The Darwin Trilogy The Principles and Practice of Integrative Medicine Majid Ali, M.D. Coming 2009

Majid Ali, M.D.

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Editor, The Journal of Integrative Medicine
Formerly, Associate Professor of Pathology (adj.), College of Physicians
and Surgeons of Columbia University, NY
Formerly, President of Staff and Chief Pathologist, Holy Name Hospital, Teaneck, NJ

Fellow, Royal College of Surgeons of England - Diplomate,
American Board of Anatomic and Clinical Pathology
Diplomate, American Boards of Environmental Medicine
Past
President Capital University of Integrative Medicine

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DARWIN, DYSOX, AND OUR FERMENTING PLANET-ESSAY 4:
OXYGEN DEFICIT IN PLANETARY WATERS AND CLIMATIC CHAOS:

 

Times are desperate for most forms of life on the planet Earth. In the man-microbe conflicts, microbes are winning. That also is the case for butterflies, bees, and bats. In my view, the reason is the changing "oxygen conditions" of planetary life. In this series of essays on the fermenting planet, I present my hypothesis that the primary result of the changing oxygen conditions is impairment of oxygen-driven energy systems of humans, animals, and plants. The oxygen-shunning species are thriving at the expense of the oxygen-loving species. This trend has far-reaching significance for all planetary life.

 

There are two predominant groups of life forms on our planet: oxyphils that thrive in oxygen-rich environments and oxyphobes that flourish in oxygen-poor conditions. Oxyphils include humans, all animals, and most plants while oxyphobes comprise fungi and anaerobic bacteria. The changing oxygen conditions are altering the balance between these groups by favoring oxyphobes over oxyphils.

 

Evolution created two primary modes of cellular energetics: low-efficiency non-oxygen-driven metabolism designated as fermentation and a high-efficiency oxygen-driven metabolism called respiratory mode of energy generation. The oxygen deficit over land masses and in planetary waters fosters the growth of the fermenters as it threatens the oxygen-utilizing species.

 

Darwin, Dysox, and Our Fermenting Planet - Essay 1

 

Hypoxia is oxygen deficit. Hypoxic waters are bodies of water with deficiency of oxygen. Anoxia is absence of oxygen. Anoxic waters are bodies of water with an absence of oxygen.  Hypoxia develops in aquatic environments as the amount of dissolved oxygen (molecular oxygen dissolved in the water) falls to a level that is detrimental to fishes and other forms of oxygen-breathing  aquatic species.56-59 The temperature and salt content (salinity) of bodies of water determine the amount of oxygen dissolved in the water. So, the  value of dissolved oxygen is expressed as a percentage of the amount of oxygen that would dissolve in the water at the prevailing temperature and salinity.  An aquatic ecosystem without dissolved oxygen (0% saturation) is designated as an anoxic aquatic system. Dissolved oxygen is measured in standard solution units of millimoles O2 per liter (mmol/L), milligrams O2. At 20 °C under sea level atmospheric pressure, the value of dissolved oxygen in freshwater is  9.1 mg/L, a value that is designated as 100% saturation. The U.S. Geological Service (USGS) offers at its web site solubility tables showing the values, in milliliters per liter [ml/L], based upon temperature and corrected for different salinities and pressures.

 

It is noteworthy that most species of fish cannot survive in waters with dissolved oxygen saturation of less than 30%. For optimal sustenance  of oxygen‑utilizing life forms, an aquatic ecosystem must not develop oxygen deficits that allow the dissolved oxygen  levels to fall below 80%.


Are natural bodies of water sometimes supersaturated? Can excess dissolved oxygen in water can sometimes be harmful for fish, aquatic animal species, and aquatic vegetaion? Not much has been documented in this area. However, it is known that oxygen supersaturation does develop under certain conditions and causes decompression damage to aquatic life.


Algae and related aquatic vegetation called phytoplankton in the water mass release oxygen by spliting water into hydrogen and oxygen in the process called photosynthesis. On the other side of the equation, oxygen is picked up and metabolized by bacteria, fish, and organisms included in the category. This is the essential "oxygen balance," not only in aquatic ecosystems, but on land masses as well. In oceans, seas, and large lakes, the equilibrium between the two mechanisms for the release and consumption of oxygen determine the amount of oxygen dissolved in the water which, in turn, determines the aquatic biomass (the total mass of living species, vegetative as well as animal species). I might add here that the difference between the amount of oxygen in the water (theoretical concentration if there were no living organisms) and the actual amount (concentration) of oxygen is designated as the biological demand of oxygen.

 
The climatic changes documented so far are deepening the "oxygen crisis" in most bodies of water in the world. If the current trends hold, the predicted climatic chaos will dangerously enlarge the bodies of anoxic waters with dire consequences for life within them. There are several mechanisms by which global warming, incremental carbonization of oceans and land masses, and chemicalization of the planet decreases the amount of dissolved oxygen saturation in water. Specifically, such mechanisms include the following.60-62

 

-Warm water holds less oxygen;
 

-Eutrophication (increased growth of plankton and algae due to addition of nitrogen, phosphorus, and potassium in water) reduces the amount of oxygen dissolved in water;
 

-Persistence of stratification in large bodies of water, as described earlier, disrupts oxygenation of deep waters;

-
Higher air temperature intensifies the density stratification of water making it less dense and relatively anoxic;


-
Solar warming of the surface water reduces water density and causes anoxia;
-
Saltier water increases the density of water;
-
Change of direction of the wind can cause significant local upwelling of the anoxic bottom water (wind can actually drag the surface water away from shore, replacing it with deeper  water);
-
Increasing anthropogenic nitrogen input;

-Stratification;

-Energetic tidal circulation; and
-
The pycnocline effect (a rapid change in water density with depth).


In the large bodies of fresh water, the density change is essentially caused by changes in the temperature, while in the oceanic waters the density change is caused by changes in water temperature and/or salinity. For further information on the above subjects and specific data concerning the extent and duration of harmful algal blooms (Microcystis aeruginosa) in the Potomac River, the reader is referred to www.marine.unc.edu/modmon

Anoxia develops in sea waters under natural conditions.  Anoxic sea water is generally found in regions of restricted water exchange. In general, oxygen does not reach the depths of the sea area due to a physical barrier, such as silt and extended periods of density stratification. Such conditions allow bacteria to increase their rates of the oxidation of organic matter, thus increasing oxygen utilization beyond the supply. For example, the occurrence of markedly anoxic conditions have been documented in the geological history of the Baltic Sea. Recent evidence shows that increasing degrees of eutrophication have increased the degrees of the anoxic regions in the Baltic Sea and the Gulf of Mexico.

Anoxic states are created by water stagnation, density stratification, influx of organic matter, thermoclines, and bacterial metabolism of sulfide. Sulfur compounds settle in the sediments and later rise into the surface waters. Recent reports of anoxic waters are disturbing both for the degrees of oxygen deficit and for the frequency with which such deficits are encountered, especially the findings of fatal anoxia in the bodies of water in which anoxia was not previously present. For example, in February 2008, severe anoxia was detected for the first time in the northern California current system, an enormous ecosystem with no previous record of extreme oxygen deficits.63 The severity of anoxia raises the specter of rapid and discontinuous ecosystem changes in highly productive coastal systems that sustain the world's fisheries.

In 1888, Lajos Winkler, a Romanian chemist, developed a method of determining  the level of dissolved oxygen in water samples.64 The test is designated as the Winkler test. It is interesting to note that the subject of the oxygen content of large bodies of water (and its effects on life in them) preoccupied a Romanian student as far back as the end of the nineteenth century. Yet, it holds little, if any, interest for doctors today, notwithstanding the central importance of oxygen factors in the pathogenesis of all chronic disorders.

 

SMOG AND OXYGEN DEFICIT


The story of smog has many interesting faces: clinical, historical, biochemical, environmental, and political. The clinical problems associated with poor quality air, first and foremost, should have been related to problems of oxygen homeostasis in health and disease. What could be simpler than that? Why do we breathe except to bring oxygen in and expel the produced waste. It both amused and saddened me when I read a large number of articles about smog posted by governmental, public, environmental, and academic groups. For three hours, I read and read without finding a single reference to smog disrupting oxygen signaling and oxygen‑driven cellular energetics. Inexplicably, the literature of smog evolved into a literature of ozone in ambient air.

For public education, the United States Environmental Protection Agency (EPA) developed an Air Quality index to explain the degrees of air pollution. For reasons that escape me, it built its entire case around the eight‑hour average concentration of ozone in the air, as if the sulfur and nitrogen pollutants do not matter. The EPA promulgated the following standards:

 

85 to 104 ppbv (parts per billion by volume):    Unhealthy for Sensitive Groups

105 ppbv to 124:                                                      Unhealthy

125 ppbv to 404 ppbv:                                            Very unhealthy

 
Smog, in reality, is much more than just the concentration of ozone in the air. It is the sum total of all noxious and toxic elements that exist in the ambient air at any given time. Did the folly of fixating on ozone levels lead to the disastrous proclamation on September 15, 2001 of Christie Whittman, the then EPA chief when she declared that air in New York was safe to breathe, following the inferno of collapsed World Trade Centers (WTC). That comment stirred me to action and culminated in the publication in early 2002 of my book September Eleven,2005  (2002),65a volume of predictions written in a fictionalized past tense. I had three primary reasons for writing that book:  

  1.   
To predict that more than 250,000 people exposed to the poisons released from the WTC inferno would become chronically ill due to 9/11‑related causes in September 2005;
 

  2.     To assert that at the levels of oxygen signaling and oxygen‑driven cellular energetics, terror turns into toxicity, and toxicity into terror;

  3.  
All patterns of chronic illness triggered by 9/11‑related events would be fundamentally caused by disruptions of the oxygen signaling and oxygen‑driven cellular energetics;

  4.      
Much of 9/11‑related illness could be prevented by robust integrative treatment plans that restore deranged oxygen signaling and oxygen‑driven cellular energetics; and

  5.      
Regrettably, the fundamental oxygen issues of the 9/11 tragedy would be ignored by the prevailing one‑disease‑one‑cause‑one‑drug model of thinking.

 
In 2008, anyone who reads September Eleven, 2005 will recognize the utter logic and predictability of events that I foresaw. In September 2001, I knew that the EPA and the mainstream medicine would stubbornly refuse what Londoners of the Roman times knew: Pollutants in the air sicken the people who breathe it. Indeed, The New England Journal of Medicine considered the 9/11 events "not necessarily medical significant"66 and advised its readers not to "medicalize"67 them (see September Eleven, 2005 for full details).

The English  claim the origin of the term "smog"and attribute it to Dr. Henry Antoine Des Voeux in his 1905 paper entitled "Fog and Smoke" presented at a meeting of the Public Health Congress.68 On July 27, 1905, the London newspaper Daily Graphic celebrated the paper, writing that Des Voeux had done a public service in coining a new word for the London fog. Californians challenge that claim, citing the use of the word "smog" by Los Angeles Times on January 19, 1893. The English need not feel up‑ended since the Times attributed it to "a witty English writer." The Londoners have sound reasons for amusing themsleves with the assertions of Angelos. Since the Roman times, they have recognized this distinction. In 1306, King Edward I briefly banned coal fires in the city. In 1661, John Evelyn's Fumifugium blamed burning coal for what people considered to be London cough. In 1952, The Great Smog darkened the city sreets and killed approximately 4,000 people in four days, claiming another 8,000 during the days and weeks that followed it. Some readers might find the following text I found in Transcultural Psychiatry69 interesting in the current context:

 

Reports of occupational mass psychogenic illness (OMPI) in the scientific literature were examined to describe underlying presentation patterns and explain their sporadic appearance in the literature. Three distinct patterns were identified: (i) mass anxiety hysteria is precipitated by the sudden appearance of an anxiety generating stimulus following the redefinition of an innocuous or imaginary odour or agent that is perceived as an immediate threat; (ii) mass motor hysteria is characterized by internalized conflict which fosters dissociation, histrionics and psychomotor agitation. Episodes are typified by an atmosphere of pre existing tension and employee dissatisfaction with restrictive management practices coupled with inhibited negotiation channels; (iii) a third presentation pattern involves the relabelling of endemic symptoms and the occasional appearance of conversion reactions, which are reinforced by a hypervigilant medical community and exacerbating factors. Social factors may explain the irregular appearance of reports.

Notice, the author does not recognize any oxygen‑related issues in his discourse on what he designates occupational mass psychogenic illness. Simple tests done to measure the urinary excretion of the metabolites of Krebs cycle and glycolytic pathways, mycotoxins, and hippuric acid in the subjects of his study would have shed much light on what was observable and documentable in the chemistry of those afflicted by the putative occupational mass psychogenic illness.

Please see  essay 5 of the Darwin, Dysox, and Our Fermenting Planet series for continuation of this discussion.

References
57. Fenchel T,  Bland J. (1995) Ecology and Evolution in Anoxic Worlds (Oxford Series in Ecology and Evolution). 1995. Oxford University Press.
58. Fischer P., K. Rademacher, and U. Kils. 1992. In situ investigations on the respiration and behaviour of the eelpout Zoarces viviparus under short term hypoxia. Mar Ecol Prog Ser. 1992; 88: 181 184.
59. Zilli M., Guarino C., Daffonchio D., Borin S., Converti A. (2005) AThe enigma of prokaryotic life in deep hypersaline anoxic basins. Science.  2005.307:121 123.
60. West TG, 1 and R. G. Boutilier RG. Metabolic suppression in anoxic frog muscle . Journal of Comparative Physiology B: Biochemical,  Systemic,  and Environmental Physiology. 1998; 168:273‑280 .
61. Richards, F.A. (1965) Anoxic basins and fjords@, in Riley, J.P., and Skirrow, G. (eds) Chemical Oceanography, London, Academic Press, 611 643.
62. Sarmiento J.L., Herbert T.D., Toggweiler J.R. Causes of anoxia in the world ocean@. Global Biochemical Cycles, 1988A;2: 115 128.
63. Chan F,  Barth JA, Lubchenco J, et al. Emergence of Anoxia in the California Current Large Marine Ecosystem. Science. 2008;319: 920.
64. Winkler, 1888 (Ber. Deutsch Chem. Ges., 21, 2843).
65. Ali M. September Eleven, 2005.  2003. New York, Aging Healthfully Books.
66. Letter to the Editor. N Eng J Med. February 21, 2002.
67. Letter to the Editor. N Eng J Med. February 21, 2002.
68. http://en.wikipedia.org/wiki/Smog
69. Bartholomew  RE. Occupational Mass Psychogenic Illness: A Transcultural Perspective. Transcultural Psychiatry. 2000;37:495 524.

  

 

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