Aly Hartman avoided sodas, crowds and gas fumes and switched to organic fruits during pregnancy.
(Christina House, For The Times)

Mounting evidence suggests that fetuses are surprisingly susceptible to outside influences such as food, environmental pollutants, even stress.

If Aly Hartman could have placed herself in a protective bubble for the duration of her recent pregnancy, she would have done so.

The Marina del Rey woman, 28, cut out alcohol, sodas and caffeine. She replaced her sugary breakfast cereal with crackling oat bran, quit eating Taco Bell MexiMelts and began stocking up on organic fruits and vegetables. She ducked back into her car while pumping gas and, when driving, sped around vehicles emitting thick fumes. She avoided crowds and handshakes, bought all-natural cleaning products and stopped wearing perfumes and lotions.

The child-talent agent admits her safety measures may seem a bit extreme, but she may actually be a model for all pregnant women.

What women eat, touch and breathe during pregnancy now appears to be more important to their babies' health than anyone ever imagined. Mounting scientific evidence suggests that fetuses are surprisingly susceptible to outside influences, such as food, environmental chemicals and pollutants, infections, even stress. Under this theory -- called fetal programming -- babies are born not just with traits dictated by their parents' genes, such as brown eyes and olive skin. They may be born with a tendency to develop asthma, diabetes or other illnesses based on what their mothers ate and were exposed to during pregnancy.

Already known were the obvious, and serious, risks posed by smoking, drinking and drug use. Now researchers are homing in on subtler changes in the fetal environment that can influence a child's health even into adulthood. In one of the most widely relevant examples, given the nation's growing waist size, research has shown that pregnant women with diets high in fat and sugar give birth to children who are more likely to become obese, perhaps because their fat cells are "programmed" in utero for later obesity.

In short, the daily experiences of a pregnant woman may be far from benign.

Pigi Cipelli for The New York Times
At least 82 Chinese companies at a Milan trade show, none of them certified, said they made pharmaceutical ingredients.

This article was reported by Walt Bogdanich, Jake Hooker and Andrew W. Lehren and written by Mr. Bogdanich.

MILAN -- In January, Honor International Pharmtech was accused of shipping counterfeit drugs into the United States. Even so, the Chinese chemical company -- whose motto is "Thinking Much of Honor" -- was openly marketing its products in October to thousands of buyers here at the world's biggest trade show for pharmaceutical ingredients.

Other Chinese chemical companies made the journey to the annual show as well, including one manufacturer recently accused by American authorities of supplying steroids to illegal underground labs and another whose representative was arrested at the 2006 trade show for patent violations. Also attending were two exporters owned by China's government that had sold poison mislabeled as a drug ingredient, which killed nearly 200 people and injured countless others in Haiti and in Panama.

Yet another chemical company, Orient Pacific International, reserved an exhibition booth in Milan, but its owner, Kevin Xu, could not attend. He was in a Houston jail on charges of selling counterfeit medicine for schizophrenia, prostate cancer, blood clots and Alzheimer's disease, among other maladies.

While these companies hardly represent all of the nearly 500 Chinese exhibitors, more than from any other country, they do point to a deeper problem: Pharmaceutical ingredients exported from China are often made by chemical companies that are neither certified nor inspected by Chinese drug regulators, The New York Times has found.

Because the chemical companies are not required to meet even minimal drug-manufacturing standards, there is little to stop them from exporting unapproved, adulterated or counterfeit ingredients. The substandard formulations made from those ingredients often end up in pharmacies in developing countries and for sale on the Internet, where more Americans are turning for cheap medicine.

In Milan, The Times identified at least 82 Chinese chemical companies that said they made and exported pharmaceutical ingredients -- yet not one was certified by the State Food and Drug Administration in China, records show. Nonetheless, the companies were negotiating deals at the pharmaceutical show, where suppliers wooed customers with live music, wine and vibrating chairs.

One of them was the Wuxi Hexia Chemical Company. When The Times showed Yan Jiangying, a top Chinese drug regulator, a list of 186 products being advertised by the company, including active pharmaceutical ingredients and finished drugs, Ms. Yan said, "This is definitely against the law."

Yet in China, chemical manufacturers that sell drug ingredients fall into a regulatory hole. Pharmaceutical companies are regulated by the food and drug agency. Chemical companies that make products as varied as fertilizer and industrial solvents are overseen by other agencies. The problem arises when chemical companies cross over into drug ingredients. "We have never investigated a chemical company," said Ms. Yan, deputy director of policy and regulation at the State Food and Drug Administration. "We don't have jurisdiction."

China's health officials have known of this regulatory gap since at least the mid-1990s, when a chemical company sold a tainted ingredient that killed nearly 100 children in Haiti. But Chinese regulatory agencies have failed to cooperate to stop chemical companies from exporting drug products.

In 2006, at least 138 Panamanians died or were disabled after another Chinese chemical company sold the same poisonous ingredient, diethylene glycol, which was mixed into cold medicine.

China has an estimated 80,000 chemical companies, and the United States Food and Drug Administration does not know how many sell ingredients used in drugs consumed by Americans.

The Times examined thousands of companies selling products on major business-to-business Internet trading sites and found more than 1,300 chemical companies offering pharmaceutical ingredients. How many others sell drug ingredients but don't advertise this way on the Web is not known.

If the Milan show is any guide, most, if not all, are not certified by China's drug authorities.

SAN FRANCISCO -- Consider the BornFree baby bottle. It's made from a plastic five times as expensive as the one routinely used for baby bottles. It has to be shipped all the way from Israel. And its retail price -- $9.50 -- is about triple that of a conventional bottle.

It's also a big seller in stores catering to parents who want the safest possible environment for their babies, stores where items labeled "bisphenol A-free" and "phthalate-free" line up next to the cloth diapers and breast pumps.

BornFree is "so popular, their products have been on back order because we can't keep them in stock," says Cara Vidano of Natural Resources, a store here for new and expectant parents.

To anyone not contemplating parenthood, phthalates and bisphenol A sound like something children bring home on chemistry quizzes, not cuddle in their cribs. But these chemicals are at the heart of worldwide scientific investigation and a debate over whether they are harmful to the very young.

Parents, activists and many scientists are concerned that if a baby drinks from a bottle made with bisphenol A or gums a toy made with phthalates, he or she could suffer serious, even permanent, harm.

The European Union and California have banned some phthalates from toys. And a division of the U.S. Department of Health and Human Services concluded that one form of phthalate used in intravenous tubing and other hospital equipment could hamper the development of baby boys' reproductive tracts.

Bisphenol A and phthalates are sometimes called "everywhere chemicals" because they're so widely used. Bisphenol A, which is used to make plastics clear, strong and shatter-resistant, shows up in water bottles, food containers, baby bottles, some dental fillings and the coatings for the inside of cans containing foods. Phthalates (pronounced THAL-ates), which make plastic soft and flexible, are used in toys, rattles, teethers, car interiors and medical devices such as tubing, catheters and intravenous bags.

Nearly every American has been exposed. A 2000 study by the U.S. Centers for Disease Control and Prevention found phthalates in the urine of 75% of people tested. CDC research has shown that 95% of Americans have detectable levels of bisphenol A in their bodies.

There's mounting evidence, some of it in human studies and more in mice and rat studies, that these chemicals also may trigger hormonal changes. That is why they are labeled "endocrine disruptors": They can mimic the hormones that the body releases and are believed to be capable of interfering with the reproductive systems of fetuses and babies, even at extremely low doses.

Phthalates, compounds used in toys and many other plastic items, have raised health concerns.

A group of obscure chemical compounds with the tongue-challenging name phthalates popped up in the news last week. Although you may have never heard of them, they're found in scores of consumer products. And they're linked by some people to a variety of health problems.

California became the first state to ban phthalates in toys and other products for children when Gov. Arnold Schwarzenegger signed a hotly debated measure into law. A day later, an Oakland environmental group filed a complaint alleging that Apple Inc.'s iPhone is a health hazard because of the presence of phthalates in the headphone cord.

First things first. How do you pronounce phthalates?

THAL-ates.

What are they?

Phthalates are a family of chemical compounds that come in the form of oily, colorless liquids. There are dozens of types of phthalates; the California law bans six of them.

How are they used?

Phthalates have been used for about 50 years to make hard plastics softer and more flexible in such products as vinyl flooring and seat coverings, raincoats, shower curtains, garden hoses and even sex toys. They're also found in children's products such as teething rings and bibs as well as in bath, beach and pool toys.

In hospitals, phthalates can be found in intravenous medical tubing, examination gloves, catheters and blood storage bags. They are also used in nail polish to prevent chipping and in perfumes to help the fragrance last longer.

Phthalates are so ubiquitous that studies have found them in almost everyone tested.

What does the new law do?

It bans the sale, manufacturing or distribution of any toy or child-care product that contains more than 0.1% of di-2-ethylhexyl phthalate (DEHP), benzyl butyl phthalate (BBP) and dibutyl phthalate (DBP). DBP is used in nail polish and paint as well as toys.

The law similarly bans any toy or child-care item intended for use by a child younger than 3 if that product can be placed in the child's mouth and contains more than 0.1% of diisononyl phthalate (DINP), diisodecyl phthalate (DIDP), or di-n-octyl phthalate (DnOP). DINP is the phthalate most commonly found in toys.

When does the law go into effect?

Jan. 1, 2009.

Why are they being banned?

Advocates of the ban -- including environmentalists, Planned Parenthood and breast cancer awareness groups -- point to studies that have linked phthalates to reproductive problems, early onset of puberty, testicular cancer and liver and thyroid damage. Other research suggests phthalates may contribute to asthma and decreased lung function in men.

"When a child puts a phthalate-laden teether in her mouth, it's like sucking on a toxic lollipop," said Rachel Gibson, attorney for Environment California, the group that led the push for the ban.

Many phthalates are already banned in certain products in the European Union, 14 more countries and in San Francisco.

What do opponents say?

EDITOR'S NOTE: We are including this article on our Web site to illustrate the plastics industry's stance on the health concerns regarding phthalates and bisphenol A. The article outlines plans by the American Chemistry Council to implement an aggressive media campaign to assure us all that phthalates and BPA are safe, while blatantly disregarding the growing body of scientific evidence that contradicts their position. In light of the scientific research, we think this upcoming campaign is outrageous and irresponsible.

E-Weekly



In a little over two years as president and CEO of the American Chemistry Council (ACC; Arlington, VA), Jack Gerard has promised members to "run the association, like you run your business", leading to a reorganization and 25 new members, as well as an increased emphasis on political responsiveness, but the term has not been without its challenges, specifically increasing hostility towards plastics. From bottle and bag bans to growing concern with plastics-related chemicals such as phthalates and bisphenol A (BPA), the ACC says the loudening plastics outcry has not gone unnoticed in political circles, with some areas getting more attention than others.

"California tends to be the incubator for many ill-conceived ideas," Gerard told the crowd in his keynote speech at the ACC's recent Center for the Polyurethanes Industry (CPI) event in Orlando (Sept. 24-26). "The ACC wants to turn the tide of anti-plastics legislation in California... We're focused on state and local laws as a beachhead to broader federal regulation."

Part of that focus has entailed gauging popular sentiment about plastics in the state, with the ACC in August questioning four focus groups along the California coast from north of San Francisco to San Diego. "[Respondents'] impressions of plastics were not fixed," Steven Russell, newly appointed managing director of ACC's plastics division, told MPW. "When we told them some of the positive aspects of plastics [with regards to energy efficiency], we found out we can move the needle."

CAMILLUS, N.Y. -- Gina McMahon is on a hunt. She's searching the Internet for a product that's tough to find in stores: Baby bottles made from materials no one has accused of posing a health risk.

She's responding to recent news reports that certain types of plastic used to make baby bottles, sippy cups and sport bottles can release chemicals that may be harmful to the person drinking from them.

The mother of 7-month-old twin boys learned the Avent baby bottles she had been using were among products made from a type of plastic called polycarbonate that some scientists believe is dangerous.

"You just don't know what to give your kids anymore," McMahon says. "As a parent, you try to keep them healthy and make good choices. Then it comes back that what you're using could be more harmful than good."

Polycarbonate gives off small amounts of a chemical called bisphenol A, or BPA. The chemical has been tied to reproductive and developmental defects in animals during laboratory tests, but little research exists regarding its effects on humans. Experts disagree over whether small amounts of BPA can harm people.

Frederick vom Saal, a biological sciences professor at the University of Missouri-Columbia, says the chemical is dangerous.

A group of BPA experts, including vom Saal, reviewed 700 studies on BPA and released a statement in August, expressing their concerns in the journal, Reproductive Toxicology. They noted that levels of BPA often found in humans tend to be higher than levels shown to cause harm in lab animals.

"If (BPA) is doing all this horrible stuff to animals, do you really want to put this in your baby?" vom Saal says.

FOR THE RECORD:
Autism link: An article in Monday's California section about a new state study that found that exposure to two pesticides may make women more likely to give birth to children with autism said it was the first study to find a link between pesticides and autism. Italian scientists reported in 2005, however, that pesticides known as organophosphates could cause neurological changes that lead to autism.