Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

Are Plastic Products Safe? An Overview Of The Science

bisphenol-a-cp-4695571There has been a lot of media attention surrounding the safety of polycarbonate plastic products containing bisphenol A (BPA). BPA is found in polycarbonate, hard clear plastic products like eye glasses, bicycle helmets, and food containers, and also in epoxy resins that act as protective coatings on everything from food and beverage cans to steel pipes and car engines.

In the next week or so, the FDA is expected to provide a new analysis of the science behind BPA safety. To gain some insight into what the fuss is all about, Dr. Steve Novella and I interviewed Dr. Steven Hentges (Executive Director of the Polycarbonate/BPA Global Group of the American Chemistry Council) on a blogger briefing call.

You may listen to the entire conversation here (and please read on for my summary of the issues):

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Here’s what I found most compelling about Dr. Hentges’ review of the BPA research:

1. BPA is essentially completely metabolized (through a process of glucuronidation) into an inert byproduct when it’s absorbed through the gut (so studies of BPA’s effects in Petri dishes are irrelevant in the body). The BPA metabolite has been shown NOT to have any estrogenic type effects in vitro or in vivo. The human body also rapidly excretes the BPA metabolite through the urine – so its half life is only 4-6 hours.

2. Previous urine analyses of random Americans do show that tiny amounts of the metabolite are present in 90% of the population but only at levels 1000 times lower (about 50 nanograms/kilogram/day) than the recommended safe amount.

3. Concerns related to the potential effect of BPA on rodents neglect to consider that these animals metabolize BPA differently than humans (they excrete the chemical in their bile rather than their urine, which means it stays in their bodies much longer and is not broken down the same way). In addition, the potential harms to rodents have been inconsistent and hard to reproduce in repeat experiments.

The podcast also offers answers to the following blogger questions (so please listen to hear the answers):

1. Could there be a synergistic effect between BPA and other chemicals that could add up to being harmful in the body?

2. What does the National Toxicology Panel report of there being “some concern” about BPA really mean?

3. Are BPA-free products safe?

4. Is there a greater exposure to BPA via medical devices than food containers?

5. Is it safe to eat out of plastic food containers that have been heated or frozen?

6. What would the economic impact be of switching BPA for an alternative product in all our manufacturing processes?

7. Why are people suspicious of plastic products when there is so little evidence of any potential harm?

About the podcast speakers:

Dr. Steve Hentges is the Executive Director of the Polycarbonate/BPA Global Group of the American Chemistry Council.  In his current position, Dr. Hentges has been deeply involved with the science on bisphenol A for more than 9 years.  Dr. Hentges holds a Ph.D. in organic chemistry from Stanford University, and has also conducted postdoctoral research at the California Institute of Technology.

Dr. Steve Novella is the Founder and Executive Editor of Science-Based Medicine. He is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society.

For More Information About International Reviews of BPA Safety:

1. European Union risk assessment.

2. Canadian Government assessment and fact sheet.

3. Japanese Government assessment.

4. The FDA’s current assessment.


You may also like these posts

Read comments »


One Response to “Are Plastic Products Safe? An Overview Of The Science”

  1. Marilyn Mann says:

    “Dr. Steve Hentges is the Executive Director of the Polycarbonate/BPA Global Group of the American Chemistry Council.”

    Hm . . . call me a cynic, but I would take any statement from the American Chemistry Council with a huge grain of salt. Dr. Hentges has a right to speak and make his — and his employer’s — views known, of course. However, I personally would no more take his word for it on BPA safety, or safety of any other chemical for that matter, than I would believe a tobacco company’s statement on safety of cigarettes.

Trackbacks/Pingbacks

  1. edwinleap.com | Reflections on science, truth and microwaving styrofoam
  2. Science-Based Medicine » Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women?

Return to article »

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

Read more »

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

Read more »

See all interviews »

Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

Click here for a musical take on over-testing.

See all cartoons »

Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

Read more »

See all book reviews »