The Washington Post - USA (2022-05-24)

TUESDAY, MAY 24 , 2022. THE WASHINGTON POST EZ EE E3

HEALTH NEWS

BY NANCY LAPID

A team of Australian research-
ers have identified a biochemical
marker in the blood that could
help identify newborn babies at
risk for sudden infant death syn-
drome (SIDS), a breakthrough
that they said creates an avenue to
future tragedy-preventing inter-
ventions.
The researchers, in a study pub-
lished in the Lancet’s eBio Medi-
cine, found that babies w ho died of
SIDS had lower levels of an en-
zyme called butyrylcholinesterase
(BChE) shortly after birth. BChE
plays a major role in the brain’s
arousal pathway, and low levels
would reduce a sleeping infant’s
ability to wake up or respond to its
environment.
This is the first evidence “that
babies who succumb to SIDS are
different from birth,” study leader
Carmel Harrington of the Chil-
dren’s Hospital at Westmead in
Australia told Reuters by email.
“An apparently healthy baby go-
ing to sleep and not waking up is
every parent’s nightmare,” she
said.
The enzyme abnormality is “a
measurable, specific vulnerabili-
ty” to SIDS that had not been
previously recognized, research-
ers said in the published study.
The Sydney Children’s Hospital
Network in Australia called the
discovery “a world-first break-
through.”
But researchers are “only half-
way” to the goal of fully under-
standing SIDS and being able to
prevent it, other experts said last
week in the New England Journal
of Medicine.
They warn that preventive
practices such as having babies
sleep on their backs and keeping

cribs bare must continue. Richard Goldstein of Children’s Hospital in Boston, lead author of the NEJM editorial, said the new study is good, but “it should not change that behavior.” Using dried blood spots taken at birth as part of a newborn screening program, the researchers compared BChE levels in 26 babies who later died of SIDS, 41 infants who died of other causes and 655 surviving infants. That levels of the enzyme were on average significantly lower in the infants who died of SIDS sug- gest the SIDS babies were inher- ently vulnerable to dysfunction of the autonomic nervous system, which controls unconscious and involuntary functions in the body, the researchers said. A failure to wake up when ap- propriate “has long been consid- ered a key component of an infant’s vulnerability” to SIDS, her team said, adding that further research “needs to be undertaken with urgency” to determine whether routine measurement of BChE could help prevent future SIDS deaths. Even if BChE is confirmed to play a role, “it’s not going to be the whole solution,” Goldstein said. Research has implicated other possible biologic contributors such as genetics, maternal smok- ing and abnormal levels of the nervous system signaling chemical serotonin. Harrington, who lost her own child to SIDS 29 years ago, has dedicated her career to research- ing the condition. “There is a lot more work to do,” she said. “We expect the next stag- es of research will take between 3-5 years.” — Reuters

Researchers discover a blood marker that could

help identify newborns who face SIDS risks

HEALTH SCAN

BY ERIN BLAKEMORE

When the bubonic plague
reached San Francisco’s China-
town in 1900, it prompted a racial
panic — and helped push science
forward.
“American Experience: Plague
at the Golden Gate,” premiering
Tuesday on PBS, tells the seeming-
ly contradictory, and all too timely,
story.
It began in a city that had the
nation’s largest Asian population
and was a center for international
trade. In 1900, an epidemic of
plague raged in East Asia, and
Marine Hospital Service bacteri-
ologist Joseph Kinyoun identified
the first case in the United States
in a Chinese immigrant named
Wong Chut King.
It was the first time the Black
Death had reached the continent,
and it prompted a racist crack-
down on San Francisco’s Asian
population. Quarantines, fumiga-
tion, searches — all focused on
Chinese immigrants and fueled by
misguided beliefs about the clean-
liness and worthiness of Asian
immigrants.
Kinyoun was convinced Chi-
nese people were spreading the
plague. But his successor, Rupert
Lee Blue, suspected the plague
wasn’t a matter of immigrants, but
of rats — and, in a race against
time, the future surgeon general
tried to stop the plague from

spreading. It’s a story of private deals, public health measures, corruption, fear and even the 1906 San Fran- cisco earthquake. And along the way, filmmaker Li-Shin Yu tells the cautionary tale of how discrimina- tion and scapegoating can spread as quickly as plague itself. It's also hopeful. The film chronicles how the Chinese community successfully fought back against the draconian public health measures — and shows what kinds of scientific in- novation and successful steps forward can occur when health offi- cials work with marginalized com- munities. The film rings especially true in an age of increased violence toward Asian American commu- nities, which are still reeling from panic surrounding the origins of the virus that causes covid-19. The real plague, the movie suggests, is racism — and hatred can both color, and interfere with, public health efforts. “Plague at the Golden Gate” will air Tuesday on PBS stations na- tionwide and on PBS’ online and app platforms. The film includes Mandarin language close-captioning.

DOCUMENTARY

How racism against immigrants hobbled

response to plague in 1900 San Francisco

American Experience: Plague at the Golden Gate PBS

BY KEVIN LORIA

R

ecent Consumer Re- ports tests of more than 100 food packaging products from U.S. restaurants and super- markets found dangerous PFAS chemicals in many of the products, including paper bags for french fries, wrappers for ham- burgers, molded fiber salad bowls and single-use paper plates. Previous CR tests found PFAS — per- and polyfluoroalkyl sub- stances — in drinking water and bottled water. That’s concerning, as growing research documents that PFAS, which are added to many materi- als to make them resistant to grease, water and stains, have led to environmental contamination around the globe and raised ques- tions about their health risks when they accumulate in our bodies.

How we’re exposed to them One of the main concerns about PFAS is how long they last. They are often called “forever chemicals” because they break down extremely slowly, if ever. That persistence, combined with the many products that now contain PFAS, means that there are many ways the chemicals can enter the environment and even- tually reach humans, too. Consider, for example, the production of food packaging with PFAS coating. In Maine, wastewa- ter sludge from mills where such products are produced has re- portedly been used to fertilize fields where cattle graze. In 2020, the Maine Department of Agri- culture, Conservation and Forest- ry tested milk from dairy farms and found levels of one particular PFAS in a sample from a farm that were more than 150 times higher than state regulations permit. When food packaging contains PFAS, some of those chemicals can migrate into food. Other products such as stain-resistant carpets can leave PFAS in house- hold dust and air. And finally, once food packaging or other products containing PFAS are thrown away, PFAS can leach out from landfills or spread from incinerators into the environment, where they can contam-

inate soil, food, water and air — just like they can when they are first produced. People may then eat food containing the chemicals, drink water that contains them or even breathe in the chemicals. And a growing number of the chemicals have been linked to a variety of health problems.

PFAS and health For decades, PFAS manufacturers have had information indi- cating that the chemicals may harm human health, according to reporting from the Environmen- tal Working Group. But for the first 60 or so years that PFAS were in production, many people thought that potential harms were specific to workers exposed to the chemicals at an industrial scale, not the general public. Then, in 1998, a West Virginia farmer named Wilbur Tennant started raising concerns about the effects that pollution from a nearby DuPont factory had on his cattle. This helped lead to a class- action lawsuit alleging that this contamination — with the PFAS chemical perfluorooctanoic acid (PFOA), also known as C8 — could be affecting the approxi- mately 70,000 people who got water from the same polluted source. The resulting settlement led to the creation of the C8 science panel, which between 2005 and 2013 assessed links between exposure to PFOA and a number of

diseases, and found probable links between exposure and thy- roid disease, higher cholesterol levels, kidney and testicular can- cer, ulcerative colitis, and pregnancy-induced hypertension. Other research on various PFAS has found links to liver damage and kidney disease.

Safety concerns at low levels Growing research has also shown that health risks can occur even at very low levels. Some of the clearest evidence about that risk comes from an unexpected place: the seemingly pristine Faroe Islands, a group of 18 small, rocky islands midway between Iceland and Norway in the North Atlantic. In 2010 and 2011, Philippe Grandjean, a professor of environmental medicine at the Uni- versity of Southern Denmark, had been studying children in the Faroes to see whether certain chemicals in the environment could dampen the immune system’s response to childhood vaccines. When he saw a study showing that PFAS could affect animal immune systems, he and col- leagues decided to see whether PFAS also affected how children responded to the vaccines. The results were dramatic. “I fell off my chair,” Grandjean says. “It was very clear these com- pounds were inhibiting the immune system.” In 2012, Grandjean and col- leagues first published their re-

search showing that higher levels of PFAS in blood samples taken from the children were associated with less effective protection after being vaccinated. The findings were alarming not just for the Faroes. Blood PFAS levels among U.S. children are comparable, Grandjean says. Follow-up research in other coun- tries has confirmed this effect, and has also shown that children with higher blood levels of PFAS have more infections, he says.

A toxic pattern Still, calculating the exact level of PFAS exposure that causes harm isn’t straightforward, especially since there are thousands of different PFAS, some more toxic than others. Manufacturers have stopped producing a couple of these chemicals in the United States, as concerns about their impact on health have become more widely known. As that has happened, however, they’ve been replaced by newer chemicals that have not been as thoroughly studied by independent researchers. Both the Food and Drug Ad- ministration and the American Chemistry Council, which repre- sents PFAS manufacturers, argue that we don’t know for sure that newer PFAS are as unsafe as the ones they are replacing. But a growing body of research suggests that many do pose risks, says Miriam Rotkin-Ellman, a senior scientist at the Natural Resources Defense Council. A da- tabase of research on more than two dozen different PFAS com- piled by a group of scientists who study the chemicals suggests harmful effects associated with many of them. “There are consistent patterns across these chemicals,” she says, “and the most consistent pattern is that they’re toxic.”

FROM CONSUMER REPORTS

Troubling risks of ‘forever chemicals’

BRIANNA SOUKUP FOR THE WASHINGTON POST In March, Adam Nordell of Songbird Farm in Unity, Maine, walks through a greenhouse filled with spinach that is now unsellable because of PFAS contamination.

Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. CR has no financial relationship with advertisers in this publication. Read more at ConsumerReports.org.

105,960

residents

The number of U.S.
residents on the
waiting list for a
lifesaving organ
transplant totaled
105,960 men, women
and children as of
late May, according
to the United
Network for Organ Sharing (UNOS), the nonprofit group that manages
the nation’s transplant system under contract with the federal
government. On average, 17 people die each day while waiting for an
organ transplant. In 2021, 41,354 transplants were done, with organs
from 20,401 donors, including both deceased and living donors.
Kidneys are the most frequently transplanted organ, followed by the
liver, heart, lungs, pancreas and intestines. Kidneys accounted for more
than half of transplants performed last year (24,670) and represent the
organ needed by more than 80 percent of those on the waiting list. Most
organs are donated after the donor has died, but some organs — the
kidney and liver, for instance — can come from a living donor. People
with two healthy kidneys can donate one and continue to live a normal,
active life. For a liver donation, a portion of the donor’s liver is removed
and transplanted, with the donor’s liver growing back to its normal size
within a few weeks. Donor groups say that a single donor can save up to
eight lives, those donating tissue can help more than 75 people, and
those who donate their corneas can restore sight to two people. The
National Institutes of Health notes that donated skin tissue can be used
as grafts for burn victims or for reconstruction after surgery, donated
bones can replace cancerous bones and help prevent amputation of an
arm or leg, and donated veins can be used in cardiac bypass surgery.
People who want to become an organ donor need to sign up with their
state’s registry, either online or by visiting their local motor vehicle
office. Donors can be of any age (although youths need parental
permission). A donor’s medical condition at the time of death will affect
what organs or tissue can be donated.
— Linda Searing

BIG NUMBER

Editors: Anjuman Ali, Margaret Shapiro • Art Director: Betty Chavarria

Advertising Information: Ron Ulrich, 202-334-5289,
[email protected] • To contact us: E mail: health-
[email protected] Te lephone: 202-334-5031 Mail: The Washington
Post, Health, 1301 K St. NW, Washington, D.C. 200 71

HEALTH & SCIENCE

BY SYDNEY PAGE

Identical twin sisters Erin Cheplak and Jill Justiniani had a running joke throughout their pregnancies that they would give birth on the same day. They never thought it would actually happen. But then, suddenly, it did. “This isn’t a joke anymore,” Cheplak said to her sister over the phone, just before 9 a.m. on May 5 — the date of Justiniani’s sched- uled C-section. “My water broke.” Just a few hours apart, the twin sisters each gave birth to their firstborn sons down the hall from one another at the Kaiser Perma- nente hospital in Anaheim, Calif. Not only were the babies born on the same day at the same hospital, but even their measure- ments matched. The boys — Jus- tiniani’s son Oliver and Cheplak’s son Silas — each weighed 7 pounds and 3 ounces at birth. They were also each 20 inches long. Although the serendipitous timing of their sons’ births was shocking to the sisters, in some ways, they said, it was par for the course. All their lives, the 30-year- old twins — both of whom live in Yorba Linda, Calif., about two miles apart — have been on paral- lel paths. “We’ve always done everything together,” said Cheplak. “It has been amazing to be able to go through life together at every stage. We are truly each other’s best friend.” As children growing up in Brea, Calif., all their hobbies and interests aligned, and as they moved into adulthood, they shared professional pursuits, too. They studied kinesiology and then completed the same mas- ter’s program in occupational therapy at California State Uni- versity, Dominguez Hills. Now they work at the same outpatient clinic as pediatric occupational therapists. Their desks are side-by-side. They often

bring each other lunch. The sisters got married rough- ly a year apart, and pregnant within just eight days of each other — which, they said, was unplanned. Justiniani and her husband, Ian, had been trying to get pregnant for nearly a year when they finally got a positive result on the morning of Cheplak’s postponed wedding celebration in August

“We were tracking and hop-
ing and praying,” said Justiniani,
who had suffered a miscarriage a
few months before.
Ten days later, while on her
honeymoon in the Maldives with
her husband Zach, Cheplak no-
ticed she had a heightened sense
of smell — sometimes an early
pregnancy symptom. She took an
at-home test, and it was positive.
“That was the beginning of this
path of feeling like this is pretty
wild, but also totally meant to
happen,” Justiniani said.
Although the news was unex-
pected, Cheplak said, it felt right:
“I just had this feeling that it was
going to work out, that we were
both going to be pregnant.”

Going through the ups and downs of pregnancy together felt natural given their synchronized lives. It also provided them with a lot of comfort. “With these pregnancies being our first, there was so much unknown,” Cheplak said. Beyond their shared DNA, the sisters believe they have a partic- ularly strong bond because of their childhood. They had a younger sister, Allison, who was born with a rare, life-threatening genetic disorder called Sialidosis. She died at age 12 when the twins were 18. “We grew up in a family where our parents had to dedi- cate a lot of their time to Allison,” Cheplak said. “Jill and I really latched onto each other during those moments.” “I really believe that we were meant to have each other,” Justin- iani said. “We were able to walk through the toughest moments of life together.” Their younger sister’s experience is also what propelled the twins to develop a shared passion for occupational therapy, as they witnessed firsthand how an occupational therapist helped Allison. They are by each other’s sides through every obstacle, and hap- py moments, too. Like during their shared gender reveal Nov.

“We were hopeful that we
would have the same gender, but
we really were unsure,” Justiniani
said. “So when we popped our
gender reveal balloons at the
same time and saw a bunch of
blue, we were both like ‘here we
go.’ ”
Still, they never anticipated

they would give birth on the same day. Although they joked about the idea, they knew the chances were slim — and even more so when Justiniani found out her son was in the breech position, and she would need to schedule a C-section. She and Ian chose May 5 — Cinco de Mayo — which was Ian’s father’s favorite holiday. He was diagnosed with amyotrophic lat- eral sclerosis (ALS) and died in January, Justiniani said. May 5 became even more mo- mentous when her sister’s water broke that morning, more than a week before her due date on May 15. Cheplak rushed over to the hospital, and Justiniani arrived shortly after. In another stroke of luck, Justiniani’s operation was delayed a few hours, so she and her husband were able to be in Cheplak’s delivery room. They helped calm her during intense and painful contractions. “Not only did I have the sup- port of my husband, but I had my sister and Ian in there,” Cheplak said. “It was like a movie.” The sisters’ story spread rapid- ly throughout the hospital, de- lighting staff and patients. Alice Lau, an obstetrician -gynecologist at Kaiser Permanente who cov- ered both twins’ prenatal care, was stunned that the sisters were simultaneously giving birth. “It made my day, my week, and my year,” Lau added. “This is such fantastic news, and it reminds us that miracles still happen.” When Cheplak was about to get an epidural, Justiniani was whisked away to the operating room for her C-section. Her son, Oliver, was born at 6:39 p.m. As the night wore on and Chep- lak was still in labor, “the nurses were like, ‘come on baby, you’re on a deadline!’ ” Cheplak said. “It gave me motivation to keep push- ing.” Then, in the nick of time, Silas arrived at 11:31 p.m. The whole hospital broke out in celebration. The boys have already had dai- ly playdates, and although they aren’t brothers, their mothers are certain they will always have a twin-like tie to one another. “We’re just so excited that they are going to be able to have a similar experience to us, and go through all of life’s journeys together,” Cheplak said. “The twin- ning continues.”

Identical twin sisters give birth on same day

BETHANY JEAN PHOTOGRAPHY Erin Cheplak, left, holds her firstborn son, Silas, with her twin sister, Jill Justiniani, and her firstborn son, Oliver.

The Washington Post - USA (2022-05-24)

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