Why Air Fresheners Can Trigger Respiratory Problems

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They may smell sweet, but popular air fresheners can cause serious lung problems.

That's the message from a new study presented over the weekend at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI). Home fragrance products often contain volatile organic compounds (VOCs) that include such nasty chemicals as formalehyde, petroleum distillates, limonene, esters and alcohols. (Download a copy of the presentation here.

Exposures to such VOCs — even at levels below currently accepted safety recommendations — can increase the risk of asthma in kids. That's because VOCs can trigger eye and respiratory tract irritation, headaches and dizziness, as Dr. Stanley Fineman, ACAAI president-elect, pointed out:

This is a much bigger problem than people realize. About 20 percent of the population and 34 percent of people with asthma report health problems from air fresheners. We know air freshener fragrances can trigger allergy symptoms, aggravate existing allergies and worsen asthma.

MORE: 5 Ways Americans' Allergies Are Getting Worse

And if you hope that "all-natural" fragrance products can give you a nice scent without the chemicals, Fineman has bad news for you — even products marketed as organic tend to have hazardous chemicals. That shouldn't be surprising since fragrance products don't eliminate bad smells; they just cover them up, and that usually requires something strong.

Fineman suggests that you'd be better off simply opening up your window and letting fresh air in — though that advice might not work well where I live.

MORE: Environmental Toxins Cost Billions in Childhood Disease

The study also gives some much-needed attention to the problem of indoor air pollution. While air freshener-related asthma is certainly a health hindrance in the developed world — at least among those who like to live in artificially sweet-smelling homes — indoor air pollution is a major health catastrophe for much of the developing world, one that leads to the premature deaths of nearly 2 million people a year according to the World Health Organization. The majority of those affected are very poor women and children who might spent hours cooking food over a wood-burning fire in a hut with little ventilation.

One solution would be to supply cleaner cookstoves that might burn biogas with far less smoke. That's one health intervention that would save lives at an incredibly low cost— almost certainly less than the $8.3 billion in revenue the global air fragrance industry is expected to earn by 2015.

MORE:  Could Microwaves Be Associated With Children's Asthma?

Bryan Walsh is a senior writer at TIME. Find him on Twitter at @bryanrwalsh. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME

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FDA: studies do not tie Chantix to mental problems

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WASHINGTON (AP) — Federal health officials said Monday that Pfizer's anti-smoking drug Chantix did not increase psychiatric problems like depression and suicidal thoughts in two studies, though the findings are not definitive.

The Food and Drug Administration has been investigating reports of mood disorders and erratic behavior among Chantix patients since 2007. The agency said in a statement that two federally-funded studies involving more than 26,000 patients did not show an increased rate of psychiatric hospitalizations among Chantix patients, compared with those using nicotine patches and smoking cessation treatments.

FDA regulators stressed that the studies only recorded psychiatric problems that resulted in hospitalization, meaning many issues likely went unreported. Additionally, the studies by the Department of Veterans Affairs and the Department of Defense were not large enough to pick up very rare side effects.

Groups like the Federal Aviation Administration have already banned the drug for pilots and air traffic controllers due to side effects that could interfere with their work.

The agency said it is continuing to study the problems and recommends patients consult their doctors if they experience side effects with the drug. Pfizer is conducting its own large-scale study of Chantix behavioral effects, but the results won't be available until 2017.

"Healthcare professionals should advise patients and caregivers that the patient should immediately stop taking Chantix and contact a healthcare professional if agitation, hostility, depressed mood, or changes in behavior or thinking that are not typical for the patient are observed," the FDA said in an online statement.

More than 8.9 million people in the U.S. have filled prescriptions for Chantix since it was approved in May 2006. Last year Pfizer reported $755 million in sales for the drug, a decline of 14 percent since its peak sales of $883 million in 2007.

Shares of Pfizer Inc. rose 30 cents to $19.36, tracking broader increases on the S&P 500.

Chantix works by binding to the same spots in the brain that nicotine does when people smoke, blocking nicotine from those spots but causing release of a "feel-good" chemical, dopamine. The drug's label already carries a boxed warning, the most serious type, listing possible side effects including hostility, agitation, depression and suicidal thoughts and behavior.

New York-based Pfizer Inc. said in a statement: "We are reviewing this important information for smokers provided by the FDA."

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Two - Question screen can help doctors Spot teen alcohol problems

Two questions during regular visit to the pediatrician may help identify youth drinking problems, according to a group of national experts organized by the National Institute on alcohol and the alcohol abuse (NIAAA), which has just released the guidelines for the screening of alcohol and treatment.

Despite the national drinking age 21, approximately 7% of Americans 12 - years have been more odd sip of drink alcoholic. According to the age of 18, that proportion rises to 70%. Children who begin drinking before age 15 - outside the parameters adapted as the religious ceremonies or family meals in cultures of drinkers of wine - are four times more likely to develop alcoholism than those who begin later.

Then that drinking deviants beginning is not necessarily to alcoholism, it indicates that the young person may be at high risk for alcohol problems and other psychiatric disorders and may benefit from early treatment.

More: Status: drunk. Can help Facebook ID problem drinkers?

Questions pediatricians should ask according to the NIAAA are as follows, with text amended to be age-appropriate:

You have friends who drank beer, wine or drink containing alcohol in the last year?

You - the last year, had you on how many days have more than a few sips of beer, wine or any drink containing alcohol?

Screening is obviously better when the parents are not present and after the child was informed of the privacy policy of the doctor. In General, pediatricians keep confidential information unless the child is in immediate danger for alcohol-related harm by engaging in activities as the daily drinking or drinking and driving.

The question to what friends drinking tends to predict future alcohol consumption. If the child responds Yes but not in the second, the doctor may welcome the child to avoid alcohol, discuss the risks of alcohol ways they can avoid drinking if their friends continue to do so.

If the child admits to drinking, the NIAAA guide provides physicians of information on the level of risk associated with various amounts of drink at specific ages, as well as advice on the implementation of what is called a "brief motivational intervention" helps people smoking or levels at least cut at least risky drinking.

Brief interventions involve "meet people when they are in," rather than requiring immediate abstinence or entry into an intensive treatment. In a brief intervention - which literally takes 15 minutes or less - the doctor discussed to reduce or eliminate risk behaviour and the means, this objective can be achieved.

More: How Teen Dating Influences Teen drinking

More importantly, however, the focus is on the objectives and the wishes of the patient. The doctor tries to help patients find their own reasons to choose of more healthy behaviour change and then support them, instead demanding or "refusal." Follow-up appointments are made to discuss the progress, sometimes combined with another follow-up medical appointments if the child does not want to disclose a problem at low altitude to parents.

Not surprising, given how short these interventions are, they have been shown to be as effective as more intensive treatment to reduce the consumption of alcohol to teens. They carry low cost and no risk of exposure of adolescents to more deviant peers that can come with the treatment of group for the substance use problems.

If adolescents are found to have ongoing problems or have engaged in threatening behavior such as drinking and driving, the NIAAA guide offers parents and physicians policy advice to find the best care, including treatment more intensive.

More:
Guide for the Parents"href="http://healthland.time.com/2011/02/17/how-to-find-the-best-drug-treatment-for-teens-a-guide-for-parents/">How to find the best treatment of drug abuse for Teens: a Guide for Parents

"We know that alcohol is by far the drug of choice among young people," said NIAAA acting Director Kenneth Warren in a statement. "Minor drinking is also a marker for other unhealthy behaviors and it often goes unnoticed." "This new tool was designed for busy professionals who manage the health and well-being of children and adolescents to conduct fast, screens of the entry into force of the alcohol and brief interventions".

Unfortunately, actually getting physicians to integrate testing into their practice can be difficult, given their time. A 4 000 adult patients NIAAA study revealed that, while 49% were questioned on their consumption of alcohol, only 14% of those with alcohol use has exceeded healthy levels advised this subject by their physicians in their most recent visit.

The guide NIAAA alcohol screening and intervention for youth are located here.

More: Teen Drug Rehab cure drug addiction or create it?

Maia Szalavitz, is a writer of health at TIME.com. Find him on Twitter at @ maiasz. You can also continue the discussion on the time Facebook page Healthland and on Twitter at @ TIMEHealthland.

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The Trouble With Health Problems Near Gas Fracking

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Enlarge Keith Srakocic/AP

Water plant operator Torrey Jones checks the clarity of a sample of treated water at the Beaver Falls Municipal Authority water treatment plant in Beaver Falls, Pa.

Keith Srakocic/AP Water plant operator Torrey Jones checks the clarity of a sample of treated water at the Beaver Falls Municipal Authority water treatment plant in Beaver Falls, Pa.

Susan Wallace-Babb lived on a ranch in western Colorado. One summer night in 2005, she drove her truck down the road into a field out past her neighbors. She stepped out of her truck, felt woozy and immediately passed out.

"When she came to, she raced out of the area, called fire department officials and sought help. But it began a period of very intense, negative health effects for her," says ProPublica reporter Abrahm Lustgarten. "By the next morning, she felt intense nerve pain in her legs, intense nausea, and eventually within a couple of days had skin rashes over her body. And her health got progressively worse from that point on."

Wallace-Babb was told by local deputies that there was a spillover between a pair of fuel storage tanks that sat next to a natural gas well, located less than half a mile away from her car. Initially she wasn't sure it was related to gas drilling.

"It wasn't until she began talking with other residents of this part of Colorado and learning that others had similar experiences and talking with doctors who had expertise in gas field exposure [that] she did come to believe that, though it is difficult to prove, that her health problems have been caused by exposure to some sort of chemical in the drilling field," he says.

Lustgarten writes about Wallace-Babb and numerous others who have experienced symptoms close to natural gas drilling sites in a feature for the investigative reporting website ProPublica. He tells Fresh Air's Dave Davies that he has heard numerous anecdotal reports of health problems near gas drilling sites since he began reporting on the subject in 2008. But figuring out the cause of their ailments is much more difficult because few data and little evidence exist.

"I hear [stories] thousands of miles apart, in various states, and to me — to an untrained medical professional — they sound alarmingly similar," he says. "But when we go to federal or state health officials, or drilling officials, or any officials, and ask how common these are ... nobody really knows. Nobody has systemically tracked how many health complaints there are, whether the complaints are similar, whether they can be tied to any specific chemical exposure or any environmental cause. It makes it very difficult beyond an anecdotal answer to get a handle on how widespread a problem this might be."

Part of the problem, writes Lustgarten, is that "the drilling companies have complicated efforts to gather pollution data and to understand the root of health complaints."

"The Clean Air Act requires reporting of emissions so that the government can collect the [toxic emissions] data from facilities of a certain size," he says. "The oil and gas facilities often fall under that threshold and an exemption allows them not to be aggregated or counted together. Because these facilities are small, there is no obligation to report to federal authorities what pollutants might be emitted from those facilities ... which means there's no information to paint a bigger picture of what communities are dealing with."

In addition, he tells Davies that states and federal agencies do not currently track anecdotal reports from people living close to drilling sites. Without an accurate measure of possible pollutants or contaminants near drilling sites, or a comprehensive database of population-based health data, it's difficult for epidemiologists to establish any link between gas drilling and ill health, says Lustgarten.

"You have to establish that there is a pollutant to be exposed to, that there is a risk to being exposed to that pollutant and then finally that people were exposed to that pollutant," he says. "And to investigate [this] scientifically would require an enormous study with, for example, a control population of people who aren't exposed to any kind of drilling and then people that are and watching them over time, while measuring air pollutants in the air and people's bloodstreams [to] definitively conclude that the specific contaminants from a specific source are the same ones that are making people sick."

The U.S. Agency for Toxic Substances and Disease Registry, a sister agency to the U.S. Centers for Disease Control and Prevention, told Lustgarten that a comprehensive study could cost upwards of $100 million.

Enlarge Lars Klove

Abrahm Lustgarten won the 2009 George Polk Award for his reporting at ProPublica on natural gas drilling.

Lars Klove Abrahm Lustgarten won the 2009 George Polk Award for his reporting at ProPublica on natural gas drilling.

"When we talked in very loose terms about what it would take to do a study about the kinds of symptoms we're seeing in the gas fields and look at these areas, they threw out this $100 million cost," he says. "And they presented it as something that needs to be done and that it's time to do, but they really don't have the capacity, staffing or bandwidth to undertake it at this point."

The oil and gas companies have also stressed the need for research over individual anecdotal accounts, he says.

"In general, they tend to be dismissive of individual complaints while expressing an understandable need for further research and concern for the health of individuals, but really shying away from any connection with their own activities," he says. "You won't hear the drilling industry say, 'This isn't an issue and we don't have to study this.' You won't hear them say they don't care about Susan Wallace-Babb. But you will hear them say 'Susan Wallace-Babb appears to not like the industry and maybe she has health issues and maybe she wants the industry to leave [where she lives]. And by the way, we need to do a whole lot more research and it's a decade-long effort and let's just get started and not talk about blame at this point.' "

Abrahm Lustgarten won the 2009 George Polk Award for his reporting at ProPublica on natural gas drilling. He has also written for Fortune, Salon, Esquire and The New York Times.

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An entrepreneur has been buying land from paper companies for a new national park in Maine.

Experts say Arizona's First Solar can't keep up with Chinese competitors if its subsidies disappear.

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Study: Dads less likely to die of heart problems

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FILE - In this April 3, 2011 file photo, a father and son head for their fishing hole at Muddy Run Recreation Park in southern Lancaster County, Pa. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/Intelligencer Journal, Marty Heisey) FILE - In this April 3, 2011 file photo, a father and son head for their fishing hole at Muddy Run Recreation Park in southern Lancaster County, Pa. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/Intelligencer Journal, Marty Heisey) In this Jan. 29, 2004 file photo, a father and son play basketball at Independence Park near uptown Charlotte, N.C. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/The Charlotte Observer, Gary O'Brien, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); Fatherhood may be a kick in the old testosterone, but it may also help keep a man alive. New research suggests that dads are a little less likely to die of heart-related problems than childless men are.

The study — by the AARP, the government and several universities — is the largest ever on male fertility and mortality, involving nearly 138,000 men. Although a study like this can't prove that fatherhood and mortality are related, there are plenty of reasons to think they might be, several heart disease experts said.

Marriage, having lots of friends and even having a dog can lower the chance of heart problems and cardiac-related deaths, previous research suggests. Similarly, kids might help take care of you or give you a reason to take better care of yourself.

Also, it takes reasonably good genes to father a child. An inability to do so might mean a genetic weakness that can spell heart trouble down the road.

"There is emerging evidence that male infertility is a window into a man's later health," said Dr. Michael Eisenberg, a Stanford University urologist and fertility specialist who led the study. "Maybe it's telling us that something else is involved in their inability to have kids."

The study was published online Monday by the journal Human Reproduction.

Last week, a study by other researchers of 600 men in the Philippines found that testosterone, the main male hormone, drops after a man becomes a dad. Men who started out with higher levels of it were more likely to become fathers, suggesting that low levels might reflect an underlying health issue that prevents reproduction, Eisenberg said.

In general, higher levels of testosterone are better, but too much or too little can cause HDL, or "good cholesterol," to fall — a key heart disease risk factor, said Dr. Robert Eckel, past president of the American Heart Association and professor of medicine at the University of Colorado, Denver.

"This is a hot topic," Eckel said. "I like this study because I have five children," he joked, but he said many factors such as job stress affect heart risks and the decision to have children.

Researchers admit they couldn't measure factors like stress, but they said they did their best to account for the ones they could. They started with more than 500,000 AARP members age 50 and over who filled out periodic surveys starting in the 1990s for a long-running research project sponsored by the National Cancer Institute.

For this study, researchers excluded men who had never been married so they could focus on those most likely to have the intent and opportunity to father a child. Men with cancer or heart disease also were excluded to compare just men who were healthy when the study began.

Of the remaining 137,903 men, 92 percent were fathers and half had three or more children. After an average of 10 years of follow-up, about 10 percent had died. Researchers calculated death rates according to the number of children, and adjusted for differences in smoking, weight, age, household income and other factors.

They saw no difference in death rates between childless men and fathers. However, dads were 17 percent less likely to have died of cardiovascular causes than childless men were.

Now for all the caveats.

Researchers don't know how many men were childless by choice and not because of a fertility problem.

They don't know what fertility problems the men's partners may have had that could have left them childless.

They didn't have cholesterol or blood pressure information on the men — key heart risk factors.

Less than 5 percent of participants were blacks or other minorities, so the results may not apply to them.

All those questions aside, however, some prominent heart experts were reassured by the study's large size and the steps researchers took to adjust for heart disease risk factors.

"I think there's something there," and social science supports the idea that children can lower heart risks, said Dr. Eric Topol, a cardiologist and genetics expert at Scripps Health in La Jolla, Calif. "Whether it's with a pet, a spouse or social interaction ... all those things are associated with better outcomes."

Dr. Daniel Rader, director of preventive cardiology at the University of Pennsylvania, said: "It's biologically plausible that there's a connection," but the reduced risk attributed to having children "is pretty modest."

Men often ask him what they can do to keep from dying of a heart attack, he said.

"I'm not really prepared to, on the basis of this, tell them to start having a few kids," Rader said.

___

Online:

Medical journal: http://humrep.oxfordjournals.org/content/early/recent

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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AUDIO: Street clutter enhances problems for elderly

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13 September 2011 Last updated at 15:59 GMT Help

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