scholarly journals Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Shahir Masri ◽  
Claudia S. Miller ◽  
Raymond F. Palmer ◽  
Nicholas Ashford
Keyword(s):  
Public Health ◽  
Environmental Protection Agency ◽  
Pesticide Exposure ◽  
World Trade Center ◽  
Chemical Exposure ◽  
Combustion Products ◽  
Chemical Intolerance ◽  
Surgical Implants ◽  
Select Group ◽  
Loss Of Tolerance

Abstract Background Despite 15–36% of the U.S. population reporting Chemical Intolerances (CI) or sensitivity, the condition has been overlooked in medicine and public health. CI is characterized by multisystem symptoms and new-onset intolerances that develop in a subset of individuals following a major chemical exposure event or repeated low-level exposures. While Toxicant-Induced Loss of Tolerance (TILT) is a two-stage disease mechanism proposed to explain CI, less is known about the exposures that initiate the disease, than about the intolerances that have been documented. Methods We reviewed eight major exposure events that preceded onset of chemical intolerance in groups of individuals sharing the same exposure. Our goal was to identify the chemicals and/or groups of chemicals that were most pervasive during each exposure event as well as identify the concentrations of key chemicals involved in each exposure event and the proportions of exposed individuals who ultimately developed TILT following exposure. Case studies we selected for review included (1) workers at U.S. Environmental Protection Agency (EPA) headquarters during renovations; (2) Gulf War veterans; (3) pesticide exposure among casino workers; (4) exposure to aircraft oil fumes; (5) the World Trade Center tragedy; (6) surgical implants; (7) moldy environments; and (8) tunnel workers exposed to solvents. Results Mixed volatile and semi-volatile organic compounds (VOCs and SVOCs), followed by pesticides and combustion products were most prevalent across TILT initiation events. As a broader category, synthetic organic chemicals and their combustion products were the primary exposures associated with chemical intolerance. Such chemicals included pesticides, peroxides, nerve agents, anti-nerve agent drugs, lubricants and additives, xylene, benzene, and acetone. Conclusion A select group of exposures were predominant in several major initiating events, suggesting their potential role in TILT initiation. Such insights are useful to public health scientists, physicians, and policymakers seeking to minimize harmful exposures and prevent future disease.

scholarly journals Carcinogenicity assessment: technical and political challenges

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Madia ◽  
A Worth ◽  
M Whelan ◽  
R Corvi
Keyword(s):  
Public Health ◽  
Safety Assessment ◽  
Chemical Exposure ◽  
Chemical Production ◽  
Chemical Safety ◽  
Cancer Disease ◽  
Cancer Occurrence ◽  
Global Trend ◽  
Exposure Patterns ◽  
Prevention Of Cancer

Abstract The rising rates of cancer incidence and prevalence identified by the WHO are of serious concern. The scientific advances of the past twenty years have helped to describe major properties of the cancer disease, enabling therapies that are more sophisticated. It has become clear that the management of relevant risk factors can also significantly reduce cancer occurrence worldwide. Public health policy actions cannot be decoupled from environmental policy actions, since exposure to chemicals through air, soil, water and food can contribute to cancer as well as other chronic diseases. Furthermore, due to the increasing global trend of chemical production including novel compounds, chemical exposure patterns are foreseen to change, posing high demands on chemical safety assessment, and creating potential protection gaps. The safety assessment of carcinogenicity needs to evolve to keep pace with changes in the chemical environment and cancer epidemiology. The presentation focusses on EC-JRC recommendations and future strategies for carcinogenicity safety assessment. This also includes discussion on how the traditional data streams of regulatory toxicology, together with new available assessment methods can inform, along with indicators of public health status based on biomonitoring and clinical data, a more holistic human-relevant and impactful approach to carcinogenicity assessment and overall prevention of cancer disease.

Developmental immunotoxicology and risk assessment: a workshop summary

2002 ◽  
Vol 21 (9-10) ◽  
pp. 473-478 ◽  
Author(s):  
M P Holsapple
Keyword(s):  
Risk Assessment ◽  
Immune System ◽  
Environmental Protection Agency ◽  
Standard Procedure ◽  
Panel Discussion ◽  
Chemical Exposure ◽  
Technical Committee ◽  
Individual Species ◽  
Standard Practices ◽  
Developmental Immunotoxicity

A workshop entitled ‘Developmental Immunotoxicology and Risk Assessment’ was held on 12–13 June 2001, in Washington, DC. The workshop was organized jointly by the Immunotoxicology Technical Committee (ITC) of the International Life Sciences Institute's (ILSI) Health and Environmental Sciences Institute (HESI) with input from the U.S. Environmental Protection Agency (EPA). Growing public concern that early exposure of the developing immune system to immunotoxic compounds may cause significant or persistent postnatal immunosuppression prompted the workshop. The main goal of the workshop was to examine scientific questions that underlie developmental immunotoxicity tests and the interpretation of the results as they relate to human risk assessment. A second goal was to provide a framework, based on current scientific knowledge, for the development of meaningful testing guidelines. The workshop focused on a series of questions that included how to address critical windows of exposure, how to develop and apply more predictive endpoints, does early chemical exposure cause transient or permanent effects on the immune system, as well as other related questions. On the first day, experts were invited to give scientific presentations relating to comparative developmental immunology, models of immunosuppression, and the regulatory aspects of developmental immunotoxicology. The second day was devoted to a panel discussion that included all the speakers as well as meeting participants, which attempted to answer each of the specific questions raised at the workshop. In general, it was acknowledged that there are a variety of techniques available for assessing immunosuppression in adult animal models, but there is uncertainty about how to apply these to a developing animal, especially if the goal is to have some standard procedure that can be applied for regulatory risk assessment. It was pointed out that although we know a lot about the developing immune system of individual species, we do not know how to relate the significance of drug or chemical effects on these systems in terms of human hazard. Overall, the panel deemed the area of developmental immunotoxicity to be still in its infancy and outlined strategies that could lead to the development of standard practices.

scholarly journals A Comparison of Burden of Disease from Toxic Waste Sites with other Recognized Public Health Threats in India, Indonesia and the Philippines

2014 ◽  
Vol 4 (7) ◽  
pp. 2-13 ◽  
Author(s):  
Jack Caravanos ◽  
Lina Hernandez Gutierrez ◽  
Bret Ericson ◽  
Richard Fuller
Keyword(s):  
Public Health ◽  
Burden Of Disease ◽  
Chemical Exposure ◽  
The Philippines ◽  
Toxic Waste ◽  
World Health ◽  
Health Conditions ◽  
Chromium Vi ◽  
Life Years ◽  
Health Threats

Background. Although toxic waste sites have been well investigated in many developed countries, their prevalence and health impact have not been well documented in low and middle income countries where risks attributable to environmental pollution are generally higher than in developed nations. Methods. We compared the burden of disease from toxic waste sites expressed in disability-adjusted life-years (DALYs) with the same measurement for other threats in India, Indonesia and the Philippines. We used Blacksmith Institute for a Pure Earth's DALY estimates for chemical exposure at 373 toxic waste sites in the 3 countries and World Health Organization (WHO) DALY estimates for different health conditions in the same countries. Results. Chromium VI causes the majority of DALYs among chemicals in India, while lead does so in the Philippines and Indonesia. In India, exposure to chromium VI showed higher DALY estimates than health conditions such as multiple sclerosis, Parkinson's disease and various cancers. In Indonesia, exposure to chromium VI and lead presented higher DALYs than conditions such as upper respiratory infections. In the Philippines, lead had higher DALYs than most of the examined conditions, including malaria and human immunodeficiency virus (HIV)/AIDS. Conclusions. This study highlights that the burden of disease expressed in DALYs from toxic waste sites may be greater than previously recognized and greater than other well addressed public health threats. We call attention to the need for surveillance of toxic waste sites, epidemiological analysis of the associations between exposure to toxic chemicals and outcomes, and remediation of chemical contamination in India, Indonesia and the Philippines.

scholarly journals A comprehensive analysis of racial disparities in chemical biomarker concentrations in United States women, 1999-2014

2019 ◽  
Author(s):  
Vy Kim Nguyen ◽  
Adam Kahana ◽  
Julien Heidt ◽  
Katelyn Polemi ◽  
Jacob Kvasnicka ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Risk Factors ◽  
Racial Disparities ◽  
Environmental Risk ◽  
Mexican American ◽  
Age Groups ◽  
Chemical Exposure ◽  
Environmental Risk Factors ◽  
Race Ethnicity

AbstractBackgroundStark racial disparities in disease incidence among American women remains a persistent public health challenge. These disparities likely result from complex interactions between genetic, social, lifestyle, and environmental risk factors. The influence of environmental risk factors, such as chemical exposure, however, may be substantial and is poorly understood.ObjectivesWe quantitatively evaluated chemical-exposure disparities by race/ethnicity and age in United States (US) women by using biomarker data for 143 chemicals from the National Health and Nutrition Examination Survey (NHANES) 1999-2014.MethodsWe applied a series of survey-weighted, generalized linear models using data from the entire NHANES women population and age-group stratified subpopulations. The outcome was chemical biomarker concentration and the main predictor was race/ethnicity with adjustment for age, socioeconomic status, smoking habits, and NHANES cycle.ResultsThe highest disparities across non-Hispanic Black, Mexican American, Other Hispanic, and other race/multiracial women were observed for pesticides and their metabolites, including 2,5-dichlorophenol, o,p’-DDE, beta-hexachlorocyclohexane, and 2,4-dichlorophenol, along with personal care and consumer product compounds. The latter included parabens, monoethyl phthalate, and several metals, such as mercury and arsenic. Moreover, for Mexican American, Other Hispanic, and non-Hispanic black women, there were several exposure disparities that persisted across age groups, such as higher 2,4- and 2,5-dichlorophenol concentrations. Exposure differences for methyl and propyl parabens, however, were the starkest between non-Hispanic black and non-Hispanic white children with average differences exceeding 4 folds.DiscussionsWe systematically evaluated differences in chemical exposures across women of various race/ethnic groups and across age groups. Our findings could help inform chemical prioritization in designing epidemiological and toxicological studies. In addition, they could help guide public health interventions to reduce environmental and health disparities across populations.

scholarly journals Multiple Chemical Sensitivity

2021 ◽  
Vol 12 (1) ◽  
pp. 46
Author(s):  
Gesualdo M. Zucco ◽  
Richard L. Doty
Keyword(s):  
Multiple Chemical Sensitivity ◽  
Environmental Chemicals ◽  
Chemical Sensitivity ◽  
Chemical Intolerance ◽  
Organ Systems ◽  
Clear Dose Response ◽  
Loss Of Tolerance ◽  
The Many ◽  
Multiple Chemical ◽  
Recurrent Set

Multiple Chemical Sensitivity (MCS), a condition also known as Chemical Sensitivity (CS), Chemical Intolerance (CI), Idiopathic Environmental Illness (IEI) and Toxicant Induced Loss of Tolerance (TILT), is an acquired multifactorial syndrome characterized by a recurrent set of debilitating symptoms. The symptoms of this controversial disorder are reported to be induced by environmental chemicals at doses far below those usually harmful to most persons. They involve a large spectrum of organ systems and typically disappear when the environmental chemicals are removed. However, no clear link has emerged among self-reported MCS symptoms and widely accepted objective measures of physiological dysfunction, and no clear dose-response relationship between exposure and symptom reactions has been observed. In addition, the underlying etiology and pathogenic processes of the disorder remain unknown and disputed, although biologic and psychologic hypotheses abound. It is currently debated whether MCS should be considered a clinical entity at all. Nevertheless, in the last few decades MCS has received considerable scientific and governmental attention in light of the many persons reporting this illness. In this review, we provide a general overview of the history, definition, demographics, prevalence, and etiologic challenges in defining and understanding MCS.

Abstract 16822: Dust Storms in the United States are Associated With Increased Cardiovascular Mortality

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
James L Crooks ◽  
Wayne Cascio ◽  
Madelyn Percy ◽  
Jeanette Reyes ◽  
Lucas Neas ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Particulate Matter ◽  
Cardiovascular Mortality ◽  
Environmental Protection Agency ◽  
The United States ◽  
Dust Storms ◽  
Ambient Particulate Matter ◽  
Protection Agency ◽  
The U.S

Introduction: Extreme weather events such as dust storms are predicted to become more frequent as the global climate warms through the 21st century. Studies of Asian, Saharan, Arabian, and Australian dust storms have found associations with cardiovascular and total non-accidental mortality and hospitalizations for stroke. However, the only population-level epidemiological work on dust storms in the United States was focused on a single small metropolitan area (Spokane, WA), and it is uncertain whether its null results are representative of the country as a whole. Hypothesis: Dust storms in the United States are associated with daily cardiovascular mortality. Methods: Dust storm incidence data (N=141), including date and approximate location, as well as meteorological station observations, were taken from the U.S. National Weather Service. County-level mortality data for the years 1993-2005 were acquired from the National Center for Health Statistics. Ambient particulate matter monitor concentrations were obtained from the U.S. Environmental Protection Agency. Inference was performed used conditional logistic regression models under a case-crossover design while accounting for the nonlinear effect of temperature. Results: We found a 9.5% increase in cardiovascular mortality at a two-day lag (95% CI: [0.31%,19.5%], p = 0.042). The results were robust to adjusting for heat waves and ambient particulate matter concentrations. Analysis of storms occurring only on days with <0.1 inches of precipitation strengthened these results and in addition yielded a mean daily increase of 4.0% across lags 0-5 (95% CI: [0.07%,20.8%], p = 0.046). In Arizona, the U.S. state with the largest number of storms, we observed a 13.0% increase at a three-day lag (CI: [0.40%,27.1%], p = 0.043). Conclusions: Dust storms in the U.S. are associated with increases in lagged cardiovascular mortality. This has implications for the development of public health advisories and suggests that further public health interventions may be needed. Disclaimer: This work does not represent official U.S. Environmental Protection Agency policy.

The public health response to the World Trade Center disaster

2007 ◽  
pp. 19-48
Author(s):  
Timothy H. Holtz ◽  
Leighton Jessica ◽  
Sharon Balter ◽  
Don Weiss ◽  
Susan Blank ◽  
...  
Keyword(s):  
Public Health ◽  
World Trade ◽  
World Trade Center ◽  
Public Health Response ◽  
World Trade Center Disaster ◽  
The Public ◽  
Health Response ◽  
The World ◽  
Trade Center

scholarly journals Using Life History Calendars to Estimate in Utero and Early Life Pesticide Exposure of Latinx Children in Farmworker Families

2020 ◽  
Vol 17 (10) ◽  
pp. 3478 ◽  
Author(s):  
Sara A. Quandt ◽  
Dana C. Mora ◽  
Theresa L. Seering ◽  
Haiying Chen ◽  
Thomas A. Arcury ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Life History ◽  
Early Life ◽  
Pesticide Exposure ◽  
Chemical Exposure ◽  
In Utero ◽  
Early Life Exposure ◽  
Research Designs ◽  
Past Life ◽  
Secondary Analyses

(1) Background: Early life exposure to neurotoxic chemicals can have later impacts on child health. Most research designs must assume that current exposure is similar to past. Life history calendar methods can help to provide data on early life exposure. (2) Methods: Life history calendars were completed by mothers of 8-year-old children from Latinx farmworker and non-farmworker families (n = 73 and 65, respectively). Measures were created of months exposure through living adjacent to farm fields and having household members who worked in jobs exposing them to toxic chemicals. Data were divided into time periods of in utero, early childhood (birth-35 months) and later childhood (36–96 months). Cluster analysis compared the measures for children from farmworker and non-farmworker parents. (3) Results: Although, as a group, children from farmworker families have greater lifetime months of probable exposure to pesticides than children in non-farmworker families, cluster analysis reveals groups of children who do not follow that pattern. (4) Conclusions: The life history calendar is a technique for obtaining data on early life toxic chemical exposure that may help assign children to proper exposure groups. Conducting secondary analyses using such information can help to clarify the association of exposures to health outcomes.

scholarly journals Characterizing the Neurodevelopmental Pesticide Exposome in a Children’s Agricultural Cohort

2020 ◽  
Vol 17 (5) ◽  
pp. 1479 ◽  
Author(s):  
Breana Bennett ◽  
Tomomi Workman ◽  
Marissa N. Smith ◽  
William C. Griffith ◽  
Beti Thompson ◽  
...  
Keyword(s):  
Environmental Protection Agency ◽  
Pesticide Exposure ◽  
Mixed Effects ◽  
Washington State ◽  
Protection Agency ◽  
Household Dust ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
Reference Doses ◽  
Neurotoxic Pesticides

The exposome provides a conceptual model for identifying and characterizing lifetime environmental exposures and resultant health effects. In this study, we applied key exposome concepts to look specifically at the neurodevelopmental pesticide exposome, which focuses on exposures to pesticides that have the potential to cause an adverse neurodevelopmental impact. Using household dust samples from a children’s agricultural cohort located in the Yakima Valley of Washington state, we identified 87 individual pesticides using liquid chromatography-tandem mass spectrometry. A total of 47 of these have evidence of neurotoxicity included in the Environmental Protection Agency (EPA) (re)registration materials. We used a mixed effects model to model trends in pesticide exposure. Over the two study years (2005 and 2011), we demonstrate a significant decrease in the neurodevelopmental pesticide exposome across the cohort, but particularly among farmworker households. Additional analysis with a non-parametric binomial analysis that weighted the levels of potentially neurotoxic pesticides detected in household dust by their reference doses revealed that the decrease in potentially neurotoxic pesticides was largely a result of decreases in some of the most potent neurotoxicants. Overall, this study provides evidence that the neurodevelopmental pesticide exposome framework is a useful tool in assessing the effectiveness of specific interventions in reducing exposure as well as setting priorities for future targeted actions.

scholarly journals Quantifying the Public Health Benefits of Reducing Air Pollution: Critically Assessing the Features and Capabilities of WHO’s AirQ+ and U.S. EPA’s Environmental Benefits Mapping and Analysis Program—Community Edition (BenMAP—CE)

Atmosphere ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 516 ◽  
Author(s):  
Jason Sacks ◽  
Neal Fann ◽  
Sophie Gumy ◽  
Ingu Kim ◽  
Giulia Ruggeri ◽  
...  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Environmental Protection Agency ◽  
Environmental Benefits ◽  
World Health ◽  
Health Impacts ◽  
Analysis Program ◽  
Common Input ◽  
The Public ◽  
Software Packages

Scientific evidence spanning experimental and epidemiologic studies has shown that air pollution exposures can lead to a range of health effects. Quantitative approaches that allow for the estimation of the adverse health impacts attributed to air pollution enable researchers and policy analysts to convey the public health impact of poor air quality. Multiple tools are currently available to conduct such analyses, which includes software packages designed by the World Health Organization (WHO): AirQ+, and the U.S. Environmental Protection Agency (U.S. EPA): Environmental Benefits Mapping and Analysis Program—Community Edition (BenMAP—CE), to quantify the number and economic value of air pollution-attributable premature deaths and illnesses. WHO’s AirQ+ and U.S. EPA’s BenMAP—CE are among the most popular tools to quantify these effects as reflected by the hundreds of peer-reviewed publications and technical reports over the past two decades that have employed these tools spanning many countries and multiple continents. Within this paper we conduct an analysis using common input parameters to compare AirQ+ and BenMAP—CE and show that the two software packages well align in the calculation of health impacts. Additionally, we detail the research questions best addressed by each tool.

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