Exporting Morbidity

"We would never market or continue to market any chemical which we genuinely felt posed a health risk or an environmental risk."
"I do believe paraquat is safe when it's used appropriately."
Philip A. Botham, head of product safety, Syngenta, Switzerland

"[The breadth of research is] about as persuasive as these things can get [that exposure to the herbicide Paraquat presents a danger to human health]."
"[It should be banned]."
Freya Kamel, scientist, National Institutes of Health, U.S.A.

"[The body of research linking Paraquat and Parkinson's has] converged to make a fairly convincing argument that paraquat is truly an environmental exposure that can either increase the risk of Parkinson's disease or collaborate with other factors, including genetic factors."
Dr. Vikram Khurana, neurologist, Harvard Stem Cell Institute, U.S.A.

"Our estimates of risk for ambient exposure in the workplaces were actually greater than for exposure at residences. And, of course, people who both live and work near these fields experience the greatest PD [Parkinson's disease] risk. These workplace results give us independent confirmation of our earlier work that focused only on residences, and of the damage these chemicals are doing."
"Our results suggest that pesticides affecting different cellular mechanisms that contribute to dopaminergic neuron death may act together to increase the risk of PD considerably."
Dr. Beate Ritz, senior author, professor of epidemiology, UCLA School of Public Health.

 
 

A survey of farmers and their families undertaken in 2011 in Iowa and North Carolina concluded that people handling pesticides were two and a half times likelier to develop Parkinson's with the use of Paraquat or Rotenone, (another pesticide). A year later, a subsequent study concluded that people whose genetic endowment included a variation were eleven times more likely to develop Parkinson's disease through exposure to Paraquat.

Paraquat has been around for over 130 years, but it wasn't until the mid-1900s that it was produced for common use as a pesticide. At the present time, over one hundred types of agricultural crops globally make use of the weed killer, including crops such as oranges, coffee and sugar cane. Even in Burkina Faso the use of the weed killer accounted for a fifth of the country's accidental pesticide poisoning cases, leading its government to seek out global regulation of its use.

As for Parkinson's and its onset connection with Paraquat, a more generalized view is that the loss of nerve cells in part of the brain owes to both environmental and genetic factors. Syngenta, the maker of Paraquat, insists that studies linking paraquat to Parkinson's fail to consider other incriminating factors. And the company that produces the weed killer has done so for a hundred years in Huddersfield, an industrial town in England.

But nowhere in the European Union may Paraquat be lawfully used; it is outlawed in recognition of its threat both to the environment and to human health. Britain produces it, but it cannot be used in Britain. Instead, it is exported to other countries of the world that continue to permit weed-spraying with Paraquat. Last year it was exported to Brazil, Colombia, Ecuador, Guatemala, India, Indonesia, Japan, Mexico, Panama, Singapore, South Africa, Taiwan, Uruguay and Venezuela, as well as to the United States.

This is a drug with a grim history of use in suicides. One sip of the weed killer can have lethal consequences. And now that research links its use to Parkinson's disease, the Environmental Protection Agency in the United States has stated: "There is a large body of epidemiology data on paraquat dichloride use and Parkinson's disease".

As a result, the agency is considering whether to allow the chemical to continue to be used on crops. A 2018 decision is anticipated. But until such time as that decision is made, the countries where Paraquat produce the chemical, but ban its internal use, are happy to continue exporting the product elsewhere. Switzerland, where the Syngenta company is based, has itself not allowed its use since 1989.

Monsanto's Roundup has the distinction of being the world's most used weed killer with 100 million kilograms of its active ingredient used in the United States in 2015. However, weeds are becoming resistant, and Paraquat has been marketed as an efficient and efficacious alternative. Though knowledge of the link between Paraquat and Parkinson's is decades old, the past five years of research appears to have sufficiently validated that link as to convince medical science hat the connection exists.

In the United States, Paraquat is classified as "restricted commercial use." People must obtain a license to use the product.
Breathing in Paraquat may cause lung damage and can lead to a disease called Paraquat lung. Paraquat causes damage to the body when it touches the lining of the mouth, stomach, or intestines. You can get sick if Paraquat touches a cut on your skin. Paraquat may also damage the kidneys, liver, and esophagus (the tube food goes down from your mouth to your stomach).
If Paraquat is swallowed, death can quickly occur. Death may occur from a hole in the esophagus, or from severe inflammation of the area that surrounds the major blood vessels and airways in the middle of the chest.
Long-term exposure to Paraquat may cause scarring of the lungs called pulmonary fibrosis. This makes it hard to breathe.

The Business of the Brain

"For the first time in all of history we have identified causes of these illnesses, not just made observations of what they look, sound or feel like, but actually discovered the basic causes of mental illness -- which are these genetic discoveries."
"This is a real dramatic sea change in knowledge, and it will lead to a whole new approach to treatment. It will change the way we treat these conditions because we will now have the opportunity to treat them based on causes, not just based on appearance or symptoms."
Daniel Weinberger, director, Lieber Institute for Brain Development

kimber7433 - bipolar depression

"What we have been doing isn't working, and now the question is, 'How do we fix this? What do we need for diagnostics, what do we need to do for therapeutics?' And when we actually have something to deliver then I will say we are at a turning point. But right now we are still at that point of saying, 'My goodness, we have a problem and we have to fix this."
"When you get checked out for chest pain, they do a combination of tests and put them all together in a risk calculator ... We put them together and say 'This is what you got and this is what you need.' ... We don't do that today with mental illness, and that is where we have to go."
Dr. Tom Insel, National Institute of Mental Health director

"We absolutely need the partnership with business, and I am not saying it will be nice to have; it's a need."
"What we have come to learn is that schizophrenia, bipolar, depression and the whole list of these illnesses are not some psychodynamic Freudian disorders. These are as organic as the neurologist treating the brain disorder."
"The inconvenient truth that ... treatment in 2014 ... is not more effective -- albeit safer -- than in 1955 is obviously embarrassing and not defensible."
"The heaviest hitters in the drug industry have left ... but we in academia are partly to blame because we haven't given them new targets to explore."
Roger McIntyre, psychiatry and pharmacology professor, University of Toronto

The holy grail in the medical community of neuroscientists is the discovery of a "cure" for depression and other forms of mental illness. A disease that has been gaining momentum, appearing poised to be represented as one of the most serious, largest global public health challenges. Well, of course there are other issues plaguing society and overtaking its health care systems; the growth globally of obesity with all the allied health complexes that morbid obesity causes.

But it is the festering and growing incidence of mental illness that has brought about a lightbulb-awareness-alliance between business and science that is now making waves. The current medical triad of of research, funding and regulatory models have maxed out, as science is now charting its way into knowledge of how the brain works, held in respectful anticipation as having the potential to turn psychiatry on its head.

This week has been declared Mental Illness Awareness Week, an event organized by the Canadian Alliance in Mental Illness and Mental Health.  Mental illness has come a long way in a relatively few short years, from being a secretive, hushed topic of fearful conversation, to making its debut as a fact of life for many people who are no longer willing to keep it under wraps. They need help, they want help, and they want it now. And their families, co-workers, friends and acquaintances are right behind them, encouraging and cheering them on.

Cathi Falconwing

The broad coalition of care providers and organizations embraced by the Canadian Alliance on Mental Illness and Mental Health sturdily represents the interests of people suffering with mental illnesses, and they're busy lobbying Members of Parliament to make an effort to improve access to care, services and any needed support for those living with mental illness. Mental Health International is working toward an international "business and science" partnership for the purpose of finding that elusive cure.

"We have to explicitly say we are going for the cure ... Mental health advocates have been too timid to fight for a cure for fear of creating false hopes, and what we are saying is it is time to do that. We have had enough advances to say a cure is a plausible dream", explained Mental Health International's Bill Wilkerson. The clues to causes of mental illness can be read in inherited genes now that research has identified in the human genome that specific genes represent risks for mental illness.

While not necessarily causing depression or schizophrenia, they link to a predisposition, the risk factor which when combined with environmental risks could lead to mental illness. With the dawning recognition of the plasticity of the human brain where new links and channels and skills are possible to engage other parts of the brain to perform tasks that an injured part of the brain no longer can, the potential is enormous. It is known by scientists that mental illness is initiated during childhood, before actual symptoms appear.

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No blood or saliva tests or X-rays are capable of diagnosing these biomarkers to recognize predisposition, not yet. What is happening is that neuroscientists and general practitioners are now "personalizing" treatment for those in their care suffering mental illness with the use of individual genetic data that give indication which drugs will work and which will not. Ketamine, an anesthetic, has demonstrated promise in easing depression and even suicidal thoughts, in a matter of hours, besting antidepressants taking weeks and months to work and then only for some patients.

The part that business can play is forthright and indispensable; helping to invest in research so that science can set achievable goals to turn advances into new treatments. Business, according to Dr. Weinberger, the world's leading expert on schizophrenia, brings discipline, flexibility and a "bottom line" sensibility lacking within the public sector and academia.

Pharmaceutical companies have all but abandoned mental illness, with no new drugs in the offing, and they're skittish to dedicate new costly-to-produce time, energy and profit to the search for newer, more effective formulas in the pharmacopoeia of mental illness, to hope to achieve equilibrium through chemical intervention. Dr. Anthony Phillips, chief neuroscientist at the Canadian Institutes of Health Research explains that the world's scientists are making inroads collaborating in network projects on Alzheimer's, Parkinson's disease, traumatic brain injury and other mental illnesses.

The business world's enlistment is a natural in the search for a mental health cure. After all, we are in a knowledge economy in the 21st Century where "brain capital" is key to innovation and creativity and advancement into newer levels of technological possibility and inventiveness. Discoveries take brain power, and a healthy mind is the key. Which equates to good sense in the drive toward a "business and science" alliance.

The Brain: Locked In

"If you know a patient is aware, then you’re going to behave differently."
"As soon as the patient themselves can be included in decision-making, we can have a really big impact on their quality of life. That may be a big thing like 'What do you want your future to be?' … or a small thing like 'What kind of television do you like to watch?'"
Adrian Owen, neuroscientist, Western University, London, Ontario 

"For the first time, we show that a patient with unknown levels of consciousness can monitor and analyze information from their environment, in the same way as healthy individuals.
"We already know that up to one in five of these patients are misdiagnosed as being unconscious and this new technique may reveal that that number is even higher."
Lorina Naci, lead researcher, A common neural code for similar conscious experiences in different individuals study

University of Western Ontario neuroscientists Adrian Owen and Lorina Naci.  (THE CANADIAN PRESS)

Dr. Owen recalls the time the father of a 34-year-old vegetative patient -- a man who had sustained a brain injury and as a result has been unresponsive for 16 years -- related to him that he had taken his brain-injured son to the movies over that sixteen-year period, hoping he would be stimulated by the exposure, that it might be possible that he would understand something of what he was witnessing on the screen.

And that inspired Dr. Owen and his colleagues at Western University to conduct some experiments with a brain scanning technique meant to monitor the response of seemingly non-responsive patients where a film by Alfred Hitchock, Bang! You're Dead, a high-viewing-impact suspense thriller was used by the research team as a tool to engage the still-functioning brain they hypothesized might yet be active within a handful of research subjects.

The result of that study was the release of a paper Monday, published in the Proceedings of the National Academy of Sciences. Post-doctoral fellows worked alongside lead author Dr. Owen, all with Western University's Brain and Mind Institute who gathered both healthy and brain-damaged participants to an MRI scan while screening the Hitchcock film.

The team found that the participants who viewed the film exhibited common patterns of brain activity reflecting resemblance to those of healthy participants. Similarities in reactions from the frontal lobes and the posterior parietal portions of the brain representing areas where reasoning and more complex processes occur were clearly evident, the findings suggesting that at least one of the vegetative participants was aware of and understood the film


The same level of response wasn't detected in another non-responsive research participant. What appeared clear to the researchers was that the 34-year-old patient was capable of understanding language, of following events unfolding in time, was able to lay down memories and demonstrably, through detectable brain signals experienced emotions while following plot changes.

The 34-year-old just happened to be the very same man whose father regularly took him over the years, to view movies. And perhaps this regular exposure helped to stimulate his son's brain, creating patterns of normal reaction and recognition. Which in turn made it possible for the research scientists to view the results of that exposure. Without doubt, this possibility may lead to a move to enrich the environment of such patients rather than consign them to their vegetative state with no relief.

This may provide insight within the medical community that a method exists whereby patients considered to be in full vegetative non-awareness state, might be exposed to tests that could help determine whether patients are really conscious, and whether or not they are capable of thinking about what they view, and what they experience. That achieved, ways in which doctors could conceivably communicate with such patients to determine their wishes may become possible.


The research paper was titled 'A common neural code for similar conscious experiences in different individuals' and is certain to give a boost of hope to families whose loved one may be locked into such a state with no hope for recovery. From detecting that the brain remains operatively functional to possibly discovering at some future date how to effectively communicate and moving from there to techniques to restore brain function may be the wave of the future.