Science Friday - Plastic In Human Brains | Local Anesthetics Recommended For IUD Insertion

Episode Date: August 23, 2024

A new study measuring microplastics in organs of the recently deceased found that about two dozen brain samples were 0.5% plastic by weight. Also, having an IUD inserted in the uterus is extremely painful for some people. The CDC now recommends that doctors use local anesthetics.Study Finds A Staggering Amount Of Plastic In Human BrainsIt only takes a quick look at our streets and waterways to be reminded that plastic pollution is a big problem. But that’s just the plastic that we can see. An increasing amount of scientific literature points to microplastics accumulating inside our bodies, particularly in organs.A recent preprint published by the National Institutes of Health found a staggering amount of microplastics in livers, kidneys, and brains of recently deceased cadavers. The brains, however, were the biggest shock: They had 10 to 20 times more microplastics than the other organs studied. Twenty-four of the brain samples measured were found to be about 0.5% plastic by weight.Joining guest host Maggie Koerth is Tim Revell, executive editor of New Scientist based in London. The two discuss this and other top stories of the week, including a possible explanation for an “alien” radio signal, a look into how orb spiders use fireflies to lure other insects, and a study that says playing video games is good for you, actually.CDC Updates Guidelines For Managing Pain From IUD InsertionThe Centers for Disease Control and Prevention recently announced updated guidelines for managing pain from inserting a popular form of birth control called an intrauterine device, or IUD. The recommendations now advise doctors to consider using local anesthetics like lidocaine to help manage patients’ pain.An IUD is a small T-shaped device that is passed through the vagina and cervix and placed in the uterus, where it can remain for several years. Figures vary, but this insertion process can be very painful for roughly 10%-20% of patients. In recent years there’s been an outpouring of patients speaking out on social media about just how painful their IUD insertions were. Many people have recounted how their doctors did not provide anything to help mitigate their pain or, in some cases, dismissed their experiences altogether.Guest host Maggie Koerth talks with Dr. Beverly Gray, associate professor of obstetrics and gynecology at Duke University to discuss the significance of these new guidelines.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

For some, getting an IUD is really painful, but now more people are speaking up about their experiences. It's definitely an important conversation that's happening in the public right now and amongst physicians as well. It's Friday, August 23rd, or as we call it around here, it's Science Friday. I'm Cyfry producer Shoshana Bucksbound. In a bit, we'll walk you through the CDC's updated guidelines to manage pain from IUD placement and what this might mean for patients. But first, here's guest host Maggie Kerth with a roundup of the top science stories of the week. We all know that plastic pollution is a big problem. We see it in our streets and in our waterways.

But scientists are increasingly paying attention to the plastic that is getting into our bodies. A new study looked at organs of recently autopsied bodies and found alarming amounts of microplastics, particularly in the brains. Joining me to talk about this and other top science stories of the week, week is my guest, Tim Revel, executive editor of new scientists based in London, England. Welcome back, Tim. Hi, thanks for having me. Okay, so let's start with this very concerning news about our brains. Just how much or how many microplastics are we talking about here? Yeah, this is quite a shocking finding. As you said, microplastics are found absolutely everywhere. They've been found in the Arctic, in the oceans,

and in us. And a new study by the National Institutes of Health looked at 91 brain samples, and they found that among those samples there was about 10 to 20 times more plastic in our brains than in other organs. And shockingly, they found that in 24 of the brain samples, there was about 0.5% plastic by weight of the brain, so a really surprising amount. How are plastics getting in there? Well, that's the thing that these microplastics are just absolutely every, They're in the air, they're in water, and so we end up consuming them both in our food and what we drink and what we breathe. Many of them will just end up going out the other end, but also they end up in our bloodstream, in our blood vessels, and they just seem to make their way around the body accumulating in different organs.

And do we know if they're having a negative impact on our health? Like what are they doing while they're there? Yeah, so though we know that they're just spreading everywhere, we actually don't know for sure what the link between micropoleal. and our health is. There's some early studies that have suggested that microplastics might disrupt our hormones or our immune systems, but the extent of that is not really known, and it's certainly far from categoric at this stage. And this is a pretty small study, correct? And there's just a few bodies taken from the same city. How likely is it that these results extrapolate to all of us? I think it's very likely. So this particular study, as you say, is quite small, but there have been

many similar ones like it. And it seems that wherever we look, we find microplastics now, and that only seems to be increasing. So I think it's likely that this pattern is pervasive. The question is how important is it? How much does that actually affect us? And that's what's still to be worked out. Well, and this is like one of those topics where it's just, it's easy to think, you know, what the heck am I supposed to do about any of this? What are experts saying should happen now? Yeah. So, I mean, most people are pointing to look, we just need to understand more about this problem. There are some that point to things like ways that you could may be able to reduce your exposure to microplastics, for example, avoiding hot food that comes in plastic containers. But really just they are so widespread at this moment that that's only limiting your exposure a certain amount.

Practically speaking, I think what we want to be looking at is how can we stop these plastics getting out into the environment in the first place? and we need to better understand what the relationship between them and our health really is. Let's move on to another story that's also a bit gloomy. There's a new best case scenario for climate change according to scientists. What is it? Yeah, so as you'll be familiar with, there's this long-touted goal of keeping global warming, the peak of global warming, to 1.5 degrees C above pre-industrial levels. And for a few years now, that goal has been looking less and less likely to come to

fruition and there's now a new study that suggests it's completely out of reach, it's not going to be possible. Why did that metric change? Yeah, so there's this team in Germany that they've been running a series of climate models to try and just predict the future essentially, where are we heading with climate change? And the thing with their models is that they featured really realistic constraints for how quickly green technologies and policies can be implemented. For some countries, this is going to be easier than others based on their current infrastructure and bureaucracy. So that all gets factored into the model. And their analysis suggests that the best case scenario now that we're looking at would be limiting the peak of global warming to 1.6 degrees Celsius. But that's, of course,

the best case scenario where we put a huge amount of effort into making that happen from now on out. The team actually think it's more likely that we're going to end up in a situation that is multiple tenths of a degree higher than that. So what might it look like for the world to be 1.6 degrees Celsius hotter than it was in pre-industrial times. What would change? Yeah, so we're already actually seeing some of those effects now. We're talking about both higher intensity and more frequent wildfires, droughts, floods, hurricanes, storm surges, and more. But with each fraction of a degree of warming, these get worse and more frequent. And so that also gives us a sense of what's worth fighting for here. If we can keep it to 1.6 degrees or even 1.7, that's going to be a lot better than

1.8, 1.9, or even 2 degrees. So there's still a lot to play for here. Well, let's switch gears and talk about some new COVID news. Here in the US, the FDA approved two new updated vaccines. Tell me a little bit about those. Yeah, so there's two new vaccines, one from Pfizer-Biontech and one from Moderna. And they're both MRNA vaccines that target the KP2 variant, which is an offshoot of Omicron. It's also expected that very soon there's going to be a third vaccine approved as well from Novovacs. So both of the target strains for these vaccines, they've now actually been outrun by some new variants that are in circulation, but they're all still part of the Omicomacom group. And so people who get these vaccines will be

offered a lot of protection by taking them. When is it recommended that people get these? Yeah. So they could be available from as soon as this weekend. And they will be open to anyone who is six months or older. And so many experts say, if you're eligible, you're someone who should get a vaccine because it not just benefits you. It also benefits those around you. Just in terms of optimal timing, the best time to get it is if there's been at least two to three months since the last time you've had a COVID vaccine or you've actually had COVID itself, that confers the most protection. And then some people will also want to consider if they want to wait until maybe September, October time, because that will then give them the best protection heading into the winter months.

Well, for our next story, let's go back to 1977 to an event known as the wow signal. First of all, remind us a little bit about what this was. Yeah, this is this incredible radio signal that was first detected in 1977. And some have said perhaps it was an alien message, which is why there's so much interest around it. It was first detected by the Big Ear Radio Telescope at Ohio State University. And it was this burst of radio waves with a surprisingly narrow range of frequencies. There was no known astronomical processes that could explain what the signal was. And so the astronomer who spotted it famously wrote,

wow, exclamation mark in red pen next to a printout of the signal. And that's the name it's been given ever since. And over the years, scientists have tried to come up with explanations, ranging from alien civilizations to fast-moving comets, but nothing had quite seemed right. until now where researchers have spotted some similar signals that might help explain what's actually going on. So what is actually going on?

So it turns out, depending on your point of view, this may be good news or bad news, but that it's probably not aliens. It appears that what could be responsible is a cloud of hydrogen atoms in front of red dwarf stars in our galaxy. That's a signal that's been spotted by some researchers in Puerto Rico. and it looks very similar to the wow signal. The only thing that's not perfect is that it's not quite strong enough, the signal,

but the researchers have come up with a scenario that could have led to an exact match to the wow signal, and that's that if there was a powerful enough light source, such as a flare from a highly magnetic neutron star, that could simulate this hydrogen cloud enough to fire out a beam of radiation that would match the wow signal exactly. Now, those might not happen very often,

so you'd have to be very lucky to spot one again. But it does give an explanation for what the wow signal may have been. Okay, but are these radio signals and aliens really mutually exclusive, though? You know, they're in the realm here of speculation. You know, they've not spotted exactly what the wow signal was. They've come up with a very plausible explanation involving natural astronomical events. But of course, who knows if aliens might be able to produce just such a sound. signal as well. So we haven't found evidence for alien life, but you know where aliens do exist

is in video games. Very smooth. And it turns out that they're actually good for us, contrary to what our parents may have told us. So tell me a little bit more about this. Yeah, this is a really interesting study because there's been a lot of studies looking at potential negative harms of video games, particularly playing video games for too long. But there's a new study that's looking at the potential positive aspects too. And this study was possible thanks to this really unique situation that arose from the COVID-19 pandemic, where between 2020 and 2022, I'm sure you remember, games consoles were in really short supply. And so in parts of Japan, they put in place a lottery to determine who was able to purchase a games console. So this was a kind of random trial that happened out of this

situation. Now, a research team has managed to survey over 8,000 people who participated in this lottery. Some of them got games consoles and some of them didn't. And they asked all of these people questions about their gaming habits and also their well-being. And what they found was a link between those people who were able to play games and having a slightly higher well-being, suggesting that actually there were positive effects of playing video games. Is this benefit capped at a certain amount of time playing games? Yeah, in this study, they did see that it seemed to plateau at around three hours a day, which seems like quite a lot, but maybe that's the point where if you're playing more than three hours a day, it starts to negatively impact you in

some way or another, because maybe you're spending all your time gaming rather than doing something else. But one of the interesting things here is we don't quite know what the mechanism is, why it would be the case that it has this positive benefit for you. But it could be things like just playing games is generally fun. Some of them have a social element. There's also a kind of some element of testing your brain whilst playing them and all of that could be linked to positive well-being. And does a study like this have anything to tell us about current concerns over screen time for kids? You know, if video games turned out to not be so bad, could the same end up being true

for cell phone access or social media? I think we're increasingly seeing that this conversation has to be nuanced. With screen time, it's of course the case that you can have a screen time habit that is unhealthy. But there are also so many positives that can come from screen time too. You have access to a huge amount of information. It can be a social device. And so all of those things have to factor into it. It's very unlikely, I think, that even with infinite amounts of research,

we're going to conclude that screens or video games are entirely good or entirely bad. And so I think this is another piece of evidence that nuance is what will be required. Well, that's all the time that we have for today. I'd like to thank my guest, Tim Rebell, executive editor at New Scientist, based in London, England. Thanks for joining us. Thanks for having me. This is Science Friday. I'm Maggie Kerth. Last week, the CDC announced updated guidelines for managing pain from inserting an IUD or intrauterine device. This is a little piece of plastic or metal that doctors can insert into a uterus to help prevent pregnancy. The recommendations

now advise doctors to consider using local anesthetics like lytocane to help manage patients pain. There's been an outpouring of patients in recent years speaking out about just how painful their IUD insertions have been, and that their doctors didn't provide anything that helped mitigate their pain at all. In some cases, the doctors even dismissed their experiences altogether. Joining me now to discuss the significance of these new guidelines is my guest, Dr. Beverly Gray, Associate Professor of Obstetrics and Gynecology at Duke University, based in Durham, North Carolina. Thanks for having me. Thank you so much for being here. What was your reaction to these updated guidelines? How much of a difference is this actually going to make for patients? I was excited to see the updated guidelines because it's definitely an important conversation that's happening in the public right now and amongst physicians as well. Focusing on patient-centered care is always necessary. You know, one important thing to note is that in 2016, the CDC actually put out some guidelines recommending that doctors talk to their patients about using lytocaine

injections for pain control. And these updated guidelines simply add more evidence to support that, as well as topical lytocene or numbing medication on the cervix as well. I think there's probably some people who are not familiar with IUDs or just don't even really know what this is. Where does the pain aspect come from when you're talking about inserting an IUD? Can you just just kind of describe a little bit about the process of this and why it might be a painful thing for people. So like you mentioned before, IUDs are placed inside the uterus. And to get inside the uterus, you first have to do a pelvic exam, expose the cervix. For some people, just that speculum exam or pelvic exam is uncomfortable. Then you use an instrument to steady the cervix.

You measure how long the uterus is because the IUD is more effective if it's right at the top of the the lining of the uterus. So you want to have a good measurement of that. So the measuring can be uncomfortable. And then the IUD is loaded in this little tube and that tube goes inside the uterus. And then the IUD opens once it's inside the uterus to fit the shape of the uterus. You know, this process typically only takes a couple of minutes. But to navigate through the cervix, that can be uncomfortable, to place the IUD that can be uncomfortable and to place that instrument to steady the cervix that can also be uncomfortable. And we know that there are certain factors that influence who has a worse pain experience. So we know that people who have never

had a child before or who have never had a vaginal delivery before tend to have more pain. We know that people who have painful periods may have more pain with insertion. People with anxiety or history of trauma or sexual trauma may have more pain. And anxiety is a risk factor for pain with a whole host of different types of procedures in medicine. So there's a lot of research to support that if people have anxiety or particularly anxiety about a procedure, it can impact their pain experience. So we know that all of those factors can influence pain at any one of those steps. But even with all that said, it's really hard to predict who is going to be like, okay, no big deal. That was not as bad as I thought. And then who might have a really difficult experience, even if they have

protective factors to protect them from pain. So the guidelines specifically mention lytocane as an option for pain management. How effective is that and how is that administered? You're talking about an injection in that case, right? So there are two options for how you can administer lytocaine. So one way is either a paracervical or intracervical block. And so the cervix is the opening of the uterus, that part that you have to navigate through to get the IUD in. And there are these nerves that pass near the cervix. And so if you can inject numbing medicine right near those spots, sort of, you know, similar, like if you have dental work, you inject near the nerves where the pain is going to be.

You know, they're mixed studies, like showing some positive effects of lytocaine, some not showing positive effects necessarily. But the breadth of research would support using a numbing medicine injection, especially for patients who have never had a child before. The new guidelines also include using topical numbing medications or lytocene. And that can numb the surface of the cervix where you're placing that instrument. And it may or may not help with the actual insertion of the IUD, but some people don't want an injection right beside their cervix. You kind of talked a little bit about how anxiety and the fear anticipation can actually influence the amount of pain that people feel.

do we know anything about why that happens? And also, you know, is that anticipation of pain dissuading people from getting IUDs who might benefit from it? You know, I don't know the exact mechanism, although I do know that across studies, anxiety and sort of heightened apprehension or anticipation of a procedure can impact pain, you know, I think sometimes having just open and frank conversations with patients so that they're not feeling like their concerns are being minimized. We've seen so many stories of people who have a very difficult traumatic experience with their IUD insertion. And I'm sure that is absolutely influencing people's decisions about whether or not they want this form of contraception. And so when you go to your doctor

and your doctor's like, oh, it's no big deal, after you kind of talk with patients about kind of this spectrum of experiences, knowing that the vast majority of people have a very tolerable experience with their IUD insertion and that there are a subset of people who have a difficult experience. I think when you have that conversation, you go through the options for pain management and you have shared decision-making, I think patients feel more control and more ease. And there are some patients who come in very concerned about having it placed but really wanting an IUD placed. And sometimes the shared decision making is to decide to place the IUD under sedation or in an operating room setting.

And I do think that concerns about pain are hindering people from choosing this as an option. How common is it to be in severe pain in these kind of situations? You know, I know that I have an IUD. I barely noticed it going in. But I have friends who've had discomfort. I've had friends who've had severe pain. do we have like any data on how common one response is versus another? I think rates are kind of around 20%.

I think it probably varies by provider experience and practice and whether or not they're routinely offering pain medication and their counseling. I would say in my own practice, I would say it's probably less than 10%. And so it's more rare that we see that. And it's more common that we see patients have a really good experience or better than they expected experience. You know, what's interesting is that if you look at physicians and OBGYNs and what they choose for contraception, a much higher percentage of them choose IUDs. And these are folks that are placing them every day in their practice and seeing what patients' experiences are like and

also seeing the other side of it, too. So there are a lot of positive side effects from from IUDs. So for people with hormonal IUDs, it can stop their menstrual cycles. It can make their menstrual cycles much less painful. You know, for myself, I love my IUD and I have migraines with aura so I can't use estrogen-based method. So for me, it is the best method. Gynecology has this long history of dismissing women's pain. Do you see these updated guidelines as a signal that something like that is changing, that we're going to see a better future where medicine is respecting and meeting women's needs? In our own practice, in our own training, and I will say kind of, at our institution. I have seen a transformation from my training to now. And I think having these

conversations are so important. I think not dismissing patients pain and calling women hysterical. Like that's not the legacy of medicine that we want. And you're right. I think OBGYN has some negative things in our history and our past. And I think the hopeful thing is that this generation of doctors is changing the practice of medicine. and we're making good advances. And I think listening to patients is key to that. That's just about all the time we have for today. Dr. Gray, thank you so much for taking the time to talk with me. Absolutely. Thanks for having me. Dr. Beverly Gray is an associate professor of obstetrics and gynecology at Duke University, based in Durham, North Carolina.

That's just about all the time we have for today. Lots of folks help make the show happen, including Felissa Mayors. Danielle Johnson. Beth Ramby. Emma Gomez. Next week, how to define what wilderness means, plus what cave art can tell us about early humans. I'm sci-fi producer Shoshana Bucksbaum.

Catch you next time.