Chemicals and Autoimmune Diseases
The allergic reactions resulting from sensitization to chemical compounds have long been described. Many are used as preservatives in cosmetics. Formaldehyde-releasing agents such as Quaternium15, DMDM hydantoin, Diazolinidyl urea, or Imidazolinidyl urea are well-known. Newer allergens are Methylchlorothiazolinone, Methylisothiazolinone and P-phenylendiamnine. All a mouthful, but unfortunately used in numerous personal care products—creams, nail polish, hair coloring products and more. Because they overlap in many items, even when replacing a certain brand the allergic reaction may not subside.
The possible link between environmental triggers and autoimmune diseases is more and more considered. Although no clear, straight forward mechanisms are currently identified, the suspicion grows among scientists and more research articles identify possible culprits, hypothesizing their ways of interfering with body’s immune cells.
Some explanations could be that toxicants can alter the cells and unmask hidden cellular materials that come in contact with immune cells. Another is that chemicals either before or after being metabolized, can bind to proteins forming new antigens. Altering the fats and proteins can activate pro-inflammatory substances by the immune cells, while altering the DNA by the toxicants can induce changes in gene expression, increasing the pro-oxidants with subsequent cellular damage.
Such reactants are toluene derivatives, phthalic anhydride, benzoquinone, formaldehyde, ethylene oxide, dinitrochlorobenzene, among others. Exposure to organic solvents (toluene, benzene, xylene, hexane), was connected to development of certain autoimmune conditions, such as systemic sclerosis, primary vasculitis or multiple sclerosis.
If not working in the production of such chemicals, how do we get exposed to any of these? For instance, people are usually not aware that non-organic vegetable oils are extracted using hexane; this chemical used in the industrial process can remain as contaminant. As opposed to using hexane, to obtain the organic oils the seeds are cold-pressed.
Of all the environmental toxicants with possible connections to autoimmune disorders, my suspicion started towards ethylene oxide (EO) before I even thought about searching its mechanisms. Suffering of the autoimmune arthritis, initially through cosmetics, thereafter through certain foods and medications, I realized that something in their composition was making my joints swelling and pain worse.
Each time I checked the ingredients, I saw they contained one or more derivatives of ethylene oxide. I didn’t know wether the long polymerized molecules were the culprit or the ethylene oxide contaminats or both, but eliminating them from use allowed me to see some improvements. That’s when I embarked on the quest to find out as much as the medical literature knows about them.
Many studies about ethylene oxide toxicity were conducted in people with occupational exposure. This means workers involved in the production of ethylene oxide and its derivatives. Based on studies primarily in occupationally exposed populations, ethylene oxide is an ocular, respiratory, and skin irritant and a sensitizing agent. Neurological effects have been observed as well.
But EO is used to sterilize some heat sensitive medical equipment (disposable or reusable), pharmaceutical and veterinary products, foods, spices, and animal feeds. Therefore, occupational exposure also extends to hospital or factory workers involved in the sterilization process. With this information, we realize how many of us are exposed to the EO residues in foods and spices.
Ethylene oxide is used as a component in the production of polyoxyethylene surfactants. These large, polymerized molecules acquire different properties, many of them not beneficial for our health, from what I read. They’re included in personal care products and medications (pills, suspensions, or injectable), laundry and cleaning products, as well as other household items. Because we use all these a regular basis, there is plenty of exposure, since a fraction of EO often persists in these products.
Other sources for the general population is the EO remaining as a contaminant in detergents, paints, coatings, in pest control products as well as fungicides, insecticides, or herbicides. Tobacco smoke contains EO—7mg per cigarette; I’m grateful for the severe measures finally imposed to limit this exposure for those who don’t smoke.
A special consideration is the exposure to EO through sterilized medical equipment. This was more extensively studied in patients undergoing dialysis because the dialyzer equipment and blood tubing is sterilized with ethylene oxide (EO), which persists in it for days even after aeration. Specific antibodies against ethylene oxide are detected in a significant 10-40 percent of dialysis patients, immune-stimulated by EO.
Another remarkable study showed that grafts sterilized with EO and used in knee tendon reconstruction surgery, produced serious joint inflammation in about 7 percent of the patients. The only way to resolve this was by removing the graft. I find this percentage meaningful because it coincides with the percentage of the general population suffering of autoimmune disorders nowadays—which is 7-9 percent.
Another interesting information I came across is the fact that not everybody can dispose of EO the same way. This is because some people have genetically decreased activity of a detoxifying enzyme complex (called glutathione S transferase). This individuals would be more susceptible to the effects of EO. Of course, it would correlate with the level of exposure.
Ethylene oxide (EO) is an agent that binds to proteins and DNA. EO is well known to cause gene mutations and chromosomal abnormalities. The National Toxicology Program deems ethylene oxide as a human carcinogen, linked with leukemia, Hodgkin’s disease, pancreatic and stomach cancer.
And as if these would not be enough, it is also linked with human reproductive toxicity (infertility in both sexes, developmental abnormalities of the fetus), as well as neurological conditions affecting the peripheral nerves and the brain, producing memory and judgement impairments.
My other concern was if ethylene oxide (EO) can also contribute to susceptibility to infections. Apparently, it does. How? By depressing the activity of T-helper lymphocytes. You may not be familiar with the functions of this type of immune cells, but these are the same cells affected by the HIV virus. The mechanism may not be the same, but if EO can contribute to impairing our defense mechanism against infections, it may be why we’re becoming sick so often.
Remember, even for those not involved in working with EO, there is plenty of exposure from the numerous products containing it or its derivatives. And these are products we use many times a day. Thereafter, we take medications and supplements to get better, but many of these have ethylene oxide derivatives incorporated in them as well.
I’m trying to finish this post on a positive note and I realize that only a strong set of new regulations can limit our exposure to this harmful chemical and many others. Until then, we have to pay attention and “ban” them at individual and family level.
RESOURCES:
https://www.hindawi.com/journals/ad/2014/437231/
https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100F-28.pdf
https://www.who.int/ipcs/publications/cicad/en/cicad54.pdf
http://dergipark.gov.tr/download/article-file/62071
https://www.jacionline.org/article/0091-6749(88)90983-9/fulltext
