Health Journal Online

Tag: Lung

  • Cleaning Products, Air Fresheners, and Lung Function 

    Cleaning Products, Air Fresheners, and Lung Function 

    There is a reason the U.S. Centers for Disease Control and Prevention prohibits not only smoking but also scented or fragranced products in its buildings.

    In a recent review entitled “Damaging Effects of Household Cleaning Products on the Lungs,” researchers noted: “Adverse respiratory effects of cleaning products were first observed in populations experiencing high levels of exposure at the workplace, such as cleaners and health-care workers, with a primary focus on asthma.” Occupational use of disinfectants has also been linked to a higher risk of developing chronic obstructive pulmonary disease, such as emphysema.

    As I discuss in my video Friday Favorites: The Effects of Cleaning Products and Air Fresheners on Lung Function, we now know that, in addition to workplace exposures, “exposure to household cleaning products has also emerged as a risk factor for respiratory disorders in childhood,” as well potentially being “an important risk factor for adult asthma.” Common household cleaning spray use accounts for as many as one in seven adult asthma cases. The thought is that inhaling chemical irritants may cause injury to the airways, leading to oxidative stress and inflammation. What can we do about it?

    Well, it may be limited to sprays. Researchers found that cleaning products that were not sprayed were not associated with asthma. It’s also possible that environmentally friendly cleaning products “may represent a safer alternative,” though they may still present some risk.

    Ideally, safer cleaning products should be available. Unfortunately, the research suggesting harm has “seldom been heeded by manufacturers, vendors, and commercial cleaning companies.” I wonder how much of that is because “most of the workers exposed to cleaning products are women”—both occupationally and, perhaps, domestically.

    One of the problems may be the fragrance chemicals. One in three Americans surveyed “reported health problems, such as migraine headaches and respiratory difficulties, when exposed to fragranced products.” And, for about half of them, the problems were so bad they actually lost work over it, either “workdays or a job due to fragranced product exposure in the workplace.”

    “Results from this study reveal that over one-third of Americans suffer adverse health effects, such as respiratory difficulties and migraine headaches, from exposure to fragranced products. Of those individuals, half reported that the effects can be disabling. Yet over 99% of Americans are exposed to fragranced products at least once a week, from their own or others’ use.”

    The effect on asthmatics may be even worse, affecting closer to two-thirds of Americans. One compound that may be of particular concern is called 1,4-dichlorobenzene, also known as para-dichlorobenzene, which is found in many air fresheners, toilet bowl deodorants, and mothballs. It breaks down in the body into a compound called 2,5-dichlorophenol, which we pee out, giving researchers a reliable measure of our dichlorobenzene exposure. Not only may it make respiratory problems worse for those already suffering from compromised airways, but exposure to dichlorobenzene “at [blood] levels found in the U.S. general population, may result in reduced pulmonary [lung] function” in people who start out with normal breathing. What’s worse, higher exposures “were associated with greater prevalence of CVD [cardiovascular disease] and all cancers combined,” another reason to avoid it. We’d better read labels, right?

    Surprisingly, “no law in the US requires the disclosure of all ingredients in fragranced consumer products.” In fact, for laundry supplies, cleaning products, and air fresheners, manufacturers “do not need to list the presence of a ‘fragrance’ on either the label or MSDS,” the material safety data sheet. We won’t know until we smell it.

    I support the U.S. Centers for Disease Control and Prevention’s ban. Not only is “the use of tobacco products (including cigarettes, cigars, pipes, smokeless tobacco, or other tobacco products)…prohibited at all times,” but “scented or fragranced products are prohibited at all times in all interior space owned, rented, or leased by CDC.” I wish rideshare services like Uber and Lyft would have a similar policy. I’d even be happy with just a fragrance-free option. About one in five of more than a thousand Americans surveyed said they “would enter a business but then leave as quickly as possible if they smelled air fresheners or some fragranced product,” so it’s in the best interest of businesses, too. “Over 50% of the population would prefer that workplaces, health care facilities and professionals, hotels, and airplanes were fragrance-free.”



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  • California Father Battling Lung Cancer Denied Coverage for ‘Last Option’ Treatment, Family Says

    California Father Battling Lung Cancer Denied Coverage for ‘Last Option’ Treatment, Family Says

    A California man battling stage 4 lung cancer was denied insurance coverage for a potentially life-saving double lung transplant just as he was preparing to fly to Chicago for the procedure, his family says.

    Deron Wells, a 59-year-old husband and father of three, had been medically approved for a rare clinical trial lung transplant at Northwestern Medicine in Illinois, according to ABC 7.

    Cigna, his insurer, had initially signed off on the necessary procedures and transport from UCLA Santa Monica Medical Center, where he had been receiving care. But on the day of his scheduled transfer, Cigna reversed course, denying coverage for both the transplant and the out-of-state medical transfer.

    “The last option we have is for us to take him to Northwestern, period. I hope Cigna really understands the seriousness of the situation. We’re not just a number. We are talking about his life,” Janet Savarimuthu, the man’s wife, told the outlet.

    Lung transplants are not typically considered standard treatment for cancer, which Cigna cited in its statement defending the denial, claiming their coverage guidelines are based on national clinical standards.

    Wells’ family and friends launched an appeal and a public campaign in an effort to pressure the insurer to reconsider. A response to the appeal is expected by Thursday.

    The man’s GoFundMe has raised more than $37,000 as of Friday morning.

    Originally published on Latin Times

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  • Does Processed Meat Affect Our Lung Function? 

    Does Processed Meat Affect Our Lung Function? 

    If the nitrites in foods like ham and bacon cause lung damage, what about “uncured” meat with “no nitrites added”?

    “Recently, the World Health Organization (WHO) classified processed meat as carcinogenic to humans.” Also known as cured meat, such as bacon, ham, hot dogs, lunch meat, and sausage, processed meat is definitively cancer-causing. What’s more, “high processed meat consumption has also been associated with increased risk of all-cause mortality”—that is, dying prematurely from all causes put together—“and is a risk factor for several major chronic diseases, such as type 2 diabetes, coronary heart disease, and stroke.” What about lung issues like asthma?

    As I discuss in my video Does Processed Meat Affect Our Lung Function?, nitrites are added to processed meats as preservatives to preserve their pink hue (so the meat products don’t turn gray), keep them less rancid-tasting, and prevent the growth of diseases like botulism. But, if that same sodium nitrite is put into the drinking water of lab animals, they develop emphysema. Nearly all of them develop emphysema. That was the extent of the scientific knowledge we had on the subject going into 2007, then this study was published: “Cured Meat Consumption, Lung Function, and Chronic Obstructive Pulmonary Disease Among United States Adults.” It found that frequent consumption of cured meat is associated with an increased risk of people developing diseases like emphysema, a form of chronic obstructive pulmonary disease (COPD). As you can see below and at 1:32 in my video, eating it every other day appeared to triple the odds of severe COPD. 

    Since it was a snapshot-in-time study, we don’t know which came first, the sausage or the COPD. For that, we need prospective studies that follow people over time, and the big twin Harvard studies in women and men both found that “the risk of newly diagnosed COPD increased with a greater consumption of cured meats after adjustment for many important confounders.” 

    We now have studies involving hundreds of thousands of people showing that higher consumption of processed meat is associated with a 40 percent increased risk of COPD. It comes out to about an 8 percent higher risk of COPD for each hot dog eaten in a week or each weekly breakfast link sausage. What is going on?

    Yes, there are advanced glycation end-products (AGEs), so-called glycotoxins that “occur naturally in meat and are formed through heat processing,” that may be pro-inflammatory, as well as saturated fat that can also trigger inflammation in the airways. And there’s the high salt content that can present a potential risk for lung inflammation, and the suggestion that processed meat intake may increase systemic inflammation in general. However, the reason attention has focused on the nitrites is because nitrites themselves may be “one of the mechanisms by which tobacco smoke causes COPD” and other diseases like emphysema. “Cured meats are the principal source of dietary nitrites,” but “nitrites are also byproducts of tobacco smoke.” One of the main constituents in cigarettes, besides carbon monoxide and nicotine, are nitrogen oxides that are converted in the lungs to nitrites.

    The way nitrites appear to cause lung damage is by affecting connective tissue proteins like collagen and elastin, which are what help keep the airspaces in our lungs open. But nitrite can modify these proteins in ways that “mimic age-related damage, including elastin fragmentation.”

    With that much lung injury, it’s logical to assume that processed meat consumption could also exacerbate the disease of those who already have it. And, indeed, cured meat consumption increases the risk of people with COPD ending back in the hospital; those eating more cured meat on average have about twice the risk of readmission. It appears the more you eat, the worse it is, as seen here and at 3:56 in my video.

    “Regarding lung health, processed meat intake has been associated with a likely increased risk of lung cancer, decline in lung function and chronic obstructive pulmonary diseases (COPD),” but what about asthma? High consumption of processed meat has also been “associated with higher asthma symptoms.” 

    We know that “higher maternal intake of meat before pregnancy may increase the risk of wheezing” in her children later on, based on a study of more than a thousand mother-child pairs. (And we aren’t talking about aspirating meat into our lungs and getting misdiagnosed with asthma.) In fact, “those who ate the most cured meats were 76% more likely to experience worsening asthma than those who ate the least.” Since obesity is a likely risk factor for asthma, might meat’s influence be indirect, by contributing to weight gain? That may be a small part of it, but the main effect appears to be direct, “suggesting a deleterious role of cured meat independent of BMI,” body mass index, a weight measurement. Put all the studies together, and “processed meat intake appears to be an important target for primary prevention of adult asthma.”

    Even if you don’t have any lung issues, processed meat consumption was negatively associated with measures of normal lung function, while fruit and vegetable consumption and dietary total antioxidant capacity were associated with better lung function.

    Can we just eat all-natural, uncured hot dogs, with “NO NITRATES OR NITRITES ADDED,” like these see here and at 5:35 in my video? 

    If you use a magnifying glass and peer at the small print, it says “except those naturally occurring in sea salt and cultured celery juice.”

    See, to avoid saying “added nitrites,” food manufacturers may add something that has a lot of nitrates, like celery, and also bacteria, “a starter culture to convert the nitrate to nitrite.” So, nitrites are being added and consumers are being duped.

    The European Union doesn’t allow this kind of consumer fraud and “considers the use of plant extracts containing high levels of nitrate with an intended technological purpose of preservation to be a deliberate use of a food additive,” and manufacturers must explicitly label their products as “containing nitrate or nitrite.” You can’t even call it natural. “In the European Union, ‘natural’ claims are also not permitted….”

    When Consumer Reports put it to the test, it found the nitrite levels in all the products were essentially the same, so “‘no nitrites’ doesn’t mean no nitrites.” Consumer Reports and the Center for Science in the Public Interest have petitioned the U.S. Food Safety and Inspection Service of the Department of Agriculture to stop this misleading practice. Nitrites are nitrites, and “their chemical composition is absolutely the same, and so are the health effects.”

    Yes, processed meat is a known carcinogen, but How Much Cancer Does Lunch Meat Cause? 

    I have many videos on both nitrites and nitrates. I know it can be confusing, so be sure to check them out. 



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  • Bone Fractures, Lung Cancer, and Vitamin B12 Supplements? 

    Bone Fractures, Lung Cancer, and Vitamin B12 Supplements? 

    What do randomized controlled trials of high-dose daily vitamin B12 supplementation show about its effects on cancer risk, death, and longevity? 

    In 2019, “Association of High Intakes of Vitamins B6 and B12 from Food and Supplements with Risk of Hip Fracture Among Postmenopausal Women in the [Harvard] Nurses’ Health Study” was published. Note, though, that only the combined high intake of vitamins B6 (≥35 mg/day) and B12 (≥20 mcg/day) was associated with an increased hip fracture risk. We know that treatment with high doses of vitamin B6 may increase hip fracture risk on its own. After a decade or so, those who had been taking high-dose (40 mg) B6 supplements had about a 40 percent higher hip fracture risk, but not those taking B12, as you can see below and at 0:35 in my video Do Vitamin B12 Supplements Cause Bone Fractures and Lung Cancer?.  

    That’s what the Harvard study found, too. High intake of vitamin B12 alone was not associated with increased risk. In fact, some observational studies suggest a slightly lower fracture risk at high B12 blood levels. What we care about most, though, are interventional studies, where people are randomized to B12 so we can see what happens, and when we look at those, we find there is no increased fracture risk among those given B12. In conclusion, based on randomized controlled trials, high doses of vitamin B12 have not been shown to be associated with the risk of fractures.

    Okay, but what about this? In 2017, a study found that men taking vitamin B12 supplements appeared to have increased lung cancer risk. Now, the researchers didn’t find any such association in women, and the increased risk was mostly among men who smoked. Could it be that B12 was feeding budding tumors? It’s hard enough imagining a vitamin being carcinogenic on its own, especially if it somehow only affects men and not also women. “Replication of these findings in additional prospective studies with careful measurement of B vitamin supplement use is warranted.” And, indeed, when you put together all the observational studies, there is no significant correlation between lung cancer and levels of B12 in the blood, whether you’ve smoked or not. If anything, most studies seemed to trend towards higher B12 levels being protective, as you can see below and at 2:03 in my video. 

    Then, in 2018, a new study found an association between overall lung cancer risk and higher circulating levels of B12, again appearing to be more of a concern with smokers, as seen here and at 2:16 in my video. 

    Now, this was another observational study. Those with higher B12 levels were just observed to have higher cancer levels. Those of you who have been following my work know the drill: There are two potential issues that arise in observational studies that prevent us from ascribing cause-and-effect: confounding factors, also known as “lurker variables,” and reverse causation.

    What might be a lurker variable in this case? What might be a third factor associated with both higher B12 levels and cancer that may be the true cause? Well, who has higher levels of B12 circulating in their blood? Those who eat a lot of meat and dairy, which are, in fact, “the most important contributors to serum vitamin B-12,” that is, B12 in our blood. And those who eat more meat do tend to have more lung cancer: “Dose-response analysis showed that consumption of red meat for 120 g per day might increase the risk of lung cancer by 35%, and consumption of processed meat for 50 g per day might increase the risk of lung cancer by 20%.” So, we’re generally talking about 35 percent more risk for every quarter-pound burger eaten each day and about 20 percent increased risk for every breakfast sausage link. It’s no wonder those with higher B12 levels in their blood could have more lung cancer. The B12 could just be a marker for meat intake.

    And, if you remember, reverse causation is when X may not lead to Y, but, instead, Y may lead to X. So, instead of high B12 blood levels leading to cancer, maybe cancer leads to high blood levels of B12. And, indeed, nearly 75 percent of patients diagnosed with cancer exhibit elevated B12 levels. So, elevated B12 levels may simply be a marker for cancer. Besides taking extra B12, there are all sorts of reasons your levels can rise, such as liver problems, kidney problems, bone marrow problems, and cancer, as you can see below and at 3:50 in my video. So, high B12 levels may just be a marker of brewing, but not yet diagnosed, cancer. 

    What about observational studies specifically linking B12 supplement use to lung cancer, though? Those could also be reverse causation: “The consequence of being at risk for cancer is that patients will engage in healthier behaviors, including taking multivitamins (reverse causality). The well-established causes, such as smoking, chronic obstructive pulmonary disease, and previous cancers, are the real lung cancer risks.” So, we’re left with this “chicken or the egg causality dilemma,” which is why, ideally, we need randomized controlled trials to see if there’s any cause and effect.

    This became even more urgent with genetic evidence suggesting that those born with higher lifelong levels may be at increased risk. Thankfully, as you can see below and at 4:47 in my video, we do have randomized controlled trials—more than a dozen randomized controlled trials randomizing thousands of people up to 2,000 micrograms of B12 every single day for years, in fact. 

    The findings? “Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality.” And this includes specifically looking at lung cancer, as seen below and at 5:02 in my video. In fact, if anything, vitamin B supplements may actually lower the risk of the most dangerous form of skin cancer. 

    If you missed my previous video, check out Do Vitamin B12 Supplements Cause Acne?.

    For my other B12 updates, see related posts below. All of these videos can be found in one digital download: Latest Vitamin B12 Recommendations.

    I’ve also explored vitamin B12’s role in stroke risk. See the related posts below. That series is available for digital download, too: Why Do Vegetarians Have Higher Stroke Risk?.



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