Cough Syrups and Kids: They Aren't Just Small Adults

I was reading an article on the New York Times website this afternoon. The essence of the article, 'Parents Warned Cough Syrups Imperil Infants,' discusses a Food and Drug Administration advisory issued yesterday. The FDA's website, says that in October the Nonprescription Drugs Advisory Committee will discuss the safety and effectiveness of cough and cold products for children. In particular, it says, "Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age." (For parents and grandparents, it's definitely worth going to this site yourself, as FDA has an important statement on, "What should parents know about using cough and cold products in children?)

Back to the NYT article. The writer, Gardiner Harris, says,

"[T]he standards for drug approvals have changed sharply in the decades since many of the medicines in children’s cough and cold products were approved. If those drugs were currently up for review, they would not be approved for use in children because the manufacturers never tested them thoroughly in children.

Instead, the drugs’ makers performed studies in adults and then simply assumed that they would work in children. Such assumptions, once common, are no longer acceptable. Indeed, a growing number of studies in children suggest that cough and cold medicines work no better than placebos."

Harris' statement highlights something I've come to understand from my research into environmental health: "children are not just small adults,", a statement that researchers and physicians at the forefront of this topic make quite frequently. A growing number of their studies show that all kinds of exposures that would be inconsequential for adults have profoundly negative impacts on kids. Because they are going through frenetic development their bodies react differently to chemical exposures than an adult's would to the same exposure.

Children are generally the most vulnerable to exposures, so we need risk assessments that focus on them.

And More Toy Recalls for Mattel

Well, this morning's news is that Mattel is again recalling millions of toys for lead and magnets. I couldn't quite understand the magnet part of the story, but according to a piece in the Wall Street Journal, "Magnet issues surfaced recently in another toy recall. In 2006, the CPSC issued a similar recall for 3.8 million "Magnetix" sets, a toy produced by Rose Art Industries Inc. of Livingston, N.J. The sets consisted of tiny magnets that, if swallowed by an infant, bonded together in the stomach and caused fatal intestinal perforation in at least one instance. The CPSC documented 34 incidents involving the magnets, including one death and four serious injuries. A 20-month-old boy died after he swallowed pieces that twisted his small intestine and created a blockage."

One of the biggest problems with our global economy seems to be that while it has kept prices down (as Ms. Burnett said on Hardball last week) there have been other hidden costs. At the same time as we were off-shoring the production of almost everything we buy in order to save that few pennies at Wal-Mart, there was general gutting the regulatory agencies that protect us. For example, the Bureau of Consumer Protection, which regulates incoming products such as toys, had actual 2002 revenue of $83 million dollars, compared to actual funding of $47 million in 2005 (the last year for which actual figures are available).

Regulators are there to protect us. In an odd fashion, by doing their jobs, they also protected the regulated: Mattel was expecting a $30 million pre-tax income cut this quarter as a result of the earlier recalls. These subsequent recalls are going to add to the sting.

It's a Funny World, Why Am I Not Laughing

In the last few months we have heard that Chinese products are:

Making our dogs and cats sick. One story I read estimated that 39,000 pets were sickened and several thousand died after eating pet foods prepared with melamine-contaminated wheat gluten. Melamine is a by-product of coal production, and used in plastics as a fire retardant. It is also a member of the cyanide family--which explains its toxicity.

Contaminating toothpaste and cough syrups. Though no one died in the US, there were confirmed deaths in Panama from people using the diethylene glycol contaminated products (some of which did make their way into this country). Diethylene glycol is an industrial plasticizer, and a coolant/antifreeze. It's toxic attributes? They are many, and not for the faint hearted to consider: Nausea and vomiting, headache, anuria, narcosis, cyanosis, tachypnea, tachycardia, hypotension, stupor, prostration, hypoglycemia and unconsciousness, convulsions and death. It can also cause degenerative changes in the kidneys and liver, central nervous system depression, nephrotoxicity, abdominal pain, weakness, respiratory failure, cardiovascular collapse, and acute renal failure and brain damage. Ah, yes, and let us not neglect to mention that somnolence has been reported in children. Personally I don't even know what some of these conditions, listed on the Material Safty Data Sheet for diethylene glycol,are, but I know I don't want to experience them.

Causing a recall of millions of toys. The toys were painted with lead, a known neurotoxicant that has been banned here since 1978 for use in any paints headed toward the consumer marketplace. According to the National Institutes of Health, there are:

1. "No effective clinical interventions" to lower the levels of lead in children's blood once it is there
2. Children are "at risk of adverse developmental effects" at concentration levels of less than 10 µg/dL
3. Children "cannot be accurately classified as having blood lead levels above or below 10 µg/dL because of the inaccuracy inherent in laboratory testing"
4. And finally, "there is no evidence of a threshold below which adverse effects are not experienced"[emphasis added].

Wow, that is all scary. So what is the funny part of the story? Last Friday, on the MSNBC program, HARDBALL, Erin Burnett (the anchor of the CNBC program, STREET SIGNS) said, "[I]f China were to revalue it’s currency or China is to start making say, toys that don’t have lead in them or food that isn’t poisonous, their costs of production are going to go up and that means prices at Wal-Mart here in the United States are going to go up too. So, I would say China is our greatest friend right now, they’re keeping prices low and they’re keeping the prices for mortgages low, too.”

OK, the implication here is that you and I and everyone else in the United States would rather have people in other parts of the world dying from handling these chemicals in the production of our goods, and have our pets die, and have our children and grandchildren suffer the IQ reduction lead is best known for, just so that we can buy pet food or toys for a few pennies less? Huh? I just don't get it. I will say right here, charge me a little more.

A reader gave me the head's up on this story by email. Thanks, Lynn.