Living near toxic-waste sites....

[Guest guest]

Nature Clinical Practice Gastroenterology & Hepatology (2006) 3, 299-300

doi:10.1038/ncpgasthep0480

Living near toxic-waste sites linked to increased incidence of primary

biliary cirrhosis

Sole

This article has no abstract so we have provided the first paragraph of

the full text.

Exposure to environmental toxins has been suggested as an explanation

for the geographic variations in the prevalence of primary biliary

cirrhosis (PBC). A number of common chemical reagents, including some

linked to PBC, have been identified at toxic-waste sites. Drawing on

data from several sources, Ala et al. investigated whether PBC and

primary sclerosing cholangitis (PSC) prevalence is higher near toxic-

waste sites in New York City.

http://www.nature.com/ncpgasthep/journal/v3/n6/full/ncpgasthep0480.html

[Guest guest]

-----Original Message-----

Living near

toxic-waste sites linked to increased incidence of primary biliary cirrhosis.

Sole

((Hi Andi, I think this is the whole article.))

Barb in Texas

Nov 22, 2006

Environmental

toxins are impossible to completely avoid. But by

reducing our exposure to xenobiotics we can reduce

autoimmune disease symptoms and flares.

Toxins

are plant or chemical substances that have the ability to cause harm. Many toxins are referred to as xenobiotics. Xenobiotics are natural or

synthetic chemicals with the capability of reacting with our body's cells and

other structures in place of the body's natural biochemicals. For instance, some xenobiotics

combine with the body's natural enzymes and form substances with altered

properties. Xenobiotic

chemicals damage our body's chemical mechanisms by reacting with one molecule

at a time. Xenobiotics are

well-known causes of autoimmune diseases, with specific xenobiotics

linked to specific autoimmune diseases.

A number

of chemicals construed as toxic waste found in contaminated water supplies are

linked to primary biliary cirrhosis (PBC). This

accounts for the clustering effect in which certain geographic areas have

higher incidences of PBC and also primary sclerosing cholangitis, with higher incidences of these autoimmune

liver disorders found near toxic-waste cites in New

York City.

Heavy

metals such as lead and mercury, and organic solvents such as

trichloroethylene, vinyl chloride, and methyl tertiary-butyl ether (MTBE) are

considered triggers for Wegener's granulomatosis

(WG). Studies show that the variability in severity

seen in WG tend to correlate with toxin exposure, with the most aggressive

cases seen in patients with the highest incidence of self-reported exposure to

toxins. Similar to toxin exposure in other autoimmune

diseases, symptoms tend to improve and the disease course in WG tends to wane

when steps are taken to reduce exposure to environmental toxins.

Perchlorate in rocket fuel and

fertilizers is a well-known trigger for autoimmune hypothyroidism. Rheumatoid arthritis, diabetes, and lupus disorders are

also associated with environmental toxins from pesticides and industrial waste. Exposure to silica dust is known to cause scleroderma, and exposure to mercury in vaccines is

associated with autoimmune autism.

While it

is impossible to avoid toxins completely, we can minimize risk by using natural

cleaning products such as lavender oil, baking soda, lemon, and vinegar. We can also use natural cosmetics, eat organic food, and

avoid exposure to any unnecessary chemicals including bug sprays. In the workplace, we can be mindful of environmental

safety, using established engineering controls and other safety precautions to

minimize our exposure to harmful chemicals.

[Guest guest]

Hi Barb and Andi;

I don't want to diminish Andi's concern that exposure to toxic

chemicals might have contributed to PSC/IBD development. In fact, as

was mentioned in our last newsletter, a possible mechanism could be

inhibition of the pregnane X receptor (steroid and xenobiotic

receptor) by polychlorinated biphenyls (PCBs):

Tabb MM, Kholodovych V, Grun F, Zhou C, Welsh WJ, Blumberg B. Highly

chlorinated PCBs inhibit the human xenobiotic response mediated by

the steroid and xenobiotic receptor (SXR). Environ Health Perspect.

2004 Feb;112(2):163-9.

http://www.ehponline.org/members/2003/6560/6560.html

However, I do not fully agree with the statement made by

Sole:

" This accounts for the clustering effect in which certain geographic

areas have higher incidences of PBC and also primary sclerosing

cholangitis, with higher incidences of these autoimmune liver

disorders found near toxic-waste (s)ites in New York City. "

If you look at the original article by Ala et al (2006), it says that

PSC was NOT associated with proximity to Superfund sites. Only

primary biliary cirrhosis (PBC) showed a significant clustering:

Hepatology. 2006 Mar;43(3):525-31.

Comment in: Hepatology. 2006 Mar;43(3):398-400.

Increased prevalence of primary biliary cirrhosis near Superfund

toxic waste sites.

Ala A, Stanca CM, Bu-Ghanim M, Ahmado I, Branch AD, Schiano TD, Odin

JA, Bach N

Mount Sinai School of Medicine, New York, NY 10029, USA.

Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis

(PSC) are uncommon liver diseases of unknown etiology. Reported

clustering of PBC cases may be due to environmental factors.

Individuals with PBC have a high prevalence of thyroid disease and

thyroid disease is reportedly more prevalent near Superfund toxic

waste sites (SFS). The objective of this study was to examine the

prevalence and potential clustering of individuals with PBC and PSC

near SFS. De-identified clinical and demographic data were used to

determine the observed prevalence for each New York City zip code (n

= 174) and borough (n = 5) of patients with PBC (PBC-OLT) or PSC (PSC-

OLT) who were listed for liver transplantation. The expected

prevalence was calculated using Organ Procurement and Transfer

Network (OPTN) and U.S. Census data. Both PBC-OLT patients and

patients not listed for liver transplantation (PBC-MSSM) were

included in the cluster analysis. Prevalence ratios of PBC-OLT and

PSC-OLT cases were compared for each zip code and for each borough

with regard to the proximity or density of SFS, respectively. SaTScan

software was used to identify clusters of PBC-OLT cases and PBC-MSSM

cases. Prevalence ratio of PBC-OLT, not PSC-OLT, was significantly

higher in zip codes containing or adjacent to SFS (1.225 vs. 0.670,

respectively, P = .025). The borough of Staten Island had the highest

prevalence ratio of PBC-OLT cases and density of SFS. Significant

clusters of both PBC-OLT and PBC-MSSM were identified surrounding

SFS. In conclusion, toxin exposure may be a risk factor influencing

the clustering of PBC cases. PMID: 16496326.

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)