Wednesday, September 14, 2011

How Environmental Contamination Can Impact Human Health, the Endocrine System in Particular

The Health Implications of Hydrofracking , Upstate Medical University Public Health Symposium
April 13, 2011 
Adam Law, M.D.
I came across the fracking# issue by honest means. A patient asked me during her office visit “You are an endocrinologist. How is fracking going to affect our health and how hormones work in our bodies?” This talk is an attempt to answer my patient's question.

She posed this question at the beginning of December 2009. I had spent that year as President of the Medical Staff at the Cayuga Medical Center. Any of you who have had the privilege to serve on a Medical Executive Committee knows the commitment of time and energy required. This was on-top of a busy clinical life with my day starting with ward rounds at the hospital from 7 – 9 am, followed by office hours, an on-call schedule of 1 in 3 and 3 teenagers at home! Hence, I hadn't had much time to read the Ithaca Journal that year and I thought the signs that had started appearing in front of people's houses with the word “Frack” and a line struck through it, were a reference to the new series “Battlestar Galactica.” However, with due diligence, I looked up endocrine disease and hydraulic-fracturing on Google and came up with a case history from Laura Amos who lived 1,000 ft from a gas-drilling site in Garfield County, Colorado, who developed an adrenal adenoma and primary aldosteronism.(1) Well, case reports on blogs are not included in the standard pyramid model of evidence-based medicine. So, I next came across TEDX – The Endocrine Disruption Exchange(2) – Theo Colborn's website that includes a detailed explanation of the term Endocrine Disruption and a section on gas-drilling. This site contains spreadsheets of chemicals used in the fracking process and whether or not they are candidates for causing adverse health effects as well as endocrine disruption. I next went to PubMed and typed in “endocrine disruption AND review”. In the first page I came across a June 2009 Endocrine Society Scientific Statement entitled “Endocrine-Disrupting Chemicals”(3) lead-authored by Andrea Gore, a leader in this field.

This article introduced me to a whole new branch of my profession I had not previously recognized at conferences, as it hadn't seemed relevant to my clinical practice. At the end this excellent review article the authors concluded “In the absence of direct information regarding cause and effect, the precautionary principle is critical to enhancing reproductive and endocrine health” - This statement was my introduction to The Precautionary Principle. The idea has an enormous influence upon my way of thinking about these issues. In this talk Section 1 is entitled “What does evidence-based medicine have to say about fracking?”, Section 2 “How the dose doesn't always make the poison” , Section 3 “Turning imponderables into numbers - risk analysis and the precautionary principle” I will wrap up my talk with a “take home message”

What does Evidence-based medicine have to say about fracking?

There is remarkably little published information about hydraulic fracturing on human health. My collaborator, Madelon Finkel, Professor of Clinical Public Health at Weill Cornell Medical College, has published extensively on a wide variety of public health issues and healthcare policy. In addition, as part of her responsibility as Department Course Director, in close collaboration with medical librarians she teaches medical students and physicians Evidence-Based Medicine. She and I co-authored a peer-reviewed commentary in The American Journal of Public Health entitled “The Rush to Drill for Natural Gas: A Public Health Cautionary Tale.”(4) This was pre-released in an electronic form on the AJPH website and is due to come out in the print version in May. This is the first discussion to appear on fracking in the medical literature. In it, we provide a general introduction to the economic potential and process of unconventional natural gas extraction. We also identify the only systematic review that partially addresses the health effects. Our conclusions are much the same as you will hear in this talk.
Continue reading...  (It's an incredible read)

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