It’s true, more men suffer severe COVID-19, and more die. Two new studies discuss how genes, hormones and environmental chemicals that interfere with hormone actions affect risks with COVID-19. Reducing environmental exposures could keep us all healthier, and now is the once-in-a-generation chance to do just that.
Looking at more than three million COVID-19 cases globally, researchers in the U.K. and South Africa found that although, on average, equal numbers of men and women got sick, men are 180 per cent more likely to land in intensive care and 40 per cent more likely to die. The scientists ascribe this to interplay between hormones, genes and the immune system. Environmental agents play a role, too.
Meanwhile, another international collaboration of scientists, which has not been peer-reviewed, found more severe COVID-19 cases when there were higher blood levels of a persistent pollutant. Per- and polyfluorinated alkyl substances (PFAS) repel water and oil, making items slippery and stain-resistant. Think of Teflon, Gore-Tex, firefighting foam, de-icing fluid at airports, the paper wrapping your burger and carton of french fries and much more. The PFAS, also called “forever chemicals,” build up in the environment and in us, including in our lungs. They interfere with hormone actions and impair immunity, but there are safer alternatives, as catalogued by the European Union.
As Canadians weather the COVID-19 pandemic, severe cases mirror a slower epidemic of pre-existing conditions. A small minority of healthy individuals may develop severe COVID-19, but from young to old, during the darkest days of 2020, most of those crowding ICUs are overweight, with diabetes, high blood pressure, asthma, vascular disease, liver disease and/or compromised immunity.
Such chronic conditions are increasing in the young. Type 2 diabetes was once a disease of aging, but children’s hospitals now have busy clinics. A six per cent annual increase in bowel disease in young children presages increasing colorectal cancer in young adults. In short, environmental contaminants are causing chronic diseases, and almost all of the severe COVID-19 cases are in individuals with these chronic conditions.
Mounting burdens of ill health — birth defects, autism spectrum disorders, multiple chronic diseases and cancers — are persuasively related to chemicals in our air, water, food and household products.
People living in poverty, with poor diets and housing, who live in more polluted areas or have hazardous work are more vulnerable to both chronic diseases and severe COVID-19. More polluted neighbourhoods are harder hit, while workers’ exposures predispose even their offspring to ill health. Radiofrequency radiation for telecommunications may amplify chemical toxicities.
Obesity is associated with many chronic conditions, including metabolic syndrome, Type 2 diabetes, cardiovascular disease, Alzheimer’s disease and also higher risks of cancers of the breast, reproductive organs, digestive tract and glands such as the pancreas and thyroid. While chronic disease is complex, increasing evidence reveals links with the hormone-like effects of “endocrine-disrupting chemicals,” or EDCs.
Thus, we must reckon with the potential contributions to chronic disease of many presumed innocuous exposures. The international Endocrine Society — scientists and physicians who study this complex biochemistry and treat these disorders — urged restrictions of EDCs with a scientific statement in 2009, which was summarized in EDCs and public health and updated in 2015.
In 2020, the society summarized concerns over regulatory assessment processes and countered the industry-friendly myth that toxic chemicals are innocuous below certain thresholds.
"Environmental contaminants are causing chronic diseases, and almost all of the severe #COVID19 cases are in individuals with these chronic conditions," writes Meg Sears of @PreventCancerNw.
We are all exposed.
Health Canada found the endocrine-disrupting herbicide 2,4-D in farmers' semen, while environmental chemicals, including PFAS and other EDCs, are regularly seen in blood and urine in the Canadian Health Measures Survey, a Statistics Canada longitudinal project that collects blood, urine, hair and other data from biosamples. Given the plausible relationship between these exposures and ill health, our main environmental law is failing us.
The Canadian Environmental Protection Act, or CEPA, is supposed to protect us from chemical harms. It was last amended in 1999, just as the concept of endocrine disruption was gaining attention. CEPA enables “management” of chemicals that may persist, build up over time and cause cancer and other serious harms; however, the law is silent on the subtleties of endocrine-disrupting chemicals, or combined effects of mixtures experienced daily.
Addressing contributors to epidemics of chronic disease that worsen outcomes during the pandemic is a big ask with potentially tremendous benefits. Industries can improve, and producing the safest, healthiest options could ultimately position Canada as a trusted — indeed, preferred — source of goods during recovery.
The time has come. The time is now for a new CEPA to be introduced in the House. A great way to wrap up 2020, and a law for a healthier 2021!
Meg Sears is an Ottawa-based scientist and chair of Prevent Cancer Now.