Breasts (13 page)

In the first photo, a four-and-a-half-year-old girl with delicate coffee-colored skin, doelike brown eyes and almost fully developed breasts lies on an examining table. She smiles with a sweet innocence at the camera, seemingly unaware of the dramatic changes that have gone on in her body.

“She had an ovarian cyst,” says Dr. Saenz [de Rodriguez] tersely.

A twelve-year-old boy stands against a white wall looking with blank bewilderment into the camera. He wears a silver crucifix around his neck, which dangles down between two grossly swollen breasts.

“We’ve had to schedule him for surgery,” says Dr. Saenz matter-of-factly. “The emotional stress on him is incredible.”

The children had reportedly eaten school-lunch chicken contaminated with high levels of DES, the same hormone Pat Hunt’s mother took to prevent miscarriage, as we learned in the last chapter. At the time, DES was given to farm animals to make them plumper. When many of Dr. Saenz’s patients stopped eating meat
and milk, their symptoms improved. But an investigation—conducted after a considerable delay—turned up only average levels of the growth hormone in more than eight hundred subsequent food samples. Investigators also considered pharmaceutical wastes and agricultural pesticides, both widespread there, but again, there was no obvious evidence. One study did find unusually high levels of phthalates in the blood of girls with early breasts, but there is the lingering possibility that those samples were accidentally cross-contaminated by plastics in the testing laboratory.

Phthalates are a family of molecules used as scent stabilizers in lotions and shampoos, and as common additives in plastics. Concerned over their health effects, the European Union will soon be restricting three types of phthalates from general use in commercial products. California recently banned several phthalates in products sold to the under-three set. Known endocrine disruptors, they’ve been recently linked to genital abnormalities in baby boys and increased “girl play” in toddler boys. It’s possible they may be turbocharging the future breast tissue of young or even unborn girls. One way to find out is to compare the urinary levels of phthalates in girls and see who gets the earliest breasts. (Unfortunately, it’s not enough to simply ask the girls which toys and personal care products they’ve used; companies are not required to list ingredients on their labels. The only reliable way to test exposures is to ask the girls for body fluids.)

The BCERC researchers are measuring girls’ blood and urine for fifty-one chemical substances, including phthalates, BPA, organochlorine pesticides, heavy metals, industrial solvents such as PCBs, and naturally occurring plant-based estrogens such as soy. Nearly all the girls have these substances in their bodies, sometimes in much larger concentrations than what is found in adults. There are also some geographical ticks: Girls in California are endowed
with the highest recorded levels of flame-retardants, probably due to that state’s strict flammability standards. Girls in New York City carry more cotinine, a molecule found in cigarettes and secondhand smoke, as well as more 2,5-dichlorophenol, used in mothballs and room deodorizers, while girls in Cincinnati carry more PFOA, a chemical used in making products with Teflon.

The Centers for Disease Control and Prevention (CDC) releases measures of the so-called body burdens of girls every two years as part of its National Health and Nutrition Examination Survey. When the BCERC researchers in Cincinnati studied the values measured in their girls, they found that fully 40 percent of them carried levels of PFOA above the CDC’s last measured ninety-fifth percentile. The researchers are currently trying to determine why the girls had unusually high levels and whether PFOA is linked to early breast development, particularly in thinner girls.

African-American girls in the study bore considerably higher levels of phthalates (the fragrance stabilizer) and parabens (a preservative in personal care products), four times the level found in white and Asian girls. Could this possibly help explain why the proportion of African-American girls who reach puberty at age eight is four times greater than the proportion of white girls? Or why African-American women in their twenties have a nearly 50 percent higher rate of breast cancer than white women of the same age (above age forty, though, the white rate surpasses the African-American rate). Researchers would like to know.

AS I FOUND OUT FROM OUR HOME EXPERIMENT, PHTHALATES ARE
everywhere. Since they bind fragrances, they’re often present in our shampoos, soaps, and moisturizers. They are an important ingredient
in softening polyvinylchloride (PVC), so they waft out of things like shower curtains, plastic toys, and fake leather. (There’s more fake leather lying around than you think. I had to throw out one of my daughter’s play wallets because it smelled so strongly of chemicals. My son has a belt made out of it, and it’s also common in sneakers. Now I have a radar for “pleather” when I go into box retail stores, and I steer clear.) Phthalates may also be present in sandwich bags and plastic wrap, but it’s hard to know for sure since manufacturers aren’t saying.

A newspaper in Taiwan recently reported that phthalates had been found in food such as baked goods. Apparently it makes them smell good even after many days on the shelf. This put officials in the absurd position of warning consumers not to buy food that smelled fresh.

For the before—or tox—phase of our experiment, I indulged in some very American habits, and Annabel joined me in some of them. For three days, we ate a couple of meals out of cans. (One out of every five U.S. dinners includes a can, according to the Canned Food Alliance.) Refried beans were a favorite. I drank a can of ginger ale at lunch and dinner. I indulged in a professional pedicure (pearly pink), the better for sitting briefly in a cloud of chemicals. We both shampooed and conditioned with “fresh” floral fragrances and used a perfume-y bar of soap. I wore brand-name deodorant, moisturized my body in “deep healing” lotion. I topped it off with a swath of coral lipstick. I felt like a beauty contestant.

As anyone on
Celebrity Rehab
can attest, detox isn’t nearly as fun as what precedes it. It was very hard to avoid food that had never touched plastic. Coffee beans? Nope. Grapes? Sorry. I rode my bike (because my car interior off-gasses phthalates as well as flame-retardants) to the farmers’ market. Even my bike had plastic
handle grips, but there was no helping that. I also wore a helmet made of shatter-proof polycarbonate, rife with BPA. (Yes, there are plenty of beneficial uses for BPA.) My prescription sunglasses are made out of the same, another product that was hard to avoid considering I left my metal frames behind in about 1999. At the market, I perused the farmers’ offerings. Some, like the tomatoes, were displayed in plastic. No tomatoes for me. But beautiful artisanal breads were wrapped in paper bags. I asked the seller where the flour had come from, and if it had touched plastic. This being Boulder, he didn’t look at me like I was a freak. He assured me the flour came straight from the mill in large cloth sacks, the old-fashioned way. I stocked up. I also bought some ridiculously expensive quinoa that came packaged in paper. I eyed some greens, but noticed the seller was serving them with rubber gloves (PVC) and stuffing them into plastic bags (phthalates). I asked him if I could handle my own greens and put them in my own cloth bag. He said sure. Boulder is apparently full of chemically sensitive plastophobes.

I had a good excuse not to do any other shopping: BPA is used to coat thermal paper, the kind used for store receipts and airline boarding passes. Unlike the BPA in polycarbonate water bottles, the BPA in paper isn’t “bound” to other molecules, so it rubs off in relatively high amounts. Although we don’t generally go around eating receipts, Sonya Lunder says the substance easily ends up on dollar bills and our hands.

By turning vegan for three days, I avoided meats and cheeses wrapped in plastic. I also knew I might drive my levels down by not eating animals that absorb chemicals from
their
food and water. The higher up the food chain, the more nasties you’ll find. Large marine mammals are probably the most polluted creatures on earth. Regardless of how many chemicals I avoided, I lost three pounds.

So how did our body burdens measure up? We compared my levels to those of other adults in the Silent Spring Institute/Breast Cancer Fund’s five-family study, as well as to the much larger CDC database. We also compared Annabel’s levels to those found in the BCERC study of hundreds of other six- to eight-year-old girls.

For BPA, my before level, as measured in urine, was 5.10 nanograms/milliliter (ng/mL), or parts per billion. That level vaulted me just into the upper quarter of the American range (U.S. levels are, incidentally, twice those of Canada). My after-detox level was 0.80, a drop of 85 percent! Most BPA we consume only lasts about half a day in our bodies, so three days of plastic avoidance, fresh food, and veganism really worked. Annabel’s levels went from 0.80 to 0.65, a drop of 18 percent. Annabel didn’t have any soda during the before phase, which is perhaps why her levels started where mine ended. Interestingly, though, her levels dropped lower than mine during detox, maybe because of my polycarbonate glasses or some other mysterious exposure. Our detox BPA values beat those for most of the other families in the study, but we were unable to eliminate our exposure altogether. “You weren’t able to go to zero, and that’s consistent with other data out there,” said Fred vom Saal, a biologist at the University of Missouri who specializes in BPA research. “We need to find out more about where this stuff is used.”

My high before level is still considered plenty safe by the EPA. My level, in fact, fell about four hundred times lower than the agency’s magic danger number. That should be reassuring, but vom Saal warned me against feeling smug. He and others argue that the EPA safe dose is woefully out of date, based only on a few thirty-yearold toxicity studies and not on more current research of “low-dose” effects on animal endocrine systems. In fact, vom Saal told me that my initial level of 5.10 is “getting toward the red zone in terms of
being related to metabolic abnormalities [in animals]. Anything you can do to lower your exposures would be good,” he intoned. Vom Saal’s lab is currently investigating low-dose BPA exposure and urethra disorders. Guess I’ll be rethinking those refried beans.

For triclosan, we got similarly spectacular detox action. The cutting-board chemical, triclosan is also added to soaps and other products as a disinfectant. Lunder’s organization, Environmental Working Group, has sniffed it out in everything from toothpastes to deodorants to children’s toys to shower curtains. Despite its dubious benefits, the “microbicide” has been a flat-out marketing success, appearing in 76 percent of commercial soaps. Unfortunately, it’s also been shown to disrupt thyroid hormones in frogs and rats.

In humans, triclosan can be absorbed through the mouth and intestines, as well as through skin. It accumulates in fat and doesn’t exit the body as fast as phthalates or BPA. The median level in U.S. children is 9.8 and in adult women, 12.0. In the BCERC group of girls, the median level was 7.2. Annabel’s before level was considerably lower than average, 3.7, but mine came in at a whopping 141.0 after I amped up my daily hygiene routine with supermarket toothpaste, bubble bath, moisturizer, deodorant, and soap. Annabel joined me in the florid, floral bath. After detox a week later, she brought her levels down 48 percent, and I brought mine down 99 percent, to 1.3 (my underarms went
au naturel
and I used “natural” products on my teeth and skin). By tweaking a few of my habits over one week, I went from over ten times the mean to one-tenth of it. Still, why couldn’t my ascetic ways zero it out? Probably because triclosan is now found in drinking water and food all around us.

Another notable chemical group we tested was phthalates. There are many types of phthalates, and each has its own molecular weight and function in commercial products. Typically, the
phthalates are measured by their metabolites, or what the molecules look like after circulating and exiting the body (again in urine). For example, one called MBZP, which is used to soften plastics, can be found off-gassing in car interiors. Another, MBP, is a breakdown metabolite of dibutyl phthalates, which, according to the CDC, are used in industrial solvents, adhesives, printing inks, pharmaceutical coatings, pesticides, and as additives in nail polish and cosmetics. Once these enter your body through your mouth or skin, half of them will be gone within 24 hours, at least until the next time you moisturize or eat. A memo released by the U.S. Consumer Products Safety Commission states that dibutyl phthalates “have become ubiquitous in the environment, and can now be found in food, water and air.” Considered an “anti-androgen,” MBP has been associated with genital abnormalities in rats and humans, decreased testosterone levels in men, and unusual mammary growth in male rats, among other problems.

The median daily level of MBP in U.S. adult females is 28.3 ng/ mL. Hold your hat: my before level was 375, or triple even the highest reported percentiles of all Americans measured by the CDC. But hold your hat one more time, and keep it off in tribute to one girl tested by the CDC: an eight-year-old Mexican American who logged in at staggering 101,000. Ruthann Rudel thinks this girl’s parents should be notified, but that is not currently the policy of the CDC, especially when there is no clear clinical protocol for treating it, as there is for lead or mercury poisoning. “I want to help her, because I’m a mom and because this is a very high level,” said Rudel.

Even after detox, my levels dropped to 63, still more than double the U.S. median. Rudel was stumped. “Both your levels were way higher than anyone else in the study,” she said. Did I use nail polish remover right before detox? (I had.) Did I take medications?
(Yes, for low thyroid.) Was I spending too much time with my printer? (Perhaps.) But Annabel’s levels were also strangely high, finishing even above mine at 80 ng/mL, or double the median for girls her age as measured in the BCERC study. This is weird and, I’ll admit, a little disconcerting. I have no idea why her levels were unusually high. Was she being exposed through food packaging in the school cafeteria? Was her toenail polish that potent? Is it because of the sunscreen I slathered on her for soccer practice? Then there was her school bus. While I was biking everywhere, she was sitting on vinyl seats.