Winter 2016 Frontlines

Parents Chemical Exposures May Affect Their Children 

Parents’ exposure to chemicals found in common household items such as paints and plastic bottles may affect the health of their young children, according to two recent studies co-authored by Philippe Grandjean, adjunct professor of environmental health. In the first, Grandjean shows that a widely used class of industrial chemicals linked to cancer and interference with immune function—perfluorinated alkylate substances—appears to build up in infants by 20 to 30 percent for each month they are breast-fed. While he stresses that there is no reason to discourage breastfeeding, Grandjean calls for the U.S. government to require the testing of chemical substances to include possible transfer from the mother’s accumulated chemical exposure to her child. A separate study finds that a couple’s exposure to endocrine-disrupting chemicals such as phthalates and bisphenol A (BPA) prior to conceiving may alter their child’s genetic structure and development, leading to increased risk of health issues such as cancer later in life.

An Enigma in Asthmatic Cells

Until now, scientists thought that epithelial cells, which are found in most organs, just sat motionless like cars jammed in traffic. But a new study shows that in the lungs of people with asthma, these cells “scramble around like there’s a fire drill going on,” says Jeffrey Fredberg, professor of bioengineering and physiology at Harvard T.H. Chan School of Public Health. Although why these asthmatic cells move so vigorously is still unknown, the new finding may be a step toward developing new treatment options for asthma. The discovery may also have implications for other processes in the body in which epithelial cells play a prominent role, such as wound healing and cancer.

Racism in the Doctor’s Office

Clinicians are not immune to the negative beliefs about race that are deeply ingrained in U.S. culture, says David R. Williams, Florence Sprague Norman and Laura Smart Norman Professor of Public Health, in a viewpoint article published August 11, 2015, in the Journal of the American Medical Association. Williams noted that even unconscious attitudes can lead to “biased treatment recommendations for black and other minority patients, as well as poorer quality patient-doctor communication.” However, eliminating racial and ethnic disparities in health isn’t just the job of the health care sector, Williams argues—it’s the job of society as a whole.

One or Two Drinks Per Day Linked to Increased Cancer Risk

While light to moderate drinking is associated with minimally increased risk of overall cancer, women’s risk of developing alcohol-related cancers, particularly breast cancer, may be elevated, according to a recent study by researchers from the Harvard Chan School and Brigham and Women’s Hospital. Male smokers who are light to moderate drinkers also have higher risk of alcohol-related cancers, which include colorectal, oral, liver, pharynx, larynx, and esophageal cancers, the report concludes. Previous studies have shown health benefits of moderate drinking, including reducing heart disease and type 2 diabetes risk. “Our study reinforces the dietary guidelines that it is important not to go beyond one drink per day for women and two drinks per day for men,” says lead author Yin Cao, research fellow in the Department of Nutrition.

Antidepressants and Bone Fractures in Women

The antidepressants known as selective serotonin reuptake inhibitors (SSRIs) have frequently been used off-label to treat hot flashes, night sweats, and other symptoms of the menopausal transition. More recently, a low-dose formulation of an SSRI was approved for this indication. But research has uncovered a potential risk with these drugs. Analyzing data from more than 137,000 women, researchers at Harvard T.H. Chan School of Public Health, Northeastern University, and the University of North Carolina found that women were 76 percent more likely to suffer a fracture one year after starting treatment, and the risk remained high over time. “These findings suggest that shorter duration of treatment might mitigate the risk of developing excess fractures,” said first author Yi-han Sheu, a doctoral student in the Harvard Chan Department of Epidemiology.

Clean Power Plan Promises Health Benefits

President Barack Obama’s proposed Clean Power Plan—which calls for reducing carbon emissions from power plants by nearly one-third of the 2005 level by 2030—promises health benefits such as fewer asthma attacks and heart attacks if implemented. Jonathan Buonocore, a research associate in the Center for Health and the Global Environment and co-author of a study in the May 2015 issue of Nature Climate Change, agrees. Buonocore notes that the proposed standards could boost health by slowing climate change, and thereby reduce the number of extreme storms and heat waves, which can lead to water and food shortages and deaths. Boosting air quality and reducing ozone levels could lead to fewer premature deaths, heart attacks, asthma, and stroke, says Buonocore.

Consumers Drowning in Sea of Health Information

While health information is more widely available than ever, most consumers have difficulty accessing and using it to make appropriate decisions and take needed action, researchers Howard Koh and Rima Rudd write in a Journal of the American Medical Association editorial published online August 6, 2015. Barriers to clear health communication include complex math concepts and the use of scientific terms and jargon, as well as complicated intake forms, discharge instructions, and insurance applications. All of these can lead to misunderstandings, difficulties navigating the medical care system, and poor health outcomes. Koh, the Harvey V. Fineberg Professor of the Practice of Public Health Leadership, and Rudd, senior lecturer on health literacy, education, and policy, call on health care providers to be proactive in making their information easy to understand, supporting dialogue with patients, and involving patients in key decisions. The authors describe an “arc of health literacy” over the past two decades that “bends toward population health,” offering the hope that someday all people can fully realize their health potential.

Outstanding in their Fields

Twenty-two Harvard Chan faculty members are included on Thomson Reuters’ 2015 list of the most highly cited researchers in science and social sciences. Faculty cited in multiple fields include Frank Hu, molecular biology and genetics, agricultural sciences, clinical medicine, social sciences; David Hunter, molecular biology, genetics; Rafael Irizarry, computer science, mathematics; Peter Kraft, molecular biology, genetics; JoAnn Manson, clinical medicine, social sciences; and Walter Willett, agricultural sciences, clinical medicine, social sciences. Harvard Chan faculty cited in social sciences include Francesca Dominici, Miguel Hernán, Ashish Jha, Ichiro Kawachi, Nancy Krieger, James Robins, Joel Schwartz, SV Subramanian, Tyler VanderWeele. David Williams, and Antonella Zanobetti. Those cited in clinical medicine include Nancy Cook, Majid Ezzati, and Meir Stampfer, Joseph Sodroski, and Bruce Walker were cited in microbiology. Approximately 3,000 researchers worldwide were dubbed highly cited, meaning they ranked in the top 1 percent of citations for their subject field and year of publication.