Painkillers in Pregnancy Linked to Male Infertility
November 20, 2010

Common over-the-counter painkillers taken during pregnancy may be to blame for a global rise in male infertility.

Even acetaminophen (Tylenol) may put a developing boy's future reproductive health at risk, suggest findings from a study of some 2,300 Danish and Finnish women by Henrik Leffers, MD, PhD, of Rigshospitalet, Copenhagen, Denmark, and colleagues.

The researchers suggest that acetaminophen, ibuprofen, aspirin, and other NSAID painkillers act as hormonal "endocrine disruptors" and interfere with normal male sexual development. Chemicals in the environment, such as phthalates, act as endocrine disruptors and have in the past been blamed for harmful effects on human sexual development.

"A single [acetaminophen] tablet (500 milligrams) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine disruptors during the whole pregnancy," Leffers says in a news release.

Despite the strong language, the researchers note that their findings are based on a small number of boys whose testicles were late to descend -- a risk factor for poor future semen quality. While they note that more study is needed, they stress the urgency of such studies.

"Although we should be cautious about any over-extrapolation or overstatement ... the use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population," Leffers says.

The Leffers study is based on questionnaires from the mothers of 834 Danish boys and 1,463 Finnish boys, and on interviews with the mothers of 491Danish boys (285 of whom also were among those who filled out the questionnaires). All of the boys were examined for signs of undescended testicles (congenital cryptorchidism).

In the end, the researchers identified only 42 boys with signs of undescended testicles. Over 64% of these boys were born to mothers who took painkillers during pregnancy.

Women who took more than one kind of mild painkiller were more than seven times more likely to have a boy with signs of undescended testicles.

It appeared that painkillers taken during the second trimester of pregnancy were particularly risky -- increasing risk of congenital cryptorchidism by 2.3-fold.

Nevertheless, these risks are based on very small numbers of affected boys. The vast majority of boys born to women who reported painkiller use did not have any sign of undescended testicles.

Leffers and colleagues will continue to follow up on the boys through sexual maturity.

Leffers' team also performed rat studies showing that acetaminophen and NSAID painkillers can affect sexual maturation.

The Leffers study appears in the advance online edition of the journal Human Reproduction.

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Looking Older Than Actual Age Not Necessarily Sign of Poor Health
November 20, 2010

Looking older than your age may be upsetting, but it isn't necessarily a sign you're in bad health, researchers say.

A study out of Canada has found that people who look less than 10 years older than they really are do not necessarily have other conditions causing the discrepancy, while those who look at least a decade older than they are probably are in severely poor mental or physical health.

"The impression that someone looks older than their actual age is not a reliable way of determining if someone is in poor health unless it's a fairly extreme discrepancy -- 10 or more years older," lead author Stephen Hwang told AOL Health.

The impetus for the project was the fact that many U.S. and Canadian medical students are taught to use how old a person looks as a measure of whether they're healthy, according to Hwang.

"Every single physician has been taught to do this. ... It is subjective," said Hwang, a specialist in internal medicine at St. Michael's Hospital at the University of Toronto. "One of the things that our study did show was that there's not a lot of agreement among physicians, which is another reason to question the practice."

Hwang and his team looked at 126 patients ages 30 to 70 who were visiting a doctor's office, asking them to fill out a questionnaire about whether or not they were in bad physical or mental health. Each person was photographed, and their pictures were shown to 58 doctors who were asked to rate how old they were and told their actual ages.

The findings showed that 99 percent of those who looked 10 or more years older than they were were in severely poor mental or physical health. But assessing that a person looked up to five years older than their actual age had little effect in determining how sick or well that patient was.

"Few people are aware that when physicians describe their patients to other physicians, they often include an assessment of whether the patient looks older than his or her actual age," Hwang said in a statement.

Hwang said the findings debunk a tool many doctors typically find valuable in outlining a patient's overall health.

"Physicians have simply assumed that their quick assessment of how old a person looks has diagnostic value," he said. "We were really surprised to find that people have to look a decade older than their actual age before it's a reliable sign that they're in poor health. It was also very interesting to discover that many people who look their age are in poor health. Doctors need to remember that even if patients look their age, we shouldn't assume that their health is fine."

The observational study, published in the Journal of General Internal Medicine, suggests that a person who looks younger isn't necessarily healthier, nor is a person who looks older necessarily in bad shape -- so it would benefit doctors to dig a bit deeper when evaluating their patients.

"It is one of those things that we're taught to do, but no one ever sits down and says this is why you should do it," Hwang told AOL Health.

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Among Cell-Phone Junkies, Rash on the Rise
November 20, 2010

If you're an incessant cell phone user and a mysterious rash appears along your jaw, cheek or ear, chances are you're allergic to nickel, a metal commonly used in cell phones.

While allergists have long been familiar with nickel allergy, "cell phone rash" is just starting to show up on their radar screen, said Dr. Luz Fonacier, head of allergy and immunology at Winthrop University Hospital in Mineola, N.Y.

"Increased use of cell phones with unlimited usage plans has led to prolonged exposure to the nickel in phones," said Fonacier, who is scheduled to discuss the condition in a larger presentation on skin allergies Nov. 14 at the American College of Allergy, Asthma and Immunology annual meeting in Phoenix.

Symptoms of cell phone allergy include a red, bumpy, itchy rash in areas where the nickel-containing parts of a cell phone touch the face. It can even affect fingertips of those who text continuously on buttons containing nickel. In severe cases, blisters and itchy sores can develop.

Fonacier said she sees many patients who are allergic to nickel and don't know it. "They come in with no idea of what is causing their allergic reaction," said Fonacier, also a professor of clinical medicine at the State University of New York at Stony Brook. Sometimes, she traces her patients' symptoms to their cell phones.

In 2000, a researcher in Italy documented the first case of cell phone rash, prompting other research on the condition. In a 2008 study published in the Canadian Medical Association Journal, U.S. researchers tested for nickel in 22 handsets from eight manufacturers; 10 contained the metal. The parts with the most nickel were the menu buttons, decorative logos on the headsets and the metal frames around the liquid crystal display (LCD) screens.

Cell phone rash is still not well known, said allergist Dr. Stanley M. Fineman, a clinical associate professor at the Emory University School of Medicine in Atlanta. While he's treated more cases of nickel allergy caused by piercings than by cell phones, "it's good for allergists and dermatologists to have cell phone contact dermatitis on their radar screens," he said.

Nickel allergy affects an estimated 17 percent of women and 3 percent of men. Women typically develop cell phone rash more often because they are more likely to have been sensitized to nickel after ear piercing, or had an allergic reaction to nickel-containing jewelry. If you get rashes from costume jewelry or the metal button on your jeans, you're probably nickel-sensitive, said Fonacier.

To treat cell phone rash, you can apply a mild over-the-counter corticosteroid, she said. (Ask your doctor about how long you can safely use it.) Then, keep the nickel-bearing parts of your phone off your face.

"Buy a phone cover, opt for a hands-free device, use the speaker phone or switch to a phone that doesn't contain nickel on surfaces that touch your skin," she said. Consult an allergist if the rash lingers.

If you know you're nickel-allergic, go online and order a nickel spot-test kit before you buy a new phone, Fonacier suggested. "Put a drop of the liquid [dimethylglyoxime] on a cotton swab and dab the swab on those parts of the phone where nickel is typically found," she said. "If the applicator turns pink, the phone contains a good amount of nickel."

Some researchers believe the United States should regulate nickel more stringently, as some European countries do, said Fonacier. Since 1994, the EU Nickel Directive has limited nickel release from consumer products that come into direct, prolonged contact with skin. Since then, the prevalence of nickel sensitivity has gone down in Germany and Denmark, according to studies published by researchers in those countries.

The best remedy for cell phone dermatitis is not to get it in the first place, said Fonacier. "Just as you cannot tell a woman not to wear cosmetics because she is allergic to fragrance, you cannot tell people not to use cell phones because they are allergic to nickel. There would be no compliance," she said. "So prevention is the key."

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Secondhand Smoke May Hurt Your Hearing
November 20, 2010

People who don't use cigarettes but who regularly breathe in other people's tobacco smoke are at increased risk of some degree of hearing loss, a new study finds.

This had been surmised because previous research has indicated that smokers are at much greater risk of some degree of hearing loss.

Researchers examined data on 3,307 adults aged 20-69 who were classified as passive smokers based on blood levels of the chemical cotinine, a breakdown product of nicotine.

Smoking Can Increase Risk of Hearing Loss in Nonsmokers

In the study, 14% of former smokers who had been exposed to tobacco smoke by others were more likely to have impaired hearing in low to mid frequencies.

The study also found that more than 46% of these former smokers who had been exposed to secondhand smoke had high-frequency hearing loss, which can make speech sound muffled. Researchers say although the risk of hearing loss was not as strong among people who had never smoked, nearly one in 10 people in that group, or 8.6%, had low- to mid-frequency hearing loss, and 26% had high-frequency hearing loss.

The findings suggest that continued exposure to smoke by former smokers could continue the progression of high-frequency hearing loss that started when the former smokers were still smoking.

Hearing Loss May Be Another Consequence of Exposure to Tobacco Smoke

"Further research is required to determine whether [passive smoking] potentiates the effect of noise exposure and aging on hearing," the researchers say. "If this finding is independently confirmed, then hearing loss can be added to the growing list of health consequences associated with exposure to secondhand tobacco smoke."

The data examined came from the National Health and Nutrition Examination Survey, a yearly household survey combined with a physical examination including hearing testing of a representative sample of the U.S. population. "Although previous studies have reported the link between active smoking and increased risk of hearing loss, this study found significantly increased adjusted odds for hearing loss by former smokers for both low-mid and high-frequency hearing loss," the authors write. "Furthermore, never smokers exposed to SMS [secondhand smoke] had increased risk of low-frequency hearing loss."

The study is published in the bimonthly journal Tobacco Control, owned by the BMJ Group.

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