Major problems in cancer chemotherapy are toxicity, resistance, and cancer heterogeneity. A new theranostic paradigm has been proposed by the authors. Many million small molecules (SM) are bound to the proteins extracted from a patient's cancer. SM that also bind proteins extracted from normal human tissues are subtracted from the cancer protein bound SM leaving a large array of SM targeting many sites on each of the cancer biomarkers. Targeting many more than the conventional (...) 1 – 4 cancer biomarkers will reduce development of tumor resistance. After several cycles of selection and counter selection, DNA codes appended to the SM will be PCR amplified to provide templates for restricted libraries of the SM to improve selectivity and sensitivity. The large array of selected and counter selected SM assures that many of the compounds in the array will penetrate the cell membrane and bind to intracellular targets, low tumor resistance, low background for imaging, low therapeutic toxicity, and targeting of the diverse biomarkers present in the heterogeneous mixture of cells in primary and metastatic cancer. Theranostic use of radiolabeled SM binding many sites on many, not necessarily critical, biomarkers provides high cancer cell killing. Experiments to provide proof of principle of this novel concept suggested by the authors. -/- . (shrink)

Cancer—and scientific research on cancer—raises a variety of compelling philosophical questions. This entry will focus on four topics, which philosophers of science have begun to explore and debate. First, scientific classifications of cancer have as yet failed to yield a unified taxonomy. There is a diversity of classificatory schemes for cancer, and while some are hierarchical, others appear to be “cross-cutting,” or non-nested. This literature thus raises a variety of questions about the nature of the disease (...) and disease classification. Second, philosophers of science have historically taken the aim of science to be arriving at true theories. However, scientists studying cancer come from a variety of disciplines, with different scientific as well as practical aims. Perhaps it is not surprising, then, that historians and philosophers of science do not seem to agree on how best to characterize the aim and structure of cancer research; it is far from clear whether the appropriate characterization of the aim is arriving at true theories, or even whether the proper units of analysis are “theories”, or instead, “models”, “explanatory frameworks”, “research programs”, “paradigms”, or perhaps, “experimental traditions”. With the rise of “big data” science—such as the Cancer Genome Atlas Project (or TCGA)—and “systems” approaches to the study of disease, both philosophers and historians of science are rethinking how best to describe and explain these distinctive kinds of scientific inquiry. -/- Third, cancer is in part a byproduct of our developmental and life history, as well as our evolutionary history. Cancer progression can be compared to a reversion of development, or, to the evolution of multicellularity. Thus, cancer raises intriguing questions about how we conceive of “functions”, “development”, and the role of our evolutionary history and particularly, selective trade-offs, in vulnerability to disease. -/- Last but not least, cancer research provides a case study for consideration of the roles of values at the science-policy interface. Epidemiological and toxicological research on cancer’s causes informs toxics law and regulatory policy, which raises a variety of questions about the nature of evidence and inductive risk in such contexts. (shrink)

The accumulation of potentially toxic elements (PTEs) has raised public awareness due to harmful contamination to both human and marine creatures. This study was designed to determine the concentration of copper (Cu), zinc (Zn), cadmium (Cd), and nickel (Ni) in the intestine, kidney, muscle, gill, and liver tissues of local commercial edible fish, fourfinger threadfin (Eleutheronema tetradactylum), and black pomfret (Parastromateus niger) collected from Morib (M) and Kuala Selangor (KS). Among the studied PTEs, Cu and Zn were essential elements to (...) regulate body metabolism with certain dosages required while Cd and Ni were considered as non-essential elements that posed chronic and carcinogenic risk. The concentration of PTEs in fish tissue samples was analyzed using flame atomic absorption spectrometry (F-AAS). By comparing the concentration of PTEs in fish tissues as a bioindicator, the environmental risk of Morib was more serious than Kuala Selangor because both fish species collected from Morib resulted in a higher PTEs concentration. For an average 62 kg adult with a fish ingestion rate (FIR) of 0.16 kg/person/day in Malaysia, the estimated weekly intake (EWI) of Cd from the consumption of E. tetradactylum (M: 0.0135 mg/kg; KS: 0.0134 mg/kg) and P. niger (M: 0.0140 mg/kg; KS: 0.0132 mg/kg) had exceeded the provisional tolerable weekly intake (Cd: 0.007 mg/kg) established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference dose (ORD) values of Cd (0.001 mg/kg/day) as provided by the United States Environmental Protection Agency (USEPA) regional screening level, thus it posed chronic risks for daily basis consumption. Besides, the value of the carcinogenic risk of Cd (0.7−3 to 0.8−3) and Ni (0.5−3 to 0.6−3) were in between the acceptable range (10−6 to 10−4) of the health index that indicates a relatively low possibility cancer occurrence to the consumers in both Morib and Kuala Selangor. This study recommended FIR to be 0.80 kg/person/day to reduce the possibility of posing chronic and carcinogenic risks while at the same time obtaining the essential nutrients from the fish. (shrink)

Despite advances in treatments over the last decades, a uniformly reliable and free of side effects therapy of human cancers remains to be achieved. During chromosome replication, a premature halt of two converging DNA replication forks would cause incomplete replication and a cytotoxic chromosome nondisjunction during mitosis. In contrast to normal cells, most cancer cells bear numerous DNA deletions. A homozygous deletion permanently marks a cell and its descendants. Here, we propose an approach to cancer therapy in which (...) a pair of sequence‐specific roadblocks is placed solely at two cancer‐confined deletion sites that are located ahead of two converging replication forks. We describe this method, termed “replication blocks specific for deletions” (RBSD), and another deletions‐based approach as well. RBSD can be expanded by placing pairs of replication roadblocks on several different chromosomes. The resulting simultaneous nondisjunctions of these chromosomes in cancer cells would further increase the cancer‐specific toxicity of RBSD. (shrink)

Histone deacetylase inhibitors (HDACi) are in clinical trials against a variety of cancers. Despite early successes, results against the more common solid tumors have been mixed. How is it that so many cancers, and most normal cells, tolerate the disruption caused by HDACi‐induced protein hyperacetylation? And why are a few cancers so sensitive? Here we discuss recent results showing that human cells mount a coordinated transcriptional response to HDACi that mitigates their toxic effects. We present a hypothetical signaling system that (...) could trigger and mediate this response. To account for the existence of such a response, we note that HDACi of various chemical types are made by a variety of organisms to kill or suppress competitors. We suggest that the resistance response in human cells is a necessary evolutionary consequence of exposure to environmental HDACi. We speculate that cancers sensitive to HDACi are those in which the resistance response has been compromised by mutation. Identifying such mutations will allow targeting of HDACi therapy to potentially susceptible cancers. (shrink)

In this essay, I propose that DNA‐binding anti‐cancer drugs work more via chromatin disruption than DNA damage. Success of long‐awaited drugs targeting cancer‐specific drivers is limited by the heterogeneity of tumors. Therefore, chemotherapy acting via universal targets (e.g., DNA) is still the mainstream treatment for cancer. Nevertheless, the problem with targeting DNA is insufficient efficacy due to high toxicity. I propose that this problem stems from the presumption that DNA damage is critical for the anti‐cancer (...) activity of these drugs. DNA in cells exists as chromatin, and many DNA‐targeting drugs alter chromatin structure by destabilizing nucleosomes and inducing histone eviction from chromatin. This effect has been largely ignored because DNA damage is seen as the major reason for anti‐cancer activity. I discuss how DNA‐binding molecules destabilize chromatin, why this effect is more toxic to tumoral than normal cells, and why cells die as a result of chromatin destabilization. (shrink)

Objectives: There are indications that institutional review board members do not find it easy to assess the risks and benefits in medical experiments, although this is their principal duty. This study examined how IRB members assessed the risk/benefit ratio of a specific phase II breast cancer clinical trial.Participants and methods: The trial was evaluated by means of a questionnaire administered to 43 members of IRBs at six academic hospitals and specialised cancer centres in the Netherlands. The questionnaire addressed: (...) identification and estimation of inconvenience, toxicity, psychosocial distress, and benefits of trial participation to patients; identification and estimation of benefits to future patients and medical science; assessment of the trial’s RBR; and assessment of its ethical acceptability.Results: Most IRB members expected trial participation to involve fairly or very serious inconvenience, fairly severe to sometimes life-threatening toxicity, and serious psychological and social consequences. Conversely, the perceived likelihood of benefits to patients was modest. Most regarded the study as important, and the balance between risks and benefits to be favourable, and believed that the protocol should be approved. The IRB members’ final judgement on the trial’s ethical acceptability was significantly correlated with their RBR assessment of the protocol.Conclusions: Because most patients who participate in clinical trials hope this will prolong their lives, it is suggested that patient information should better describe the anticipated benefits—for example, the likelihood of prolonging life. This would allow patients to make decisions regarding participation based on realistic expectations. (shrink)

Thanks to the evolution in medical and pharmaceutical research, to date, the number of cancer treatments is increasingly on the rise. Despite this, several side effects related to cancer treatments can exacerbate patients’ physical and psychological conditions, such as cardiotoxicity. Over the years, researchers have explored the possible relationship between psychological variables and physical diseases. Even though some authors examined the relationship between personality and specific diseases, no scientific attention has been paid to the role of personality in (...) the development of cardiotoxicity arising from cancer treatments. Yet this is an important objective, given that determining whether personality influences cardiac toxicity of anticancer treatments could inform the processes by which stable psychological factors influence health. This contribution summarizes and analyzes the available scientific evidence about the association between personality and main cardiotoxicity-related-diseases of anticancer therapies, including cancer and cardiovascular diseases, in order to sketch a hypothetical model of the relationship between personality traits and cardiotoxicity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 7.2 (2002) 194-196 [Access article in PDF] The Body Toxic: An Environmental Memoir by Suzanne Antonetta. Washington, D.C.: Counterpoint, 2001. Pp. 242. Hardback $26; paper $15.00. ISBN 1-5824-3209-0. Memoirs rely on the power of recollection to reproduce the inward texture of experience. Autobiographies cast their authors as historians of the self, combing through documents and old letters, checking facts. In her first prose work, the (...) accomplished poet Suzanne Antonetta crosses the boundary between memoir and autobiography. Interweaving the rough textures of memory with slick surfaces of corporate data, she gives us a lyric meditation on the struggle to become undeceived. Recounting both the facts of corporate malfeasance and our fantastic capacity to filter our reality, she captures the relation between failures of understanding and failures of responsibility. She shows us how difficult it is to accept an unofficial truth. The Body Toxic is a thoughtful and obsessively readable contribution to environmental ethics.Antonetta tells us of childhood exposure to toxic wastes in a penurious and neglected corner of Barnegat Bay. She writes in retrospect, with painfully acquired knowledge of cancer clusters and disease-ridden families. [End Page 194] Her own body's malformed reproductive organs, riddled with tumors, prove spectacularly and tragically infertile when quadruplets spontaneously abort. Sharp backward glances at childhood pleasures; crabbing, berrying, and running through the sweet-smelling spray of DDT, twist us around. Children of the 1960s trail through pesticide as if the weekly truck brought some poisonous ice cream. The mosquitoes thrived: what happened to the children? We revisit these scenes obliquely. Denzer-Schaefer empties its effluent into the bay, cost-efficient Ciba-Geigy rids their chemical wastes through a pipe running straight into the woods, the local farm has become an illegal toxic dump for an unscrupulous contractor. Fire at a nearby nuclear weapons silo has hapless firemen spraying radioactive water into the air. The government responds: they build a chain link fence around the site. A nuclear power plant of the 'old-school' emanates levels of radioactivity to rival Chernobyl. The plant managers assiduously cover it up. This is not some national catalogue of Superfund sites: all take place within a dozen or so miles of a childhood summer house in New Jersey. These shards of a case study are scattered throughout Antonetta's non-linear narrative, piecing together experience, cause and effect.But this work is more ethically and artistically ambitious than the artificial clarity of case studies. Powerfully, Antonetta shows us the inner tangle of toxic mental life: the depression, listlessness, confusion, and self-medication of barely cognized symptoms. Self-clouding toxicity affects both the body and the mind. She fears that she and other family members are not right in the head. How far can she trust herself, and how far can she trace the causes? Is it heredity? Is it toxicity? Has toxic exposure potentiated some family trait? She reads out strings of hazardous chemicals like a rosary, overdetermining all of her symptoms. The distance between cause and effect shields the guilty. Strong toxicity undermines the ability of its victims to understand and act. The Body Toxic is part case study, part phenomenology of altered consciousness, and all too human. A course in environmental ethics could make imaginative use of its insights into a wide range of anthropocentric concerns. Antonetta considers questions of environmental justice, religious beliefs about the natural order, environmental responsibility and property rights, nuclear risk, and cost-benefit analysis in multi-dimensional form, an entry point for philosophical reflection. The Body Toxic is stimulating, controversial, and beautifully written.Many great works of literature signal their ethical intent by fostering a sense of identification with their subjects or protagonists. Antonetta's deft [End Page 195] blunt portraiture expands our moral sensibility by showing us how to be concerned for people with whom we are not meant to identify. The story begins before the beginning, with Antonetta's immigrant family. They are strangely familiar and not entirely sympathetic people, isolated between first generation immigrant cultures and fantasies of prosperous America, clinging to islands of... (shrink)

Exposure of man to chemical agents can occur intentionally, as in the treatment of disease, or inadvertently because the environment contains a wide range of synthetic or naturally occurring chemicals. The alkylating agents are a diverse group of compounds (Fig. 1) and comprise a good example of such xenobiotics, since much is known about their occurrence, and their biological effects include carcinogenicity, mutagenicity, toxicity and teratogenicity.Exposure to potentially carcinogenic alkylating agents such as nitrosamines may occur occupationally, from cigarette smoke, (...) from certain foodstuffs and even endogenously through the ingestion of the appropriate precursor chemicals.1 At the other extreme, the cytotoxic effects of agents such as the chloroethylating nitrosamides or mustards have been exploited in the design of certain antitumour drugs.2 The effectiveness of antitumour agents and the other, mostly adverse, biological effects of alkylating agents have been ascribed to their ability to damage cellular macromolecules, in particular DNA. This review concentrates on investigations carried out over the past two years on the role of DNA damage in carcinogenesis, but we shall see how recent advances in this area of research have also led to a better understanding of the mechanisms of the cytotoxic effects of alkylating antitumour agents. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 7.2 (2002) 194-196 [Access article in PDF] The Body Toxic: An Environmental Memoir by Suzanne Antonetta. Washington, D.C.: Counterpoint, 2001. Pp. 242. Hardback $26; paper $15.00. ISBN 1-5824-3209-0. Memoirs rely on the power of recollection to reproduce the inward texture of experience. Autobiographies cast their authors as historians of the self, combing through documents and old letters, checking facts. In her first prose work, the (...) accomplished poet Suzanne Antonetta crosses the boundary between memoir and autobiography. Interweaving the rough textures of memory with slick surfaces of corporate data, she gives us a lyric meditation on the struggle to become undeceived. Recounting both the facts of corporate malfeasance and our fantastic capacity to filter our reality, she captures the relation between failures of understanding and failures of responsibility. She shows us how difficult it is to accept an unofficial truth. The Body Toxic is a thoughtful and obsessively readable contribution to environmental ethics.Antonetta tells us of childhood exposure to toxic wastes in a penurious and neglected corner of Barnegat Bay. She writes in retrospect, with painfully acquired knowledge of cancer clusters and disease-ridden families. [End Page 194] Her own body's malformed reproductive organs, riddled with tumors, prove spectacularly and tragically infertile when quadruplets spontaneously abort. Sharp backward glances at childhood pleasures; crabbing, berrying, and running through the sweet-smelling spray of DDT, twist us around. Children of the 1960s trail through pesticide as if the weekly truck brought some poisonous ice cream. The mosquitoes thrived: what happened to the children? We revisit these scenes obliquely. Denzer-Schaefer empties its effluent into the bay, cost-efficient Ciba-Geigy rids their chemical wastes through a pipe running straight into the woods, the local farm has become an illegal toxic dump for an unscrupulous contractor. Fire at a nearby nuclear weapons silo has hapless firemen spraying radioactive water into the air. The government responds: they build a chain link fence around the site. A nuclear power plant of the 'old-school' emanates levels of radioactivity to rival Chernobyl. The plant managers assiduously cover it up. This is not some national catalogue of Superfund sites: all take place within a dozen or so miles of a childhood summer house in New Jersey. These shards of a case study are scattered throughout Antonetta's non-linear narrative, piecing together experience, cause and effect.But this work is more ethically and artistically ambitious than the artificial clarity of case studies. Powerfully, Antonetta shows us the inner tangle of toxic mental life: the depression, listlessness, confusion, and self-medication of barely cognized symptoms. Self-clouding toxicity affects both the body and the mind. She fears that she and other family members are not right in the head. How far can she trust herself, and how far can she trace the causes? Is it heredity? Is it toxicity? Has toxic exposure potentiated some family trait? She reads out strings of hazardous chemicals like a rosary, overdetermining all of her symptoms. The distance between cause and effect shields the guilty. Strong toxicity undermines the ability of its victims to understand and act. The Body Toxic is part case study, part phenomenology of altered consciousness, and all too human. A course in environmental ethics could make imaginative use of its insights into a wide range of anthropocentric concerns. Antonetta considers questions of environmental justice, religious beliefs about the natural order, environmental responsibility and property rights, nuclear risk, and cost-benefit analysis in multi-dimensional form, an entry point for philosophical reflection. The Body Toxic is stimulating, controversial, and beautifully written.Many great works of literature signal their ethical intent by fostering a sense of identification with their subjects or protagonists. Antonetta's deft [End Page 195] blunt portraiture expands our moral sensibility by showing us how to be concerned for people with whom we are not meant to identify. The story begins before the beginning, with Antonetta's immigrant family. They are strangely familiar and not entirely sympathetic people, isolated between first generation immigrant cultures and fantasies of prosperous America, clinging to islands of... (shrink)

The future clearly lies in restricting the introduction of new treatments into medical practice unless they are beneficial and an improvement over existing compounds, together with a stepwise re-evaluation of current therapies. The days of analogue development which give 10% or 15% improvement in toxicity over existing compounds are no longer acceptable, and resources should be preserved for real advances. These may require support in their development, particularly at the randomised controlled trial level, by government or research institutions in (...) collaboration with industry.Patients in general are now better informed by their physicians, nurse specialists and self-help groups, although few regions have gone as far as Oregon in information dissemination and involvement of patients in resource allocation decisions. We should take comfort from the fact that in spite of all the difficulty, new treatments continue to be developed, reflecting a commitment from the public, government and the private sector for continued progress. The way forward may be challenging, but the medical profession has to demonstrate leadership by countering the short-sightedness and over-regulation which has resulted from the recent economic recession. We should be seen to be acting with foresight in maintaining the quest for real improvement in the best interests of patients. Governments in turn have a responsibility to ensure they maintain independent bodies of professionals who have the qualities of flexibility, critical ability and vision to ensure continued development of high quality care. (shrink)

The rapidly changing field of genetics affects society through advances in health-care and through implications of genetic research. This study addresses the impacts of new genetic discoveries and technologies on different segments of today's society. The book begins with a chapter on genetic complexity, and subsequent chapters discuss moral and ethical questions arising from today's genetics from the perspectives of health care professionals, the media, the general public, special interest groups and commercial interests.

Until recently, cardiotoxicity in the setting of a malignant disease was attributed solely to the detrimental effects of chemo‐ and/or radio‐therapy to the heart. On this account, the focus was on the evaluation of well‐established cardiac biomarkers for the early detection of myocardial damage. Currently, this view has been revised. Cardiotoxicity is not restricted to a single organ but instead affects the endothelium as a whole. Indeed, it has come into light that not only cancer therapy but also malignant (...) cells per se can impair the cardiovascular system, through a paracrine and endocrine mode of action. Even more intriguingly, a clear interplay between molecular pathways involved in cancer and cardiovascular disease has become prevalent, suggesting a common nominator that governs the pathophysiology of these two entities. Taken together, our strategy in the quest of novel biomarkers in the emerging field of cardio‐oncology should be critically reshaped. (shrink)

This chapter explores the hidden depths beneath the vibrant veneer of AppleTV's breakout, award-winning sitcom – Ted Lasso. Ted Lasso depicts several flavors of toxic masculinity. Toxic masculinity is the wrong path, clearly a moral vice. It encourages harmful behavior, such as sexual assault and domestic violence. Toxic masculinity has also been found to harm men, increasing rates of depression, stress, and substance abuse, as well as alcoholism, cancer, and sexually transmitted infections. In contrast, Ted Lasso consistently depicts positive (...) masculinity as balancing traditionally masculine and feminine traits. (shrink)

While cancer rates continue to increase, therapy has dramatically decreased the mortality rates. The increased efficacy of current therapies may unfortunately have profound toxic effects on gamete function in both adolescent and reproductive age groups, with infertility as an expected consequence of cancer therapy. Significant progress in the advancement of fertility preservation therapies provides realistic options for future fertility in cancer survivors. However, a number of challenging issues need to be considered when presenting fertility preservation options. This (...) overview highlights some of these considerations including religious-cultural-ethical values, access to care and cost of services, developmental capacity and consent, and posthumous reproduction. (shrink)

Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer survivors in young adults increased from 1 in 1,000 to 1 in 250 patients due to more aggressive therapies. Current therapies may have profound toxic effects on gamete function with infertility as an expected consequence of cancer therapy. Depending on the site and stage of cancer, age (...) of the patient, and the type of treatment, approximately 90% of men and women diagnosed with cancer may be at risk of permanent infertility.Fertility preservation has emerged as a discipline dedicated to improving the future reproductive potential of cancer survivors. Significant progress in the advancement of fertility preservation therapies and a heightened awareness of the availability of therapies has occurred in the past 10 years. The American Society of Clinical Oncology and the American Society of Reproductive Medicine have advanced these efforts by formally recognizing the importance of fertility awareness. (shrink)

In accordance with the critical women’s health literature recounting the ways that women are encouraged to submit themselves to various sorts of health “imperatives”, I investigate the messages tacitly conveyed to women in “campaigns for the cure” and breast cancer awareness efforts, which, I argue, overemphasizes a “positive attitude”, healthy lifestyle, and cure rather than prevention of this life-threatening disease. I challenge that the message of hope pervading breast cancer discourse silences the despair felt by many women, furthers (...) a tacit blaming for disease infliction via a rhetoric of personal responsibility, underemphasizes other cogent health determinants like environmental toxicity, and undermines legitimate critiques of current biomedical practices like widespread mammography. While finding a cure for breast cancer is a laudable and worthwhile healthcare goal that can understandably be shared by women’s health activists, corporate sponsors, and the medical community, this paper resists the current formation of campaigns for the cure and “pink ribbon activism” in general. (shrink)

This chapter contains sections titled: Toxic Chemicals in the Arctic Stratospheric Ozone Loss and Global Warming References and Further Reading.

American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.

In this follow-up to the highly successful _Ethnography Unbound,_ Michael Burawoy and nine colleagues break the bounds of conventional sociology, to explore the mutual shaping of local struggles and global forces. In contrast to the lofty debates between radical theorists, these nine studies excavate the dynamics and histories of globalization by extending out from the concrete, everyday world. The authors were participant observers in diverse struggles over extending citizenship, medicalizing breast cancer, dumping toxic waste, privatizing nursing homes, the degradation (...) of work, the withdrawal of welfare rights, and the elaboration of body politics. From their insider vantage points, they show how groups negotiate, circumvent, challenge, and even re-create the complex global web that entangles them. Traversing continents and extending over three years, this collaborative research developed its own distinctive method of "grounded globalization" to grasp the evaporation of traditional workplaces, the dissolution of enclaved communities, and the fluidity of identities. Forged between the local and global, these compelling essays make a powerful case for ethnography's insight into global dynamics. (shrink)

Discusses a number of pressing social issues, including nuclear weapons, radiation in the food supply, technological disasters, cancer, and other diseases traced to toxic chemicals in the air and water.

Facilities that emit hazardous toxins, such as toxic landfills, oil refineries, and chemical plants, are disproportionately located in predominantly Black, Latinx, and Indigenous neighborhoods. Environmental injustices like these threaten just distribution of health itself, including access to health that is not dependent on having the right skin color, living in the right neighborhood, or making the right amount of money. Facilities that emit environmental toxins wrongly make people's race, ethnicity, income, and neighborhood essential to who is allowed to breathe clean (...) air and drink clean water, and thus, who is allowed to be healthy. This can be seen in the environmental crises in Louisiana; Mississippi; Houston, Texas; and Flint, Michigan. Since bioethics purports to concern itself with the principle of justice as applied to individuals and increasingly to populations, the field ought to concern itself more with environmental injustice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The 2004 Meeting of the Society for Buddhist-Christian StudiesFrances S. AdeneyThe 2004 meeting of the Society for Buddhist-Christian Studies was held in San Antonio, Texas, 19–20 November 2004. This year's theme was "Dealing with Illness and Promoting Healing: Buddhist and Christian Resources." During the first session panelists Laura Habgood Arsta, Jay McDaniel, and Beth Blizman presented Christian views on dealing with illness, and Rita Gross responded from a Buddhist (...) perspective. The second session focused Buddhist resources for promoting healing by panelists Francis Tsio and Grace Buford, with Laurel Curran presenting a Christian response.Laura Habgood Arsta presented research done by undergraduate students in border communities between the United States and Mexico. The topic was the connection between the Pentecostal movement and environmental health. Pentecostal Christianity (250–400 million members worldwide) emphasizes the signs that accompany the presence of Christ, evidenced by experiences of spirit baptism and faith healing.Their sample indicated that poor and minority people don't identify with the environmental movement until personal health problems emerge. One possible reason for Pentecostal religion thriving, according to this research, might be that exposure to toxins and poverty draws people to healing, a theological pillar of Pentecostalism. Religious services provide an emotional outlet and inspire self-confidence, which can become a mental health component of a healing solution. Women are free to share and lead services, finding leadership opportunities and a social group in churches. As an inexpensive alternative to medical care, healing in the Pentecostal church provides a sense of physical healing as well as help in overcoming addictions.Beth Blizman informed the group of the toxicity of the Lake Erie area of northern Ohio. Cancer is becoming normalized in this region, which has the highest level of multiple cancers in the United States. Beth feels called to heal her own body and become part of the healing process of that region. She argued that an attitude that disrespects the earth leads to disrespect of one another. "How can healing be found?" she asked. She discussed many resources from ancient monastics to modern women religious, from process and feminist thought to new cosmologies. Finally she connected [End Page 149] Audre Lourde's work on the rejection of difference to the bioregional studies that she has been doing on toxicity and illness.Jay McDaniels followed by giving a Christian perspective on Alzheimer's disease as an ecumenical Christian influenced by Buddhism. He addressed three questions that Christians ask in this situation. The first question is "Where is God now? Is God inside my loved one? How?" In response to this question, Jay outlined an evangelical view of God that understands God as a transcendent being, "way up there, watching from a distance." He contrasted this view with a process view of God as an "umbrella of compassion that envelops the world without smothering it." In this view, God is the great companion, sharing the confusion and anxiety of the ill person.So where is the person as they experience personality changes caused by the disease? Jay addressed this second question through process theology, stating that in process theology the person is defined in Buddhist terms, inheriting from the past and contributing to the future. A person is constantly in flux or transformation, so the person with illness may be a different person than they once were but can be embraced as the person that they are now. The multidimensional universe of process theology allows for a person to live "with one foot on earth and one foot in heaven."Help for dealing with Alzheimer's disease, Jay's third question, can be found in the Benedictine vow of obedience, stability, and ongoing conversion. The deepest need for those with Alzheimer's is to be with them, being available to others to listen. Stability is the vow to stay with the relationship through these changes. Ongoing conversion can come through Alzheimer's as those with this disease invite us into a space of creative imagination and a new kind of respect.Rita Gross responded to the three presentations by arguing that how one perceives a situation changes it tremendously. Two Buddhist principles that apply here are... (shrink)

The scenario is all too common: the elderly woman with end-stage dementia readmitted to the hospital for the fourth time in three months for anorexia, now static cancer progressing despite all proven chemotherapy now pursuing a toxic experimental treatment, or the patient with a rampant infection leading to multiple organ failure who requires machines, medications, and devices to filter the blood, pump the heart, exchange oxygen, facilitate clotting, and provide nutrition. Modern medical science is adept at sustaining life. The (...) field of bioethics has, since its earliest days, debated end-of-life issues; yet American society more broadly remains ill equipped for the experience of dying. This can be .. (shrink)

Quantitative health risk assessment is a procedure for estimating the likelihood that exposure to environmental contaminants will produce certain adverse health effects, most commonly cancer. One instance of its use has been a California air toxics public “right-to-know” law. This article examines the ways in which credible health risk measurements were produced and challenged during the implementation of the California public policy. Fieldwork and documentary analysis finds that stakeholders negotiated within the formal constraints of the risk assessment procedures but (...) still expressed their competing visions for the implementation of the risk communication policy. The abstract results of the method were contextualized according to different time frames and allocations of uncertainty. Furthermore, the article demonstrates that the political process privileged consistency of measurement over accuracy, revealing political negotiations at a fundamentally technical level. The struggle and variation in interpretations can be explained best by the demand to organize the program around the discordant values of democratic accountability and technical efficiency. (shrink)

Humans accumulate porphyrins in the body mostly during the course of porphyrias, diseases caused by defects in the enzymes of the heme biosynthesis pathway and that produce acute attacks, skin lesions and liver cancer. In contrast, some wild mammals and birds are adapted to accumulate porphyrins without injurious consequences. Here we propose viewing such physiological adaptations as potential solutions to human porphyrias, and suggest certain wild animals as models. Given the enzymatic activity and/or the patterns of porphyrin excretion and (...) accumulation, the fox squirrel, the great bustard and the Eurasian eagle owl may constitute overlooked models for different porphyrias. The Harderian gland of rodents, where large amounts of porphyrins are synthesized, presents an underexplored potential for understanding the carcinogenic/toxic effect of porphyrin accumulation. Investigating how these animals avoid porphyrin pathogenicity may complement the use of laboratory models for porphyrias and provide new insights into the treatment of these disorders. (shrink)

Many servicemen and women began suffering from a variety of symptoms and illnesses soon after the 1991 Gulf War. Some veterans believe that their illnesses are related to toxic exposures during their service, though scientific research has been largely unable to demonstrate any link. Disputes over the definition, etiology, and treatment of Gulf War-related illnesses continue. The authors examine the roles of science, policy, and veteran activism in developing an understanding of GWRIs. They argue that the government’s stress-based explanation of (...) GWRIs and its insistence on a scientific link between service in the gulf and veteran illnesses forced veterans to shift from pleas for care, treatment, and compensation on moral grounds to engagement in the scientific process and debates over the interpretation of scientific findings. The authors compare the experiences of veterans to those of breast cancer activists to explain the stages of illness contestation in general. (shrink)

The demonstration that pluripotent stem cells could be generated by somatic cell reprogramming led to wonder if these so-called induced pluripotent stem (iPS) cells would extend our investigation capabilities in the cancer research field. The first iPS cells derived from cancer cells have now revealed the benefits and potential pitfalls of this new model. iPS cells appear to be an innovative approach to decipher the steps of cell transformation as well as to screen the activity and toxicity (...) of anticancer drugs. A better understanding of the impact of reprogramming on cancer cell-specific features as well as improvements in culture conditions to integrate the role of the microenvironment in their behavior may strengthen the epistemic interest of iPS cells as model systems in oncology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ice Cream for BreakfastMichelle MethvenIn June of 2011, on a warm sunny day in Toronto, Canada, my partner and I brought our daughter Stella into the local hospital emergency room for what we believed would be a routine check–up. She had been exhibiting worsening clumsiness and limping for the previous two weeks and we thought it would be easier just to get her seen and have whatever it was (...) dealt with rather than wait two months to see a specialist. My partner and I believed it was likely a severe ear infection, or maybe Lyme disease from a recent camping trip. We each called our workplaces and said we would be an hour or so late. Nothing could have prepared us for the news 22 hours after arriving at the hospital, that Stella had a cancerous mass in her brain. After a biopsy three days later to confirm the diagnosis, Stella was diagnosed with Diffuse Intrinsic Pontine Glioma (DIPG), and given less than a year to live.Parents most often describe DIPG as “a monster.” The tumour saturates the pons and shuts down nerve pathways one at a time. In no particular order, and in no particular time, sufferers (most often young children) lose the ability to walk, sit up, hold up their head, speak and see. The pons is also responsible for breathing, swallowing and regulating the heartbeat, so death can come in many forms at any given time. Though it destroys the brain’s ability to command, the person continues to think and understand as the main part of the brain is untouched. Different from most cancers, chemotherapy and radiation have almost no effect on DIPG; even trials with the most toxic chemotherapies do not slow its progress.My partner and I were shaken to the core at this diagnosis. Looking at our energetic, redheaded [End Page 31] mop–topped little imp, it was impossible to fathom that she had just been given a fatal diagnosis. Yet we knew the doctors at the hospital were among the best and most sought–after in the world, so denial was never a part of our mantra.A week after Stella was diagnosed, we met with a neuro–oncologist to discuss our plans. The only treatment that is slightly effective for DIPG is focal radiation, which can stall the tumor’s growth, granting what is known as a “honeymoon period” of no new symptoms. The honeymoon lasts approximately six months, but there are no guarantees. Twenty percent of children get no honeymoon whatsoever after radiation, and others get only weeks. The doctor we met with confirmed radiation would not be curative, but would “buy time”. He explained that radiation involved six weeks of treatment, seven days a week. Following the six weeks of treatment, there would be a period of anywhere from one to six months in which Stella would likely be asymptomatic. However, at some point, the symptoms generally return and when they do, children deteriorate relatively quickly. Sometimes it takes a month or two, but on occasion there is as little as two weeks between progression and death.As Stella’s parents, we were not convinced that the prescribed radiation was something we wanted to subject Stella to. Because she was only two, and a very spirited and energetic child, it would have been virtually impossible to have her lie quietly on the table in hospital each day for six weeks while radiation was put behind her ear. The neuro–oncologists’ solution was that Stella be sedated for each daily radiation treatment, which would make her groggy for a big part of the day and necessitate needles and IV. As parents, we were presented with an impossible gamble. Do we risk taking away six weeks of her still somewhat symptom–free life for a possible extra three to six months later? And the timing was difficult as well. It was late June. If we chose to radiate it would mean spending the entire summer shuttling her between hospital and home with no weeks at the cottage, and much less time to attend neighbourhood BBQ’s, parties, trips to the park, the library, science centre and zoo... (shrink)

Multidrug resistance resulting from expression of an energy‐dependent drug efflux pump encoded by the human MDR1 gene is a major impediment to effective cancer therapy. Pharmacologic intervention aimed at inhibiting this multidrug transporter should improve existing chemotherapy of human cancer, but drug development has been delayed by the difficulty and expense of developing valid animal models. Using recombinant DNA technology, a transgenic mouse has been engineered whose bone marrow is protected from the toxic effects of chemotherapy by expression (...) of the MDR1 gene. This animal system allows the rapid screening of drugs which inhibit the multidrug transporter and heralds a new era of using transgenic animals for pharmacologic screening. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Courage To LiveAntonella ColaceI am not the patient. I have not received an organ. I am her mother; I am a shadow patient. My responsibility was to make decisions about a gift for my one-year-old daughter in the summer of 2007. A liver.Elisa had a hepatoblastoma. After chemotherapy, the tumor might have been removed, but in the final stages of the work-up a portal vein malformation necessitated a (...) transplant. The medical team at a hospital in northern Italy informed us of the intervention.So many words! Trying to understand what they were saying seemed like a lost cause to me, but I quickly realized that these were people I should trust blindly.These medical team members, by the end of the experience, would all become part of my family. They embraced us in their capacity as professionals and as human beings. I never felt alone or excluded.How many times late in the evening I heard a soft knock at the door of Elisa’s hospital room and behind that delicate touch, I found her doctor ready to leave for home, but not before one last [End Page 131] recommendation for his little patient and a wish of peaceful sleep.The relationship between health workers and the family has developed into an effective relationship of communion and understanding, which has often translated into affectionate terms in communicating with each other. They asked me: “Mom, how is Elisa?”..... Yes—mom!These highly trained medical experts have understood that a parent can sometimes somehow discern the danger behind the otherwise asymptomatic daughter’s subdued attitude; or a surreptitiously high fever, of little concern because Elisa was playing and laughing.I was made to feel an active part of every initiative and decision. My observation point on Elisa, who could not speak for herself, was fundamental for them.I never experienced the hospital as a hostile environment—quite the contrary!It comforted me to have people around us, ready to intervene, reason, and solve the physiological difficulties of my little girl. The hospital was a room in my house, a room whose door was always ajar and in need, I crossed its threshold full of trust, hope, and courage.Today some of those doctors and nurses are my friends. I have a lot of respect for them, gratitude, and admiration.Elisa being placed on the transplant list and waiting for a donor were the first obstacles to overcome.The “warrior” fought against two monsters, time and the tumor. The timing was everything because Elisa had to be in the period of non-toxicity after chemotherapy but could not wait too many weeks without active therapy in favor of a cancer that, lurking like a vulture, was only waiting for the ideal moment to start growing again.The most dramatic thing to overcome and accept was hoping for someone’s death. For Elisa to live, someone else had to die. I felt like an executioner. I didn’t think of anything else; I didn’t sleep at night.In the end, choosing to visualize death as a gift, I had to accept it.It was summer, on August 20th, and another hot and boring night in hospital awaited us. The nurse came into the room to tell me that our lottery ticket had won that night. There was a compatible liver for Elisa. The organ would come from a young woman who had died while swimming in the Sicilian Sea.If they had stabbed me at that moment, maybe not a drop of blood would have left my body. I was paralyzed, incredulous, terrified.My daughter had already been operated on, but it would be different this time. This time they would open her abdomen to remove her diseased liver and replace it with that of a dead young woman, by now sealed in a body bag in a Sicilian morgue. A cold body, deaf now, silent!A young woman for whom, while I was rejoicing, some other shadow patient was despairing, caught up in an unstoppable whirlwind of pain.I felt like throwing up while I cried tears of joyful hope. Guilt grew in my... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A New Graduate Nurse’s StoryJill MountI was taking pre–med courses on the west coast when my mother was diagnosed with acute leukemia. I immediately finished out my classes, packed up my bags and cat and moved back to the town on the east coast where my parents lived. While my mother was fighting the leukemia, I spent many hours in her hospital room and I learned more about the (...) roles of doctors and nurses. Unlike what I had seen on television, where the doctors were always nearby and available to their patients, my mother’s doctors were seldom present. It was the nurses who spent the most time with my mother in the hospital. I wanted to care and be present for my patients like her nurses. So I decided to become a nurse. I didn’t realize that not all cancer units were like my mother’s where the nurses had time to really care for their patients.My mother’s attending doctor would visit her bedside once a day. The doctor would generally stand a few feet away from the foot of my mother’s bed and describe my mother’s latest blood counts. The doctor always seemed to keep her distance at the foot of the bed. As my mother’s series of chemotherapy treatments failed to put her in remission, the doctor would describe the next chemotherapy protocol that my mother would endure. My mother wanted desperately to live and she would keep copies of the blood counts her doctor provided her and would insist on trying the next round of chemotherapy, despite the list of grim side effects each seemed to come with. The doctor generally stayed an average of five minutes during these visits.My mother’s nurses, however, were a constant presence. I had not realized at the time that people are hospitalized primarily for nursing care. My mother was assigned several great nurses, who not only took her vital signs and administered her medications, but who seemed to care about her as a person as well. The nurses seemed to understand how difficult it was for my mother, a very independent person, not to have control over her health. To help her regain control, they provided her with guided visualizations. This was during the mid–eighties so they had her visualize her immune system as Pac–man eating all the cancer cells. My mother liked this because when she did the Pac– man visualizations, she felt she had some control directing her immune system to fight the disease.The nurses also provided my mother with emotional support. We were not a very physically affectionate family and the nurses encouraged us to give my mother hugs when she was not at risk for infections. They also gave her lots of back rubs. One of the nurses gave my mother a relaxation audiotape, which she listened to for hours, others provided her with poetry books. I believe it was partly the nurses’ physical and emotional care that enabled my mother to live as long and to fight the cancer for as long as she did. During the course of my mother’s illness, she received five rounds of chemotherapy over a period of ten months. Unfortunately her efforts to combat the cancer were unsuccessful and she died of complications of the disease and from the cumulative toxic side effects of the chemotherapy.After observing all the ways the nurses cared for my mother, I decided this was what I wanted to do and I decided to go to nursing school instead of medical school. I was able to apply my pre–med prerequisite courses to an accelerated nursing program [End Page E16] and I graduated with my bachelors in nursing after 18 months of nursing school.My nursing program emphasized the importance of viewing the patient as a whole person and not merely viewing them in terms of a particular disease or condition. Nursing school also reinforced how important nurse caring was for patients. I remember one of our exam questions focused on caring. The question was about a nurse walking into a patient’s room and finding the patient... (shrink)

ArgumentThis paper brings together the history of risk and the history of DNA repair, a biological phenomenon that emerged as a research field in between molecular biology, genetics, and radiation research in the 1960s. The case of xeroderma pigmentosum (XP), an inherited hypersensitivity to UV light and, hence, a disposition to skin cancer will be the starting point to argue that, in the 1970s and 1980s, DNA repair became entangled in the creation of new models of the human body (...) at risk – what is here conceptually referred to as the vulnerability aspect of body history – and new attempts at cancer prevention and enhancement of the body associated with the new flourishing research areas of antimutagenesis and anticarcinogenesis. The aim will be to demonstrate that DNA repair created special attempts at disease prevention: molecular enhancement, seeking to identify means to increase the self-repair abilities of the body at the molecular level. Prevention in this sense meant enhancing the body's ability to cope with the environmental hazards of an already toxic world. This strategy has recently been adopted by the beauty industry, which introduced DNA care as a new target for skin care research and anti-aging formulas. (shrink)

The heme‐containing cytochromes P‐450 are a ubiquitous family of monooxygenase isozymes responsible for the oxidative metabolism of a wide variety of endogenous as well as exogenous compounds. Many of the compounds metabolized by this enzyme system are effectively detoxified and converted to derivatives more easily eliminated from the organism. However, some compounds can be activated to reactive species capable of eliciting a cascade of toxic lesions, including cancer. Since its discovery nearly 30 years ago, the cytochrome P‐450 enzyme system (...) has received a great deal of attention, particularly in the areas of their mechanisms of metabolism, range of substrate specificity, the purification and characterization of the multiple isozymes and, more recently, the regulation of expression of specific forms. This review will discuss current notions concerning the expression of at least one cytochrome P‐450 isozyme and future directions that should lead to a more complete understanding of cytochrome P‐450 gene expression in general, particularly as it impacts upon biochemical pharmacology. (shrink)

The DNA in human cells is continuously undergoing damage as consequences of both endogenous processes and exposure to exogenous agents. The resulting structural changes can be repaired by a number of systems that function to preserve genome integrity. Most pathways are multicomponent, involving incision in the damaged DNA strand and resynthesis using the undamaged strand as a template. In contrast, O6-alkylguanine-DNA alkyltransferase is able to act as a single protein that reverses specific types of alkylation damage simply by removing the (...) offending alkyl group, which becomes covalently attached to the protein and inactivates it. The types of damage that ATase repairs are potentially toxic, mutagenic, recombinogenic and clastogenic. They are generated by certain classes of carcinogenic and chemotherapeutic alkylating agents. There is consequently a great deal of interest in this repair system in relation to both carcinogenesis and cancer chemotherapy. BioEssays 24:255–266, 2002. © 2002 Wiley Periodicals, Inc.; DOI 10.1002/bies.10063. (shrink)

Although we are likely unaware of it, in one troubling respect nearly all of us today wear the ring of Gyges. Because we are “invisible,” we use the ring to harm others with impunity. What is our ring of Gyges? It is our use/release of epigenetically toxic environmental pollutants (ETEP), such as endocrine disruptors, metals, and some pesticides. For developmentally/pre- and-postnatally-exposed children, ETEP often cause heritable gene-expression changes, developmental toxicity (DT) that increases later-life disease/dysfunction/death, including asthma/allergy, cancer, cardiovascular (...) disease, depression, diabetes, hypertension, immune/precocious autoimmune diseases, infertility, neuro-developmental/neuro-degenerative diseases, obesity, osteoporosis, puberty, and schizophrenia.Yet, like Gyges, we offenders are “invisible” in at least two senses: (i) invisible before the law, because current regulations do not prohibit ETEP exposures able to cause DT; (ii) invisible as perpetrators, because most child-DT harms appear later in life. This paper (1) uses ETEP and DT to explain how we cause severe, hidden, pollution harms to children and future generations, (2) argues that no major ethical theory can justify allowing avoidable ETEP, and (3) shows that we have justice-based duties to help stop avoidable ETEP exposures, because, to varying degrees, we help cause ETEP and profit from them. Finally, the paper (4) answers objections to (3). (shrink)

Topoisomerase enzymes – found in prokaryotes to human cells – control conformational changes in DNA and aid the orderly progression of DNA replication, gene transcription and the separation of daughter chromosomes at cell division. Several classes of anti‐cancer drugs are now recognised as topoisomerase poisons because of their ability to trap topoisomerase molecules on DNA as ‘cleavable complexes’. Understanding how drugs generate such complexes and why they are toxic to actively growing cancer cells is a major challenge for (...) the development of modern approaches to chemotherapy. (shrink)

Recent work in science and technology studies has looked at how chemical industries manufacture doubt about the toxicity of their products and manage to establish their scientific views in the field of international regulations on toxic substances. Rather than examining yet another “victory” for the industry, this article analyzes the deployment of a “pro-industrial” scientific position, punctuated mainly by failure and opposition. This trajectory is tracked through the analysis of several data sets: archives, scientific documentation, and sociological interviews. The (...) first part of the article charts the development of a biochemical concept, “peroxisome proliferation,” within an academic subfield and its subsequent appropriation by certain industrial parties who used it as a defensive weapon for their commercial interests. Through the example of the International Agency for Research on Cancer and its network of interdependent institutions, the article goes on to analyze the multiple attempts of chemical industry players to establish their interpretation of the concept within the regulatory bodies for carcinogenic substances. The study of such systems of sociological interdependence shows that a full analysis of the “doubt manufacturing” requires an examination not only of the manufacturing process but also of the reception of the ideas produced. (shrink)

The aim of this study was to obtain in-depth knowledge about caring confirmation of patients with cancer, from the patients’ point of view. The research topic was: what is the significance for patients of their being confirmed by nursing personnel? Fifteen men and women between 43 and 80 years of age participated in this study. The method of data collection used was qualitative research interviewing. A hermeneutic approach was used to interpret the data, in which Kvale’s self-perception, the ‘common (...) sense’ level, and theoretical levels were applied. The results are summarized in three areas: an outer confirmation, an inner confirmation, and a lack of the latter. Outer confirmation meant being understood and taken seriously; the maintenance of human dignity and worth indicated inner confirmation. A lack of inner confirmation is primarily manifest in terms of patients’ mental, spiritual and existential concerns. In relation to the theory of Eriksson, these patients were confirmed at the level of having and being, but seldom at the level of becoming. (shrink)

The relationship between science, law and justice has become a pressing issue with US Supreme Court decisions beginning with Daubert v. Merrell-Dow Pharmaceutical. How courts review scientific testimony and its foundation before trial can substantially affect the possibility of justice for persons wrongfully injured by exposure to toxic substances. If courts do not review scientific testimony, they will deny one of the parties the possibility of justice. Even if courts review evidence well, the fact and perception of greater judicial scrutiny (...) increases litigation costs and attorney screening of clients. Mistaken review of scientific evidence can decrease citizen access to the law, increase unfortunate incentives for firms not to test their products, lower deterrence for wrongful conduct and harmful products, and decrease the possibility of justice for citizens injured by toxic substances. This book introduces these issues, reveals the relationships that pose problems, and shows how justice can be denied. (shrink)

In this book, Carl Cranor utilizes material from ethics, philosophy of law, epidemiology, tort law, regulatory law, and risk assessment to argue that the evidentiary standards for science used in the law to control toxics ought to be ...

Medical and public health professionals recommend wearing face masks to combat the spread of the coronavirus disease of 2019. While the majority of people in the United States support wearing face masks as an effective tool to combat COVID-19, a smaller percentage declared the recommendation by public health agencies as a government imposition and an infringement on personal liberty. Social media play a significant role in amplifying public health issues, whereby a minority against the imposition can speak loudly, perhaps using (...) tactics of verbal aggression taking the form of toxic language. We investigated the role that toxicity plays in the online discourse around wearing face masks. Overall, we found tweets including anti-mask hashtags were significantly more likely to use toxic language, while tweets with pro-mask hashtags were somewhat less toxic with the exception of #WearADamnMask. We conclude that the tensions between these two positions raise doubt and uncertainty around the issue, which make it difficult for health communicators to break through the clutter in order to combat the infodemic. Public health agencies and other governmental institutions should monitor toxicity trends on social media in order to better ascertain prevailing sentiment toward their recommendations and then apply these data-driven insights to refine and adapt their risk communication messaging toward mask wearing, vaccine uptake, and other interventions. (shrink)