Environmental Toxicants Human Exposures And Their Health Effects Pdf


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Read terms. The Program on Reproductive Health and the Environment endorses this document. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change.

Epidemiological studies play an important role in quantifying how early life environmental chemical exposures influence the risk of childhood diseases. These studies face at least four major challenges that can produce noise when trying to identify signals of associations between chemical exposure and childhood health. Challenges include accurately estimating chemical exposure, confounding from causes of both exposure and disease, identifying periods of heightened vulnerability to chemical exposures, and determining the effects of chemical mixtures.

Nearly every activity leaves behind some kind of waste in the environment. Households create ordinary garbage. Cars, trucks, and buses emit exhaust gases while in operation. Industrial and manufacturing processes create solid and hazardous waste. Some wastes contain chemicals that are hazardous to people and the environment.

Environmental Toxicants: Human Exposures and Their Health Effects, 3rd Edition

Read terms. The Program on Reproductive Health and the Environment endorses this document. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change.

This information should not be construed as dictating an exclusive course of treatment or procedure to be followed. ABSTRACT: Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals.

Patient exposure to toxic environmental chemicals and other stressors is ubiquitous, and preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course. Prenatal exposure to certain chemicals has been documented to increase the risk of cancer in childhood; adult male exposure to pesticides is linked to altered semen quality, sterility, and prostate cancer; and postnatal exposure to some pesticides can interfere with all developmental stages of reproductive function in adult females, including puberty, menstruation and ovulation, fertility and fecundity, and menopause.

Many environmental factors harmful to reproductive health disproportionately affect vulnerable and underserved populations, which leaves some populations, including underserved women, more vulnerable to adverse reproductive health effects than other populations. The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine join leading scientists and other clinical practitioners in calling for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure.

Robust scientific evidence has emerged over the past 15 years, demonstrating that preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course 1 2 3. Exposure to toxic environmental agents also is implicated in increases in adverse reproductive health outcomes that emerged since World War II; these changes have occurred at a rapid rate that cannot be explained by changes in genetics alone, which occur at a slower pace.

For additional information, a detailed review is available at www. Exposure to environmental chemicals and metals in air, water, soil, food, and consumer products is ubiquitous. An analysis of National Health and Nutrition Examination Survey data from — found that virtually every pregnant woman in the United States is exposed to at least 43 different chemicals 4. Chemicals in pregnant women can cross the placenta, and in some cases, such as with methyl mercury, can accumulate in the fetus, resulting in higher fetal exposure than maternal exposure 5 6 7.

Prenatal exposure to environmental chemicals is linked to various adverse health consequences, and patient exposure at any point in time can lead to harmful reproductive health outcomes. For example, prenatal exposure to certain pesticides has been documented to increase the risk of cancer in childhood; adult male exposure to pesticides is linked to altered semen quality, sterility, and prostate cancer; and postnatal exposure to some pesticides can interfere with all developmental stages of reproductive function in adult females, including puberty, menstruation and ovulation, fertility and fecundity, and menopause 8.

A group of chemicals called endocrine disrupting chemicals has been shown to interfere with the role of certain hormones, homeostasis, and developmental processes 9. They represent a heterogeneous group of agents used in pesticides, plastics, industrial chemicals, and fuels.

One study shows that the endocrine disrupting chemical bisphenol-A works in a fashion that is comparable to diethylstilbestrol at the cell and developmental level Likewise, research has clearly shown that many industrial chemicals can affect thyroid function 9 Because of deficiencies in the current regulatory structure, unlike pharmaceuticals, most environmental chemicals have entered the marketplace without comprehensive and standardized information regarding their reproductive or other long-term toxic effects Although exposure to toxic environmental agents is ubiquitous among all patient populations, many environmental factors harmful to reproductive health also disproportionately affect vulnerable and underserved populations and are subsumed in issues of environmental justice.

In the United States, minority populations are more likely to live in the counties with the highest levels of outdoor air pollution 13 and to be exposed to a variety of indoor pollutants, including lead, allergens, and pesticides than white populations In turn, the effects of exposure to environmental chemicals can be exacerbated by injustice, poverty, neighborhood quality, housing quality, psychosocial stress, and nutritional status 14 Women with occupational exposure to toxic chemicals also are highly vulnerable to adverse reproductive health outcomes For example, levels of organophosphate pesticides and phthalates measured in occupationally exposed populations are far greater than levels measured in the general population 17 Furthermore, low-wage immigrant populations disproportionately work in occupations associated with a hazardous work-place environment 19 Recognition of environmental disparities is essential for developing and implementing successful and efficient strategies for prevention.

The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Obstetricians and Gynecologists the College and the American Society for Reproductive Medicine ASRM join numerous other health professional organizations in calling for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure 1 22 Reproductive care providers can be effective in preventing prenatal exposure to environmental threats to health because they are uniquely poised to intervene before and during pregnancy, which is a critical window of human development.

An important outcome of pregnancy is no longer just a healthy newborn but a human biologically predisposed to be healthy from birth to old age 3 It is important for health care providers to become knowledgeable about toxic environmental agents that are endemic to their specific geographic areas.

Intervention as early as possible during the preconception period is advised to alert patients regarding avoidance of toxic exposure and to ensure beneficial environmental exposure, eg, fresh fruit and vegetables, unprocessed food, outdoor activities, and a safe and nurturing physical and social environment. By the first prenatal care visit, exposure to toxic environmental agents and disruptions of organogenesis may have already occurred.

Obtaining a patient history during a preconception visit and the first prenatal visit to identify specific types of exposure that may be harmful to a developing fetus is a key step and also should include queries of the maternal and paternal workplaces. A list of key chemical categories, sources of exposure, and clinical implications are provided in the online companion document to this Committee Opinion www.

Once this exposure inventory has been completed, information should be given regarding the avoidance of exposure to toxic agents at home, in the community, and at work with possible referrals to occupational medicine programs or United States Pediatric Environmental Health Specialty Units if a serious exposure is found Reproductive care professionals do not need to be experts in environmental health science to provide useful information to patients and refer patients to appropriate specialists when a hazardous exposure is identified.

Existing clinical experience and expertise in communicating risks of treatment are largely transferable to environmental health. Physician contact time with a patient does not need to be the primary point of intervention; information and resources about environmental hazards can be successfully incorporated into a childbirth class curriculum or provided in written materials to help parents make optimal choices for themselves and their children Reporting identified hazards is critical to prevention.

For example, the reproductive toxicity of a common solvent used in many consumer products was first described in a case report of a stillbirth Physicians in the United States are required to report illnesses or injuries that may be work related, and reporting requirements vary by state. No authoritative national list of physician-reporting requirements by state exists. Illnesses include acute and chronic conditions, such as a skin disease eg, contact dermatitis , respiratory disorder eg, occupational asthma , or poisoning eg, lead poisoning or pesticide intoxication Patient-centered actions can reduce body burdens of toxic chemicals ie, the total amount of chemicals present in the human body at any one time 29 30 31 Likewise, study results document that avoiding canned food and other dietary sources of bisphenol A can reduce measured levels of the chemical in children and adult family members 31 , and that short-term changes in dietary behavior may significantly decrease exposure to phthalates Clinicians should encourage women in the preconception period and women who are pregnant or lactating to eat fruit, vegetables, beans, legumes, and whole grains every day, to avoid fast food and other processed foods whenever possible, and to limit foods high in animal fat, while providing information about how certain types of food affect health and how individuals can make changes.

Also, patients should be advised that some large fish, such as shark, swordfish, king mackerel, and tilefish, are known to contain high levels of methylmercury, which is known to be teratogenic.

As such, women in the preconception period and women who are pregnant or lactating should avoid these fish. To gain the benefits of consuming fish, while avoiding the risks of methylmercury consumption, pregnant women should be encouraged to enjoy a variety of other types of fish, including up to 12 ounces a week two average meals of a variety of fish and shellfish that are low in mercury.

Five of the most commonly eaten seafood items that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. White albacore tuna has more mercury than canned light tuna and should be limited to no more than 6 ounces per week.

Pregnant women and breastfeeding women should also check local advisories regarding the safety of fish caught in local lakes, rivers, and coastal areas. If no advice is available, they should consume no more than 6 ounces per week one average meal of fish caught in local waters and no other fish during that week Ultimately, evidence-based recommendations for preventing harmful environmental exposure must involve policy change Action at the individual level can reduce exposure to some toxic chemicals 29 31 32 and informed consumer-purchasing patterns can send a signal to the marketplace to help drive societal change However, individuals alone can do little about exposure to toxic environmental agents, such as from air and water pollution, and exposure perpetuated by poverty.

The incorporation of the authoritative voice of health care professionals in policy arenas is critical to translating emerging scientific findings into prevention-oriented action on a large scale. Accordingly, many medical associations have taken steps in that direction The College and the ASRM join these associations and call on their members to advocate for policies to identify and reduce exposure to environmental toxic agents while addressing the consequences of such exposure.

Advancing policies and practices in support of a healthy food system should be pursued as a primary prevention strategy to ensure the health of pregnancies, children, and future generations.

Environmental Protection Agency and other federal and state agencies to take all necessary actions when reviewing substances to guarantee health and safety. In addition, the College and ASRM fully support rigorous scientific investigation into the causes and prevention of birth defects, including linkages between environmental hazards and adverse reproductive and developmental health outcomes. Timely and effective steps must be taken to ensure the safety of all mothers and infants from toxic environmental agents.

Because data are lacking on the safety of most chemicals, careful consideration of the risks posed must be given while the potential immediate and long-term health and genetic risks are evaluated. A chemical should never be released if a concern exists regarding its effect on health.

Published concurrently in the October issue of Fertility and Sterility. All rights reserved. Exposure to toxic environmental agents. Committee Opinion No. American College of Obstetricians and Gynecologists. Obstet Gynecol ;—5. Bulk pricing was not found for item. Please try reloading page.

For additional quantities, please contact sales acog. Patient Education Materials For Patients. Featured Clinical Topics.

Jump to Jump to Close. Search Page. Resources Close. Reproductive Environmental Health Robust scientific evidence has emerged over the past 15 years, demonstrating that preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course 1 2 3.

Vulnerable Populations and Environmental Disparities Although exposure to toxic environmental agents is ubiquitous among all patient populations, many environmental factors harmful to reproductive health also disproportionately affect vulnerable and underserved populations and are subsumed in issues of environmental justice. Prevention The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Obstetricians and Gynecologists the College and the American Society for Reproductive Medicine ASRM join numerous other health professional organizations in calling for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure 1 22 Providing Anticipatory Guidance It is important for health care providers to become knowledgeable about toxic environmental agents that are endemic to their specific geographic areas.

Primary Prevention: The Role of Reproductive Care Professionals Beyond the Clinical Setting Ultimately, evidence-based recommendations for preventing harmful environmental exposure must involve policy change Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr Rev ;— Article Location. Article Location Article Location. Download PDF. Please Confirm. Confirm Cancel.

Exposure to Toxic Environmental Agents

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Read article at publisher's site DOI : To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. Cited by: 54 articles PMID: Brent RL. Cited by: 13 articles PMID:

I agreed to review this book because I assumed from the title that it would contain some analytical content—a book on human exposure must, I thought, surely, include some chemical analysis. If it does, it is well hidden. The book is, instead, an encyclopaedic collection of non-occupational levels of toxicants likely to be encountered, and toxicity data associated with these; if analysis of the toxicants had been covered in the same depth the book would have been at least twice the size. According to the same publicity it is written by leading environmental health scientists. The book contains 30 chapters and the criteria used to arrange these, if any, are not obvious. The first is, of course, the Introduction. The next seven cover general topics risks, their reduction, respiratory toxicology, industrial perspectives and practices, by-products from disinfection of drinking water, and food.

Copy the HTML code below to embed this book in your own blog, website, or application. An uncorrected copy, or prepublication, is an uncorrected proof of the book. We publish prepublications to facilitate timely access to the committee's findings. The final version of this book has not been published yet. You can pre-order a copy of the book and we will send it to you when it becomes available. We will not charge you for the book until it ships. Pricing for a pre-ordered book is estimated and subject to change.

Health Effects from Chemical Exposure

Я люблю тебя, Сьюзан, - подумал.  - Помни это…. Ему казалось, что с него сорваны все внешние покровы. Не было ни страха, ни ощущения своей значимости - исчезло. Он остался нагим - лишь плоть и кости перед лицом Господа.

Новых сообщений не. Сьюзан прочитала их. Стратмор в отчаянии нажал на кнопку просмотра. ОБЪЕКТ: ЭНСЕЙ ТАНКАДО - ЛИКВИДИРОВАН ОБЪЕКТ: ПЬЕР КЛУШАР - ЛИКВИДИРОВАН ОБЪЕКТ: ГАНС ХУБЕР - ЛИКВИДИРОВАН ОБЪЕКТ: РОСИО ЕВА ГРАНАДА - ЛИКВИДИРОВАНА… Список на этом не заканчивался, и Стратмора охватил ужас. Я смогу ей объяснить.

Все десять присутствовавших при этом человек в напряженном ожидании молчали, когда вдруг заработавший принтер выдал им открытый текст: шифр был взломан. ТРАНСТЕКСТ вскрыл ключ, состоявший из шестидесяти четырех знаков, за десять с небольшим минут, в два миллиона раз быстрее, чем если бы для этого использовался второй по мощности компьютер АНБ. Тогда бы время, необходимое для дешифровки, составило двадцать лет. Производственное управление АНБ под руководством заместителя оперативного директора коммандера Тревора Дж. Стратмора торжествовало победу. ТРАНСТЕКСТ себя оправдал.

 Когда мы внесем эту поправку, - добавил Стратмор, - мне будет все равно, сколько ключей гуляет по свету: чем их больше, тем забавнее.  - Он жестом попросил ее возобновить поиск.  - Но пока этого не произошло, мы в цейтноте. Сьюзан открыла рот, желая сказать, что она все понимает, но ее слова были заглушены внезапным пронзительным звуком. Тишина шифровалки взорвалась сигналом тревоги, доносившимся из служебного помещения ТРАНСТЕКСТА.

 - Если бы они знали, сколько террористических нападений мы предотвратили благодаря тому, что можем взламывать шифры, они запели бы по-другому. Сьюзан была согласна с этим, но в то же время прекрасно понимала: Фонд электронных границ никогда не узнает, насколько важен и нужен ТРАНСТЕКСТ. Эта машина помогла предотвратить десятки преступлений, но связанная с ней информация строго засекречена и никогда не будет раскрыта. Причина такой секретности проста: правительство не может допустить массовой истерии. Никто не знает, как поведет себя общество, узнав, что группы фундаменталистов дважды за прошлый год угрожали ядерным объектам, расположенным на территории США. Ядерное нападение было, однако, не единственной угрозой.

Беккер открыл конверт и увидел толстую пачку красноватых банкнот. - Что. - Местная валюта, - безучастно сказал пилот.

Он замер, чувствуя мощный прилив адреналина. Неужели Стратмор каким-то образом проскользнул наверх. Разум говорил ему, что Стратмор должен быть не наверху, а внизу. Однако звук повторился, на этот раз громче.

Я тоже хотел бы с ней покувыркаться. Заплачу кучу денег. Хотя спектакль и показался достаточно убедительным, но Беккер зашел слишком. Проституция в Испании запрещена, а сеньор Ролдан был человеком осторожным. Он уже не один раз обжигался, когда полицейские чиновники выдавали себя за похотливых туристов.

 Боль внизу нестерпима, - прошипел он ей на ухо. Колени у Сьюзан подкосились, и она увидела над головой кружащиеся звезды.

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