Tuesday, November 25, 2008

Melamine Poisoning: “ Tip of the Ice Cream”

Like many similar incidents in the past, the melamine poisoning scandal is just a symptom of a decadent global food system characterized mainly by corporate greed and government neglect. The government ridiculously tries to show it is doing something to address the problem by parading to the media hurriedly confiscated milk product, yet at the same time, it downplays the dangers by echoing a familiar corporate whitewash that human will have to ingest unrealistically huge volume of contaminated milk to be poisoned. Just as quickly, Nestle and other companies put out expensive adverts proclaiming that their products are safe, even without undergoing the appropriate tests. These short-sighted and self-serving knee-jerk reactions do not protect the health of consumers but perpetuates the pathetic state of affairs as far as safety is concerned.

Food safety has been a serious concern of government and corporations, particularly with the advent of corporate globalization. WTO provisions related to food safely, for example, clearly subordinate protection of health and environment to corporate interest. Countries, especially the weaker countries, are forced to import food products contaminated with toxic chemicals or substances. Any attempt to ban or restrict such harmful substances, even those already banned in other countries, is met with fierce resistance by corporate giants and their host countries. Such is the case, for example, for pesticides, artificial sweeteners and additives, GMOs, and now melamine.

Exposure to melamine and related chemicals, in fact, is not new. Melamine is a triazine synthetic chemical used, usually with formaldehyde, in a wide range of products such as kitchen dishes and utensils, formica, laminate flooring, whiteboards, furniture, cleaning agents, fabrics, glues, colorants, flames retardants, fertilizers and drugs. Melamine is also a metabolite of cyromazime, a triazine pesticide commonly used in vegetable and chicken farms. In 1987, melamine was demonstrated to be present in coffee, orange juice, fermented milk and lemon juice, originating from migration of melamine from the cup made of melamine-formadehyde resin. From 1979-1987, there was widespread melamine contamination of fish and meat meal in Italy and in 2004, there was nephrotoxicity outbreak in pets in Asia. Again, in 2007, thousand of cats and dogs, mostly in the US, became seriously ill or died of acute renal failure after eating pet food contaminated with melamine and related triazine compounds such as ammelide, ammeline trichloromelamine and cyanuric acid. Hogs, chicken and fish were also found to be contaminated with melamine and cyanuric acid. Cyanuric acid is a common disinfectant used in swimming pools together with chlorine. Cyanuric acid was used as an ingredient in herbicides and is also used in the production of melamine and sponge rubber. It is also an intermediate chemical in the bacterial degradation of melamine and in the production of chlorinated bleaches and whitening agents. Trichloromine is the chlorinated form of melamine and is mainly used as disinfectant and cleaning agent.

Melamine may cause adverse reproductive effects, may affects genetic material and may cause bladder cancer based on animal data. It may also cause skin, eye and respiratory tract irritation and irritation of the digestive tract with nausea, vomiting and diarrhea, and may damage the urinary system. Cyanuric acid and trichloromelamine have pretty much the same spectrum of toxicity as melamine. However, cyanuric acid and trichloromelamine have the greater toxicity potential, particularly, in causing kidney damage, development toxicity and cancer.

By themselves, melamine and cyanuric acid are considered to be of low acute toxicity by regulatory agencies based on standard ask assessment for each chemical. It is from this limited risk assessment that official tolerance level (e.g., “15 cups of milk per day fro several months) are derived. However, multiple source and multiple chemical exposures, including exposure to both melamine and cyanuric acid (which has been found to be much more toxic in combination), is the more likely exposure situation and this should be the basis for assessing risks to human health. Other important triazine compounds must also be considered in the assessment of risks. For example, the triazine herbicides are known to cause neuroendocrine and endocrine related developmental, reproductive and carcinogenic effects.

Despite the limited scientific data and the low acute toxicity attribute to melamine and related traizine compound, much can be said about the potential harm that these chemicals pose to animals and human being. The mechanism of rental toxicity melamine and cyanuric acid is well established and that acute or chronic exposure would likely result in adverse renal toxicity that could lead to renal failure. Existing empirical and scientific data indicate that exposure levels sufficient to cause harm likely to be reached under present circumstances. In fact, the European Food Safety Authority, despite using the conservative risk assessment methodology, came up with this statement, “ in worst case scenarios with the highest level of contamination, children with high daily consumption of milk toffee, chocolate or biscuits containing high level of milk powder would exceed the TDI (tolerable daily intake)”. This assessment did not consider potential additional exposures likely to occur in developing countries, such as, cyanuric acid in swimming pools, melamine from the pesticide cyromazine and in contaminated vegetables, fish and meat, and melamine leachate in kitchen wares. Since milk and milk products from products from China were already banned in Europe at the time of the assessment, the worst case scenario for European children did not even consider potential sources from milk and ice cream!

The extent of harm that melamine and related compounds have caused is not at this time but the problem is not just melamine and simply confiscating products will not solve the problem. Government officials should not downplay the dangers of toxic chemicals contaminating food. Mechanisms for appropriate monitoring and timely intervention should be established. Food safety should be placed high in the political agenda and greed, corporate and otherwise, eliminated. Safe food should be put in the hands of the people!

Original article by:
Romeo F. Quijano, M.D.
Professor
Department of Pharmacology and Toxicology
College of Medicine, University of the Philippines

Tuesday, November 11, 2008

Where does suicide stand today?

I am featuring a news item from Waiting Room, a magazine compromising news for the health and wellness-conscious and believing that information is power—that it empowers people to take control of their lives and bring about positive change in themselves and the community in which they belong. In reporting and communicating health information, its commitment is to truth, integrity, fairness, professionalism, and excellence so to help establish a responsive and responsible health-care system.

Little being done to curb suicides pushes for a wide attention regarding the soaring rates of both suicide attempts and suicides from “. . . governments that are not committing enough resources to prevention but also in part because suicides are often recorded as violent murders or accidents”.

“There are more than one million people who die by suicide each year in the world, which is more than those who die from war, terrorist attacks, and homicides every year,” Brian Mishara [president of the International Association for Suicide Prevention (IASP)] said.

According to World Health Organization (WHO), the following are the challenges and obstacles why this issue gets scant attention:

 Worldwide, the prevention of suicide has not been adequately addressed due to lack of awareness on suicide as a major problem and the taboo in many societies to discuss openly about it. In fact, only a few countries have included prevention of suicide among their priorities.

 Reliability of suicide certification and reporting is an issue in great need of improvement.

 It is clear that suicide prevention requires intervention also from outside the health sector and calls for an innovative, comprehensive multi-sectoral approach, including both health and non-health sectors, e.g. education, labour, police, justice, religion, law, politics, the media.

There states, in its website, that approximately one million people died from suicide: a “global” mortality rate of 16 per 100,000 or one death every 40 seconds in the year 2000. In the last 45 years, suicide rates have increased by 60 % worldwide making suicide as the third leading cause of death among those aged 15-44 years (both sexes). Mental disorders (particularly depression and substance abuse) are associated with more than 90 % of all cases of suicide. However, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family and individual crisis situations (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/, October 2008).

In the Philippines, issues on suicide are rare and that they are only featured if there involve suicide bombings. The latest suicide rate dates back in 1993 which states that the country has a total of 2.1 (suicides per 100, 000 people), 2.5 for males while females with 1.7 (http://www.who.int/mental_health/prevention/suicide/suiciderates/en/, October 2008).

Young Adult Fertility and Sexuality Study 3 (YAFSS) has concluded that young Filipinos are capable of doing drastic acts such as committing suicide.
It is surprising to note that despite the general notion of the youth being in the prime of their life, suicide ideation is substantial with about 12.4 per cent reported that they ever thought of committing suicide. Larger percentage of females than males admitted to suicide ideation (17.1 % vs. 7.3 %) with very little difference across age group (Cruz and Berja, 2004, p. 67).

The rareness of information-drive on suicide is an attestation that it is, up to this day, considered taboo as dictated by influences coming from different cultures, societies, and religions.

If this scenario continues to persist, what will happen, then, to the advocacy which promotes suicide prevention? At surface, where does suicide really stand today? Or does it have a stance?

Perhaps, this is another “culture of silence”.

-Amanah Busran Lao
HAIN Research Associate

Citations:
• “Little being done to curb suicides”. Waiting Room: May-June 2008, page 1.
• World Health Organization. October 24, 2008 .
• World Health Organization. October 24, 2008 .
• Cruz, Grace T., Berja, Clarinda L. Non-Sexual Risk Behavior. Youth Sex and Risk Behaviors in the Philippines. Demographic Research and Development Foundation, Inc. University of the Philippines Population Institute Diliman, Quezon City