The blowing of the wind provides some of life’s pleasures. Whether it is a breeze on a sunny day or an exciting gale before a storm, we enjoy the stimulation and aliveness of the various winds that clear the air and lift our senses in different ways from day to day. But winds can also carry pesticides and that is a different matter, the very embodiment of the expression “an ill wind that blows no good.” It is hard to imagine that the air we breathe can be a risk to our health. It is unreal to think that a drive in the countryside can provoke nervousness and depression from pesticides carried on the wind. I have had reports from patients, especially those who were unusually sensitive to organophosphate pesticides, such as malathion, diazinon, chlorpyrifos and dursban, to name a few. Measurement of plasma cholinesterase, which is destroyed by these chemicals, provides convincing evidence of low cholinesterase. Pesticides bring it down, too low to control acetylcholine neurotransmitter activity. Out of control acetylcholine overstimulates synapses and thus causes nervousness and a myriad of physical symptoms: tremor, asthma, stomach upset, frequent urination, headache, insomnia, nightmares, temper outbursts—and eventual memory loss.

Pesticides are often sprayed from airplanes during growing season in agricultural areas, including the Napa Valley and, of course, the San Joaquin and Imperial Valley areas. But molecules fly through the air and into the waters right close to home for city folks also. A very enlightening report was published in the San Francisco Examiner on March 29, 1998. The California Department of Pesticide Regulation released results of a survey of diazinon in 20 creeks in the Bay Area and 14 more in Mendocino area. At concentrations of only 40 parts per trillion (about 1 trillionth of a gram per drop of water) fish and game begin to get sick. At 80 parts per trillion toxic effects are full blown. All readings were over 40 parts per trillion. In the Bay area they ran as high as 590 at various times. Rainfall flushes pesticide residues into streams. Thus in Mendocino after a rainfall, diazinon levels ranged from 400 to 5500 parts per trillion, ten times more and certainly a hazard to life in the ecosystem. In particular, pesticide run-off kills organisms in the streams, thus interrupting the life cycle of fish. Aside from the direct toxic effects, the indirect effect is under-nutrition, growth inhibition, and disease. Less than a tablespoon of diazinon in a day’s creek flow is sufficient to cause a safety hazard!

The key point in the article is summarized in a quote from the manager of Palo Alto’s water pollution prevention program: “We’re not worried about what’s coming from farmers in the fields. It’s coming from houses.” However in the Central Valley the run off from fields and orchards into the streams and rivers is also carried into ground fog and eventually into the clouds. Rain samples over several hundred miles from Red Bluff to Patterson had diazinon at levels 100 times higher than the water quality criteria to protect fish. Bad as that is, it comes nowhere near the amount contained in rainfall runoff in Castro Valley, where 1 million parts per trillion was measured in storm drains from housing developments. These organophosphates are available over the counter at hardware stores everywhere. Ultimately these chemicals make their way into the estuary, the confluence of waters where rivers meet the sea in San Francisco Bay. The dwindling numbers of salmon, stripers and sturgeon are the victims at the end of the line.

But there are other poisons that can fly with the air currents around our homes and buildings and into our open windows. Years ago I examined a middle-aged man, a banker, who suffered headache and eventual neuropathy, paralysis of long nerves. After careful questioning it became clear that he spent a lot of time in his study at his home in Tucson, Arizona. Summer temperatures over 100º F. were an everyday occurrence as his window opened under the eaves. Convection currents moved into his cool study, expanding from adjacent sun-heated areas, which emitted fumes, probably from insulating materials or duct tape. His symptoms matched most closely with a syndrome associated with n-hexane, which is found in glue and in duct tape. A form of this compound, phenyl-cyclohexane, has been linked to similar symptoms from the backing of synthetic carpets. If it smells like glue it is not good for you. The problem with n-hexane is that it does not have a strong odor and it damages the nerve cells rather than irritating surface tissues of eye and lung. In other words, it can sneak up on the victim and cause damage before anyone suspects the source of the problem.

I ran into a sneaky problem like that recently in a young man who already had cerebral palsy at birth, which left him with unsteady gait, difficulty lifting his feet, stiffness in his right side, slowed and crude movements, and slurred speech. He was unable to speak until age 5 and has always been easily confused. Nevertheless, as an adult he has struggled to live independently and he works in a supervised shop. In the past two years he had anger outbursts and ups and downs of energy and mood. He was increasingly irritable, confused, and with spells in which eye movements were abnormal and automatic—seizure-like. Conscientious attention to nutrient supplements and lowered carbohydrate intake led to improvement, but less than expected.

Then came a breakthrough: a urine mineral panel showed thallium, 5 mcg per ml (5 ppm). I couldn’t believe my eyes, for he did not exhibit hair loss and chronic thallium overdose is regularly associated with alopecia totalis, loss of hair everywhere. It is not a minor symptom because nerve damage is equally severe and this young man was already injured in that department. I treated him with acetyl-cysteine, mineral supplements to displace thallium, antioxidants to protect nerve cells, and omega 3 fatty acids to support the repair of damaged nerve cell membranes. But the most important strategy in dealing with poisons is to identify and terminate the exposure. This can be a real detective problem.

I ordered repeat tests of thallium, including blood and hair samples. The urine and blood were high in thallium but his hair was not. That means he was exposed to thallium in the immediate time period of the test but not at levels sufficient under chronic conditions to show up in his hair. It must be an intermittent and fairly low level exposure. Where was it coming from? He went for a month to live with a relative in Florida. On return thallium was no longer detected in his urine. I guessed that it might be from rat poison in the home of a relative he stayed with regularly. A search was conducted; no rat poison was found. A similar search at his board and care home also failed to identify thallium. However some months later I learned that another resident there did show a similar thallium test result.

I now went over a map of the board and care home, questioning the possible use of chemicals and pesticides, especially in kitchen and bathrooms. A search of his bathroom and bedroom did not turn up rat poison. We drew a map of the house and plotted the direction of the prevailing winds. Thallium in dirt or dust on his side of the building could blow in through his window. The other victim’s room was next door to his—same side of the building. Years earlier, when the owner bought the house, rat poison was placed around the perimeter in order to get rid of rodents. The rodents ceased to be a problem and where there had been open areas now shrubbery had grown, so no one remembered the exterminator’s earlier mission. The health department was notified and Stan moved to a new residence. When he moved out thallium disappeared from his blood and urine and his seizures gradually stopped. Pigmentation of hair follicles in his beard also faded away within a few months.

I recently was consulted by a young woman who had a relapse of a Purpura, a disease of the blood platelets, which can prove fatal due to uncontrollable bleeding. In her case the platelet count was so low that she required transfusions in order to survive. Careful questioning revealed that she had been exposed to fumes from flea bombs on four occasions in the weeks before she first became ill. Despite the fact that the family left the home for several hours each time, there was enough residual chemical residue to sensitize her cells. It is possible that she was sensitized also by dint of a virus “flu” during one of those exposures, and the combination of viral plus chemical exposure is known to vastly increase the risk of complications. I have seen an almost identical scenario with the same outcome just a few years ago in another patient. He was not so lucky: transfusions and cortisone treatment failed to halt the relentless process of cell destruction and he died after a lengthy and courageous struggle.

Experts tell us that only one in a hundred toxic reactions in agriculture is actually reported. I have considerable respect for the power of pesticides because some of my patients have strayed into the path of ill winds. I have seen a number of cases of such “pesticide neurosis,” usually in people who also have a lower than normal cholinesterase in their blood. The cholinesterase enzyme is a key to calm nerves and relaxed muscles; and when it fails to inactivate the neurotransmitter, acetylcholine, muscle tension, anger outbursts, and a variety of autonomic nervous symptoms all act up: wheezing, hyperacidity, irritable bowel, urinary urgency and difficulty in controlling handwriting. Of course the expression of the syndrome is quite individual but the main thing is that the diagnosis is usually missed in an urban practice. It is not something that we doctors are focused on.

One of my patients lived in a college dormitory uphill from a strawberry patch in San Luis Obispo. We tend to think of pesticide spray as confined to the fields; but when the winds blow, poisons can freely travel. Donald was a college junior in computer science and was doing quite well until May 1997 when he suddenly became too weak to walk. He had to stay in bed for a week and then was so weak and shaky that he required assistance in order to walk for the next two weeks. His local doctor was baffled and offered no treatment. Acupuncture helped a little but he was too weak and shaky to attend class and he was about to lose out on the entire year

This was a puzzling case. He had enjoyed good health except for an adverse reaction to pertussis vaccine given at age 12 months, which caused strabismus and required surgery for crossed-eyes at age 8. But neurological examination was normal now, and so was laboratory testing. The total picture fit a diagnosis of a neuro-toxic event occurring a month before consulting me. He had a high ALT test (a sign of liver irritation), a low carotene, and low DHA (an essential fatty substance) possibly oxidized by the presumed toxic hit. Cholinesterase was normal however, so it was not likely a nerve gas type of exposure.

About that time I heard about reports of methyl bromide use in California. That made a lot of sense so I called Don and checked out the possibilities. It turned out that his dormitory room was but a 5-minute walk from a strawberry field, which was repeatedly treated with methyl bromide. His dorm was downwind and uphill. The air currents would catch under the eaves of the roof, carrying the toxic fumes into his place of study—an ill wind.

I called his local physician, to remind him to call the local health authorities to report this as a pesticide exposure. I also treated with milk thistle and antioxidants, i.e. acetyl cysteine, lipoic acid, and taurine. He regained his strength, lost his tremor, and was well enough to return to class for the Fall semester.

Is this an isolated case? Testing of air samples near Watsonville last year found methyl bromide at levels 10 times higher than California safety limits. This startling news was released in February 1997 by the Environmental Working Group, a Washington DC organization, which supports banning methyl bromide after detecting dangerous levels of 2115 parts per billion the next day after a strawberry field adjacent to an elementary school was treated. The name of this particular school is Salsipuedes, Spanish for: “get out if you can.” Not a bad idea considering that the safety limit of methyl bromide is set at 210 parts per billion, far below the 2115 parts per billion found around the school. In case you haven’t heard: methyl bromide is proven to cause nerve damage and birth defects at low concentrations. It enters the human body by inhalation and direct skin contact.

Testing by the Environmental Working Group (home office Washington DC) revealed systematic abuses on the part of the California Department of Pesticide Regulation. In particular, the report was critical of the agency for failing to insist on buffer zones to protect the public, and for failure to monitor at all. The Group report recommends the following remedial actions:

1. Establish buffer zone models.

2. Publish health risk assessments about the true dangers of methyl bromide.

3. Revise the 24-hour safety standard for exposure

4. Increase the permit fees to help pay for monitoring and research costs.

5. Increase the monitoring of air, soil, and water contamination.

6. Require public notice of applications near homes, schools, and workplaces.

Agricultural workers and their families are at greater risk than the rest of us and from experience they share a real fear of the consequences of exposure to the chemical soup that pervades their environment. A school in Watsonville actually protested fumigation of a strawberry field on an adjoining property. They must know something that the University faculty in San Luis Obispo haven’t found out yet. Almost half of the school’s students and a number of teachers staged a “sick-out,” but state officials insisted that the chemicals are in concentrations too small to cause illness. Lest you fail to appreciate the magnitude of the problem, consider the fact that 75 million pounds of methyl bromide were applied to agricultural fields in California from 1993 to 1997. During that time the state did not monitor the air adjacent to fumigated fields anywhere, not even in schoolyards and backyards.

However California EPA scientists did study the Lompoc Valley because of repeated complaints that the residents there suffer excessively from bronchitis, asthma, lung cancer and infant lung disease, more than other regions. Dr. Robert Holtzer, a physician and biologist formerly with California EPA, retired from Health hazard Assessment because he so strongly opposed the departmental policy of discounting the evidence of lung cancer and respiratory illness. He returned as consultant to a study, which was completed in draft by November 1997. This study confirmed an 85 percent excess rate of bronchitis, and up to 5 times more sinusitis than elsewhere in California. Even more frightening: the rate of lung cancer is almost 40 percent higher than that of the surrounding three counties, and infants in Lompoc have a two-fold greater rate of respiratory disease requiring hospitalization.

The manufacturers of 2,4-D, a form of dioxin, spent over 30 million dollars on studies to influence EPA. Industry is fighting for the continued use of organophosphates, particularly. chlorpyrifos, diazinon, and methyl bromide. All of these nerve poisons need to be tightly regulated in order to protect the agricultural workers, pesticide operators, and the public. But methyl bromide has just been extended for four more years. Bad as it is down on the farm there may be more danger lurking in your own home, lawn and shrubbery. The National coalition Against Misuse of Pesticides (NCAMP) found that of the 36 most commonly used lawn pesticides, 13 cause cancer, 14 cause birth defects, 15 damage kidneys, and 21 damage the brain and nerves.

From 1988 to 1995 more than 65 bills were introduced in Congress to better control these pesticides. None of them passed. Could it be that the millions of dollars paid to political campaigns in the past 45 years has affected our legislators? For example in the ten years 1987 to 1996, Sen. Pat Roberts of Kansas got $78,268 from pesticide manufacturers. It doesn’t have to go to the entire Congress—just those in the agriculture and drug regulatory committees. Money well spent if you are in the business. It pays to be aware of these hazards. Then you can at least make a sensible effort to protect yourself.

NOTE: (from an article in Alt Med, #24).

For example a link between spontaneous abortion, miscarriage, and tap water was reported in the journal, Epidemeology in March 1998. Over 5000 women from 3 California counties were interviewed regarding water intake during their first three months of pregnancy. Women who drank five or more cups of chlorinated tap water with 75 parts per million trihalomethanes had an almost double risk of miscarriage compared to those who drank less water or water with lower levels of the chlorine by-products. The actual rates of miscarriage were 15.7 vs 9.5 percent. This strikes me personally because the study included San Francisco and the report was published in the Water Quality Report issued by the San Francisco Public Utilities Commission and the Department of Public Health in April 1998. There I learned, to my surprise, that San Francisco water has averaged 76 ppb THM over the past ten years.

Chlorine is added to our water as a disinfectant, to kill germs. However it is chemically reactive and produces toxic compounds upon contact with earth residues in the water. The specific compounds are chloroform, bromoform, bromodichloromethane (BDCM) and chlorodibromomethane. While all of these are toxic and carcinogenic, only the BCDM has been identified as a cause of miscarriage, and this only at concentrations above 18 ppb. San Francisco water averages only 8 ppb and yet the rate of miscarriage is still doubled for those who drink 5 glasses of water or more per day if the total trihalomethanes exceed 75 ppb. Could there be other contaminants? Is fluoride contributory in humans as it is in cattle?

These points were not considered in the publications, but as a result of this research, the water departments are switching from chlorination to chloramine, expecting to cut the levels of THM in half. However, chloramines cause cancer all by themselves; so this does not solve the problem. Ultimately, point of service filtration is likely to be the answer. In fact the San Francisco report actually advises either bottled water or home treatment now. They also advise us to boil our water for one minute! So the experts really do take this seriously

On the other hand the reports also say that showers and swimming do not pose health risks. I disagree. Their research data measured only a catastrophic event, miscarriage. How about subtle effects, especially the local effects on skin? It would be logical to expect increased chemical reactivity and irritation, especially under a hot shower, as this must cause depletion of unsaturated fatty acid reserves. Skin might react with thickening (keratosis) and be more susceptible to fungal infections. Even if the effect were only cosmetic, it is not fair to the uneducated consumers to say that chemically treated water is without adverse effects, especially when the measured end-point is death. Think of it: 5 glasses of water containing 18 ppb of BDCM, only 23 millionths of a gram per day, doubled the rate of miscarriages. How about the effects that were not measured?

Santa Clara County is abandoning chlorination in favor of ozone gas treatment. There is a paradox however: Mountain View voters approved fluoridation of their water in November 1998. Will the effects of fluorine, which is chemically similar to chlorine, prove any better—or only different? One might even ask if there could be an adverse interaction between ozone and fluoride, both chemically reactive substances.

A 1993 study conducted at Medical College of Wisconsin reported that chlorine by-products caused a 15 percent increase in over-all cancer rate. Risk was greater for rectal cancer (38 percent increase) and bladder cancer (21 percent increase). A 1997 study, including over 28,000 women, found a 25 percent increase in cancer rate, with colon cancer up 68 percent (compared to areas not chlorinated??

Methyl bromide was scheduled to be withdrawn in 1999; however the Clinton administration extended its life for 4 more years. It is an ill wind that blows no good. This one does not blow favorably on the unsuspecting victims to be.

Lompoc California has higher rates of asthma, bronchitis and lung cancer than neighboring areas. Air tests failed to account for this: les than 25 percent of air samples taken by the Department of pesticide Regulation contained pesticides and these were below dangerous levels. Office of Environmental Health hazard Assessment found 69 percent more bronchitis, 58 percent more asthma, and 37 percent more lung cancer in Lompoc. A haze, fondly called: "The Lompoc Crud" lingers over this town in Santa Barbara County. Farmers are relieved that the 3 chemicals found in the preliminary air samples may have originated from fumigators or home backyard sprayers. Methyl bromide has not been included in these samples.

A UC Berkeley researcher, Dr. Norman Terry, published a study showing off his demonstration project in which a 90-acre marsh at Chevron's refinery in Richmond, CA absorbed 89 percent of selenium from millions of gallons of wastewater. Joe Skorupa, a US Fish and Wildlife biologist called Dr. Terry's claims "nothing more than self-promoting hyperbole."

Skorupa points to the fact that the marsh was too toxic for wildlife 3 years ago. Malformed duck embryos were found and they were traced to high selenium. In order to discourage waterfowl, the water level at the marsh has been raised and extra vegetation densely planted so the birds cannot nest there. Other strategies, such as mowing the vegetation, removing it and allowing re-growth, have yet to be assessed. Terry also launched a study with Tulare Lake Drainage District to test the method. Greg Karras, with Communities for a Better Environment, said: "We have the technology to remove selenium. It'd be better not to produce the pollution in the first place."

Nicotine is a natural pesticide. It is also an inhibitor of MAO B. Research by Dr. Joanna S. Fowler at Brookhaven National Laboratory found a 40 percent reduction in activity in smokers compared to those who no longer or never smoked. This degree of blockade compares with L-deprenyl, a drug used to relieve parkinsonism and depression. As a result of low MAO activity, catecholamines, particularly dopamine, are free to increase to higher than normal levels. Dopa and dopamine have been used to treat Parkinsonism; and nicotine must have a similar effect by interfering with MAO activity. This may explain why Parkinsonism is less common in smokers.

©2007 Richard A. Kunin, M.D.

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