Teflon causes cancer. Perfluorooctanoic acid

Q: There have been recent reports that Teflon causes cancer. Should I discard my Teflon pans?
A: Teflon has not been found to cause cancer. Perfluorooctanoic acid (PFOA), a chemical used in the synthesis of Teflon, has been labeled a "likely carcinogen" by a panel advising the Environmental Protection Agency. But Teflon pans do not emit PFOA when used properly.
Teflon cookware might emit a small amount of PFOA when heated to extreme temperatures -- for example, when a frying pan has been left empty on a heated burner for an extended period. Even then, it has not been established that overheated Teflon produces a dangerous amount of PFOA. Still, it wouldn't be unreasonable to dispose of a Teflon pan that has been left empty on a heated burner.

Approximately 95% of the population has some amount of PFOA in their bloodstream -- but most of this PFOA likely comes from stain- and water-repelling treatments used on carpets and fabrics. Grease-resistant food packaging, such as microwave popcorn bags and cardboard fast-food boxes, also might contain small amounts of PFOA. The fact that PFOA is in our bodies does not mean that we're all going to die from PFOA-related cancers. Individuals who have worked in factories where PFOA is produced, and perhaps some people who live in neighboring areas, seem to have the highest levels of PFOA.

Our inside source: Ronald L. Melnick, PhD, senior toxicologist with National Institute of Environmental Health Sciences, a division of the National Institutes of Health, Research Triangle Park, North Carolina. He is currently conducting experiments on chemicals related to PFOA.

FDA WARNING RE: RITALIN AND HEART ATTACK

At my children's school, it seems as if more and more kids are being put on methylphenidate (Ritalin) for so-called behavioral disorders. But in a dramatic reminder that Ritalin and related attention deficit hyperactivity disorder (ADHD) medications are potent drugs with dangerous side effects, a US Food and Drug Administration (FDA) advisory panel has recommended that they carry a "black box warning" -- the FDA's highest level warning -- that they may increase the risk of death from heart attack and other cardiovascular problems. This advice came after 25 deaths and 54 serious cases of cardiovascular problems among children and adults taking these stimulants (methylphenidate or amphetamines) between 1999 and 2003. Pick your poison, eh?

TOO MANY DRUGS FOR TOO MANY CHILDREN

In recent years, there has been growing concern that too many children are being put on ADHD medications. Once reserved for kids with obvious and major symptoms (hyperactivity, impulsivity and inattention), there seems to have been a kind of trickle-down effect. Now children who would formerly have been considered merely fidgety, impatient or inattentive are being pumped full of powerful drugs.

Is it just my perception or are parents using drugs to medicate behavioral and discipline issues? To learn more about this dilemma, I consulted advisory panel member Steven E. Nissen, MD, interim chairman of the Department of Cardiovascular Medicine at The Cleveland Clinic and president of the American College of Cardiology. He told me that he hopes the new awareness of the risks will slow down the escalating number of prescriptions for ADHD.

All drugs have side effects, and should be prescribed only when absolutely necessary. This is especially true when it comes to powerful stimulants like Ritalin, which can cause adverse cardiovascular effects including high blood pressure, a racing heart, abnormal heartbeat or stroke.

TRY NONDRUG APPROACHES FIRST

In Dr. Nissen's opinion, while there are still some children who need and benefit from Ritalin, this drug should be prescribed only after other approaches have been exhausted. Be certain that it truly is profound ADHD and not just a child overwhelmed by his/her overscheduled world or in desperate need of parental attention. Psychotherapy, behavior modification, social skills training and nutritional guidance have all met with some degree of success in controlling ADHD symptoms.

Often a combination of strategies is best, along with a team approach ensuring that parents, physicians, therapists and teachers are all on the same page.

The bottom line: If you're the parent of a child with behavioral difficulties, rest assured that you're not alone, and there are many helpful treatment options. Don't let yourself be talked into giving your child powerful drugs with powerful side effects until you explore more healthful alternatives.

Integrity of science is in jeopardy

Asking researchers to declare conflicts of interest that might prejudice their work is not enough to safeguard the integrity of science, says Catherine DeAngelis, editor of the Journal of the American Medical Association (JAMA). Universities should do more to investigate staff who don't disclose relevant financial ties, she says.

JAMA and The New England Journal of Medicine both require authors to disclose links that could influence a study. Yet several researchers have failed to do so in work published in JAMA this year. In one case, when JAMA rejected a study because the authors refused to obtain an independent analysis of the data, the work was simply published in a different journal.

Even when researchers declare financial ties, readers still don't know how much the conflict has skewed the results, says Daylian Cain, a moral psychologist at Harvard University. Disclosure could even tempt researchers to exaggerate findings, in order to counter anticipated scepticism from readers, he says.