Harvard Trained Pediatrician Dr Leonardo Trasande Teaches Us that Microplastics are Micromonsters

What if some of the biggest health challenges we face aren't JUST about diet, exercise, or genetics, but also about the invisible chemicals we're exposed to every day?

In this eye-opening episode of Skincredible, Dr. Lisa Swanson sits down with renowned pediatrician, epidemiologist, author and overall health expert: Dr. Leo Trasande. Here they unpack the surprising science behind microplastics and endocrine-disrupting chemicals. Together, they explore why these tiny exposures may have a much bigger impact than most people realize, why the conversation is changing and how you can help.

You'll hear about emerging research, some of the most surprising everyday sources of exposure, and why scientists are paying close attention to everything from fertility and child development to chronic disease. But this isn't a doom-and-gloom conversation. Dr. Trasande also shares practical, realistic ways to reduce exposure without completely overhauling your life and explains why consumers have more influence than they might think.

You have probably heard the term "microplastics" thrown around online and on social media. This episode offers a thoughtful, evidence-based perspective that may change the way you look at your home, your products, and your health.

Keywords

Dermatology, recycle, reuse, sustainable fabrics, inflammation, plastics, microplastics, macroplastics, endocrine disrupting chemicals, hormone disrupting chemicals, hormone disruptors, environmental toxins, toxic chemicals in everyday life, chemicals and human health, environmental health, environmental medicine, toxic chemical exposure, hidden toxins, phthalates, BPA, bisphenol A, flame retardants, PFAS, forever chemicals, pesticides and hormones, chemicals and obesity, chemicals and diabetes, chemicals and infertility, chemicals and reproductive health, chemicals and child development, chemicals and ADHD, chemicals and autism, chemicals and brain development, chemicals and immune system

Links, Attachments

Dr. Trasande’s book (no affiliation): https://www.amazon.com/dp/1328553493?lv=shuf&channelId=500&plpRedirect=mhFallback

More About Dr. Trasande: https://med.nyu.edu/faculty/leonardo-trasande

Chapters

00:00 Intro and Welcome

00:16 Introduction to Microplastics and EDCs

05:27 Understanding Endocrine Disrupting Chemicals

09:42 Health Impacts of EDCs

18:28 Fertility and Reproductive Health

21:11 Emerging Trends in Pediatric Dermatology

26:00 Understanding Microplastics and Their Impact

26:53 The Role of Obesogens in Health

28:09 Air Pollution and Its Connection to Plastics

29:01 Concerns About Dermal Absorption of Chemicals

31:18 Regulatory Challenges in Chemical Safety

33:49 Practical Steps for Reducing Plastic Exposure

37:36 The Impact of Fast Fashion on Health

40:07 Addressing Plastic in Children's Toys

43:41 Consumer Power in Driving Change

The information shared on this podcast is for educational purposes only and is not a substitute for personalized medical advice. Always consult your  physician regarding your health.

Transcript

SPEAKER_00 0:04

Welcome to Skin Credible, where we tell you what you should know about your skin and how to blow. Because your skin's incredible.

SPEAKER_05 0:17

Hello, everybody, and welcome to a really super special episode of the Skin Credible podcast. We are in the company of somebody who I think is kind of a superhero because he is on a mission to save the population, to save our health, by talking about the danger of microplastics. And I'll let him do a formal introduction. This is Dr. Leo Trisande. Hi. So I am wearing all organic materials today in honor of this episode. I have realized that I need all new clothes because I have discovered this hidden danger of microplastics in everything. I have been researching and I read your book. Everybody, he has an amazing book, Sicker, Fat, or Poorer. It's an optimistic view of the danger of microplastics. I also watched something on Netflix that you're featured in called the plastic detox, which was wonderful.

SPEAKER_01 1:31

Thank you.

SPEAKER_05 1:31

And so, first thing to start off, let's kind of level set for the audience what are endocrine disrupting chemicals?

SPEAKER_01 1:41

So endocrine refers to hormone. Hormones are natural signaling molecules that underlie basic biological functions from temperature, metabolism, salt, sugar, and even sex. They're natural chemicals and they operate at very low levels, like grains of sand in the Sahara, grains of salt in the Olympic-sized swimming pool to give you a sense. So these natural molecules are fundamental to biology. And it's the principles of endocrinology that make them work so effectively at really minute doses. Now, when we're talking about endocrine disrupting chemicals, we're talking about synthetic chemicals. We're talking about chemicals, we'll talk about their uses and what we know the best. But for just right now, they are hackers of our hormone function. And they too operate in these very minute levels of exposure. We're not talking about things that'll give you seizures. We're not talking about things that will poison you the way arsenic does. There's this Swiss philosopher named Paracelsus who coined the phrase, everything is a poison, only the dose makes the thing an actual poison or something to that effect. And I respect Paracelsus. I'm kind of jealous. His notion from 500 years ago stands largely to this day. But when we're talking about synthetic chemicals that hack hormones, we have to think about the principles of endocrinology and how hormones work. And hormones don't work in what we call straight-line exposure response functions. They don't work where you have to have very high doses before you have a bad thing happen. Because of the way hormones work, you have funny curves. So the effects can be steeper than straight lines at the very lowest levels of exposure. In fact, it's actually the lowest exposures, getting them as close to zero that can give you the biggest bang for the proverbial buck. We know this, by the way, for other chemicals like lead, mercury, methylmercury, certain pesticides that probably are because of hormone disruption, that they operate at superlinear exposure response functions. And then sometimes you actually have oddball U-shaped or roller coaster ride exposure response functions, and that's based in biology as well. We'll talk a lot about bisphenols and aluminum can linings and thermal paper receipts. But bisphenol A, the prototype bisphenol, is well known to have what we call U-shaped effects because the body has sometimes multiple receptors that respond to the same chemical. And if like an off-switch is turned at one point, later on another receptor can have an on-switch that counteracts the effect of the off-switch. So, in fact, you then have a change in function. This is all nerdy sounding, but at some level, the point I'm trying to bear is that you can take high-dose animal experiments and reason down to low-level experiments, low-level human exposures. And that's why we are in this problem. We for many years have assumed that you can take a rat or some animal and you can do a high-dose experiment, find out when you don't see any effects, and then reason down to human populations and say, okay, this is safe. The reason we're here right now is that many of these chemicals failed this test of going from high-dose exposures to low dose effects in humans. And that's where we are today. And then I'm happy to go through the specific chemicals where we have very large amounts of evidence.

SPEAKER_05 5:27

Yes, yes. So you mentioned in your book that there's kind of four main categories of these EDCs, endocrine disrupting chemicals. There's pesticides, flame retardants, plasticizer chemicals, which includes phthalates, and then bisphenols, the most common of which is bisphenol A. And let me tell you, this um blew my mind because I enjoy Diet Coke and Diet Pepsi. And I had switched from bottles to cans not long ago. And then now turns out neither one, neither one is acceptable.

SPEAKER_01 6:04

Well. So we've talked about bisphenols already. Um phthalates are used to soften plastic, polyvinyl chloride plastic in particular. The pipes that are being being used to replace water lines in Flint, Michigan from lead exposure are polyvinyl chloride, but they're the harder variety, so they don't get phthalates added to them. They're polyvinyl chloride plastic. But if food packaging phthalates, a food packaging PVC rather gets phthalates added to it because you need that property of crinkliness and softness to work with it in real life. And that's where we have the conundrum of exposures. Now, we talk about flame retardants in the book in a way as though they're not plastic chemicals at first.

SPEAKER_04 6:55

Right.

SPEAKER_01 6:55

But I need to be clear that for many years, plastics and still to this day have chemicals added to them called flame retardants that are there because the plastic is flammable. So back in the 70s, polyurethane foams and furniture, the thought was, well, they burn too fast, so we're going to add flame retardants to slow the spread of fires. That was an epic mistake on two reasons. One is the chemicals did not work to save lives. They just magnified exposures tenfold compared to Europeans, where there was no requirement to add flame retardants, period. You had just the situation where you intentionally expose people and then the consequences followed.

SPEAKER_05 7:37

Yes, definitely. And then the other thing I was learning is recycling. Is recycling kind of a myth that it helps us at all with the plastic war?

SPEAKER_01 7:50

Well, let's just start with some stats.

SPEAKER_05 7:52

Okay.

SPEAKER_01 7:53

So if we talk about plastic, we've accumulated only recycled 9%. So 91% goes to three fates. It export to countries where they deal with it, which then goes to two real options. They either go to landfills or they get burnt. You burn it, you create another endocrine disrupting chemical category called dioxins that are very potent carcinogens and obesogens. They chemicals that make us better. We'll talk a little bit more about what these chemicals do later. But the point here is that we have failed to manage our use of plastic effectively. And plastic growth is exponential. We'll triple by 2040 the production of plastic. So keeping the tap on wide open, even if we recycle our way to 30% or 40%, we're going to have an accumulation of plastic in a couple of different ways. One is an environmental fate, which we will talk about. And then the other is human exposure. And human exposure takes two general forms. We've been focusing mostly on chemicals in plastic. And I think we need to dwell on that a little bit more. But the micro-nanoplastic is what woke everybody the heck up. It's when we found it in hearts and lungs and testes. I apologize, that the findings in men that really caught people in a wrong spot. And we see it in ovaries, we see it in, you know, variety of female reproductive tissue, don't get me wrong. But unfortunately, due to the way power dynamics are and the manosphere is going these days, that seemed to really bring this issue home in a way that finally people were like, okay, I actually have to think about this.

SPEAKER_05 9:42

Yeah. Yeah. Well, and and that brings me nicely to like why we care as human beings. And there are numerous health issues that these EDCs, endocrine disrupting chemicals, have been associated with. I'm going to read through the list as I have learned from your book and from the network. So lower IQs in children, ADHD, autism spectrum disorder, obesity, type 2 diabetes, heart disease, stroke, infertility, low sperm counts, birth defects, endometriosis, fibroids, breast cancer, ovarian cancer, testicular cancer. Wow.

SPEAKER_01 10:24

Yeah, I'm not saying everything has a hundred percent perfect evidence. I'm not saying it's a hundred percent of ovarian cancer that's related to chemicals. If anybody tells you that, they're full of it because all these conditions are what we call multifactorial, multiple factors explaining a disease endpoint. So, for example, I talked to you about obesogens. There are 50 or so chemicals that literally make us fatter. Diet and physical activity are still the major drivers of the obesity and diabetes twin pandemics. There's nothing, no one's gonna hide from that. Yeah. And at the same time, there's a third leg to a stool, to the stool. And in that case, I'll give you an example. There's a study that successfully got people to lose weight through healthy diet and physical activity. They measured their serum for PFOS, and then they followed them. They found that the higher PFOS-exposed people who had worked so hard to keep their weight off gained more weight back. Then they said, well, why is that? They found that PFOS were associated with a reduction in the resting metabolic rate that explained the effect on weight after losing through healthy diet and physical activity. So nothing I'm gonna talk about here today doesn't invoke the broad milieu of genetics and diet, et cetera, that are important to these conditions. And then, you know, we can go through some of these other conditions and what the evidence is. Some are really strong, like brain development effects of these chemicals are extremely strong. Obesity is kind of in the middle. Cancers are an early day field, but there's enough data from laboratory and other studies to suggest that there are 900 chemicals that are carcinogens to the breast. We know of those, 414 are in plastic. Additives, monomers, like single chemicals that make up a polymer that is plastic, et cetera.

SPEAKER_05 12:24

Well, and two questions for the audience. PFAS, what does that stand for?

SPEAKER_01 12:28

Yeah. Per and polyfluoroalkyl substances. In simple English, they're nonstick chemicals. The carbon-fluorine bond is a really useful thing in chemistry because it makes things not stick. And they are forever chemicals. Well, at least the initial original PFAS were forever chemicals because they stay in the body for a very long time. Because the human body also looks at these chemicals and goes, wow, they're actually pretty good. I'm gonna, I may excrete them, but I'll absorb them right back up through the kidney. And that's why the half-lives are in the order of years. That takes years to get rid of half of it out of your body.

SPEAKER_05 13:06

Was the original PFOS, was that Teflon?

SPEAKER_01 13:09

That is one of the early long-chain PFOS, the these 8 to 12 carbon molecule chains with fluorines all over them, everywhere you could put them.

SPEAKER_00 13:21

Okay.

SPEAKER_01 13:21

And that was, you know, DuPont and 3M have had various formulations of these compounds over the years. They voluntarily phased out the longer chain PFOS, but they've replaced a good number of them with all sorts of wacky chemistry with four to six chain carbon PFOS. Same chemistry. The only difference is they get excreted faster, so that doesn't mean their biology is different.

SPEAKER_05 13:49

Yeah. The other thing, and you know, yeah, I think it's very important to say that like all of these things have some evidence to be associated with these EDCs. It varies in terms of how much there is. But the one thing I was really struck by was everything to do with like fertility and like male development. So I I made note of something talking about a shorter analysis. First time that word is mentioned on the pod. Yeah. Um in babies, in native boys, is associated with hypospateus, um, undescended testicles, smaller penis size, lower sperm count, and fertility when they grow up.

SPEAKER_01 14:30

Yeah, I've never seen so many reproductive anatomy pictures on the Joe Rogan experience and related podcasts, but that's where this goes.

SPEAKER_02 14:39

Yeah.

SPEAKER_01 14:39

So the anogenital distance is the distance from the anus to the genital of depending on sex.

unknown 14:47

Yeah.

SPEAKER_01 14:48

And so what we know is that that represents sex hormone balance. Androgen, testosterone versus estrogen. And in boys, we're going to start with boys, but there are effects in girls too. This is not just the boy thing. It's just that the the hype about it was all about the male reproductive effects.

SPEAKER_05 15:08

Yes. Typical.

SPEAKER_01 15:10

Yeah, for the re it's it's not right, but it's just how this has evolved.

SPEAKER_02 15:16

Yeah.

SPEAKER_01 15:16

So what we know is that short analysis is a marker of then low testosterone compared to higher estrogen function, which is not suboptimal in males. Now, what we also know is that your rank in the AGD distribution is going to be the same when you're born as opposed to when you're an adult. That's because most of the reproductive development's happening in pregnancy.

SPEAKER_04 15:45

Yeah.

SPEAKER_01 15:46

There's a little window called mini puberty, two to six months of age, where there's a little bit of change, don't get me wrong. But what you are as a baby is what you are as an adult. And what we know about adult AGD is that short AGD in males is associated with decreased sperm count, decreased fertility, and increased cardiovascular disease. We also know this is where you have to go like this, you know, these nerdy epidemiologists, these scientists, they need to walk you through three or four steps.

SPEAKER_04 16:12

Yeah.

SPEAKER_01 16:13

So I've explained that if if there's something that shortens your AGD is happening in pregnancy, right? So studies have looked at pregnancy exposure to chemicals like phthalates and looked at analysis in the babies that were reasonably born. What they found in general is that phthalates are associated in boys with shortening of that AGD. So that's how you can connect the dots all the way to adult sperm count being lowered by plastic exposure in the womb. Now, there are some earlier studies, early ish studies that are saying that girls also have effects. Um the direction of those effects is actually longer AGD, which may represent androgen exposure. Now, there's a lot of poly, they don't call it polycystic ovarian syndrome anymore. They call it uh multiple endocrine syndrome. I actually I'm drawing a mental blank. I you know, I work closely with endocrinologists, so I'm embarrassed to say that my brain is drawn a blank about the new name of the syndrome. But the point is that it's it's largely an excess of inuterotestosterone exposure that explains effects in girls that can be obesity, insulin resistance, and reproductive consequences. So no study has looked that long to show polycystic ovarian syndrome in association with prenatal exposure. It's just that we've been able to show that anogenital distance is a suggestive early signal that may be a harbinger for the long-term consequences in girls as well on reproduction.

SPEAKER_05 17:53

And also, I think, you know, for those of uh listeners that might be affected by this, there is hope in the Netflix show, The Plastic Detox, Dr. Shauna Swan, who seems amazing, by the way, um, she put six couples on a plastic detox program over 12 weeks. And these couples had all been trying to have children for at least two years. And at the end of the program, three out of the six couples were pregnant.

SPEAKER_01 18:28

So let's be clear, yes, it it tugs at all the heartstream. Yes. Yes, and it's a study. Let's be clear, it's it's a study, it's a very promising finding. Yeah, it's six.

unknown 18:45

Yeah.

SPEAKER_01 18:46

So I think what this does is give hope for the ability for people to have some power over these exposures, which is totally true. Yeah. I want to be clear. Yeah. And I don't think this is proven in the way that you're gonna be able to tell a pregnant woman, don't worry about your infertility. I have a way out for you. I don't think we're there yet. And I think that's the the yes and yeah. Not yes, but yes and to this, to this uh analogy. I think it's very promising. I wasn't involved in the study, didn't even know about it until the documentary came out. I did it was not, they didn't tell me. Gotcha, gotcha, as context. Yeah. And so it's very promising. And and and there are studies that show you can reduce your exposure to these chemicals in days. That's the other hope.

SPEAKER_03 19:49

Yeah.

SPEAKER_01 19:49

So, you know, you you don't microwave and machine dishwash plastic. You use more glass than stainless steel. Um, you, you know, you maybe filter your air for dust that may have these plastic chemicals. You reduce your canned food consumption. All of those steps can add up to reductions in urinary exposure, urinary measures of phthalates and bisphenols, phthalate metabolites and bisphenols in days. And if you sustain that interpolation, by the way, that's in low-income and high-income communities, let's be clear. Yeah.

unknown 20:23

Yeah.

SPEAKER_01 20:24

So it's not a bougie thing. It's not something that should magnify health disparities. Yeah. And if you sustain that intervention, you'll see hormone levels change in weeks and long-term outcomes, potentially like the ones that Shauna was trying to assess in the months and years that follow, which is akin to fertility outcomes and ultimately having babies.

SPEAKER_02 20:47

Yeah.

SPEAKER_01 20:48

Um, not everybody out there is interested in having babies as an endpoint. Some people may say, thank you, no, so much. Right. And and and but it's also true that you can change, you know, there's a lot of impotence in house. There are benefits across the entire spectrum, whether you wish to conceive or not.

SPEAKER_05 21:10

Well, and speaking of that, there's I'm a dermatologist, I'm a pediatric dermatologist. And so we have observed a few things in the world of pediatric dermatology that I wanted to just run by you and get your thoughts on. So, number one, acne is happening at younger ages, and it's because puberty is happening at younger ages. And it used to be abnormal to have acne before the age of nine, and now it's only abnormal before the age of seven. Thoughts on this?

SPEAKER_01 21:41

So there is something going on that has explained something in the environment. Now, hold on when I say that you got to hold that thought that is explaining the trend in earlier. And earlier puberty in girls is known to be a risk factor for breast cancer. So It's not a clean, oh, this is just things happening earlier in biology. So that's the first thing. So let's talk about what environment I meant by environment. So there's there are increases in obesity. Obesity is tissue that can be biologically active and make certain hormones different, particularly estrogen into androgen. We think that androgen is somewhere involved. I'm not a dermatologist, so I'm gonna like defer to you on the on the but you know, there is something about androgens and the way the sweat plans fail to drain and and you know the biology there that could be behind this, first of all. Second of all, um there, but but but that's my point in terms of chemicals, you know, all the way to acne. But if we just say chemicals to, let's say, puberty timing, well, you know, these chemicals that we're talking about, bisphenols and phthalates, are estrogenically active and antagonizing androgen in some cases. So that can do a couple different things. It can make puberty sooner or make puberty longer. And there have been a bunch of cohorts that have started to look at this. I think the jury is still ambiguous, not for the fact that some chemicals make puberty sooner. That has been pretty well established. I would say we could always use more evidence. Um, I'm always gonna say further research is needed, but we have data for action.

unknown 23:36

Yeah.

SPEAKER_01 23:37

That's really my dichotomy here.

SPEAKER_05 23:40

Well, and we've also noticed increased psoriasis in kids and a lot more hydroadenitis separativa in teens.

SPEAKER_02 23:49

And it's horrible than I know, I know.

SPEAKER_05 23:54

And both of these conditions do have an association with obesity. In fact, the number one comorbid condition of psoriasis in kids is is obesity. And so it but also these microplastics can contribute to inflammation just in general. So part of it might be the obesity part and part of it might be the pro-inflammatory part.

SPEAKER_01 24:16

So I think there's two opportunities here to talk about. One is that, again, let's just hammer down on the fact that this is hard to tease apart. There's so much going on at the same time. I could also argue that diet has evolved, you know, the carb heaviness of it, not the caloric volume, but the quality of it has gone down. So the reality is that this is a multifactorial thing. But if I can get rid of one to three percent of something by preventing it, by regulating a chemical out of use for its safety, that's valuable at a population level, even if you don't see a clinical increment that is going to change healthcare provider behavior. We are part of the problem and we are also part of the solution, by the way. We can get into that later. But the the point I want to make right now that you hit on is when we refer to microplastics, sometimes we're actually really talking about plastic exposure. And and plastic exposures is complex mixture. That's the that's the biggest thing. So I used to think of plastic as just chemical exposure. That was the what I thought the micro nanoplastics, or back then we didn't really barely had the term microplastics, by the way. It's only 25 years old, 26 years old now. But the reality is that it's much more complicated than the monomers and the additives and the impurities in plastic compounds. Plastics are polymers, and with time they break up into different length pieces. And if they're really long, they stay macroplastic. They're not dissolvable. That's why you see them in the sands and the beaches and all that stuff. The micro-nanoplastics start to get invisible because the molecules are getting smaller and they're getting a little more dissolvable. And it's those dissolved organic matters, microplastics, nanoplastics, and these Dashgarn chemicals that are this very complex mixture. And so some of the early studies that in some of which I was involved in are just looking at the chemicals and not looking at the total plastic picture. So as we evolve our narrative here in the public consciousness, I hear the word microplastic, but I think for folks on the on on the on the pod, they got to be careful about what we're really talking about. Because it sometimes is really more plastic exposure and exposure to a particular type of plastic that gives you these multiple different routes of exposure that are problematic.

SPEAKER_05 26:53

Well, and you mentioned earlier obesogens. Um describe those. I think in your book you mentioned that air pollution contains obesogens.

SPEAKER_01 27:04

There are polycyclic aromatic hydrocarbons uh in particular, uh, that are the, again, these are organic chemicals that may be impactful. Um, they're estrogenically active, androgenically antagonistic in some cases, and also affect receptors that are important for metabolism. It could also be that air pollution is and has some microplastic components that may be impactful. That's the other thing. The air pollution field is just catching up to plastic as a component. We used to think of air pollution as vehicle exhaust, right? Yeah. Just burning of fossil fuels. Now, by the way, plastics come from fossil fuels, so it still is a fossil fuel problem. It's different flavors of the same issue.

SPEAKER_05 27:55

That made me wonder. So, Vaseline, white petrolatum, was discovered around oil drills and things, and that's where we got. So is Vaseline okay?

SPEAKER_01 28:09

So I need to take three steps back and then we'll go three steps forward for a minute. So I want to be very clear that there are plastic chemicals that are used in a variety of dermally absorptive products. And as you know better than I, dermal absorption is a great rapid pathway and it skips, it's what it does what us healthcare people call skip the liver. So the liver doesn't, the liver, when you ingest something, it filters, it modifies what you're eating through bile and through other processes, because the gut sends blood volume with your food up to the liver to check it before it goes to the rest of the body. With skin, it absorbs, it goes right into the bloodstream, and it's biologically active. That's why there is a strong concern about some of these chemicals because they don't they can act right away when they're absorbed. Now, petrolotum's a tricky one because it's a polymer, a mixture of materials that we used to think was inert. Right.

SPEAKER_04 29:07

Right.

SPEAKER_01 29:08

And I suspect, I suspect most of it is. Let's be fair. The problem is everything can have a little bit of something in this case that could be problematic. And I'm not dismissing everything as bad. I'm not suggesting that. But in this case, something that we used to think was 99% pure. I'm sounding like an uh like a certain soap brand there.

SPEAKER_02 29:34

But yeah.

SPEAKER_01 29:35

But, you know, even though it's 99% pure, that 1% could be really problematic.

SPEAKER_05 29:40

Yeah. Right. Okay.

SPEAKER_01 29:41

And so in general, I tried, but I'm not insistent on if when I talk about plastic prevention, steering clear of like hydrolyted, petrolotomy, and fossil fuel-related compounds in dermal material. My attitude is if you've got a kid with eczema, for example, you want to make sure their skin is moisturized. Because there are consequences that are really adverse. If your only option to that is hydrolated petrolatum, I can give you a whole bunch of other things to do in the plastic space that don't have to break the bank. Like when I lead with plastic prevention, I don't lead with these germal compounds. Largely because the products that are being offered as naturally derived themselves, I'm still concerned, are not fully vetted for other reasons. Because we know natural compounds are not necessarily safe.

SPEAKER_05 30:40

Yes.

SPEAKER_01 30:41

So there's a complex situation here.

unknown 30:44

I guess.

SPEAKER_01 30:44

Welcome to my work. Yeah. I mean, and and it's interesting because some of the some of the I've I've interacted with some adult dermatologists over the years that are not so thoughtful as you in terms of framing the risks. They're sometimes like, well, it's all, you know, like just go ahead and do your thing. I'm admitting that we have, and this is largely due to the way the Food and Drug Administration has reviewed these materials historically over the years, which is problematic on many levels. So we we are behind. I'm not blaming the current administration. What I am saying is that we have problems historically in the way we've allowed chemicals to be used and products in this space.

SPEAKER_05 31:27

Well, and you mentioned in your book that basically the way things have functioned is that any chemical is considered safe until proven otherwise.

SPEAKER_01 31:37

Largely for, especially for food. Right. This is a huge problem. And actually for many toxic chemicals until the revised Toxic Substances Control Act. So the federal government is a weird thing with chemicals. They treat food and drug on one side, FDA, and so cosmetics and personal care products are also over there. And then Tosca is everything else furniture, electronics, per you know, other products for sale in general. They're over there. And you can have this situation where you can have two different policy spaces. They've both historically been frighteningly bad. That's why, you know, we've had a legacy of all these chemicals going in through diet as well as through products in people's lives. It got a little better on the EPA side during the, you know, at the tail end of the Obama administration because there was a law put into place. The late Senator Frank Lautenberg had led it for many years. It finally got through after his passing. And there were improvements. There were supposed to actually be some testing before products are put on to market. The problem is since then it's been a lot of rollback. And so we are almost, you know, we're not really progressing the way we should, particularly for all these legacy compounds. And still the new compounds are coming in with largely a rubber stamp. They don't need data proving safety. The upside is that Europe insists on that. So there are situations where products in Europe, cosmetics, 1300 chemicals are banned there. In US, it's roughly 11. Those numbers are maybe off by a few here and there. But that's generally the gist. For food chemicals, it's a similar situation because the Food and Drug Administration has this thing called the generally recognized as safe exemption that allows, with a pen, food to just have these chemicals that are, that's why the food colorings were in that were very unique in the United States compared to everywhere else in the world. Got a lot of attention in the eyes of the current administration. I think it's got a long way to go to undo some of the legacy damage that's been done by allowing many chemicals of concern into food as well.

SPEAKER_05 33:50

And so that's all kind of the Debbie Downer parts of this and transitioning to hope and actionable items. You know, I made some notes about some of the things you mentioned that are relatively easy changes. So choose organic foods when you can.

SPEAKER_03 34:11

Yes.

SPEAKER_05 34:12

Um try to choose personal care products that are labeled phthalate-free.

SPEAKER_03 34:17

Yes.

SPEAKER_05 34:18

Avoid obvious plastics, you know, plastic bottles use glass or stainless.

SPEAKER_03 34:23

Yes.

SPEAKER_05 34:24

Um pans. So we mentioned kind of the non-stick stuff. How do you avoid being exposed with your the stuff you cook in?

SPEAKER_01 34:34

So cast iron and stainless steel work quite well for most uses. Olive oil, last I checked, was good for you from a heart health perspective. So you have a situation where you have alternatives in hand. And okay, a cast iron steel can be a cast iron pan, rather, can be fairly heavy. But other than that, there it's just a matter of inconvenience. It's not a cost trade-off that we're invoking here.

SPEAKER_05 35:01

And then canned food and beverages, much to my dismay, not good at all. You mentioned as alternatives, Tetra packs and ole resin lined cans.

SPEAKER_01 35:14

Yeah. So I'm not saying they're perfect. We don't have full data on oleoresin safety as an alternative. And many companies don't disclose whether their the linings are ole resin or some other material or not. In fact, BPA free doesn't necessarily mean bisphenol free, by the way. There's 140 bisphenols out there, and bisphenol S is as estrogenic as toxic embryos and as persistent in the environment. But back to the point, tetrapax are still plastic, let's be clear. It's just that they tend to have a safer profile. To me, it's about not doing everything in one go. You can't let the perfect be the enemy of the good here. Right. Um and there are some families that aren't going to be able to do everything on that list. You, if you live in a food desert area, you may not have access to organic food options in the same way as others. But let's be clear it's the leafy greens and vegetables that have the highest pesticide residue of concern. And I'm saying big box stores coming into line with similar price points around their organic and conventional agriculture. So this notion that it is just bougie is is no longer valid. It's true, but you don't have to do everything. The avocado has a protective layer that can bounce off a lot of you're not eating that.

SPEAKER_04 36:37

Mm-hmm. Mm-hmm.

SPEAKER_05 36:38

Um, and then one of the other things that was heartbreaking to me as a clothes lover, fabrics.

SPEAKER_01 36:44

Yes. It's a tough thing for me as a runner, too, because there are, you know, a lot of running is plastic, you know, poly nylon. I can't say I'm perfect. I think the biggest thing is to use a natural-based layer, if you can, to protect yourself from the chemicals that might absorb through heat and sweat and other things into your skin much more readily as a result of using plastic clothing. We have a problem with fast fashion. There's no way, no hiding around it. That's accelerated this problem. So you can indirectly contribute by uh reusing. That's the other thing. Is like we need to use reuse and reduce much more than recycling. And at the same time, I'm not racing to tell everybody to to take out their wardrobe and completely replace it. That's what I'm doing.

SPEAKER_05 37:38

That's what I've been doing the past 24 hours, Leo.

SPEAKER_01 37:40

Well, you you're a special human. And and and and that's a good thing. And and that, you know, if you have it in your capacity and you want a wardrobe redo, go for it. Like, I'm not against it, but I don't like again, I go back to their safe and simple steps. And you know, in the clinical setting, we all know like one to three things. You gotta write them down and be very clear about your directions to patients if you want them to receive them and actually do it. And they're gonna that's gonna filter through their own cognitive biases and psychological perspectives about what you're advice. I I think changing wardrobes might be lower on my priority list than other things. But if you have something that is has high skin contact, um it's something to think about it as you're shopping. Right. Um and some of those products last longer. Yeah.

SPEAKER_05 38:42

Well, and for the listener, the kind of safer fabrics would be cotton, wool, linen, and silk.

SPEAKER_01 38:51

Yeah. Okay. Generally those are the big four.

SPEAKER_05 38:54

Okay. But yeah, I too, I was like, what on earth am I gonna wear to work out? That was my big that's my big question.

SPEAKER_01 39:00

It's a lot of companies now are developing wool that's a lot more breathable.

SPEAKER_00 39:05

Okay.

SPEAKER_01 39:06

That's probably one of the pathways, same for cotton. And so I think the tech, that's a little bit of a mental note that I gotta read the label a little more carefully because I'm wondering what's added on.

SPEAKER_03 39:15

Yeah.

SPEAKER_01 39:16

But the technology for natural fabrics is such that you're seeing development of things that allow you a lot more latitude to navigate. Like say in New York City, it's up to 90, the heat index is near 100. So I'm sure other parts of the country are worse. You got to hydrate, make sure you're replacing salt depending on how long you're working out, et cetera.

SPEAKER_05 39:38

Gotcha. And then um, children's toys, they're all plastic.

SPEAKER_01 39:44

What do we do? They didn't have to be, they didn't used to be.

SPEAKER_05 39:47

Yeah.

SPEAKER_01 39:48

If you can, you know, would other toys are important? I think this is aligned with the reduction of screen time as well.

SPEAKER_04 39:59

Yeah.

SPEAKER_01 40:00

Because uh there are a lot of devices in kids' lives that add exposures indirectly. For example, there are phosphate-based flame retardants that are many of our digital devices uh that then come in contact through dust and and hand to mouth, et cetera. I'm not saying eliminate those. I'm just saying it is a a challenging space. And I think that's the that the the point that I'm I need to make and just draw a line under is that these safe and simple steps we're talking about can probably bring your exposure down 30 to 50 percent. Yeah. Policies are gonna be the grand leveler beyond that. And if people start to ask questions about what's in their products, companies are not dumb. They're listening and they understand that the the power is in our hands, actually, financially. Yeah. The power of a wallet, the pocketbook, et cetera, is going to push market share in a direction where new companies are coming in to compete out the old companies that are doing the wrong thing, or the old companies are going, well, I better buy that new company because I gotta figure out how to do this right.

SPEAKER_05 41:08

Yeah. Yes. I have two other personal questions about my attempts to eliminate plastics from my life. Number one, the containers that prescription medicines come in.

SPEAKER_01 41:19

Oh boy, yeah. Um I uh again, I think we as a medical community, healthcare community, need to have a dialogue about how we reduce our own plastic footprint.

SPEAKER_03 41:35

Yeah.

SPEAKER_01 41:35

Um, we're seeing some progress on climate in healthcare institutions. I think that's getting a lot more attention. I think plastic is going to soon follow. We have a waste problem. We are a big driver of waste. You can imagine suture kits or IV setups and surgical procedures. There's lots of plastic that doesn't get used. And then what do you do? You incinerate it or you throw it away because guess what? It becomes suddenly unsterile. I'm not saying you don't need a backup for things. Right. And similarly, like what products we put in IV tubing, etc. Um, we need to think about these things carefully. The medical system is a source of phthalate and other exposures, for example.

SPEAKER_05 42:18

Well, and then I have a home and we have an insect person who comes to spray the yard and things. What questions should I be asking them about their products?

SPEAKER_01 42:29

Well, what's in their product? Give the, get the, get the get the label.

SPEAKER_05 42:32

Okay.

SPEAKER_01 42:33

And and, you know, uh, there's a lot of these days with AI, there's a lot of easier ways to scan and evaluate based on what are the ingredients and components. There's also this thing called integrated pest management where you don't just spray, you think. You think where is the pest getting in and why. So last I checked, crit critters like food. So keeping food away from critters is is a very straightforward way to reduce the attractiveness of an environment to critters.

SPEAKER_05 43:11

Gotcha.

SPEAKER_00 43:12

Okay.

SPEAKER_05 43:13

And then in our closing moments, you talked, you mentioned this a little bit earlier, and you mentioned in the book the power we have as consumers.

SPEAKER_02 43:23

Yeah.

SPEAKER_05 43:23

Even if we even if I don't have any power to enact legislation to help change these things, even though that's an uphill battle, we have the power of the money we spend and the products we choose to purchase. Let's close with your comments on that.

SPEAKER_01 43:41

Let's talk about BPA getting out of baby bottles and sippy cups. The FDA regulated that, not because of science, because moms cried out about the presence of an estrogenic chemical in the baby bottles and sippy cups that they were drinking at high volume. Suddenly, BPA got came out and levels have declined with time. We've seen some replacements come in, like bisphenol S, but that's a great example of the power of the public and the purchaser in driving the change we seek.

SPEAKER_05 44:14

I love that. I love that. Well, thank you so much. I feel so honored to have you on the pod. You are a big deal. Dr. T, you're a very big deal. I love all the work that you're doing, and I appreciate you the time you took to talk with us. Thank you so much.

SPEAKER_01 44:31

It's an honor and a joy. Thank you.

SPEAKER_05 44:33

Thank you. Thank you guys for tuning in to this episode of Skin Credible. Please keep liking, subscribing, watching, telling your friends, and get rid of the plastic stuff you can get rid of. Thank you guys.