This episode is sponsored by Global Medical Response, yet another sponsor that I have tracked down because they have a solution to one of the biggest problems we have in emergency medicine and healthcare.
We often hear the term 911 abuse, but what I love is the concept that this should be a three-tier system.
ALS, BLS and then the non-emergent element.
With the evolution of telehealth and telemedicine, that third tier is now possible virtually.
In 2018, Global Medical Response pioneered 911 Nurse Navigation.
In communities across the country, GMR's nurse navigators use evidence-based clinical protocols to screen a patient's current condition,
providing an appropriate resource to meet the patient's unique healthcare needs,
whether that's dispatching a rideshare to an urgent care, an appointment at a federally qualified health center, or virtual care with a physician on the spot.
The five-level screening system ensures patients receive the right resource at the right time, in the right setting, to achieve the right outcome at the right cost.
So as a huge advocate for our first responders' health and of course the people that we serve, this solves three issues.
It allows the patient to have a far less expensive option when it comes to their non-emergent issue.
It stops a firefighter or a paramedic being woken up for that call and it frees up an ER bed for a true emergency.
So if you want to hear more about how GMR can integrate nurse navigation in your 911 system,
listen to episode 998 with Joshua Rose and Dr. Jared Troutman or go to globalmedicalresponse.com.
This episode is sponsored by TeamBuildr, yet another company that's doing great things for the first responder community.
As a strength and conditioning coach myself who also trains tactical athletes, dissemination of wellness information is one of the biggest challenges.
Now TeamBuildr is the premier strength and conditioning software for tactical athletes and there are several features that really impress me.
Firstly, there is a full exercise library so you, the personal trainer, does not have to create that within your own department.
Secondly, you can send out programming but also individualize, which I love.
So you blanket program for everyone. Now you can tweak based on someone's injury, someone's need to maybe drop some body composition
rather than having to write a program for every single person on their own.
TeamBuildr also allows you to build custom questionnaires to collate health and wellness data.
It integrates with wearables and I think one of the most important things is obviously it tracks.
To me, it's imperative that we as a profession start tracking our people from day one and then over the full span of their career,
therefore catching potential wellness issues and injuries before they happen.
Now if you want to try TeamBuildr, they are offering you, the audience of the Behind the Shield podcast, a free 14 day trial to experience all of the features.
And if you want to take a deeper dive into Team Builder, listen to episode 1032 with Melissa Mercado or go to teambuildr.com
and I'll spell that to you because it's not as you think. T-E-A-M-B-U-I-L-D-R.com.
Welcome to the Behind the Shield podcast. As always, my name is James Gearing and this week it is my absolute honor to welcome on the show
Kiran Patil and Peter Holm Jensen.
Now what makes this conversation so excited is PFAS is one of these buzz terms that we're hearing at the moment and rightly so.
This is a specific forever chemical that is found in nearly all of the humans on this planet because of their toxicity and inability to break down.
They are known to be behind numerous diseases including cancer.
And the same PFAS is in our bunker gear, it's in our firefighting foam, as you can imagine it's what's being dropped all over California at the moment.
So the ability to remove this from water and from the human body is an imperative conversation when it comes to a compound that will not denature on its own.
So Peter and Kiran have developed a company called Cambiotics. They have discovered that there is a certain probiotic strain that will actually extract PFAS from the human body.
So in this conversation we discuss a host of topics from each of their backgrounds in India and Denmark, their individual journeys through science,
Parkinson's disease, pollution, probiotics, gut health and so much more.
Now before we get to this incredibly exciting conversation as I say every week, please just take a moment.
Go to whichever app you listen to this on, subscribe to the show, leave feedback and leave a rating.
Every single five star rating truly does elevate this podcast, therefore making it easier for others to find.
And this is a free library of over 1,000 episodes now.
So all I ask in return is that you help share these incredible men and women stories so I can get them to every single person on planet Earth who needs to hear them.
Now one more side note, I don't mention this on every episode but I like to periodically.
My second book, KINDER, is not only available now on paperback and ebook but also audiobook as of the new year.
And you can find all of those on Amazon, Audible and iTunes.
So with that being said, I introduce to you Kiran Patil and Peter Holm Jensen. Enjoy.
Well, Peter and Kiran, I want to start by saying two things.
Firstly, thank you to Diane Cotter and Hitheshi for making this happen and secondly to welcome you both onto the Behind the Shield podcast today.
Thanks a lot James.
Yeah, pleasure to be here and very happy to speak to you, James.
So where on planet Earth are we finding you both today?
Well, today you are finding us in Copenhagen in Denmark.
That's not my usual location. Usually you would find me in Cambridge, UK.
But today I'm in Copenhagen together with Peter.
Brilliant. All right. Well, I want to start at the very beginning of each of your journeys because obviously you guys have different backgrounds.
So let's start with you, Peter. Tell me where you were born and tell me a little bit about your family dynamic, what your parents did, how many siblings.
Yeah, so I'm from Denmark, originally from a small village called Hornslid in Jutland, which is the largest part of Denmark.
I have two brothers. We lived in a small village and I one of these provincial towns where you have a fantastic childhood if you do sports.
If you don't do sports, there's nothing to do. So I did sports my entire childhood.
And it was a fantastic childhood I had together with my two brothers.
And then when you become around the age of 13, 14, you start getting bored in these small villages and then you really need to go somewhere else.
So I then went to another part of Denmark called Fyn, where I was studying for some years in university.
And then like 25, 30 years ago, I moved to the capital of Denmark, Copenhagen, where we are today.
When you said you were playing sports, which sports were popular back then in your village?
Well, anything really. I think the most it was soccer.
That's the biggest sport in Denmark. So I played that for sure.
Handball is also a big thing, maybe not in the US, but in Denmark.
It's a big thing, maybe because we are world champions in handball.
But I mean, I also did swimming, volleyball, basketball, tennis, running.
Once a week you did it all.
When people talk about education in the world, usually Scandinavia is at the top.
And I think I've had people like from Finland, for example, an educator from there.
And it seems like there's a more holistic view of the child and education versus America,
where we have this very standardized testing and we're really preparing children for tests rather than for life.
When you look back now, what were some of the good things about your Scandinavian upbringing that maybe other countries could learn from?
Yeah, well, my generation, me and my brothers, we are the first generation in my family that had an education on university level.
And I think that's really due to the welfare system that we have in Scandinavia,
where it's society paying for the education for everybody.
So, I mean, my parents did not have to use all the spending for my education.
So I think it's one of the things that I believe that society can learn from the Scandinavian model is really that education should really be for everybody.
And society should pay for education for everybody, because it's also society benefiting from that.
Everybody is able to generate knowledge and participate in the development of society.
So that is for sure something that has been important in my upbringing and in my education.
And, you know, if we had been living in the US, I don't know whether my parents had been able to pay for my education.
Yeah, my wife just finished, we've had to finish medical school and she's going to have close to half a million dollars worth of debt,
just from being a doctor, which she's then going to go and help people in America for the next few decades.
So I truly agree. I think if you had a system where, you know, if the kid just went to university and messed around and got drunk and failed,
then you give them the bill for that.
But if they actually graduate and become, you know, a contributor to society, I believe that we should help our children or young people
so that they can then be, you know, elevated to some position where they're going to make the country better.
Yeah, for sure.
So staying with you, Peter, one more question.
When you reflect back, where did the interest in science come from your younger years?
I think it came from a fantastic chemistry teacher that I had in high school that really inspired me.
And even though I was interested in science on a high school level, I think, you know,
having the right teachers is something that really is decisive on which route you take.
So already in second grade of high school, I was pretty convinced that which direction I wanted to go in terms of natural sciences.
And I was convinced that I was going to be able to do that when I should be studying next level at university.
So I would thank my teachers for that, I would say, specifically two teachers without naming them.
Brilliant. Well, that's another important factor that I've had from a lot of people.
Whatever their upbringing was like, whether they had two great parents that were present or whether they only had a parent or they were living with grandparents,
that steer them in to a good direction. So whether it's a teacher or a sports coach or a spiritual leader, whoever it is,
we all have the ability to affect children's lives, even if they're not their own.
Yes. No doubt about that.
All right. Well, Kiran, on to you. So tell me where you were born and tell me a little about your family dynamic, what your parents did, how many siblings?
Well, James, I was born in India, in the rural part of India in southwest.
And I actually as a child, my family moved around quite a bit because my father worked in the FDA.
And that he was a food inspector. And that job required that every five years he had to work in a new city.
And that's how it was the nature of the job. I grew up in many different places in that region,
which was hard in some ways because, of course, moving is always difficult.
You change your school, your friends and everything. As you become a teenager, it becomes progressively more difficult.
But looking back, actually, I'm quite happy that we did that because also I made new friends,
got to new places, new schools and to some extent learned how to adapt to new places.
And it was fun also meeting new people, new classmates and so on.
And what about sports? What were you playing?
Well, that's an easy one. Everyone plays cricket. So you don't have many different options.
Nowadays, there are more options, but cricket is kind of the standard thing that you do.
So which is what I did as well.
With this traveling that you had as a family, India obviously is very diverse.
And you have a lot of poverty in some of the cities and the abuse of industry in some areas.
But then you have obviously all the rural beautiful areas too.
The same kind of lens as I asked Peter, what were the things that India was doing really well?
And then seeing as we're going to get into chemicals and pollution,
what were some of the things that they weren't doing well when it came to the health of their people?
I mean, I can only speak in hindsight because when you live in a society,
especially when you grow up there, that's your world, right?
That's how the world is. You kind of have nothing to contrast it against.
And looking back, I lived in Europe for a long time now, more than 20 years.
And there are incredible things in India. It's very populated.
It's tense and you have big inequalities in many different regards.
But it's actually quite amazing that it functions, which is a big thing.
But also you have incredible people, right?
People you can see that are living in poverty but doing absolutely amazing jobs.
They are very dedicated to what they do.
They make every effort and try to help others even though they are poor themselves.
You kind of have these incredible features.
Also with education, I must say that similar to what Peter said,
I think free education actually is still...
You have private universities in India, but most good places actually are public universities and public schools.
This is where I studied and I'm very grateful for that, having that opportunity to have good education.
It's kind of a bit of a mixture because we have good education, but it's still very competitive.
Simply because we are a lot of people, which means that if you want to go to a good place, you have to compete.
And this is not competition who got most money to pay for the fees, but you have to just rank high in the price.
To some extent, there's also a lot of pressure.
I think India could also actually learn a bit from Scandinavia that you have to kind of balance the open up more opportunities for people to do things.
What is it about Indian culture and that environment that creates so many great people in science and medicine
that ultimately find themselves in the UK and America and other countries?
I mean, it's a difficult question to answer.
Explaining human nature has never been easy.
But I think, at least based on my experience and observations, I think part of this is resilience.
It's a system that you have to work through.
And a good example of that is if you look at a typical traffic situation in India, it's very crowded.
A lot of people trying to pass through in small vehicles, bicycles, pedestrians, animals, all at the same time.
And it's a little bit chaotic, but very rarely you will see that people are angry about it.
If you have a similar situation in Europe, somewhere you will see people will get very agitated and trying to shout at each other or hon.
And trying to, in India, they will just kind of wait for someone to pass and then they will just go about their way.
It builds some degree of resilience and patience that you have to just wait out certain things and go forward.
And I think that sometimes it can be, of course, not good to be too patient.
But I think I personally feel that I benefit from that.
You kind of don't get upset easily.
Well, Peter, let's go back to you then.
Let's walk through your journey into the science world.
And then I'd love to hear more about working with Carlsberg.
Yes.
So I started my education in science at the University of Odense at Fyn.
And then after four years, when I had to do my masters, I moved to Copenhagen, where I did my masters at the Carlsberg laboratory.
When people hear about Carlsberg, they think it has to be about brewing.
When you do some science at Carlsberg laboratory, actually, it doesn't.
When you enter the Carlsberg laboratory, it says that on the wall, that everything we do has to be for the benefit of mankind.
One thing, however, that Carlsberg says they would like to focus their science on is proteins.
And you could say life, our bodies and all other life is built of proteins through the building block of life.
So I studied proteins when I was doing my masters and also my PhD at Carlsberg.
But I looked at that time on proteins sitting on the surface of nerve cells and tried to explain how nerve cells adhere to other nerve cells instead of, for instance, adhering to muscle cells or brain cells.
And I was allowed to do that at Carlsberg because Carlsberg has an interest in proteins because there's a lot of proteins in beer.
We say the foam and taste in a beer is made out of proteins as well.
And that's the only link actually to Carlsberg.
The reason why we were allowed to do that, it was a fantastic, inspiring place to do both my master and PhD.
At that time, it was really a melting pot of, I think, 40, 50 different nationalities and maybe 200 different scientists, some of them visiting scientists being there for half a year, others that had been working there for 10, 15 years.
And then a lot of PhDs and postdocs and master students working together.
And it was a really unique place where some fantastic science were made.
And evidence of that is that it was actually also at that time that the Danish Nobel Laureate, Morten Meldahl, he did his science at the Carlsberg Laboratory.
And I think that's really due to the culture that was there at that time, that you were allowed to work in this area that are in between academic science and industrial science without any limitations.
But it has to do with proteins, the building blocks of life.
So that has really inspired me a lot.
I think one of the other things that have inspired me a lot from Carlsberg is also that they allow themselves to work also in the interface between art and science.
And I think that's also very inspiring because sometimes you can really use art to express something about science that science cannot express itself.
So I think that's sort of two of the most valuable things that I've learned in my career from the Carlsberg Laboratory.
When I think about nerve cells joining, I think about neurogenesis and traumatic brain injury and spinal cord injury.
Was there any kind of glimmer of hope in your research in that field as far as people who are injured in the central nervous system and the ability to regrow some of that damage?
One thing that we actually ended up doing a small company on was it was not directly due to specific damages that you referred to, but it was in the focus on development of Alzheimer's medicine.
So that's where we through the work of myself in my PhD and also two other PhDs, we identified some ligands that could be potential drug candidates for treating Alzheimer's disease.
And we actually had some very nice, very nice preclinical data on these potential drug candidates.
And we ended up failing in terms of not being able to find the right formulation, which is where many drugs, they end up failing.
It's really getting them from a petri dish in the lab and then getting it to where it has to function in the brain without being damaged.
So it was a very nice task to make a pill or kind of injection where you could either eat it or inject it into the bloodstream and then it could go across the blood brain barrier into the brain where it had to function.
So I think the only way where you could actually administer it in any clinical trials were that you had to drill a hole in the head of the patient and then put it in through that, which is not really the proper way to administer a drug.
It ended up not becoming a full development of a drug, but it had the potential to in terms of finding drug candidates that could actually partly cure Alzheimer's.
But unfortunately, we couldn't get it to function because of the formulation of the drug candidate.
Well, let's go to the world of PFAS then obviously we're going to talk about removal from water and even the human body. But when were you even made aware of this chemical?
And then let's start talking about the impact that it has on the human body and the environment.
Yeah, so the first time I really started to digging further into PFAS was around 10 years ago when I was a CEO of a Danish BiSolutions company called Aquaporin where we reused the way that nature filtrates water in a more industrial context.
We take the protein from living cells that filtrates water in and out of living cells and incorporate that into a membrane that can, for instance, purify drinking water from PFAS contaminants.
And here we started looking into the problem of PFAS in drinking water, both globally, but also in Denmark.
Because every year we see an increase in the number of well drillings where PFAS has been contaminating these sources.
Last year in 2024, around 55% of all new drillings in a country like Denmark showed PFAS contamination.
When I started looking at it like close to 10 years ago, it was maybe 20 to 30% of new drillings in Denmark for drinking water that showed contamination with PFAS.
So every year we see an increase in the contamination of PFAS in water resources, even in a country like Denmark, where we actually feel we have some of the world's cleanest drinking water.
Then we started working with that as a value proposition for the Aquaporin site technology.
And we got into contact with different collaboration groups, both universities and also industrial collaboration partners in that project.
That's where sort of my journey with PFAS started.
I had Rob Belart on the show who was the lawyer that really helped expose the PFAS contamination here in America.
It was interesting obviously hearing about the states and I want to get to some of our standards as far as that in a little bit.
But when I think of Denmark, Sweden, Norway, I think of also high standards and a lot of cleanliness.
How was PFAS penetrating Denmark?
Was it companies within your country or was it actually coming from other countries?
I think it's coming from primarily industrial pollution that are created in Denmark, within Denmark.
I think we have something like 1600 contamination sites in a small country like Denmark known today, already today.
It could be from firefighter test sites.
It could be from industrial production of chemicals.
It could be from coding processes that are done in the automotive industry or a lot of other industries.
So I think we are part of our own pollution.
We are to blame ourselves in Denmark.
I don't think we can blame any other country for the pollution that we find in Denmark.
And I think that goes for most other countries.
The European Environmental Agency just last year came out with a study where they had shown PFAS pollution in teenagers all over Europe.
And on average, it was shown that by the nine countries that were tested in this study, Denmark was not included in that.
On average, 14% of all teenagers in Europe, they show elevated PFAS levels in the blood above the health-based guidance values.
In countries like, for instance, Norway and Sweden, it's more than 20% of the teenagers that today have PFAS levels above the health-based guidance values.
You can ask yourself, how come that in a very regulated country like Sweden or Norway, Denmark for that matter, because I think we have the same levels, it is that high.
One of the reasons could be that, for instance, in Norway and Sweden, one of the national sports, we just talked about sports before, is skiing.
And all ski wax, more or less today, contains PFAS.
So all teenagers are actually indirectly in contact with ski wax and other things that are contaminated with PFAS without knowing it.
So it could be a very concrete reason to why a lot of teenagers in countries like Sweden and Norway have even higher PFAS levels in the blood than the average in Europe.
I think it was surprising to see that this study by the European Environmental Agency showed PFAS levels that were very high in countries like Norway and Sweden.
But for instance, in a country like Spain, it was only around 2% of the teenagers in Spain that had PFAS levels above the health-based guidance values.
And you can ask yourself why. I don't have the answer for that.
But I think it will be hard for us to blame anybody else but ourselves and our own governments and our own industries for the pollution.
Well, when you think about skiing, I'm also thinking about the waterproofing and all the ski wear too, because obviously the fire bunker gear that we wear has all the waterproofing.
So not only have you got it on the wax, I'm assuming that all the clothes they're wearing have probably got it in too.
Yeah, for sure. I mean, also if you take it, I mean, Gore-Tex is made of PFAS. We all have Gore-Tex jackets, right?
If you do water repellent coatings that you spray onto your skiing equipment, that for sure holds PFAS compounds in it as well.
So, yeah, it's in many different types of ski approvals.
I think there was a study that looked into professionals that have very high level.
And I think amongst the groups that are at highest levels, I think were professional ski waxers, which of course are exposed to it a lot more.
Yeah, I didn't even think about that.
Well, Kiran, while we're on you, let's just kind of roll the clock back a little bit and then we'll walk through to your introduction of PFAS.
But just prior to that, how did you find yourself in my home country in Cambridge?
Well, it has been a long journey. I remember I told my mother that I was going to Denmark just for one year.
That's how I left India, but haven't gone back, figuratively speaking.
Of course, I go back every year or twice.
So I studied chemical engineering in India.
And while doing that, I got very interested in biotechnology, like fermentation processes, microbial biotechnology and so on.
And I had actually one of my textbooks that I used in university was from Professor Jens Nielsen from Copenhagen.
And I said, this is what I want to study.
So I wrote to him and he said, OK, come here for one year.
We will try out whether we match each other in our interest overlap.
And that's how I came here for one year, got a PhD scholarship, did my PhD here with Jens Nielsen.
Then after that, I was assistant professor in the same university for four years.
Then I moved to EMBL, that's European Molecular Biology Laboratory in Heidelberg in Germany.
I was there for 10 years and then we moved to Cambridge, where we are currently based.
So prior to Cambiotics, what were some of the areas that you were studying?
Yes, so as I mentioned, I started studying chemical engineering and then mostly microbial biotechnology, yeast fermentations.
Especially I was interested in transcription regulation.
So how gene regulation acts within the yeast and how it responds to different genetic and environmental perturbation.
And also thinking about how we can use that knowledge to improve biological processes, industrial processes.
And when I moved to Heidelberg in Germany, with some of my other colleagues, we got very interested in microbiomes.
Partly just because of the curiosity and the complexity that it presents.
You study yeast, one microorganism, and then it's complex.
But if you now think about things like microbiome, where hundreds of different species living together, that gives fascinating complexity.
And we started thinking about how one could tackle this.
And then we got interested in microbiomes.
We were very interested in understanding the impact of therapeutic drugs like medications, how that interacts with microbiome.
And this got them more generalized into the interaction of chemicals with microbiomes.
And that's what we've asked him a lot.
My dad's a veterinary surgeon, but he actually says that he's more of a biologist because he's just fascinated on that side, even though he did a full career with horses and small animals.
But every time I talk to that man, we always get onto the conversation of microbiome.
He loves gut bacteria and poo more than anyone I've ever known.
But the more I listen, the more we talk, the more we realize we talk about that gut brain connection.
Speak to me about how impactful the health of our gut bacteria is in relation to overall health.
Because if I think about one of the least healthy countries in the world, which is where I'm sitting now, the US,
the one common denominator is all the processed food and the things that I would imagine are actually destroying our gut bacteria.
And it's reflected on physical health, on mental health.
So what have you seen as far as the health of gut bacteria in a human being and all the diseases that we're aware of?
Yeah, I mean, it's a very interesting question.
And of course, health is a holistic concept. So I think often in health, I think it's very important in a complex system,
which is the human body, is that usually in most situations, gut microbiota will not be the driver of things, but it will be a contributing factor.
So it's a part of a complex wheel. And every cog in that machine is important.
And I think that microbiome is one of them. So with that in mind, I think that microbiota,
just because it's a central position in our physiology, contributes to many, many health and disease states.
So because food is kind of old saying that we are what we eat in a way, and everything that we eat needs to go through the GI tract.
This is where our microbiota resides. So what they do to this food, how they interact or with the medication, other things that we eat.
So it makes a very, very important and crucial contribution to the development.
And I think one good example of that is training of the immune system.
So our immune system needs to learn to recognize friends from the force from very, very early on.
And our microbiota presents that opportunity, because you can't react, hyper react to every microbe that comes around,
because otherwise we wouldn't survive at all. We'll be always in the kind of a hyper implemented state.
So the gut microbiota provides that crucial training. And since we grow with it and we have evolved with it,
I think a lot of our bodily functions, immune systems, gut function, and so on and so forth,
and including our neurological system actually trained to work with the microbiota and the metabolites that they produce.
So it actually is a very tight connection.
How effective are probiotics overall?
Are we being given roughly the right kinds of strains that we would need to improve our gut bacteria?
Or is there a spectrum where some of the things that we're seeing on the shelves aren't very effective, but there are some other ones that are?
That's a billion dollar question literally.
And I think it really depends on the context.
Again, it's a question of complexity and how complex systems respond.
So if a particular complex system, some stimuli can make a big difference only if you're in the right state.
I think regarding probiotics really comes down to what that person is, what their health status is, what their microbiome status is, and what that probiotic is.
So I think there's a lot of personal individualized elements to it.
So I think it's very difficult to make a general statement.
What we know from the scientific literature is that many of the probiotics that people are trying to study, they don't end up colonizing the microbiota.
Of course, it doesn't mean that they don't make any effect.
They can stimulate immune responses, for example, or change the microbiota composition temporarily in a certain direction and so on.
So there's definitely, I think, more work needed to understand what makes a probiotic colonize the gut and not colonize the gut and how that functions.
But it really depends on the thing in a very, very individual context.
Well, one more question for you, Kiran.
Your introduction into PFAS, when did you first discover this?
And then what were you seeing as far as the UK, India, some of the areas that you were looking at?
So I first came across it around five years ago, actually, around the time when I moved to the UK.
And that was the time I was thinking about, you know, we have studied a lot about, you know, drugs and microbiome interactions.
But it's really that the classification between what we call medications and some of the other chemicals is to some extent arbitrary.
Who decided what should be called, for example, a pesticide, and what should be called medication, what should be called a plant toxin?
There are some clear distinctions, but some are arbitrary, if you see from a chemical structure perspective.
And this is how I thought that, I think, what other things our microbiota would be exposed to beyond medication that we take.
And, you know, we started thinking about pollutants around pesticides, other industrial chemicals and so on.
And then we decided that together with my PhD student, Anna, that we can't pick one or two molecules because we are exposed to a lot of them.
So we decided to be ambitious and do a large screen of, I think we did more than a thousand different pollutants,
you know, to test them against, cut back to how they affect them. And when we were deciding what chemicals we should include, you know, the pesticides were obvious one.
And then we started looking at what else. And this is how I came across the literature about PFAS and how big that problem is.
And coincidentally, I think it was around the same time we were studying PFAS and other pollutants that we're exposed to.
There was a news, local news in Cambridge that there's a village next called Shelford,
probably one of the most expensive villages in England, possibly.
And there was a news that the water supply for Great Shelford actually had higher PFAS levels than what was allowed, you know,
and that made to the local news and so on. And then it made us even more interested in that, trying to understand about these compounds.
Well, Peter, back to you. You mentioned a second ago about firefighters.
So talk to me about what you've observed as far as firefighting foam, our turnout gear and other areas in my profession we're exposed to PFAS.
Well, I would say when we talk to professionals working with PFAS pollution and testing people and firefighters for PFAS contaminants in their blood,
we hear numbers that when we test firefighters that are some of the groups that are in the risk zone of having elevated PFAS levels,
it's between 60 to 80 percent of the people they test that have elevated PFAS levels where you are in the risk zone of getting these terrible diseases
that are associated to PFAS poisoning, like, for instance, cancer or lower immune responses, higher cholesterol levels, decreased fertility rates and so on.
So when you compare that to the average, let's say, teenage offense in Europe, we are talking about, you know, maybe 500 percent higher numbers compared to the average person in society.
So I think, as you mentioned before, whether you are a skier or whether you are a firefighter, you have these you have these approvals, which are water repellent.
They contain PFAS. They're the best ones at repelling water. That's why we use them.
So I think the challenge here is that we have we have some chemicals that are very, very effective, very durable, very cheap, actually, to produce and to put on to clothing and to do coatings on a lot of different types of equipment, even firefighter equipment, even put it in firefighter foam.
Unfortunately, they are toxic and they are I mean, they're toxic like hell.
It's very hard to find chemical pollutants that are as toxic as PFAS because it's so small amounts that are needed in order for it to be carcinogenic, for instance.
So to cause cancer. Yeah.
I'm sitting and thinking whether I'm answering your question on what type of equipment is it in.
I'm more thinking what type of firefighter equipment is it not in.
That's that's more the challenge.
Yeah. Also, when I see the big fires that is going on, as we speak right now in California, when I see how I mean, the only way that we can effectively fight these big fires is also by using equipment or firefighter foam or things we throw out from planes
that can sort of that can kill the fires.
But again, a lot of these materials, not all, but a lot of them, they also contain PFAS because there's the most effective ones.
So right now we actually, you know, seeing it a dilemma where we say, should we use these materials to fight the fire and thereby also polluting the environment afterwards because we know we are.
And of course, that's a terrible dilemma to be in.
But this is the dilemma we have with using PFAS as we do today.
It's been interesting talking to several members of the wildland community that are thought leaders when it comes to innovation and the safety and mental health of the firefighter.
But I never hear them say we need more chemicals.
I hear them say, you know, we need to be allowed to do prescribed burns because a lot of towns, I don't want smoke in my town, so they'll oppose prescribed burns, you know, making ordinance where you can't have brush within a certain amount of space, you know,
distance from your home. So you create a natural fire break. So they're all very proactive, preventative measures. And then also just to the sheer workforce.
I think the American Fire Service on the wildland side are only operating at about 70 percent of their workforce.
And as we see now, now they're all, you know, being asked to do incredible things in California.
So you're lacking people, you're lacking equipment as well.
So I think when people understand that you can't just simply fly over and drop, you know, chemicals all over the place because that's going to affect the food that's grown and, you know, the children playing after the fact.
I hope this is another push towards being more proactive.
And the other thing is just, you know, maybe not allowing people to build houses on the side of a mountain as well.
I mean, it sounds harsh, but, you know, if you're putting yourself right in the middle of a place that's going to naturally is burned for millennia, then now you're endangering all the people around you as well.
I mean, there's no doubt that the answer long term and doing it is, of course, we don't need more chemicals.
We need to do the right things long term with all the prevention measures that you mentioned.
The problem, of course, arises if you are in the middle of a catastrophe like we are right now.
What you do short term in order to stop the catastrophe might be a very bad thing on the long term.
But obviously, I mean, you have to stop the catastrophe when you're standing in it.
Absolutely. Well, when we spoke a few weeks ago, I remember you talking to me about the longevity of some of these chemicals.
So talk to me about that. Which ones are the ones that are staying in our body?
And then talk to me about another group that actually is excreted naturally or breaks down on its own.
Yeah. So I think our focus in in Cambodia is really to focus on the long chain PFAS,
which are the one that bioaccumulates the most in human beings.
And then the short chain PFAS, they can also be toxic and carcinogenic.
However, they are naturally excreted by the body on its own within a week or two.
Actually, there's quite a fantastic study that just recently came out where there was a German volunteer
that ate a lot of PFAS, different lengths of PFAS chemicals.
And then he tested, they tested on him how fast and slow they were excreted by the body,
which I don't know how they found that volunteer.
But thank you to volunteer for science. It's as we said, you can only be a German.
I mean, fantastic sacrifice from these studies.
We have seen that short chain PFAS, they actually excrete by themselves quite fast from the human body.
So the biggest concern we have in terms of bioaccumulation in humans causing being the root cause to terminal diseases like cancer
is for sure the long chain PFAS. That is also what we focus on here.
And these type of PFAS, they have lifetimes of more than a thousand years.
How long they are in the environment, we don't really know yet because they have only been around for around 70 years.
The first ones were developed as part of the Manhattan Project when we developed the atomic bomb.
And then during the last decades, we have developed hundreds or even for some decades,
thousands of new PFAS chemicals. So they haven't been around for that long.
But the one that I exposed and goes into our drinking water today, they might have been put into the environment 50 years ago.
So the chemicals we put into the environment and nature today will be the chemicals that will pollute our grandchildren.
And we don't know, but we know that they will be here for a long time.
And I think they will be here as long as the pyramids have been there. So in a way, they are our pyramids.
So it's not a very pleasant thought, but it is something we have to address because we have to face the fact
that we are living in a world where we have to live together with PFAS pollution.
We can't get PFAS out of the environment, out of all the drinking water and all the soil. That's impossible.
We don't have the money. We don't have the energy or resources to detoxify all the soil and the drinking water that is already polluted today.
So we have to find a way where we actually are able to live alongside PFAS chemicals that surrounds us today.
We know that because when we look at the food chain today, already today, we find PFAS in things like even eggs or butter, strawberries, other berries in nature.
And I mean, we eat them on a daily basis. So I mean, you're not able to be a normal consumer, even if you do ecological and organic food.
You cannot live in society today without being exposed to PFAS. That's unfortunately just a fact.
And how long they will be here and how much it will affect human health is a big experiment, to be honest.
Well, I think we've seen just chemicals in general, the chemicals in our food, in our air and our water.
And you look at the growth of cancer. I mean, my feed every day now is people dying of cancer, you know, amongst other things.
And if some of them were exposed to actual firefighting carcinogens, but arguably a lot of them, it was probably in their food, you know, or the stress of shift work or all these other things that are contributing as well.
But yeah, I mean, we seem to have normalized cancer. You know, we do our 5Ks and shave our heads when someone's getting chemo and all that kind of stuff.
But it's this proactive conversation we need to have. And if we can't make the PFAS go away, as we're about to say, how can we then at least try and get it from the human body?
Yeah. And I think one thing we can do is we can change the law on how we allow chemicals to be used in the industry and thereby also indirectly polluting the environment and nature.
And here just a week ago, there was a very interesting article coming out from the New England Journal of Medicine where a big group of scientists, they proactively go in and say,
we have to change the laws on how chemicals are being approved today.
Because if we don't, then we will continue to find new chemicals that 50 years from when they have been introduced into the market, we find out that they're actually toxic and very harmful or even carcinogenic to human beings or other animals.
So I think we have to change our mindset on how chemicals can be used and also be allowed in industry.
That's a good point. I think it's a very good article, Peter. I think they also make a case that, of course, a dose makes a poison, right? So one can argue that, you know, small amounts, you know, what does it do and so on.
But another fact is that at what stage of life we are exposed to also makes a big difference, or which organs get exposed to. And I think, you know, early life exposure during development, I think it can be very, very critical because small effects there can amplify and, you know, may make manifest, you know, 10 years, 20, maybe 30 years later.
It's quite important to take into context not only what concentrations, what substances we are exposed to, but when we are exposed to, how we are exposed to, which organs are being exposed.
That's just one comment to that. For my time in the water industry in the aquapurine, I remember that when I talk to people that has been in the water industry for decades, a lot of them, they had this saying, they said, well, pollution is not really a problem.
The solution to pollution is dilution. That's a saying that people use in the water industry, which makes me a little bit mad sometimes, to be honest.
But it has been the fix for the last decades for 30, 40 years. And now we've come to a stage where we can't dilute our way out of it anymore, because it's all over.
I mean, it's in the whales. That's why people in the Faroe Islands or Greenland get it. They don't have their own industry polluting the environment.
It's actually because it's in the food chain. And now it ends up in the whales and seals that they consume.
But yeah, even in the ice bears, you find them. I think there was a study on penguins that they found in penguins.
So now we've come to a stage, for instance, with PFAS, where the solution to pollution can no longer be dilution.
That's a scary place to be. And I think that's also why we feel that there's a need for treatment where you can actively also work on detoxifying your own body.
Because no matter how much you try to prevent PFAS pollution, you will be exposed to it.
Well, I want to get to the probiotic. One more question before we do. Rob was obviously talking about DuPont and the cover-ups that were going on there.
He also talked about the renaming of the chemicals, so finding a slight variation of PFAS. And now it's not PFAS anymore.
So what has been the resistance to addressing this from the industry side?
Well, I guess profit. When you make good money, you would like to keep that profit as long as you can.
So I think the reason is greed. And that's the prime reason.
Because if it was not greediness that had sort of influenced decision makers, then they would have taken other decisions when they knew it was toxic.
We have known that for decades.
Keir, anything to add?
No, I think I agree with Peter. I think, of course, it is difficult to put ourselves in someone else's mind and see what thinking going on.
I mean, just another perspective to that is that PFAS are not, I mean, at least in the amounts that people have, they are not acute toxins.
It's not that you know, it's not that, you know, sarin or something that, you know, you come in contact with.
It's kind of a, I think analogous thing would be smoking, right? It's not, you know, smoking one cigar is not going to do, you know, or maybe you don't see anything immediately.
So it's kind of a slow poison thing, right? And that also makes very difficult from decision making what to do about it.
And other thing is that they are good materials. So there's a demand for materials like that.
You know, people want to have waterproof clothes. People want to have non-stick pants.
You know, there are certain applications where their properties are just very good.
And I think this is kind of that confounds the whole scenario because there is a continuous demand on this kind of properties.
So I think it's a, it's kind of interaction of all these different things coming together.
Absolutely. All right. Well, then let's talk about the solution that you've come up with.
So Kiran, staying with you, we were talking about gut bacteria.
Talk to me about the discovery that, you know, you could use certain probiotics to actually remove some PFAS from the body.
So, yeah, as I mentioned earlier, I think we were very curious about understanding interaction between chemicals that were exposed to and the gut microbiota,
especially chemicals that come via food or water. And we decided to do this as systematically as we practically could.
So we looked into more than a thousand chemicals that we might be likely to be exposed to industrial chemicals, including PFAS, of course, but also pesticides and so on.
And we did a systematic screen looking into the interaction with 20 commonly found gut bacteria.
So this gut bacteria we chose based on their prevalence, meaning that how many people who generally have them.
So we chose one that are highly prevalent, usually in high abundance as well.
And also some other bacteria that are famous to some extent because they have good properties or linked to diseases or health and so on.
And this is so in the beginning, we did not look specifically for PFAS, but just we look broadscape.
And so Anna, when my student, she had the results and we looked with and we were, you know, the PFAS kind of stood out and we were kind of curious because
no one had reported that bacteria can actually accumulate PFAS in such high amounts.
And so we were very curious about it. So we decided to kind of like in science, you would do you kind of repeat those experiments in different contexts and see if you can validate those.
And we were very, very, I must say I was very surprised, but also positively and impressed by the capacity of this bacteria to accumulate PFAS.
And we thought, you know, could we now put it to use somehow because these are natural human bacteria.
So it means that, you know, we could actually, in a way, repurpose them to kind of sequester PFAS out of the human body.
And then the idea, you know, this is where the chembiotics idea was born.
And we decided to go ahead with that. And this would help in two different ways.
One is that, of course, the PFAS that comes with the water and food that goes to the human body, also the GI tract, this bacteria could act on them.
PFAS also, curiously enough, actually circulate between the blood and liver and the GI tract together with enteropathy circulation.
So that's kind of a natural body process where bile acids are secreted in the early part of GI tract, in particular to absorb the lipids and fats that's going in there.
And they're reabsorbed again. And PFAS actually find bile acids and go through the circulation.
So, in a way, I think this bacteria that are in our GI tract also has a chance to act on them.
So that's the basic idea.
So, Peter, talk to me about the kind of the coalition of the two of you and the creation of chembiotics.
And what can we see over the next couple of years as far as the US and then the rest of the world?
Yes. So based on the really great science that Kjern and his team did at Cambridge, we sat down and talked about that.
Maybe we could use this as a sort of a thesis for a company where we could use biology to detoxify our bodies from the chemicals that we know accumulate in our bodies
and are the root cause to a lot of different diseases that we see today in society.
And you could say there's a certain logic behind that because if a chemical compound like PFAS can bioaccumulate in a human cell,
well, maybe the same chemical can also bioaccumulate in other living cells like bacteria.
So that's sort of the thesis behind the company saying that if a chemical can bioaccumulate in the human body and in human cells,
well, maybe biology and other living cells like bacteria are the answer to how we can get rid of it again.
And there's a certain logic to that because it has to cross the cell membrane.
And it's a good thing a bacterial cell and a human cell is built of the same components.
And in many ways, we live in synergy with each other.
It's like Kjern talked about before, we have the microbiome and looking at our human body, we have approximately as many bacterial cells in or outside our human body
that we have human cells, more or less one to one.
So we are living in synergy with bacteria and almost every cell is in contact or dialogue with bacterial cells on a daily basis.
And through the science made in Cambridge, we have then been able to identify some families that could clearly bioaccumulate PFAS
and thereby also detoxify the body from this.
So we sort of actually based on the science from Cambridge, we are quite far in the sense that we already know which bacterial cells to work with,
which families to work with.
So we just and now I said just because that's a big work, we just have to take these identified cells and then produce them in larger scale,
formulate them into the right capsule format, which are in many ways standard in the probiotics industry today.
And then we actually have a product which we can test out in humans.
It's important to say until now, it has been tested in the labs in Cambridge.
And we also have mouse studies showing that it could work as an effective probiotic for PFAS detoxification.
But it has never been tested in humans yet.
The reason for that is that you actually more or less have to finalize the product, both with the right bacterial cells, formulate that in the right way,
put that into a capsule that we can digest on a daily basis and then test it over a period of three to six months.
So essentially, we are in a position where we are finalizing the product now.
And then by the end of the year, we expect to do to start up the first clinical trials in humans.
And if we see the same results as we have seen in the animal studies and in the lab studies in Cambridge,
we expect to be able to put this into the market in the US by the end of 2026.
But it's not something that we hope will be on the market in 10 years from now.
It's actually by the end of next year, we expect to be able to provide this to, for instance, firefighters in the US.
And we are very interested in getting into dialogue with the right people and associations in the US
for being our first customers, if this turns out to have the same effect in humans as it has shown in the lab in Cambridge.
When I think about animal trials versus human trials, there's some products, procedures, obviously, that just aren't apples to apples.
But understanding the very limited amount that I do when it comes to bacteria, I would assume,
and please correct me if I'm wrong, that the bacteria, even though it's in a mouse, is the same, basically, bacteria that would also be in a human.
Therefore, it's very optimistic that this is going to transfer well in the human studies.
Yes, so from a microbiome perspective, yes, they would be the same bacteria.
In fact, the mouse GI tract physiology is different from the human physiology.
But I think there are researchers, for example, in Stanford have shown that you can actually humanize the mouse microbiome.
Meaning that you can actually get rid of all the antibiotics, for example, with other procedures, get rid of the normal mouse microbiome.
And if you give them a cocktail of human bacteria, they will colonize it well.
And you could actually get very similar to human microbiomes in there.
Yet there are differences. We are not mice.
The length of the GI tract, its morphology, is different.
The way bile acid functions, the kind of food that they eat.
And of course, we have to do testing mice that are living in cages, and they have very defined food and so on.
So there can be differences. But we are optimistic.
And I think one reason behind that optimism is that we...
So probiotics is a general term, right? So they can work in many different ways.
Some can do immune stimulation. Some need to interact with, let's say, host immune system.
Some needs to interact with other components of the microbiota and make something happen.
So more steps are required to have the effect.
More likely it is that something may not work, or it may not work in everyone.
So in our case, our bacteria need to do one job, which is to sequester PFAS.
And it does not necessarily require to interact with the host.
Of course, it will interact with the host, but it's a natural human common cell bacteria.
So I think there is a good room and scientific basis for optimism.
But we are not mice, so we have to just try it out and go through all the process that Peter described.
And have the regulatory approval, of course, before this part of the process as well.
And maybe I can just add here that it's...
What Kjern is saying is that, yes, we are optimistic on this, but the only thing that we need to do here is to test it in humans.
And then we have the answer. Then we know whether we have a treatment or not.
So it's just one step away from being a yes or no.
And the good thing about our treatment here using probiotics and naturally occurring gut bacteria is that we are...
...almost zero percent risk of it having any side effects.
Because what we're working with here is a naturally occurring gut bacteria.
And then we are using the natural process or we are supporting the natural process of PFAS removal that the body already does.
Because PFAS will come out of your body if you're not exposed to more PFAS over a period of maybe, let's say, 10 years or so.
Very slowly. What we do is we accelerate that process.
So instead of having a small percentage, you have a big percentage of these gut bacteria that detoxify your body.
So we essentially just support the already existing process, which is a natural process.
And we are not like, for instance, if it was a drug, we would take an inorganic compound and put it into the body.
We don't know what happens here. We take an existing bacteria that already exists in our gut microbiome and enhance the number of those.
That's it. So there's almost no risk associated to what we will do.
And then we'll see how big the effect is to the clinical trials we will start next year.
So, yes, we are very optimistic and we are ready to go as soon as the production has been upscaled.
I think it's a problem. I think that's worth making effort for. That's why we are doing it.
And I think we would like to give it a best shot and think about how we are going to formulate it,
how we are going to make sure that it's delivered to the right site in the GI tract and so on and so forth.
Well, I'm extremely excited. I mean, as you mentioned, just the average civilian has a lot of PFAS.
My community have so much more, as you talked about.
What do you envision that kind of therapeutic process looking like?
I mean, it's going to be probiotics. It's going to be excreted through the feces. It's a very natural process.
Would a firefighter be taking it for six months?
What are you anticipating the prescription of this would be?
Yeah. So first of all, I think it's important to say it is not a therapeutic treatment.
It's a dietary food supplement we're doing.
So it's a capsule that you take on a daily basis together with your vitamin pill, something like that.
And then we expect that you take it for a period of six to 12 months.
And throughout that process, you will be able to detoxify your body.
And the good thing about this is that already today, there are companies that test the levels of PFAS in individual's blood.
So you will actually be able to monitor the PFAS levels in your blood.
If they're elevated, you take the probiotic dietary supplement.
And then over time, let's say every three months, you actually measure the PFAS levels in each individual.
So we can measure efficacy in each individual throughout the treatment process.
And that makes us quite certain on where are we, how long should you take it, and how effective is the treatment.
So that's one of the things that makes this product a little bit unique in the market,
because when you talk about, for instance, probiotics that are on the market today that you referred to indirectly before, James,
some of them refer to gut health.
And of course, gut health is important. But how do you measure gut health?
It's a feeling. It's a gut feeling, right?
Whereas here, we are actually able to measure the efficacy in each individual with a specific number of PFAS levels in each individual's blood.
And therefore, we feel we have something that will for sure stand out in the market.
And it will be a true precision probiotics that does something very specific for the people that need it. And only that.
I think it's extremely exciting. I really do.
And as you do the trials, obviously then we'll make sure that we connect you with all the people over here to get this out.
Because I know I can envision so many fires, car fires, dumpster fires, industrial fires where I was standing knee deep in foam.
And I mean, just the exposures are insane. And not only the fires I fought, but all the workouts I did in my gear,
that my pores were open and absorbing even more. So I will be certainly buying some of this as well.
But before I let you go, are there any other areas, any other topics, any other messages that you want to impart before we wrap up?
I think it's quite important that we think about certain long term solutions.
Because PFAS problem comes because these molecules are very resistant to degradation.
And it means that they hang around for a long time. Unfortunately, we are where we are.
I think the solution-wise also we have to think in a broad sense.
That is, there's not going to be, it's not practically possible that we get rid of all the PFAS.
And I think we need to think about living with PFAS that's around us. Even if we stop producing all PFAS production from tomorrow, it's still around there.
I think from my perspective, where does it do the most harm? I think it does most harm within our body.
So let's start thinking about how do we get rid of from our body.
And I think this is how I think we need to systematically move forward, getting rid from the agriculture systems, farming systems, and so on and so forth.
And I think that's the way forward.
Maybe I would say that I think I would take this opportunity, James, to just to reach out and say,
if anybody that is listening to this podcast feels that this is an important and interesting area,
then we are looking for partners, any type of partner, I would say, that can help us to get this realized
and to become a product that can help people that suffer from PFAS poisoning.
Because we have started this process, but we can only do it together with partners.
And like any other partner, we need manufacturing partners, we need distribution partners,
we need getting it out into the community, whether that's through marketing or influencers.
And we need also to get in contact with the customers that need this product.
So I would just like to reach out and say we are a small company from Denmark.
It has a good idea. We hope to be in the market by the end of 2026.
But we need all the help we can to get this out to firefighters in the US and other personnel that has been poisoned by PFAS through their professional work.
So, yeah.
Well, thank you. I mean, there's one company that I'm going to connect you with.
I think we talked about before. But yeah, I mean, as far as anyone else listening, please feel reach out to me through the website and I can connect you with these guys.
I just want to thank you so much. It's been such an important conversation.
I mean, I love the background stuff as well, kind of hearing, you know, your journey into science.
But what you are doing, I mean, literally is going to change lives because this PFAS conversation, the fire service,
literally only in the last couple of years has become a huge hot topic. And I hope that we'll see PFAS free gear, truly PFAS free gear, you know, emerging as an alternative for us now.
But most of us, I'm sure, are wondering, well, what are we going to do with this that's already in our body?
And if this really does show efficacy on the human trials, then this is going to be life changing, even if it's just for my profession, not to mention all the other ones.
So I want to thank you both so much for your work and also for being so generous with your time and coming on the Behind the Shield podcast today.
Thanks a lot, James, for, you know, taking up this very important topic on your podcast.
Thank you very much, James. It was a pleasure talking to you and hope it was useful to you and to the others who are listening.