Editorial by José Manuel Silva, President, Portuguese Medical Association. Published first in Portuguese in the July/August 2015 issue of the Portuguese Medical Association Magazine.
The New Statutory Rights of the Portuguese Medical Association and Glyphosate
It may seem odd, but there is a connection! The Portuguese Parliament approved the new statutes of the Portuguese Medical Association, which will allow for a significant improvement in its management, organization and response time. After complex and laborious negotiations, a process that many feared finally reached its end in a reasonably satisfactory fashion, respecting and reinforcing the abilities and interventional skills of the Association. In the future I shall comment on the new statutes that are now being sent to the nation’s President for almost certain enactment. There are many substantial changes.
One I intend to underline here is the creation of the Association’s National Consultative Council on Ecology and Health Promotion. Obviously many people don’t feel ecology is the main issue of the moment, but it is truly the future of life on Earth that is at stake. This is not a drill… Even Pope Francis has been emphasizing ecological issues and the threat of global warming.
Considering records show that the Earth lost 30% of its wildlife in the last 100 years and another 50% could be extinguished before the end of the century, that 2015 may well be the hottest year on record, and that current levels of consumption require 1.5 planets (4 planets for a US lifestyle and 2.5 for the UK’s), the Portuguese Medical Association could not continue to ignore the many serious implications environmental issues have on Health and Life. These are new dimensions for doctors to intervene in society and frame the Association’s approach to improved protection of patients, doctors and health itself.
In fact, the planet’s sustainability and environment related diseases are the major vital and ethical challenges for humanity and medicine. Many examples could be named. One of those is glyphosate, better known as Roundup, its commercial name. This is the most used herbicide in Portuguese agriculture and urban areas for weed control.
In the last decade glyphosate use has increased about 50%, with 1400 tons applied in 2010 alone. In total, more than 130 million tons a year are used around the world. Because of this glyphosate is routinely detected in food, air, rainwater and rivers, urine, blood and even breast milk. Its presence is so overwhelming that legal limits had to be stretched in order for it to continue being used, with serious potential and cumulative risks to human health. In the European Union, in 1999, the maximum acceptable level for glyphosate in soy was increased 200% (from 0,1 to 20mg/kg) and in 2013, the US government also increased the tolerance level on dozens of crops. Other countries, and even the Codex Alimentarius, have been going the same route. We must not forget that the genetically modified foods and seeds of plants designed to tolerate glyphosate can carry higher concentrations of this toxin, which is used to kill ‘weeds’ more freely in these cases.
Recent articles show the epidemiological connection and the biological plausibility of glyphosate being a risk factor for the increase in celiac disease, infertility, congenital malformations, kidney disease, autism and other pathologies (Interdiscip Toxicol, 2013; 6 (4): 159-84 // Int J Environ Res Public Health, 2014; 11: 2125-147 // Surg Neurol Int, 2015; 6: 45). Mortality in acute intoxication varies between 3.2 and 29.3%, mostly by pulmonary and / or kidney disease. The various pathological mechanisms for glyphosate are well-known and include changes in the intestinal micro-biome, disruption of cytochrome P450, vitamin deficiencies, metal chelation, molybdenum and selenium deficiencies, etc.
An additional concern is the fact that the International Agency for Research on Cancer (IARC) announced, in March 2015, that glyphosate had been classified as a “probable carcinogen”. The IARC is the world’s leading authority on cancer and this decision was unanimous among the 17 experts of the panel headed by Dr. Aaron Blair, a geneticist, who for 30 years led the occupational cancer unit at the US National Cancer Institute.
The IARC assessed firsthand all the relevant scientific research published to date, namely in epidemiological terms. The reason glyphosate wasn’t classified as fully carcinogenic to humans, was because of the limited epidemiological evidence, whose studies are particularly complex. Three of these studies show a connection between glyphosate exposure and non-Hodgkin lymphoma (NHL), whose incidence has increased significantly in the last 30 years, while a fourth study points to multiple myeloma but finds no connection to NHL.
Although, according to the IARC, the evidence in humans is not clearly incriminating (as has happened, in an initial phase, with so many toxins), it is extremely worrying. It is not easy to show this connection because there is a hiatus – sometimes dozens of years long – between carcinogen exposure and appearance of the “corresponding” cancer.
As if all this wasn’t enough, two additional issues suggest the IARC is erring on the conservative side. The first is that evaluations have focused on the active ingredient – glyphosate itself – even though the commercial formulation contains other chemical compounds. Consistent research shows that a significant share of the pesticides’ total toxicity may be attributed to these adjuvants (BioMed Research International. Vol 2014, Article ID 179691). Despite its benign reputation, Roundup is among the most toxic herbicides used in the European Union.
Furthermore, human beings are exposed simultaneously to chemical compounds of multiple origins which may interact synergistically. Some examples are well-known in toxicology: carbon tetrachloride and ethanol, together, have a far more devastating effect on the liver than the sum of their individual impacts. But even if the effects resulted from a summation only, with no synergies, none of that is taken into account when evaluating risks, approving the compounds and establishing classifications or limits. It is also noteworthy that those living in the western world carry in their bodies hundreds of synthetic contaminants that didn’t even exist 200 years ago.
Taken together, this data suggests that a careful reflection on glyphosate’s future, and globally on the management of food chemical risks, is in order. The worldwide acknowledged precautionary principle says that, in the face of clear evidence of harm, action to protect human health and the environment should not wait for final scientific evidence. For glyphosate the conclusion is clear: this herbicide should be banned worldwide.
Who should take action in Portugal? Without a doubt, the Government and the Directorate-General for Health must take the lead. Economic interests cannot, and must not, suppress the moral imperative of citizen health protection. The sluggishness of legal procedures does not excuse inertia either. European law allows temporary safeguard clauses to be quickly invoked until science comes up with final answers.
Cancers of unknown origin abound, and the highly chemical and industrialized society we live in is certainly partly responsible. In the future, it should be possible to improve this state of affairs. However, for those cancers which can already be avoided in the present, governmental inaction is unacceptable.
As for doctors, they cannot continue to alienate themselves from these environmental issues without failing health prevention – the main focus of their mission – and many disease diagnoses. Glyphosate is just one example among many…