Where You Work Matters When It Comes to Breast Cancer Risk












Regulations to protect workers from on-the-job hazards—and to compensate them for occupational harms—have a strong and storied history in the United States and Canada. But those protections are lacking for women who are at increased risk of breast cancer due to their occupation, says the author of a new study on breast cancer risk.


Previous research has hinted that some types of occupational exposures can raise the risk of breast cancer. Chemicals used in plastics manufacturing jobs, like polybrominated diphenyl esters—or PBDEs—are known carcinogens, as is secondhand tobacco smoke. Yet too little attention has been paid to women’s exposures to these chemicals and cancer risk, says Dr. James Brophy, adjunct faculty at the University of Windsor in Ontario, and a co-author of the new research.












The study, published in the journal Environmental Health, looked at women who were diagnosed with breast cancer in Essex or Kent Counties in Southern Ontario. Researchers  surveyed 1,006 women with breast cancer and a control group of 1,147 women without the disease regarding factors known to influence breast cancer risk—such as family history, use of hormone therapy, smoking, number of children and other factors. The women also described where they worked and their job activities.


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The study showed that women who worked for 10 years in jobs that involved exposure to chemicals had a 42 percent increased risk of breast cancer compared to women who worked in occupations without chemical exposures.


The findings should help shine a light on the link between breast cancer and occupational exposures, Brophy told TakePart.


“In cancer causality, there has been a real turning away from involuntary exposures since the late 1970s,” he says. “Cancer causality has been considered lifestyle choices, such as smoking, drinking, diet. Attention to other causes of cancer has been considered marginal. But the majority of women who get the disease don’t have the known or suspected risk factors. The disease is occurring among many healthy women. That’s opening up a major public health question about why. “


Breast cancer likely arises due to a combination of factors, such as genetics and outside influences, like chemical exposures or diet. But in the study, researchers found a clear link to some occupations even when controlling for many of the other risk factors for the disease.


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Women who work in farming had a 36 percent increased risk of breast cancer, Brophy says. In Canada, he notes, employment in farming often begins early in a woman’s life. Early exposure to pesticides may account for the excessive risk.


The study also showed that the breast cancer type was linked to some occupations. For example, women in agricultural occupations with breast cancer were more likely to have a type known as estrogen receptor negative.


“That is the most difficult breast cancer to treat,” Brophy notes. “What we showed was these different occupational exposures were influencing the predominant type of tumor status in these women. That is a significant thing. It added weight that occupation was influencing the disease and the development of the disease.”


Breast cancer risk was almost double for women working in the Canadian car industry’s plastics manufacturing sector. The study showed that breast cancer risk was nearly five times higher in premenopausal women working in plastics and food canning. Breast cancer typically occurs after menopause.


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“The elevated risk for premenopausal women in auto plastics and canning was really very shocking,” he says. “These diseases are occurring among young women, which is normally a low-risk group.”


Overall, breast cancer risk was doubled for women working in food canning or tinning. Women in metalworking had a 73 percent increased risk of breast cancer.


Perhaps not as surprising, women employed in bars, casinos and at race tracks had double the risk of developing breast cancer, most likely due to secondhand tobacco smoke exposure.


More attention has been paid to the health effects of chemical exposures to males in particular industries, Brophy notes, such as the risk of lung cancer linked to mining. However, the theory that certain chemicals, called endocrine disruptors, can cause cellular changes during critical periods of breast development is well known in the medical world.


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“In occupational health, in general, there has been an ongoing tension about the lack of focus and concern about issues for women,” he says. There is a lack of attention to blue-collar occupations, but even less attention paid to the working conditions of women.”


Even in occupations where men and women hold the same position, women are affected differently and may require a different set of workplace protections, he says.


“A woman janitor in a hospital is assumed to have the same exposure as a male janitor in a hospital ,” he says. “The accepted idea is that their exposures are the same as men. But what we discovered in our study is often in these workplaces there is a division of labor in which men have certain tasks and women certain tasks and their exposures can be entirely different…Women have a different vulnerability. On the whole issue of hormonal disruption, what that means for a woman would differ than for a man.”


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The concept that workers should be protected from occupational harm has been expanding in recent years in some areas. For example, some countries now recognize that working irregular shifts or night shifts can increase the risk of obesity and obesity-related diseases, like diabetes.


But there is still no workplace standard that accounts for exposure to chemicals that are known endocrine disruptors, Brophy says.


“There is very little being done to protect women from these exposures,” he says. “I think there is an awareness among workers. The problem has been what you can do about it.”


Emerging scientific evidence may give workers  an avenue to seek compensation for harms through the courts, Brophy adds.


“It’s only after you establish compensation that there is a real incentive for employers to do something about it,” he says.


Question: Should employers act now to protect female workers from an increased risk of breast cancer linked to particular occupations? Tell us what you think in the comments.



Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.


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'We had the best crop in years': Residents feel pinch after FDA shutters plant

PORTALES, N.M. (AP) — Farmers in a revered peanut-growing region along the New Mexico-Texas border should be celebrating one of the best harvests in recent memory.

Instead, millions of pounds of their prized sweet Valencia peanuts sit in barns at a peanut butter plant shuttered for two months amid a salmonella outbreak that sickened 41 people in 20 states.

Farmers are worried about getting paid for their peanuts, nearly a third the plant's 150 workers have been laid off, and residents wonder what toll an increasingly contentious showdown between the nation's largest organic peanut butter plant and federal regulators could ultimately have on the region's economy.

The tension boiled over when the Food and Drug Administration on Monday said it was suspending Sunland Inc.'s registration to operate because of repeated safety violations, meaning the plant will remain indefinitely shut down as the company appeals the decision. The company had planned to reopen some its operations this week after voluntarily recalling hundreds of products and closing its processing and peanut butter plants in late September and early October.

Many in this flat, dusty and solidly Republican farm town of about 20,000 denounce the FDA's tactics as unfair and unnecessarily heavy-handed — and become defensive about the shutdown of the largest private employer in town.

"We had the best crop in years, and then these (expletives) came in and started this," said resident and local telecomm worker Boyd Evans.

For the first time ever, the FDA is using authority granted under a 2011 food safety law signed by President Barack Obama that allows the agency to shut food operations without a court hearing.

The FDA said inspectors found samples of salmonella in 28 different locations in the plant, in 13 nut butter samples and in one sample of raw peanuts. Inspectors found improper handling of the products, unclean equipment and uncovered trailers of peanuts outside the facility that were exposed to rain and birds. Inspectors also said employees did not have access to hand-washing sinks, and dirty hands had direct contact with ready-to-package peanuts.

The FDA has inspected the plant at least four times over the past five years, each time finding violations. Michael Taylor, the FDA's deputy commissioner for foods, said the agency's inspections after the outbreak found even worse problems than what had been seen there before.

The salmonella outbreak was traced to Trader Joe's peanut butter produced at the plant. Sunland produces products for a number of national grocery and retail chains, and New Mexico Peanut Growers Association President Wayne Baker says the industry generates about $60 million in the region each year.

Valencias are a variety of peanuts that come almost exclusively from eastern New Mexico. Because of their sweet flavor, they are favored for organic and natural peanut butter products because they require few additives.

The peanut is celebrated every year at the town's annual Peanut Valley Festival, and most residents have stories related to peanuts, whether growing up on a peanut farm, helping to haul them to harvest or knowing peanut workers or farmers.

"Peanuts is, like, everything here," said local shopkeeper Brittany Mignard.

The plant's retail store remains open, although its shelves are bare of its own products. The few items remaining include peanut brittle made in Lubbock, Texas. The shelves are stocked with jelly, but no peanut butter.

Baker, who is also a Sunland board member, said the company had never been notified of any past violations. And the company has vehemently denied FDA allegations that it knowingly shipped any potentially tainted products.

Plant officials said they were blindsided by the FDA's suspension on Monday. Just hours before it was announced, the plant had announced plans to start shelling the bumper crop on Tuesday. Plant officials said they had notified the FDA last week of their plans to reopen the processing operations while waiting for approval to resume making peanut butter.

"The FDA is overreaching its power and putting out information that isn't true," Baker said. "We don't understand what is going on. We don't think we are guilty."

FDA officials wouldn't comment on his allegations, saying it was an ongoing investigation.

Food safety expert and Cornell University professor Bob Gravani said given the number of salmonella outbreaks in recent years, he believes the FDA is being heavily scrutinized about why they are not using their rules more frequently or more aggressively.

Putting aside the "he-said, she-said" between the FDA and the company, he said, "I would say suspension is warranted in this case."

This is not the first major outbreak since the FDA gained authority to pull a facility's registration in the 2011 food safety law. An outbreak of listeria in cantaloupe in 2011 is linked to at least 30 deaths and investigators found similar conditions at Jensen Farms in Colorado. Unlike Sunland, however, Jensen Farms did not attempt to restart operations after the recall and FDA investigation. The company later filed for bankruptcy.

Baker said officials have been trying for the past two months to cooperate with the FDA to get the plant reopened.

"That hasn't worked," he said. "But we are not going to give up. We are going to fight this. We have got no choice."

He said officials have begun calling the state's senators and congressman and talking with other agricultural groups about getting help in Washington with an appeal of the FDA action. No hearing has yet been scheduled.

Coburn said about 30 percent of the plant's workers were laid off Monday.

Although peanuts can be stored for a while, Coburn and Baker acknowledged that time is of the essence for getting to work on what Coburn said were "many, many millions" of pounds harvested from this year's crop.

Farmers, Baker acknowledged, are worried about getting paid. But he said Sunland has committed to paying them for their crops.

Under a worst-case scenario, he said, Sunland could sell the peanuts to other producers.

___

Associated Press reporter Mary Clare Jalonick in Washington contributed to this report.

___

Follow Jeri Clausing on Twitter at http://twitter.com/#!/jericlausing

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Rugby-England add flyhalf Burns to squad for All Blacks’ test












LONDON, Nov 27 (Reuters) – England called up uncapped Gloucester flyhalf Freddie Burns on Tuesday to their squad for Saturday’s test against New Zealand in place of the injured Toby Flood.


Flood sustained ligament damage to a big toe during the 16-15 loss to South Africa at Twickenham last Saturday.












Owen Farrell, whose last start was in the first test in South Africa this year, is set to replace Flood in the starting XV against the world champions.


Lock Courtney Lawes, who missed England’s first three tests of the November series because of a knee injury, has also been included in the 23-man squad. Two other locks, Mouritz Botha and Tom Palmer, have been omitted.


After beating Fiji in their opening match, England have lost to Australia and the Springboks and now face a daunting match against the All Blacks who are unbeaten in 20 tests since the start of their victorious World Cup campaign last year.


“For those in Saturday’s squad the message is clear – last week we went toe to toe with the second best team in the world and felt we should have won,” England head coach Stuart Lancaster said in a statement.


“Now we have a chance to take on the number one side in front of a passionate Twickenham crowd, who have been fantastic throughout the Internationals, and it is a challenge we will meet head on.” (Reporting by John Mehaffey; Editing by Ken Ferris)


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Turkish PM fumes over steamy Ottoman soap opera












ISTANBUL (Reuters) – A hit TV show about the Ottoman Empire‘s longest-reigning Sultan has raised a political storm in Turkey, with Prime Minister Tayyip Erdogan urging legal action over historical inaccuracies and the opposition accusing him of artistic tyranny.


Erdogan tore into the weekly soap opera “Magnificent Century”, which attracts an audience of up to 150 million people in Turkey as well as parts of the Balkans and Middle East, in response to criticism of his government’s foreign policy.












The lavish television production, which grips audiences with tales of power struggles and palace intrigue, is set during the 16th century reign of Suleiman the Magnificent, when Ottoman rulers held sway over an empire straddling three continents.


Bristling at suggestions that Turkey was meddling too much in its neighbors’ affairs, Erdogan recalled Turkey’s heritage, and said Suleiman had been a proud conqueror rather than the indulgent harem-lover portrayed in the show.


“(Critics) ask why are we dealing with the affairs of Iraq, Syria and Gaza,” Erdogan said at the opening of an airport in western Turkey on Sunday.


“They know our fathers and ancestors through ‘Magnificent Century’, but we don’t know such a Suleiman. He spent 30 years on horseback, not in the palace, not what you see in that series.”


Scenes that showed Suleiman with women in the harem have prompted calls from viewers in the mostly Muslim and largely conservative country for the broadcasting regulator (RTUK) to ban the series. But it tops the viewing charts each week.


Erdogan said the director of the series, which has been on air since January 2011, and the owner of the channel that broadcasts it had been warned, but also said he expected the judiciary to act, without elaborating.


Erdogan’s opponents accused him of authoritarianism.


“The prime minister must be jealous of the series’ popularity. He thinks there’s no need for another sultan when he’s in power,” said Muharrem Ince, the deputy chairman of the main opposition Republican People’s Party (CHP).


“Erdogan wants to be the only sultan.”


Elected a decade ago with the strongest majority seen in years, Erdogan has overseen a period of unprecedented prosperity in Turkey. But concerns are growing about his increasingly authoritarian rule.


Hundreds of politicians, academics and journalists are in jail on charges of plotting against the government, while more than 300 army officers were given prison terms in September for conspiring to topple him not long after he swept to power.


Turkey has been increasingly assertive in regional politics, most notably over the crisis in neighboring Syria, where it has led calls for international action and scrambled war planes in a warning to Damascus not to violate its territory.


“I think the prime minister’s aim here is to change the agenda. I can’t think of any other reason to discuss an imaginary television series when there are so many problems in a country,” Nebahat Cehre, who played Suleiman’s mother during the first two seasons, told Turkey’s Birgun newspaper.


(Editing by Nick Tattersall and Jon Hemming)


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Youth HIV Rate High, Testing Low












Americans between the ages of 13 and 24 accounted for more than a quarter of new HIV infections in 2010 — about 12,000 cases — but only a third of that age group had ever been tested for the virus, the CDC reported.


“This is our future generation, and the bottom line is that every month, 1,000 youth are becoming infected with HIV,” said Dr. Thomas Frieden, director of the agency.












The “shocking” data, reported in a Vital Signs article from Morbidity and Mortality Weekly Report, detail the prevalence, incidence, and risk factors of HIV among youths, Frieden said in a teleconference with reporters.


Read this story on www.medpagetoday.com.


One implication of the new incidence data is a growing future healthcare burden, Frieden said.


Noting that the lifetime cost of care for a person with HIV is about $ 400,000, he said: “Every month we are accruing about $ 400 million of healthcare costs — and every year $ 5 billion — from preventable infections in youth.”


“It is just unacceptable that young people are becoming infected at such high rates,” Frieden said.


CDC researchers used surveillance data to analyze 2009 prevalence rates of diagnosed HIV among youths and the number of new infections in the 13 to 24 age group in 2010.


They also assessed the prevalence of risk factors and HIV testing among youths, both those still in high school and those 18 through 24.


They found that in 2009, the prevalence of HIV among youth was 69.5 per 100,000 population, with a state-by-state range from 2.3 to 562.8 per 100,000.




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The rates were higher in southern and northeastern states compared with the West and Midwest.


Also, of the estimated 47,500 new HIV infections in 2010, 12,200 (25.7 percent) were among youths.


More than four-fifths of the new infections in 2010 (82.8 percent) were acquired by males.


Among newly infected youth, 57.4 percent were African American, 19.6 percent were Hispanics, and 19.5 percent were white.


Male-to-male sexual contact accounted for 72.1 percent of infections, while 19.8 percent were because of heterosexual contact. Injection drug use accounted for 4 percent, and 3.7 percent of infections were due to a combination of male-to-male sex and injection drug use.


Among males, 87.1 percent of infections were attributed to male/male sex, while among females, 85.7 percent were attributed to heterosexual contact.


Overall, youths with HIV made up 6.7 percent of the 1.1 million HIV-positive people in the U.S., the agency reported, and 59.5 percent of those did not know they were infected.


“That’s a much higher proportion than the less than the 20 percent we estimate overall don’t know they are HIV-infected,” Frieden said.


The agency used data from 12 states and nine large urban school districts, collected in 2009 and 2011, to analyze risk behaviors among male and female students in grades 9 through 12.


Males who reported sexual contact with other males, the CDC found, reported more risky behavior than other youths.


For instance, they were more likely to report sexual intercourse with four or more persons during their lifetime (39.4 percent versus 26.9 percent) and to have ever injected any illegal drug (20.4 percent versus 2.9 percent).


Importantly, they were also significantly less likely to have used a condom during last their sexual intercourse (44.3 percent versus 70.2 percent), the agency reported.


They were less likely to report having ever been taught in school about AIDS or HIV infection (74.6 percent versus 86.3 percent), the CDC found.


Overall, in 2011, 12.9 percent of all students in grades 9 through 12 reported that they had ever been tested for HIV, but the proportion reached 22.2 percent among those who reported being sexually active (49.2 percent of males and 45.6 percent of females).


In the older group – those 18 through 24 — 34.5 percent reported ever having been tested for HIV.


The CDC has recommended for several years that HIV testing should be part of routine medical care, but Frieden said many doctors still haven’t bought into the idea.


“You have a very, very small proportion of who refuse testing,” he said, “but unfortunately a relatively large proportion of doctors who don’t make it routine.”


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W.H. blasts GOP 'obsession' with Rice

Arizona Sen. John McCain, the ranking Republican on the Senate Armed Services Committee—flanked by fellow committee …The White House sharply escalated its attacks Tuesday on Republicans trying to stop Ambassador to the United Nations Susan Rice from succeeding Hillary Rodham Clinton as secretary of state. Press secretary Jay Carney described GOP lawmakers as being gripped by a politically fueled "obsession" with a series of television appearances Rice made shortly after the deadly Sept. 11 attack on the U.S. diplomatic compound in Benghazi, Libya, in which she wrongly suggested the attack had stemmed from a demonstration over an anti-Muslim video rather than a terrorist assault.


Carney's comments came after Rice met privately on Capitol Hill with Republican senators who have said they intend to block her nomination if President Barack Obama chooses her to replace Clinton as the nation's top diplomat. Rice also acknowledged for the first time, in a written statement issued by her office, that her initial public comments on the Benghazi assault were wrong because there had been no protest outside the compound.


Carney said the U.S. still does not know who carried out the assault, which claimed the lives of Ambassador Chris Stevens and three other Americans. But he said GOP focus on Rice's early statements was a politically motivated distraction from efforts to identify those responsible for the killings.


"The questions that remain to be answered have to do with what happened in Benghazi, who was responsible for the deaths of four Americans, including our ambassador, and what steps we need to take to ensure that something like that doesn't happen again." Carney said.


In appearance after appearance, Rice said that American intelligence had pinned the blame on the assault on extremists who took advantage of a demonstration outside the facility.



Tuesday, Rice acknowledged the information initially provided by the intelligence community was wrong.


"Neither I nor anyone else in the administration intended to mislead the American people at any stage in this process, and the administration updated Congress and the American people as our assessments evolved," Rice said.


Rice, accompanied by Acting CIA Director Michael Morell, met with Republican Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Kelly Ayotte of New Hampshire, who have accused Rice (and the Obama administration in general) of misleading the public by tying the assault to the video. Republicans have suggested the administration hoped to blunt the potential political impact of the attack—the first to claim the life of an American ambassador in 30 years—shortly before the presidential election.


"Bottom line: I'm more disturbed now than I was before," Graham told reporters after the meeting. "We are significantly troubled by many of the answers that we got and some that we didn't get," McCain said.


Carney shot back, saying there were "no unanswered questions" about Rice's early televised statements.


"The focus on—some might say obsession on—comments made on Sunday shows seems to me and to many to be misplaced," Carney said. "I know that Sunday shows have vaunted status in Washington, but they have almost nothing to do—in fact zero to do—with what happened in Benghazi."


And neither, to hear Carney tell it, did Rice.


"Ambassador Rice has no responsibility for collecting, analyzing and providing intelligence, nor does she have responsibility as the United States ambassador to the United Nations for diplomatic security around the globe," he said.


So why, then, did the White House anoint Rice the administration point person to answer questions about a possible intelligence failure and consular security? Why not Secretary of State Clinton? Director of National Intelligence James Clapper? Defense Secretary Leon Panetta? National Security Adviser Tom Donilon?


"She is a principal on the president's foreign policy team," Carney said.


He added, "To this day it is the assessment of this administration and of our intelligence community … that they acted at least in part in response to what they saw happening in Cairo and took advantage of that situation."


In other words, according to one well-placed source, the perpetrators of the attack may have concluded that anger at the video gave them the maximum opportunity to get sympathy or support across the Muslim world, and might even inspire copycat attacks. Rice's much-dissected Sept. 16 comments broadly follow those lines.


Obama has fiercely defended Rice, while carefully declining to say whether he has chosen her to succeed Clinton. Another leading contender is the Democratic chairman of the Senate Foreign Relations Committee, John Kerry.


McCain and Graham have pledged to try to filibuster her confirmation, but they are well short of the votes needed to do so.


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Dog days in Cuba: from shih tzus to schnauzers












HAVANA (AP) — The Cuban capital has played host to political summits and art festivals, ballet tributes and international baseball competitions. Now dog lovers are getting their chance to take center stage.


Hundreds of people from all over Cuba and several other countries came to a scruffy field near Revolution Plaza this past week to preen and fuss over the shih tzus, beagles, schnauzers and cocker spaniels that are the annual Fall Canine Expo’s star attractions. There were even about a dozen bichon habaneros, a mid-sized dog bred on the island since the 17th century.












As dog lovers talked shop, the merely curious strolled the field, checking out the more than 50 breeds on display while carefully dodging the prodigious output of so many dogs.


The four-day competition, which ended Sunday, included competitions in several breeding categories, and judges were flown in from Nicaragua, Colombia and Mexico.


“This is a small, poor country, but Cubans love dogs,” said Miguel Calvo, the president of Cuba’s dog federation, which organized the show. “We make a great effort to breed purebred animals of quality.”


Winners don’t receive any trophy or prize money, but that doesn’t mean the competition is any less fierce.


Anabel Perez, owner of a cocker spaniel named Lisamineli after the U.S. actress, spent more than half an hour coifing the dog’s hair in preparation for the competition, while the owner of a shih tzu named Tiguer meticulously brushed his coat nearby.


“I’m a hairdresser for humans,” explained Tiguer’s owner, Miguel Lopez. “So it’s easy for me. I like shih tzus because they are a lot of work to keep well groomed.”


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HP hit with civil securities lawsuit over Autonomy deal












SAN FRANCISCO (Reuters) – Hewlett-Packard Co was sued on Monday by an investor who claimed the company knew statements about its Autonomy acquisition were misleading and led the stock to fall, according to lawyers representing the plaintiff.


The proposed class action lawsuit was filed in a San Francisco federal court.












HP dropped a bombshell last Tuesday with an $ 8.8 billion write-down on its acquisition of British software firm Autonomy, saying the company inflated sales with improper accounting. Autonomy co-founder Mike Lynch has denied any wrongdoing.


HP bought Autonomy for a hefty $ 11.1 billion last year. HP has said it alerted regulators on both sides of the Atlantic.


The lawsuit, one of the first to be filed by investors on the Autonomy mess, said HP hid the fact it gained control of Autonomy based on financial statements that could not be relied upon. It also said that HP had not revealed to investors that it tried to undo the Autonomy agreement before it closed because of the accounting issues.


(Reporting By Dan Levine and Poornima Gupta; Editing by Gerald E. McCormick and Andre Grenon)


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Actor: CBS comedy ‘Two and a Half Men’ is ‘filth’












NEW YORK (AP) — The teenage actor who plays the half in the hit CBS comedy “Two and a Half Men” says it’s “filth” and through a video posted by a Christian church has urged viewers not to watch it.


Nineteen-year-old Angus T. Jones has been on the show since he was 10 but says he doesn’t want to be on it. He says, “Please stop watching it. Please stop filling your head with filth.”












The video was posted by the Forerunner Christian Church in California, where Jones says he went to meet his spiritual needs.


Show producer Warner Bros. Television has no comment. CBS hasn’t responded to a request for comment left Monday.


The show stars Jon Cryer as Jones’ uptight dad and originally featured Charlie Sheen as his hedonistic philandering uncle, but Sheen was replaced by Ashton Kutcher.


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Grapefruit, Medicine Interaction Warning Expanded












Nov 26, 2012 5:48pm



49078  gty grapefruit juice medication ll 121126 wblog Grapefruit, Medicine Interaction Warning Expanded

Image credit: Johner/Getty Images













ABC News’ Ben Maas reports:


It has long been known that grapefruit juice can pose dangerous — and even deadly — risks when taken along with certain medications. Now, experts warn the list of medications that can result in these interactions is longer than many may have believed.


Check below to see whether your medication appears on the list.


In a new report released Monday in the Canadian Medical Association Journal, researchers at the University of Western Ontario said that while 17 drugs were identified in 2008 as having the potential to cause serious problems when taken with grapefruit, this number has now grown to 43.


“The frequency of these reactions may be small, but the risks are not worth it, especially for drugs which could cause sudden death,” said lead study author David Bailey, a professor of pharmacology and one of the first to report the interactions between grapefruit juice and certain medications 20 years ago. “Physicians need to know that this affects a number of new drugs and apply this information to their practice and patients.”


So how does a common breakfast fruit cause these problems? Grapefruits contain chemicals called furanocoumarins that interfere with how your body breaks down drugs before they enter the bloodstream. By preventing this normal breakdown of a drug, these chemicals in grapefruit can effectively cause a drug overdose and more severe side-effects.


Among the side effects sometimes seen with grapefruit-induced overdoses are heart rhythm problems, kidney failure, muscle breakdown, difficulty with breathing and blood clots. Atorvastatin — commonly known by the brand name Lipitor and taken by millions of Americans — is one of the drugs that have been linked to serious cases of drug toxicity when combined with grapefruit products. Other common heart medications — including verapamil and amiodarone — have also led to serious interactions when consumed with grapefruit or grapefruit juice.


While there have been many reported cases of serious side effects attributable to this problem, the total number of Americans who have been affected is not known.


As little as one grapefruit or one 8-ounce glass of grapefruit juice can cause an effect that may last more than 24 hours.  Other fruits including Seville oranges, limes, and pomelos can have the same effect, although sweet orange varieties do not produce this interaction.


“People know that drugs react with drugs, but fewer are aware of drug-food interactions,” said Professor Paul Doering of the University of Florida Pharmacy Department. “Health professionals need to learn as much as they can about this.  Undetected there are very serious adverse effects.”


For consumers, the best advice may be to ask a doctor or pharmacist when they are prescribed a new drug whether there are foods or other medicines that they should avoid.


A-C
Alfentanil (oral)
Amiodarone
Apixaban
Atorvastatin
Buspirone
Clopidogrel
Crizotinib
Cyclosporine


D-F
Darifenacin
Dasatinib
Dextromethorphan
Domperidone
Dronedarone
Eplerenone
Erlotinib
Erythromycin
Everolimus
Felodipine
Fentanyl (oral)
Fesoterodine


H-P
Halofantrine
Ketamine (oral)
Latatinib
Lovastatin
Lurasidone
Maraviroc
Nifedipine
Nilotinib
Oxycodone


P-Z
Pazopanib
Pimozide
Primaquine
Quinine
Quetiapine
Quinidine
Rilpivirine
Rivaroxaban
Silodosin
Simvastatin
Sirolimus
Solifenacin
Sunitinib
Tacrolimus
Tamsulosin
Ticagrelor
Triazolam
Vandetanib
Venurafenib


Verapamil
Ziprasidone



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