found chemical emission differences based on the voltage of the e-cig vaporizer and how many puffs users take. Those differences are a particularly interesting takeaway because they touch on ways that manufacturers, or even users, may be able to minimize potentially harmful exposures.

However, study co-author Hugo Destaillats, a staff scientist at the Lawrence Berkeley National Lab and deputy leader of its Indoor Environment Group, stressed that while the study's findings are concerning, they are not a definitive statement as to whether e-cigarettes are less, just as or more harmful to human health than regular cigarettes.

"I don't want to be seen as scaremongering," Destaillats told me. "It may be that (e-cigarettes) are better than traditional cigarettes, especially for people who want to quit (cigarettes) but can't. …But there are decades of research on smoking and little on vaping, so I wouldn't be surprised if people find health effects we didn't consider."

To conduct the study, researchers simulated vaping using three different e-liquids (the substances heated to produce vapor) and two different vaporizers, and then used a method known as gas and liquid chromatography to determine the contents of the e-cigarette emissions. They found several volatile ingredients in the e-liquids, including two solvents (propylene glycol and vegetable glycerin), nicotine, propylene oxide, ethanol and acetol. When the two solvents, which the study noted are found in most e-liquids, were heated and began to decompose, it led to emissions of acrolein, a known irritant, and formaldehyde, a known human carcinogen. Researchers also said that propylene oxide, a likely impurity of propylene glycol, is probably present in most e-liquids now on the market, which is concerning because propylene oxide is also considered a probable carcinogen as well as a known respiratory and eye irritant.

The study also found big differences in the emissions produced by the first and last puffs. To imitate how people use e-cigarettes in real life, researchers used an apparatus that took puffs lasting five seconds every 30 seconds. Emissions were significantly higher once the vaporizers reached a steady temperature (what researchers called "steady-state") at around 20 puffs, as compared to the first five to 10 minutes of puffing when the temperature was still rising. In fact, researchers found that in some cases, emission levels increased by a factor of 10 or more between initial puffs and steady-state puffs. For example, levels of the eye and respiratory irritant acrolein went from 0.46 micrograms to 8.7 micrograms per puff between initial temperature and steady-state temperature.

"When we look at the chemical composition in the first couple puffs versus the final puffs, there were dramatic changes," Destaillats said. "Even the same device with the same e-liquid can give different emissions depending on how you use it."

Researchers also found big emission differences between vaporizers with a single coil and double coil. (Destaillats explained that when the same voltage is split between two coils, as opposed to just one, fewer emissions are produced.) On the issue of voltage, the study found that as the battery power output increased, the average vapor temperature reached at a steady state was higher. As a result, as voltage went up, the amount of e-liquid consumed per puff was higher too.

Here again Destaillats emphasized that the findings don't mean that lower temperatures make for safer vaping, saying: "By emitting less, the exposure may be less harmful…but we cannot say it's safer or it's healthier."

Destaillats and his colleagues also examined how the age of a vaporizer affected emissions. In using a single vaping device for nine consecutive rounds of 50 puffs — similar to how an e-cigarette user would vape in real life — researchers found that aldehyde emissions increased by more than 60 percent, with greater contributions of formaldehyde, acetaldehyde and acrolein. The effect was likely due to residue buildup inside the vaporizer, or what users call "coil gunk."

Destaillats and study co-authors Mohamad Sleiman, Jennifer Logue, V. Nahuel Montesinos, Marion Russell, Marta Litter and Lara Gundel write:

Since harmful chemical emissions are primarily due to thermal decomposition of e-liquid constituents, reducing these temperatures is a promising approach to limiting the harm caused by e-cigarettes. Proper maintenance or more frequent replacement of coils may also reduce emissions by avoiding accumulation of polymeric residues. From the regulatory point of view, particularly in light of recent U.S. (Food and Drug Administration) regulations issued in May and European Union regulations from 2014, it should be highlighted that toxic emissions originate primarily from heating the solvents propylene glycol and glycerin, which are the constituents most commonly found in e-liquid formulations.

Destaillats told me that this study is far from comprehensive, as the market is home to hundreds of different e-liquids. But he said it does tease out the particular problem of solvents, which are a common e-liquid ingredient that when heated up do, indeed, emit harmful chemicals. Destaillats and colleagues will soon publish another study on secondhand e-cigarette exposures, attempting to measure the composition of e-cig vapors that people exhale.

He noted that because e-cigarette use among young people is growing so quickly and health officials worry such trends threaten to reverse hard-fought declines in traditional smoking, understanding the true harms posed by e-cigarettes is crucial.

"Yes, there is some urgency to this kind of research," Destaillats said. "But we're often behind because the technology changes so fast."

To request a full copy of the e-cigarette emissions study, visit Environmental Science & Technology.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.

NASA’s Revived STEREO-B Could Save Us From A Trillion Dollar Disaster (Synopsis) [Starts With A Bang]

Posted: 26 Aug 2016 07:56 AM PDT

"Concentrate all your thoughts upon the work at hand. The sun's rays do not burn until brought to a focus." –Alexander Graham Bell

In 1859, the Sun surprisingly increased in brightness so significantly for just a brief while that it was noticeable from Earth during the day. Less than 24 hours later, aurorae were visible so brightly and so far south that people awoke in the middle of the night, thinking it was dawn. But in addition to the spectacular sights, there were also downsides: telegraph wires spontaneously caught on fire, causing significant amounts of damage.

The atmospheric effects of the aurorae, as seen from space. Image credit: NASA / ISS expedition crew 23.

The atmospheric effects of the aurorae, as seen from space. Image credit: NASA / ISS expedition crew 23.

The physics behind it is simple and straightforward, as the charged particles emitted from a solar flare interacted with the Earth’s atmosphere, changing its magnetic field over time and inducing current in any long-length (or coiled) wires. In the 21st century, such a flare would be a trillion dollar disaster, and we have very little to defend against it in place. Thankfully, with STEREO-B back online, our best early warning system is now 100% functional again!

Conceptual drawing of NASA's twin STEREO spacecraft monitoring the Sun. Image credit: NASA.

Conceptual drawing of NASA's twin STEREO spacecraft monitoring the Sun. Image credit: NASA.

Go get the full story about solar storms, their human impact and how NASA’s revived satellite just might be key to avoiding catastrophe when the inevitable occurs!

ScienceBlogs Channel : Medicine & Health

ScienceBlogs Channel : Medicine & Health


E-cigarettes emit a range of harmful chemicals, some known human carcinogens [The Pump Handle]

Posted: 26 Aug 2016 08:00 PM PDT

The verdict on whether electronic cigarettes are safer than traditional cigarettes is still very much out. However, a recent study found e-cigarette emissions contain a variety of concerning chemicals, including some considered to be probable carcinogens.

In a study published in July in Environmental Science & Technology, researchers found significant levels of 31 harmful chemical compounds in e-cigarette vapors, including two that had yet to be detected: propylene oxide and glycidol, both of which health researchers have described as reasonably anticipated to be human carcinogens. Researchers also found chemical emission differences based on the voltage of the e-cig vaporizer and how many puffs users take. Those differences are a particularly interesting takeaway because they touch on ways that manufacturers, or even users, may be able to minimize potentially harmful exposures.

However, study co-author Hugo Destaillats, a staff scientist at the Lawrence Berkeley National Lab and deputy leader of its Indoor Environment Group, stressed that while the study's findings are concerning, they are not a definitive statement as to whether e-cigarettes are less, just as or more harmful to human health than regular cigarettes.

"I don't want to be seen as scaremongering," Destaillats told me. "It may be that (e-cigarettes) are better than traditional cigarettes, especially for people who want to quit (cigarettes) but can't. …But there are decades of research on smoking and little on vaping, so I wouldn't be surprised if people find health effects we didn't consider."

To conduct the study, researchers simulated vaping using three different e-liquids (the substances heated to produce vapor) and two different vaporizers, and then used a method known as gas and liquid chromatography to determine the contents of the e-cigarette emissions. They found several volatile ingredients in the e-liquids, including two solvents (propylene glycol and vegetable glycerin), nicotine, propylene oxide, ethanol and acetol. When the two solvents, which the study noted are found in most e-liquids, were heated and began to decompose, it led to emissions of acrolein, a known irritant, and formaldehyde, a known human carcinogen. Researchers also said that propylene oxide, a likely impurity of propylene glycol, is probably present in most e-liquids now on the market, which is concerning because propylene oxide is also considered a probable carcinogen as well as a known respiratory and eye irritant.

The study also found big differences in the emissions produced by the first and last puffs. To imitate how people use e-cigarettes in real life, researchers used an apparatus that took puffs lasting five seconds every 30 seconds. Emissions were significantly higher once the vaporizers reached a steady temperature (what researchers called "steady-state") at around 20 puffs, as compared to the first five to 10 minutes of puffing when the temperature was still rising. In fact, researchers found that in some cases, emission levels increased by a factor of 10 or more between initial puffs and steady-state puffs. For example, levels of the eye and respiratory irritant acrolein went from 0.46 micrograms to 8.7 micrograms per puff between initial temperature and steady-state temperature.

"When we look at the chemical composition in the first couple puffs versus the final puffs, there were dramatic changes," Destaillats said. "Even the same device with the same e-liquid can give different emissions depending on how you use it."

Researchers also found big emission differences between vaporizers with a single coil and double coil. (Destaillats explained that when the same voltage is split between two coils, as opposed to just one, fewer emissions are produced.) On the issue of voltage, the study found that as the battery power output increased, the average vapor temperature reached at a steady state was higher. As a result, as voltage went up, the amount of e-liquid consumed per puff was higher too.

Here again Destaillats emphasized that the findings don't mean that lower temperatures make for safer vaping, saying: "By emitting less, the exposure may be less harmful…but we cannot say it's safer or it's healthier."

Destaillats and his colleagues also examined how the age of a vaporizer affected emissions. In using a single vaping device for nine consecutive rounds of 50 puffs — similar to how an e-cigarette user would vape in real life — researchers found that aldehyde emissions increased by more than 60 percent, with greater contributions of formaldehyde, acetaldehyde and acrolein. The effect was likely due to residue buildup inside the vaporizer, or what users call "coil gunk."

Destaillats and study co-authors Mohamad Sleiman, Jennifer Logue, V. Nahuel Montesinos, Marion Russell, Marta Litter and Lara Gundel write:

Since harmful chemical emissions are primarily due to thermal decomposition of e-liquid constituents, reducing these temperatures is a promising approach to limiting the harm caused by e-cigarettes. Proper maintenance or more frequent replacement of coils may also reduce emissions by avoiding accumulation of polymeric residues. From the regulatory point of view, particularly in light of recent U.S. (Food and Drug Administration) regulations issued in May and European Union regulations from 2014, it should be highlighted that toxic emissions originate primarily from heating the solvents propylene glycol and glycerin, which are the constituents most commonly found in e-liquid formulations.

Destaillats told me that this study is far from comprehensive, as the market is home to hundreds of different e-liquids. But he said it does tease out the particular problem of solvents, which are a common e-liquid ingredient that when heated up do, indeed, emit harmful chemicals. Destaillats and colleagues will soon publish another study on secondhand e-cigarette exposures, attempting to measure the composition of e-cig vapors that people exhale.

He noted that because e-cigarette use among young people is growing so quickly and health officials worry such trends threaten to reverse hard-fought declines in traditional smoking, understanding the true harms posed by e-cigarettes is crucial.

"Yes, there is some urgency to this kind of research," Destaillats said. "But we're often behind because the technology changes so fast."

To request a full copy of the e-cigarette emissions study, visit Environmental Science & Technology.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.

EEOC sues poultry company for “screening out” injured workers [The Pump Handle]

Posted: 26 Aug 2016 08:02 AM PDT

The Equal Employment Opportunity Commission (EEOC) brought a lawsuit last week in U.S. district court against a Georgia-based poultry company for discriminating against an employee with a work-related injury. The firm, Wayne Farms, is one I've written about previously (e.g., herehere, here.)  They're a company identified by OSHA for not only serious safety problems, but for injury care that was seriously "out-of-date and contrary to good medical practice."  In one example, a worker with a repetitive motion injury had been seen at least 94 times at a plant’s nurses station before being referred for appropriate medical care.

The EEOC lawsuit asserts that Wayne Farms failed to provide reasonable accommodation to at least two employees with disabilities which is a violation of the Americans with Disabilities Act (ADA). One of those workers, Salvadora Roman, developed carpal tunnel syndrome (CTS) because of her work at the plant in Decatur, AL. She had been employed for nearly 17 years as a poultry processing worker. The EEOC’s case explains that Roman worked on an assembly line where she cut and deboned chicken parts at a very rapid pace. Eventually she developed severe pain in her hands and wrists and was diagnosed with CTS.

Because of the musculoskeletal disorder, Roman took leaves of absence from time to time to rest her wrists and hands. She provided doctor's notes for absences and requested job assignments that would not exacerbate her disability. Wayne Farms, however, had a discipline program that assigns "points" for infractions, including absences. Ten absences in a 12 month period and an employee is automatically fired—even if those absences occur because of a work-related injury. That's what happened to Salvadora Roman. She lost her job after having 10 absences because Wayne Farms would not provide reasonable accommodation. That accommodation could have been, for example, flexibility in their attendance policy or assigning her tasks that didn't exacerbate her CTS.

The EEOC calls Wayne Farms’ attendance policy one designed to “screen out” individuals with disabilities. It’s a business model that I’d call “chewing up and spitting out”: have production processes that fail to address ergonomic hazards, cause employees to develop disabling musculoskeletal injuries, and fire them when those injuries lead to absences.

The other worker named in the EEOC’s lawsuit is Latonya Hodges who suffers from asthma. Hodges missed work from time to time because of her illness and also requested not to be assigned to areas of the plant which exacerbated her asthma. As was the case with Salvadora Roman, the EEOC asserts that Wayne Farms failed to provide reasonable accommodation for Hodges’ disability.

The Southern Poverty Law Center assisted Roman and Hodges in filing the initial complaint to the EEOC, using the ADA as the basis of their complaint. The agency’s investigation led to the agency’s lawsuit filed last week against Wayne Farms. SPLC, which released in the 2013 the report Unsafe at These Speedssaid they were pleased that their complaint led to EEOC’s action:

“The poultry industry is notorious for firing employees after working them to the point of injury and permanent disability. For far too long, this industry has flouted the law by shamelessly treating its workers as a disposable commodity that can be used up and thrown away once they can no longer endure the grueling work conditions.”

SPLC has become a leading advocate on behalf of poultry workers, most of whom are immigrants and persons of color. In 2014 they assisted workers from Wayne Farms plant in Jack, AL in filing a safety complaint with OSHA. It led to citations against the company and a proposed $102,000 penalty, which the company is contesting.

In June of this year, SPLC assisted a former workers from a Wayne Farms operation in Albertville, AL to file a complaint with OSHA. I won’t be surprised if that investigation finds more of the same: policies designed to “screen out” employees with work-related injuries.

 

Friday, August 26, 2016

ScienceBlogs Channel : Medicine & Health

ScienceBlogs Channel : Medicine & Health


The Cleveland Clinic: Promoting dubious diet device on Twitter and beyond [Respectful Insolence]

Posted: 26 Aug 2016 12:04 AM PDT

I've mentioned on quite a few occasions that there's a quote attributed to philosopher Arthur Schopenhauer that is much beloved of cranks:

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.

I also like to point out that Schopenhauer probably never said this and just how silly the thought behind this quote is when you think about it. Unfortunately, as I was perusing Twitter yesterday, I couldn't help but think of this quote, but not in the way quacks and cranks usually intend. Rather, I was thinking of a modified version of it to describe my feelings towards quackademic medicine.

Quackademic medicine, as you might recall, is a term first coined (as far as I can tell) by Dr. R. W. Donnell to describe the infiltration of outright quackery into academic medicine in the form of "complementary and alternative medicine" (a.k.a. CAM), which is now more commonly referred to by advocates as "integrative medicine," the implication being that integrative medicine provides the "best of both worlds," alternative medicine and real medicine. In actuality, it does nothing more than "integrate" pseudoscience and quackery into real, science-based medicine. In any case, in the world of quackademic medicine, one of the quackiest of the quackademics, a veritable bastion of quackademic medicine, is the Cleveland Clinic. It's an academic medical center that has always had a lot of woo in its integrative medicine department, but in 2014 it surpassed itself by being the first academic medical center to host a traditional Chinese medicine (TCM) herb dispensary and clinic, run by a naturopath. Not satisfied with that, later that same year, it started a functional medicine clinic run by the founder and guru of all that is functional medicine, Mark Hyman, who also wrote an antivaccine book with Robert F. Kennedy, Jr. himself. Functional medicine, of course, is basically quackery gussied up to look like scientific medicine that is basically making it up as you go along. Unfortunately, that hasn't stopped the Cleveland Clinic's functional medicine clinic from being wildly successful.

Yesterday, I happened to see in my Twitter feed responses to the Cleveland Clinic Twitter account. It wasn't pretty. The reason it wasn't pretty is because of what the Cleveland Clinic's social media people were Tweeting. Mixed in among the usual self-promotional Tweets designed to promote the institution were some real howlers. For example:

My first reaction to this was that this sounds like something I would find being promoted by Dr. Oz's or Oprah's or—dare I say it?—Gwyneth Paltrow's Twitter feed, not the Twitter feed of a respected academic medical center. What actually brought my attention to this particular Tweet were the reactions though, reactions like:

And:

And:

And perhaps my favorite:

Indeed. As was pointed out, spinach is great stuff from a nutritional standpoint, but it won't give you a firmer bottom because of its vitamin C. It might help you get a firmer bottom if you eat more green leafy vegetables and exercise, but that's less popular a message.

There's more where that came from, unfortunately:

OK, the term "superfood" is a marketing term, not a term that has anything to do with medicine or science. It is a term that should never be seen on the Twitter account (or on other social media) of a reputable academic medical center. There is no such thing as "superfoods." The term "superfood" implies, well, something "super" in the food, that the food is somehow far superior to most other foods or has some sort of nutrient that allows it to improve or bolster health or cure disease. Let's listen to a real professor of nutrition:

"There's no such thing as a superfood. It's nonsense: just one of those marketing terms," says University College Dublin professor of nutrition Mike Gibney, throwing on the garb of Ireland's superfood Grinch. "There is no evidence that any of these foods are in any way unusually good."

Yet here's the Cleveland Clinic claiming that kiwi, pineapple, guava, and papaya are "superfoods" that'll give you smoother skin. It's antiaging woo combined with nutrition woo, and it's all over the recent Twitter feed of the Cleveland Clinic. For example:

Of course, the benefits of antioxidants aren't nearly as clear as the Cleveland Clinic would lead you to believe, and there's a paucity of evidence that antioxidants do anything like that. Worse, one almost gets the feeling that Oprah now owns the Cleveland Clinic:

And:

Either that, or a fashion magazine has taken over. As a friend of the blog put it:

In any case, is there anything more inane, from a medical standpoint, than these Tweets from the Cleveland Clinic? A significant fraction of recent Tweets seem to be pushing vegetables more as a source of substances that'll rejuvenate a woman's skin, giving her a tight bottom and smooth lips and:

Seriously, who has snakeskin hands? Is that anything like snakeskin cowboys?

I suppose I shouldn't be surprised. If you had taken a look at the webpages for the Cleveland Clinic Center for Integrative & Lifestyle Medicine, you wouldn't be surprised either. Take a look at the services offered:

  • Acupuncture
  • Chinese Herbal Therapy
  • Chiropractic Services
  • Guided Imagery
  • Holistic Psychotherapy
  • Lifestyle U
  • Massage Therapy
  • Reiki Therapy
  • Yoga

Take a look at what it says about reiki:

Reiki is a form of hands-on, natural healing that uses universal life force energy. The term comes from the Japanese words "rei," which translates into universal, and "ki," which means vital life force energy that flows through all living things. This gentle energy is limitless in abundance and is believed to be a spiritual form of energy. It is not tied to any specific religion or nationality.

The Reiki practitioner is the conduit between you and the source of the universal life force energy. The energy flows through the practitioner's energy field and through his or her hands to you. The energy does not come from the practitioner; it comes through the practitioner from the universal source. There is no energy drain on the person giving the treatment. You may experience the energy as sensations such as heat, tingling, or pulsing where the practitioner places her hands on your body, or you may feel these sensations move through your body to other locations. This is the energy flowing into you. Some people may not perceive any change at all. Most people feel very relaxed and peaceful. Many clients even fall asleep while receiving Reiki treatment.

Elsewhere, the Cleveland Clinic asserts that it offers reiki for:

  • Cancer
  • Infertility
  • Parkinson's disease
  • Psychological illnesses
  • Chronic pain
  • Digestive problems
  • Stress-related diseases

Every time I go back to the section about reiki on Cleveland Clinic's website I keep hoping that I won't find that passage. I've been hoping in vain for several years. This is the same text I found on a pamphlet from the Cleveland Clinic at least seven years ago. Of course, as I've explained time and time again (more times than I can remember, but it's worth explaining briefly again), reiki is nothing more than mystical magical wishful thinking. Think of it this way. Its adherents claim reiki "works" by allowing the reiki master to channel "energy" from what reiki believers call the "universal source" through him and into the patient in order to heal. Now substitute the word "Jesus" or "God" for "Universal Source." Now what are you dealing with? That's right. You're dealing with faith healing. The only difference is that reiki bases its faith healing on Eastern mystical beliefs instead of the Judeo-Christian god.

And the Cleveland Clinic has been featuring a credulous description of this superstitious belief on its website for several years now, at least.

That's not all, of course. the Cleveland Clinic also offers the Esselstyn Program, which is a plant-based diet program to "reverse heart disease" developed by Caldwell B. Esselstyn Jr., MD. He's a former surgeon who's become a vegan evangelist. According to his book, Preventing and Reversing Heart Disease, to reverse hear disease you must follow the following rules:

  • you may not eat anything with a mother or a face (no meat, poultry, or fish)
  • you cannot eat dairy products
  • you must not consume oil of any kind
  • generally you cannot eat nuts or avocados

As the Skeptical Cardiologist has pointed out, Esselstyn's program is based on incredibly bad science. For example, he points out that the best randomized controlled clinical trials that we have for diet to prevent heart disease "have shown that supplementing diet with olive oil and nuts substantially lowers CAD."

Longtime readers know that I did my general surgery residency at University Hospitals of Cleveland back in the late 1980s and early 1990s and that I got my PhD at Case Western Reserve University in the early 1990s. I know Cleveland. Even though, back in those days, the Cleveland Clinic was the bitter rival of University Hospitals, there was always respect. When I moonlighted as a flight physician for Metro LifeFlight for two and a half years, the Cleveland Clinic was a frequent destination for the transport of cardiac patients. Its cardiology and cardiac surgery programs were world class then, and they're still world class. That's why it's so depressing to me to see what the Cleveland Clinic has become.

Cupping Just Sucks [Page 3.14]

Posted: 25 Aug 2016 11:33 AM PDT

Even as Michael Phelps piled a 23rd gold medal onto his stack, he also drew attention at the Rio Olympics for circular bruises on his shoulder resulting from a pseudoscientific medical treatment called cupping. Several ancient cultures practiced variants of cupping in order to reduce pain or heal injury. On Respectful Insolence, Orac writes “even if it does date back 5,000 years, arguably so does bloodletting.” He continues “there is no compelling evidence that cupping is effective for any condition. Certainly, there is no credible evidence that it helps athletic performance.” The benefit that Phelps and other Olympians perceive from cupping treatment is likely a result of the placebo effect. Treatments may also become part of a ritual for athletes or a superstition. Orac says “athletes have a distressing tendency to embrace pseudoscience, as long as they think it can give them an edge.” Certainly Phelps has his edge, but there’s no reason to think suction cups have anything to do with it.

See also: What’s the harm? Cupping edition

 

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