Can Plastics Make You Sick? More evidence BPA may cause heart disease, diabetes, liver damage – JAMA.

by James Hubbard, M.D., M.P.H.

If you haven’t heard of bisphenol A, you will.  A study coming out in the September 17 JAMA shows an association of bisphenol A (BPA) with heart disease, diabetes and lab abnormalities of the liver.

Bisphenol A is a very common chemical found in some plastics like certain children’s toys, baby bottles, the resin lining of cans and dental sealants. Although we can absorb it through the skin and inhale it, our main exposure is diet.

At JHMFD we’ve written about companies eliminating polyvinylchoride (PVC), which can contain BPA.  I’ve blogged about the NIH being concerned about exposure in children. It’s a hot topic, and everyone is exposed.  So what do we do?

The JAMA study consisted of 1,455 adults 18 to 74, about equally male and female.  Since bisphenol A is excreted in the urine, that was how researchers measured it.  Higher concentrations of bisphenol A were associated with heart attacks, angina (heart-related chest pain), coronary heart disease (clogged arteries around the heart that cause angina and heart attacks), diabetes and abnormal liver tests (suggesting liver disease or damage).

This article is one of the first to study the effect of BPA on humans. Previous studies have been on animals, showing evidence of multiple adverse effects, but animal studies don’t always cross over to humans.  Future ones will probably focus on children.  The NIH worries about effects on the brain, behavior and prostate gland in this group.

The NIH has some good info on BPA, with basic recommendations of:

  • Don’t microwave polycarbonate plastic food containers. Polycarbonate is strong and durable, but over time it may break down from overuse at high temperatures.
  • Polycarbonate containers that contain BPA usually have a #7 on the bottom.
  • Reduce your use of canned foods.
  • When possible, opt for glass, porcelain or stainless steel containers, particularly for hot food or liquids.
  • Use baby bottles that are BPA-free.

As for me, I am not going to become obsessed but will try to avoid BPA as much as I can, keeping in mind the above recommendations.  I need more information about my drinking water, whatever the source.  The FDA’s current regulations say that the acceptable daily intake of BPA is 50ug/kg per day, but the animal studies have shown adverse effects at much lower levels.  Hopefully the FDA will lower that standard.  I think the marketplace will help.  Companies are already starting to take BPA products and packaging off the shelf.  I look forward to more focused studies that show more proof than just association.

In my opinion, those pregnant or who have children should be more vigilant. I would not allow children to play with BPA-containing toys if they might chew on them, and not eat or drink out of BPA-laden containers.  I don’t think there’s any evidence that vinyl furniture is of consequence (unless you’re chewing on it). That’s just my 2 cents.

What are you doing, or do you think this is just another hype?

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11 Responses to “Can Plastics Make You Sick? More evidence BPA may cause heart disease, diabetes, liver damage – JAMA.”

  1. Liz S Says:

    Dr. Hubbard:

    Thank you for putting these findings into prospective before hysteria hits. What were the potential confounders?

    Liz Ss last blog post..Like a Heatwave, Burning in My Heart

  2. lhubbard Says:

    Great. I love soup–in cans.

    Oh well. I think I just won’t chew on any toys. That’ll be the trade off so I can enjoy my soup.

    :-)

    I wonder if the people in the study already had a propensity toward those diseases and maybe BPA is a potential additional aggravator. If they come out next week and say glass is killing us, too, then we’re really up a creek.

    Leigh Ann Hubbard
    Managing Editor
    James Hubbard’s My Family Doctor

  3. Mark Salinas Says:

    I have a friend that has a baby, this has been a hot topic within their conversations. They have steered towards the bottle bag inserts. I am going to send him this post. Good information! Thanks!

    Mark Salinass last blog post..Music and Health by Andrea May

  4. James Hubbard, M.D., M.P.H. Says:

    Thanks Mark. I think you should be better safe than sorry with the baby’s. They get a relatively larger dose due to size, and there is a lot of uncertainty on development.

  5. Judy Rodman Says:

    I appreciate this fact-based information about plastics. I will now look for the number 7 on my plastic stuff.

    I have changed the way I get my water, from those big 5 gallon plastic barrels to using water from my tap with a filter (Aquasana) screwed to it. I change the filter regularly. I fill tall glass bottles which come with foam bag carriers for portable use. I am at the age that my toxic limit for drinking from plastic water bottles is probably up :<

    A pity about the soup cans, though!

    Judy Rodmans last blog post..Performance: How to make your next one masterful

  6. James Hubbard, M.D., M.P.H. Says:

    Liz S and Leigh Ann:
    This was analysis study to see if there was an association between BPA and the diseases looked at. They looked at several diseases and saw an association with the 3 mentioned. It would be like checking hair color and seeing there was more hypertension in blondes than brunettes and redheads. It may be just a coincidence, or it could be due to genetics, bleach, etc (confounders). Several years ago, a large group of men were reviewed who had prostate cancer. It was found that more men who had prostate cancer had undergone vasectomies, ie an association was found. After more focused studies, this was found to just be a coincidence and there was no “cause and effect” at all.

    So next to be taken into consideration is finding an understandable, underlying mechanism of why there might be more diabetes, heart or liver disease associated with BPA, or is this just a coincidence. BPA has been studied in animals and the mechanism is there for diabetes and liver disease, but not yet in heart disease.

    A major weakness is that the BPA concentration in the urine has a short half-life, so the investigators were just associating these diseases with a “moment in time” of BPA exposure in the participants’ life.

    Leigh Ann, even if they have a tendency for these diseases and BPA is the “last straw on the camel’s back” that pushes them into the overt disease, that would be significant. Good point because further studies will probably look into that point.

    Liz S, as you know, confounding is a variable (something else) that could have caused the association with the diseases other than the BPA. The science of statistical analysis tries to remove as many of these as possible. In this study several things were taken into consideration (adjusted for confounding) by the investigators, so hopefully these did not affect the study. The study was adjusted for age, sex, race/ethnicity, education, income, smoking, body mass index, waist circumference and urinary creatinine concentration (kidney function).

    The authors acknowledge that there could be other chemicals that associate with BPA, so that the participants who ingest BPA also ingest these chemicals at the same time. These chemicals could be causing the diseases rather than the BPA. The main weakness is that they just took a one time measurement of BPA, looked at a bunch of diseases to see if there any were more prevelant with high BPA concentrations and made the connection. “Independent replication is now needed to confirm these associations reported”. Additional studies will measure concentrations of BPA for longer periods (months?) in the participitants to see if there is still an association.

    Independent scientists will find more flaw. in the days ahead. They love to do that. They will develop new studies to account for these weaknesses. This study was just a beginning. It will take a few years to objectively find out if the association is true, or just a coincidence.

  7. James Hubbard, M.D., M.P.H. Says:

    Thanks Judy, just don’t chew on plastic toys and you will probably be ok.

  8. lhubbard Says:

    Whoa. Now that’s a good answer. Thanks for the explanations.

    - Leigh Ann

  9. Liz S Says:

    Thanks much Dr. Hubbard for the concise and informative response.

    Liz Ss last blog post..Like a Heatwave, Burning in My Heart

  10. James Hubbard’s My Family Doctor Blog » Blog Archive » Consumers Union suggests major FDA overhaul. Cites mercury, BPA, more. Says:

    [...] on December 15, Consumers Union further called on the FDA to quit wasting time and ban the chemical bisphenol A from infant and children’s products.  They say there is enough proof that BPA may affect [...]

  11. James Hubbard’s My Family Doctor Blog » Blog Archive » Fat virus: Is obesity contagious? A doctor’s opinion on those studies. Says:

    [...] When you think of it, that’s all the proof we have in many cancer risk associations, even with BPA in children.  We have an association of increased disease with increased exposure in humans, along with proof [...]

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