The War on Microplastics with Dr. Leo Trasande

There is a lot of hope. There are companies that are showing leadership and using sustainable and alternative materials that are free of these chemicals. They're thinking about a new way and part of the reason we're stuck is there some entrenched interest that are keeping, or they're holding on, gripping on tight to the $500 billion a year industry and they're costing human health in the process. Everybody welcome to the Secretary Kennedy podcast today. My guest is Leo Trisson Day, who is a pediatrician, one of the country's leading experts on environmental health and toxic exposures. He's a full professor in NYU and he's the director of the Grossman Center for Environmental, the study of environmental hazards. His work focuses on how substances are food and our air and water, especially microplastics, to affect our children's health and get tribute to chronic disease. Dr. Trisson Day is helping bring national attention to the hidden costs of these exposures. Both in human health and in economic terms, his perspective is especially important as we launch a new effort at HHS to better understand and reduce these risks. Welcome to the show. Delighted to be here with you. And so, you know, I first met you when we made our announcement about we're going to spend a lot of money now of $100 million to study microplastics for the first time, and particularly the fate in your body. Right. Because we know that microplastics are now ubiquitous in the environment and talk about that for a minute. How dramatic has been has the increase in our environment and also in our bodies. So, a plastic truly represent a multi-dimensional and urgent threat to human health. When you boil down plastics, there are multiple layers. We're talking about macroplastics that you see on the beaches and in sea turtles. You're talking about micro nanoplastics, you know, visible and invisible materials. Where we've really recognized the urgent threat to each of us of plastics in our lives were the chemicals in plastic. We know that there are 16,000 chemicals, synthetic chemicals that are in plastic. We don't know anything about 10,000 of them. What little we know about the 6,000 is that they harm a wildlife and they harm human health. In particular, the evidence is extremely strong for the effects of plastic chemicals on our hormones. These are our natural signaling molecules that underlie basic biological functions, temperature, metabolism, salt, sugar, and even sex. And the impacts run from cradle to grave and womb to tomb. We're talking about, I'm just going to focus here on the chemicals with the greatest evidence. This phenols use in polycarbonate plastics, thallates, use in personal care products, cosmetics, and food packaging. We're also talking about perm polyfluoralcul substances, the non-stick forever chemicals profiled in Mark Reffelot's movie Dark Waters from a large contaminated population in West Virginia. I was actually on attorney on that case. Thank you for all your support and leadership in that regard. It really helped move the needle. And it was those studies in West Virginia that set the foundation. Those were very high level exposures, as you know. Now we know that extremely low levels of exposure that we commonly see in blood testing that the Centers for Disease Control and Prevention run to the National Health and Nutrition Examination Survey. These are exposures that literally affect us all. We assumed at first that only the dose made the thing a poison. This is a notion that was first discussed in 1500s by a Swiss philosopher named Paracelsus. And the idea was that, okay, a little bit of everything will be fine, if you will. Our bodies can adjust. And the most basic was the common cry in that regard. But we realized that at extremely low levels of exposure to a host of chemicals, metals, lead, metal mercury, pesticides, and flame retardants can have significant consequences. Is that those extremely low levels of exposure? We're talking about grains of sand in the Sahara or grains of salt in the Olympic-sized swimming pool. If you will, extremely low levels of exposure based on the principles of endocrinology because our hormones are natural molecules run around in those same levels of exposure. And whether the chemicals are competing with hormones directly or they're changing mechanisms behind the scenes and how our genes are expressed, they're affecting us all. We're talking about just to start in the cradle. We're talking about babies being born too soon. Fowlates these chemicals that are used in commonly in food packaging. Contribute to 50,000 premature bursts in the US. Each year we're talking about kids who are born with inadequate brain development as a result of that. And they're less well able to perform in school and less well able to perform in the economy. And their additional healthcare costs that are directly related to those toxic exposures. And I'll talk about that. I can talk about that a little bit later. But just to move along the lifespan, we're talking about babies being born too small as well those non-stick chemicals, the PFAS that we just talked about. They shrink growth such that the baby is metabolically programmed to come out of the womb in an avid calorie rich environment. They gain too much weight as a result because their thermostat is just set the wrong way and they accrue more fat than people who are not exposed to these chemicals are experiencing. And so we know that there are at least 50, perhaps 100 or more chemicals that literally make us fatter, many of which are plastic chemicals. And the impacts, as a pediatrician, I'm always going to say kids are uniquely vulnerable, pound for pound they eat more food, drink more water, breathe more air. So they're uniquely susceptible. Their organ systems are also just being primed. And so if you disrupt that there are lifelong and permanent consequences of those toxic exposures that can arise. But to be perfectly candid secretary, we are all susceptible to these chemicals. For example, again the PFAS are associated in multiple studies with diabetes, instant diabetes and adults. In adults who've actually lost weight through a healthy diet and physical activity intervention, they've gained more weight back. And then when they look for a mechanism they realize that the resting metabolic rate was lower in those highly exposed subpopulations. And they had drawn serum right before right after they had lost the weight, working hard to keep healthy. And they ended up gaining more weight back as a result of that PFAS exposure. We know that bisfinals also contribute to incident diabetes. We have a large body of evidence now that reproductive development is particularly harmful. We are dealing with increases in infertility across the US population. We know for example that again, that leads our antagonists to the male sex hormone and those impacts on the male sex hormone lead to a reduction in what we call a genital distance. And the analgenital distance you're born with is the analgenital distance in a population that you'll have as an adult. Many puberty, there's a period in infancy where you can change that a little bit because there's a surge of sex hormones. But we know that if you're born with that A.G.D., you're more likely to have a short A.G.D. in adulthood. And then with short A.G.D., because of an imbalance of male and female sex hormone factors, are more likely to have infertility lower sperm count and even cardiovascular risk. So we're talking about a broad range of consequences. We know that hormone sensitive cancers are directly related to plastic chemicals. We know that bisfinals are synthetic estrogens that can have ovarian impacts. They, PFAS have been associated with incident breast cancer. So again, we're talking about impacts that run the entire lifespan. Cardiovascular disease. Again, nothing I'm talking about mitigates the importance of healthy diet and physical activity and combating the obesity and diabetes. twin pandemics. But we know that Thalates contribute to inflammation in the coronary arteries. They can contribute to cardiovascular mortality. We've identified that 50,000 Americans between the ages of 55 and 64 die early because of cardiovascular disease, costing the economy roughly $20 billion a year. So those are just some illustrative impacts. And that's just talking about really the chemicals that are either additives to plastic materials, monomers, in plastic materials. These are mind-juplastics are long polymers. They're rather boring polymers compared to DNA, DNA as for AGCT in the system. You can vary it a little bit. Polymer chemistry is essentially the same molecule being strung over billions of times. And we assumed for many years that plastics were what you might call a nerd that they didn't break down as part of the natural process contact with food, contact with the environment with the water supply. And yet we know now, unfortunately, that these chemicals leach directly into our bodies. You're talking about PFAS and PFOAs and these are and what we call forever chemicals. And these are the plastic constituents. They can also be inflammatory tartans as you pointed out. And in glues and those are also ubiquitous in the environment. But talking about one of the interesting things that I learned when we did the dark water, in this case, is how dangerous these particular molecules are because your body has such difficulty excreting them. And that's one of the reasons they call them forever chemicals. Can you explain that? Sure. So the earliest PFAS that were in manufacture were what we call eight to 12 carbon chains of molecules. There's a carbon atom. So I don't mean to make my undergraduate degrees in chemistry. So I'm going to sometimes sneak in a little chemistry and nerd out a bit. But just to take a step back, these are eight carbon molecules and that carbon fluorine bond that makes these per and polyfluoralcul substances is extremely what we call polar. It stretches out the electron energy is distributed in a way that makes it so that materials don't stick. That's really what in the end in the polymer chemistry makes them such useful materials. That's why they put it on your frying pan. That's right. And that's why you should use an iron to scale it. I love cast iron and stainless steel. Last I checked olive oil was good for your heart. So there you go. So go ahead. Why does that leave your body? Well that carbon fluorine bond also makes it hard to get out of the body because your kidney doesn't really know what to do. In fact, it'll actually get excreted and then reabsorbed into the bloodstream. So the body actually has this uncanny ability to recirculate some of these longer chain PFAS in particular. Now as attention with your leadership has been placed on what we call these long chain PFAS. There are now 16,000 PFAS out there. The chemical industry is very adept. As because every time we get one band, they alter a couple of molecules on it and then sell the same thing and then it takes us 10 years to prove that it's doing the exact same thing as the predecessor chemical. I don't mean to laugh. I think it's tragic that we have this problem. We literally whack the mole. That's a theme in the field that I study. It keeps me gainfully employed in ways that I'd rather be put out of business if you will. Not having to deal with these chemical compounds that the industry keeps modifying and we have to keep following a tiger that's getting loose. And in that regard, it's what's really unfortunate is we've gone so far to get some of the longer chain PFAS out of manufacturer. This was through a voluntary agreement between EPA and the industry some years ago. And now the chemical industry has developed what we call these shorter chain, these smaller slimmer molecules. Now they aren't living in the body forever the same way. They actually are being excreted a lot more readily, but they're so ubiquitous in their exposure that they're having the same impact as the older PFAS. And I can go through examples with bisfinals and thalates where we have the same old story where the chemistry gets modified. We find out the effects of one chemical. That's what really accelerated the change. And then we realize that the same the new replacement is as problematic if not more so than the old one. You mentioned fertility. I mean, I by virtue of me being the secretary of age HHS, I also sit on the Social Security Administration Board. And which means I have to go to a meeting once here. And in the meeting they talk about one of the things they do at the meeting is they talk about the life of the Social Security Trust Fund. So when is Social Security going to run out of money? And one of the key metrics that they have to know in order to make that prediction is the fertility rate in American children. So this is they do a lot of collection data collection on fertility. And the fertility levels that we came up with in this last meeting a couple of weeks ago were stunning and historical and everybody in that room who understood the at the implications was in shock because we went from 1.9 which is already extremely low to 1.75 and it was the greatest drop in fertility that has been seen in human history. 2 is the replacement rate. 2 is the replacement rate and they actually believe that we're somewhere around 1.4 because there's there is data manipulation. So it has all these kind of economic implications like you know our ability to support Medicare and the date when the Social Security Trust Fund is going to run out of money. But it also has all other kinds of implications about families and about just the way that we live our lives. You're seeing young people's behavior change and we're seeing not you know we can't explain exactly why fertility is decreasing because as you know there are thousands of exposures that are enterchronic disruptors. Right disrupting it. But clearly plastics and microplastics are part of that picture. Absolutely. And male sperm can honestly think in this country down 50% for teenage males. I read the other day that teenage males today have less sperm than the average 65 year old American man and their and testosterone rates are dropping and then use the female fertility issues to like nothing that we've ever seen before. We talk about that. Yeah so the you know the reality here is that it's as much a problem for fertility as it is a marker of chronic disease because we know that obesity and diabetes and cardiovascular disease is are also impairing fertility. And you know you talk about the replacement rate we have when you have a chronic disease epidemic bearing down on the population that means that the ability of the population that's alive to serve the economy in a way that keeps that engine going that generates a revenue for the Medicare trust fund to stay solvent. You have almost the perfect you know if you have a collapse from two different ends if you will as a result. And the Medicare trust fund at this point just so that people know it is scheduled to go bankrupt in in 2033. That's not making me very comfortable. We had a fortune with that on. Exactly. Go ahead. Yeah no problem. So you know we have to really take a step back here and go to Adam Smith the father of modern economics at some level. So you make a product to earn a buck. No one here you know I myself here is a pediatrician who studies environmental hazards. I'm not trying to impune. Yeah but you're supposed to pay for all the costs of getting that product building it and getting it to market. Right. And what the plastic industry does is an externalized that costs. You nailed it and I put the costs on the American people so that they get to avoid the cause and they get to outcompete their competitors in the packaging industry. And we end up paying for their profits essentially. I've taught you. Which gives them that huge advantage in the market. marketplace. Yeah, I've taught undergraduates and graduate students at NYU for over a decade about the fact that Adam Smith is rolling over and is grave about externalities because if you're a nerdy economist you realize that that means you overproduce the materials above the market equilibrium and the cost is lower than the true social cost. So it's really not the way the market should work. Period. It's a market failure. The ability for companies for these, for the plastic industry to externalize their cost means they're not functioning in a free market to come in. A true free market, you can't make yourself rich without making your neighbors rich without enriching your community. But what all polluters do is they escape the discipline of the free market and force the public to pay their production costs. And on a true free market economy, there should be incentive. The incentive is, you want to punish bad behavior and reward good behavior. But if bad behavior is not punished, if it just goes for free, then you're going to get a compounding effect. And that's what we're seeing with, you know, every time we catch them, they just produce a new molecule that does the exact same thing. And they're getting away with it. Yeah, I've spent my nearly my entire career studying and quantifying these externalities. I'm an epidemiologist. I'm still a pediatrician, so I still wear those hats. But what we first did back in 2015 was document for a limited number of conditions, a limited number of chemicals, the social costs of endocrine disrupting chemicals. And what's frightening when you take a comparison of Europe to the United States is that policies predict exposures, exposures contribute to disease and disease ultimately costs us all. So in the European Union, the cost of endocrine disrupting chemicals is about 163 billion euro, 1.2% of gross domestic product, nothing to laugh at. In the US, using similar methodology, $340 billion. And what's the difference in Europe, they actually have taxes on producers that if you're going to produce or introduce a product like packaging into the stream of commerce, they have to behave for its recovery. And so they're incentivized to not only to recycle and to reuse, but also to reduce the amount of plastics. And Europe, you can't get out there. I remember they used to be able to buy a CD in this company, the country that is this big, but it would come in a package this big. And we've all gotten Amazon boxes with a little tiny, you know, item in there that are filled this high with peanuts. Oh, start from peanuts. And in Europe, they would never do that because they would eat up their profits because they got it to dispose of every one of those peanuts. And that's why in Europe, you know, they don't have landfills. Like we have the fresh kills landfills is the highest point on these customers north America, because we're subsidizing the disposal of garbage and packaging. And in Europe, they don't do that. They force the guy who we introduce that into the stream of commerce to pay for its recovery or its disposal. And that means you'll get you get products there that are not or natively wrapped. Right. Because that wrap is causing them here, the taxpayer just bad for that wrapper. Yeah. So Flamer Tardens, for example, just to build on that were roughly two thirds of that $340 billion, $200 some odd billion. The costs in Europe, because they didn't require it be added to again, this is a plastic related cost because they were adding it to polyurethane foam in the United States under the guise that you were going to. Oh, fire safety. Correct. They were going to slow the spread of fire. And you were going to save kids lives. They were, they were, I mean, while it killed a lot of firemen, sadly, it didn't do any, it didn't do any good. It didn't save any. I can't serve you. You know, you see, you have all these firemen now. And we're suffering from testicular cancer because of the chafing from the fire gear. Well, the biggest cost of all was the developing brains of young children because, you know, baby relies on mom's thyroid hormone through the second trimester of pregnancy. And even, and this is the sad part is that obstetricians, they don't see the effects because the, the impacts of even in the clinically normal range of thyroid hormone, even subtle changes in thyroid hormone function contribute to cognitive deficits, autism and attention deficit hyperactivity disorder. So what you see is a silent epidemic of kids with lower IQs in the United States compared to Europe as a result of that legacy of exposure. So, you know, just to put this in context for the audience, a kid loses an IQ point, mom doesn't notice pediatrician. Oh, he knows. He knows. He knows. He knows. No offense. You know, the back in the 1980s, we got let it gasoline out of the gasoline and it, and as a direct result from that, the national average IQ went up to points. Yep. And I remember talking to an epidemiologist at that time and he said, you could lose five IQ points across an entire population. Nobody would notice. You know, but getting, getting let out a crippling that society. That's right. You get, you got, but getting let out a gasoline and paint provided a $200 billion dollar to this day economic stimulus package because each IQ point is roughly worth 2% of a child's lifetime economic productivity. And at fall and average, they make a billion, a million dollars, excuse me, a mix of my millions, my billions, haven't had enough coffee. That's $20,000. You multiply that up around four million kids born in the US each year. You get a lot of zeros on the right side. And, you know, we should have learned from the success story, the public health victory, getting let out a gasoline and paint. But here we are, just to use flame retardances as an example. And you see this disparity where the Europe only has $9 billion or so in costs. And the US suffers $200 billion in lost economic productivity and other costs associated just with flame retardants because they're being added to these plastic phones. I remember seeing all the studies from the lead in the gasoline because lead caused behavioral issues and it caused violence. Yes. And that generation was the most violent generation in American history. We had the riots and crime rates going through the roof. And when the lead came out, it was co-terminous with a reduction in a lot of that violence. But I'm wondering if the same thing isn't going on with plastic, as plastics are not just causing physical problems. There are behavioral issues as well. And you know, that they made be connected to ADHD and depression. And like you said, autism. So, you know, in many ways, it's a good analogy because plastics is like a lead moment. Back in the 70s, we didn't have perfect science. We didn't have, we had a few studies that were very suggestive of cognitive impacts and behavioral impacts in kids. But the adage is you look at the stakes involved in the problem. When you, Sir Austin Bradford Hill, who this British physician who described the criteria for causality, he was doing it during the tobacco wars. Mind you talk about another group of industrial activities that have had their effects. And for people who don't know the Bradford Hill criteria is a, it's a schematic for proving causation. It's a, it's a series of questions that you need to answer in order to prove that a certain exposure results in kidney cancer or whatever the outcome that you're looking for is and it's used in court to, it's used throughout medicine. It's used throughout the regulatory approval process, but it's also used in court cases to show causation. And where it's gotten manipulated over the years, is we've assumed that we have to have a randomized control trial to prove an effect. You're never going to be able to design, you can maybe reduce exposures to plastics, let's say in people's lives and follow the populations to see what happens. But in the context of all the different plastic exposures, those are hard to control. And you compare that to a drug trial where you're intentionally giving for benefit a pharmaceutical to a population. You can have a proper control group, if you will. That's just not going to happen when it comes to chemical exposures. So we have to look at observational evidence. And we have to again use what you talked about the Bradford Hill criteria, you see what happens in laboratory animals and tits. issues. You look at consistency across different observational populations. People you look at, and yes, you're not going to have that proper control group, the unexposed control group. But when you look at the evidence for plastics in human health, you have that independent corroboration just to give you an example for Thalates and Brain development. Thalates were also thyroid hormone disruptors, by the way, and they're linked to cognitive evidence. And that's in plastic packaging. That's right. They make plastic softer. Those PVC pipes, even if my hamburger meat, it comes with that plastic wrap or on it. That is going to be loaded with Thalates. That usually is the case, or at least I haven't seen industry proof that they've taken it out altogether. Let's just put it that way. And so in this large Dutch cohort where we looked at Thalate exposure, supported by the National Institutes of Health, mind you, so I want to give due credit, or credit is due, it's that science that really brought us to a place where we understood the impacts on human health. We not only found decreases in IQs through neuro-psychological testing, these are psychologists who are testing how kids are performing on various tests and things. They looked at the brains using magnetic resonance imaging. And they found smaller brains. And when you connect the dots and they did statistical tests to try to explain the pathway, the loss of gray matter, if you will, the smaller gray matter, smaller total brain volume, excuse me, was explained a lot of the effects on IQs. So there's two things going on here. You have an explanatory path, and thyroid is part of that explanatory path. It's part of the mechanistic insight that really gives us the evidence, the strong evidence, the rigor and reproducibility. And you have different ways of measuring the same outcome, giving you the same readout. So when Sir Austin Bradford Hill talked about, you know, the criteria for causality, he always talked about it as shades of gray. There are things we still don't know, Mr. Secretary, about lead and their impact on the general population. But now we've accumulated all this evidence that tells us that that was the right thing to do at the time. And so you have to weigh the stakes of the action together with the available evidence, because it's never going to be perfect unless you have another generation of people who are exposed to the same toxic exposures. Now I do want to point at just a word for Herbert Nidleman. Yes. He was this very tenacious, courageous scientist who was the first one to lead to the loss of IQ in all these behavioral wishes. And he was as predictably vilified and his career was almost destroyed. And he was marginalized and censored and ridiculed by the press for long. The mainstream press by television and radio and newspapers and the industry was funding all under the sub-rosa funding to destroy them the same way they did with Rachel Carson. And anybody who challenges these paradigms. Well, science is inherently political. And I appreciate this in the field having learned from Dr. Nidleman's legacy. That you have to develop a bit of a tough skin and appreciate that these industries are profiting, if you will. And again, I don't disabuse myself of the fact that people have to profit in life. But to give you a statistic that puts it in context, the plastics industry, global revenues, this is all across the world, is $500 billion or so dollars. We did a series of studies built on that end of Krin disrupting chemical evidence that I talked about earlier that $340 billion US cost. We had some other data for PFAS, some other data for PLAS, for Thalate impacts that we had later identified. So mind you, this is like 20 or so chemicals that we were able to isolate a subset of diseases due to the few chemicals we studied. And a subset of costs due to the few diseases due to the few chemicals we studied. This is an underestimate of an underestimate of an underestimate. And we found the cost for $250 billion a year in the US population. Well, that's the subsidy that the industry is getting from us. Half of their revenues are subsidies. Off of our skin. So at some level, this industry, I hate to say it is a bit of a loser. I'm not going to call anybody a loser. That's rude. But I am going to acknowledge that we need to change our ways. And, you know, we can talk about this later on. But there is a lot of hope. There are companies that are showing leadership and using sustainable and alternative materials that are free. Of these chemicals. They're thinking about a new way. And part of the reason we're stuck is there some entrenched interests that are keeping, or holding on, gripping on tight to the $500 billion a year industry. And they're costing human health in the process. Talk about the principal vectors by which plastic, microplastics get into the human body. And first of all, quantify how much plastic are we all carrying around right now, and particularly in our brain. So there are people who have attacked that camp in the University of New Mexico for this estimate that it's a proverbial tablespoon of plastic in the human brain of microplastics. Every American on average has about a teaspoon. If it's a teaspoon or a tablespoon, it almost doesn't matter. I think the point that it is that it's there and if they're in substantial quantities. It's about, it's about, it's like 1% of the volume of the human brain. But even if it were point one, Mr. Secretary, let's say, let's say we could remove the decimal one way or the other. And mind you, the controversy, the attacks he's gotten are that fat can be when you put it on the instrument that you use to measure micro nanoplastics gives you what we call a polyethylene is a form of plastic. A polyethylene signature in the machine, read out that is clouded by the same signature you'd be looking for the polyethylene plastics, the micro nanoplastics. So if I said to say that even if we, I don't even want to have that debate because it's not worth having, it's there. And it's there in substantial levels and mind you, the higher levels were associated with dementia in those populations, decident brains with higher micro nanoplastics. People like the cadavers, correct. Who had dementia had consistently much higher levels of micro plastic in their brain. And then they looked temporally based upon the year of death, they had an annotated archive in the short of trajectory that was upward. So it could be point one, it could be point two, one, I, at some point I don't really care. I think I care about what's happening to the human body at some level. And there is no way that we know of at this time of key lading it out of your body. At the present time, no, but we'll talk a little bit about the stomp initiative I assume and the opportunities to look at things like that. But this is prevention as the cure. I'm right. Prevention is the cure. Let me get back to my original question, which what are so the audience can know? What do the primary vectors as a bottled water, is it eating fish with micro plastic in it? What are the primary vector? Is it cooking with non-stick surfaces? What are the worst ones? It's a great question. And I actually don't have the percentages to give you, because we haven't done a national human exposure assessment study for about a couple decades, unfortunately. I'm hoping perhaps administrators, Eldon, might be interested in pushing that forward, because we could really do a study of dust, of water, of food packaging, of air, and really integrate the totality of exposure so we could tease that out. But I can give you top line. Do you do that with animal model studies? You do it with doing people's homes. Survey them the way you knock on doors and take 100 people from one part of the country, 100 people from another. And then what do you do with blood test? You would do dust levels, water levels, urine levels, serum levels. You would look at a lot of different tissues and integrate the data and see what you would find out, in which signals are really ticking up people's experience. So what is your guess then? Yeah. I think food is number one. If I'm not a person who wages, but food packaging and food contact materials are likely the biggest source, I would say, you know, and I think here's the, this is multi-dimensional threat as I talked about. So I'm giving you the best available data based on the chemicals more than the micro nano plastics. We don't actually have a lot of data. lot of data right now about the sources of micro nanopostics exposures. What I can tell you is when it comes to plastic chemicals, there's enough PFAS in the water supply of 150 million Americans such that the National Academy of Sciences suggests clinical testing for these populations. And I'd argue suggests the opportunity for water filtration and steps because you can improve lipid levels, you can reduce the risk of thyroid cancer or thyroid dysfunction. Sorry, it's actually not thyroid cancer, kidney and testicular cancer that have been increased most of it. And he gets the outcome we sued in the dark waters case. And so I can tell you that dermal exposure is an unappreciated route. The number runner, running requires often a lot of materials that are tightly adhered here into the skin, the way the designer has developed them over the years is mostly polyester or nylon. I have adapted a lot more towards cotton or at least using the inner layer that's natural to try to avoid that. But that gives you an example. Cosmetics are a major source of exposure. And that's because things just absorb into the into the skin quite readily. Thermal paper receipts are unfortunately a significant source of bisfinal exposure because that is a polycarbonate film that is often I think some of the industries will debate whether it's still polycarbonate. I'd like to see the data and then I'll back off the claim when that's really given to me. But you touch that material, particularly if you use like hand sanitizer or alcohol or lotions that will also facilitate the absorption into the into the skin and ultimately directly into the serum. But bypasses the liver. So the first time around the body it can have a even more significant effect. So we inhale these chemicals as well and inhale, particularly a concern about micro nano plastics is that these act like particles. That's the big debate here too is when we're talking about micro nano plastics on the one hand and chemicals in plastic on the other. Are they toxic drug delivery systems for the chemicals or are the particles like punching bags or literally fists hitting tissue and being wrecking balls directly. That's like kind of what we thought a particulate matter was doing to contribute to lung cancer as a chronic obstructive pulmonary disease and such. That's where the stompe initiative can break a lot of ground because from a scientific perspective I can't tell you what those micro nano plastics are doing. Mind you, we use in medicine micro nano plastics as drug delivery systems. Those sustained release capsules are plastic particles. That might make people shudder a little bit but the intent is to actually deliver beneficial drugs to tissues. But that's just the imaginative perspective I can give you in that these micro nano plastics are not a nerve and they are good at delivering chemicals on the one hand beneficial when it comes to pharmaceuticals like a meprizol or what have you. On the other hand toxic chemicals like phallate or bisfinols. You mentioned a couple of times a stomp and just the audience knows. Sure. That's a program that we announced from our age which is part of my agency and it develops cutting edge solutions and it can act very, very quickly. It's very nimble and we're putting $145 million into that to look. The first time at the fade of various kind of plastics in the human body. So there are, as you said, thousands of constituents and there are different families of plastics and some of them may be inert. Some of them we know are very, very dangerous and yet we don't know what different ones do when they enter your body where they migrate to and where they lodge and what kind of harm they do. So for the first time we're going to have that map and we're going to be able to characterize it. But talk for a minute about plastic water bottles. Yeah. So plastic water bottles, I wrote in my book "Cickre Fatter Porre" when I was recently just focused on endocrine disrupting chemicals. It was a broader issue, everything from pesticides to plastic to other materials. I talk about the fact that you're in the car. You're going to grab a hot water bottle that's been in the sun and there's been a lot of weathering to that plastic bottle and that plastic bottle is just not inert enough to handle it and the plastic leaches in variety of forms. Micro nanoplastics, well on this hand and then chemicals as well. And that kind of leaching has been very well described and it's probably an important source in contribuers. That's a big reason why I drink from other materials, stainless steel water bottles. If I'm getting on a plane, I'm going to clear security with an empty water bottle or have some ice in it and then top it up with water so I can get where I'm going. And often when you're buying a plastic water bottle, you're really buying not the water but the plastic bottle. Right. Because the water is free. Right. It's coming out of the ground or it's coming from the tap and they're treating it slightly for nothing. Right. You're paying for the packaging, you're paying for the plastic bottle and the cardboard case that it comes in. That's absolutely right. As I was looting to there, every water supply is a little bit different. So there are certain circumstances where you might not want to pour from the tap or you might want to get filter your water or even more aggressively use like a reverse osmosis filter if you have a significant PFAS contamination issue. But buying that plastic water bottle and assuming it's free of toxic chemicals is maybe a bit foolish to assume. How about the big plastic bottles that people put in the little water machine? Well, those are, have a recycling number seven and sometimes have polycarbonate in them. And polycarbonate is a polymer of bismanols typically. And is there a difference when you buy a gallon jug of water? Some of the water bottles are cloudy. And some of them are clear. Is there any difference between those two? That's hard to say. Unfortunately, all I can tell you is based on the recycling number. That's the number with three triangles in the middle. The ones I try to avoid across the border, three, six and seven, three is for polyvinyl chloride, which includes thalates as an additive typically. Six is polystyrene. Styrene the monomer is a known carcinogen. And seven is a bit of a hodgepodge class. I should take a step back and just clarify that it includes polycarbonate plastics and some bioplastics. But the specificity and the declaration on the label is a bit ambiguous. So I usually suggest getting avoiding three, six and seven in general. But also in general, I would suggest trying to use stainless steel or glass whenever possible. Can you just just talk a little bit more about angiocrylate? And disruptors. So I'd start by saying there are safe and simple steps that we can all take to reduce endocrine disrupting chemical exposure. And endocrine disruptors are chemicals that interact with our sexual development or our hormone system. Any variety of hormones from temperature, metabolism, salt, sugar, and even sex are affected by these endocrine disrupting chemicals. And the good news is there are safe and simple steps that don't require Ph.D. and chemistry and they don't have to break the bank. Reducing canned food consumption can reduce your bisfinal exposure besides thermal paper receipts, which we already talked about having as a potential source of bisfinal exposure. Avoiding microwaving and machine dishwashing plastics is important. We already talked about that hot water bottle, bleaching plastic, micro nanoplastics, and chemicals of concern. We know that microwaving machine dishwashing plastic is just inviting at a molecular level at an invisible level these chemicals or micro nanoplastics, so each into food. Now air is something to think about as well. During the pandemic, there were some studies done at Brown University that did greater air filtration and found PFAS flame retardant and thallate levels to drop substantially. This was in concert with colleagues at SoundSpring Institute, a great research group that documented this. So as much as we talk about infectious transmission being reduced by air filtration, you also have the benefits of reducing chemical exposure in the process. another. setting, just taking healthy building materials and putting them into place can reduce dust levels of these chemicals as well. A little bit more of a higher level intervention, maybe a little bit more out of your control. But again, if you talk about reducing your canned food consumption, using more glass and stainless steel, last I checked cast iron stainless steel pans are not that much more expensive than nonstick cooking materials. And not microwaving a machine dish-washing plastic if I haven't talked about that already. These are steps again that don't have to break the bank and short term changes have shown big impacts. There are studies that have shown 30 to 50 percent decreases in urinary levels. The fallates and bisfinels, for example, in contrast to the forever chemicals that we call them everywhere chemicals because they're everywhere and they were circulate in and out of the body super fast. Their half lives, that's the time it takes to agree about half of them is 24 to 48 hours. So it shouldn't surprise you that if you take a dietary intervention in a high income population or even in a low income population just reading the label and selecting cosmetics without the word "fally," that's a mouthful to spell "ph.ph." is what I always tell people to look out for. Or fragrance. Fragrance is a big loophole if you will that you can drive a MAC truck through unfortunately. You should avoid thalle. You should avoid fragrances when you get your cosmetic. Yes. The short term exposure reductions can when sustained change hormone levels in weeks and then in the long term contribute to reductions in chronic disease risk. And when I wrote the book "Cecrophaterpour" or seven years ago, that was the hope was to get that message out there and change us from a situation where 1 to 2% of us know about it and bring us to 3 to 5%. And I'm really grateful, gratified, to have your support and leadership in so many ways in this space through the ARPA-H initiative, through listing microplastics as water contaminants. The generally recognized as safe exemption is something that you've shown just some tremendous leadership in pushing out there. And I hope you keep pushing. There are a lot of petitions out there in the Food and Drug Administration that with your pen you could get rid of so many of these chemicals that are in the food supply. You have so much power and this is a really crucial moment. I know you've got the support of so many people out there in the general public. I appreciate that. Dr. Leo Trasande is the Director of the Grossman Center for the Study of Environmental Hazards at New York University and thank you Dr. Trasande for joining me today. It was an honor and joy to be with you. Thank you so much. Produced by the US Department of Health and Human Services.