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Section II Outline Links: Chemicals and Disabilities • • • • • Basic Toxicology Lead Mercury PCBs Pesticides Basic Toxicology: Exposure-related Concepts • Persistence • Bioconcentration • Transient exposures Basic Toxicology Toxicity-related Concepts: specific processes disrupted by neurodevelopmental toxicants proliferation radiation, ethanol, mercury, cholinesterase inhibitors migration radiation, mercury, ethanol differentiation ethanol, nicotine, mercury, lead synaptogenesis radiation, ethanol, lead, triethyl tin, parathion, PCBs gliogenesis & myelinization dec. thyroid, ethanol, lead apoptosis signaling ethanol, lead, mercury ethanol, cholinesterase inhibitors, mercury, lead, PCBs Basic Toxicology Neurodevelopmental Toxicants: The State of Knowledge • Only 12 chemicals tested for neurodevelopmental toxicity according to current EPA guidelines. • Extensive data on effects of lead, mercury, polychlorinated biphenyls (PCBs), alcohol, nicotine. • Less extensive but substantial data on neurotoxic pesticides, solvents other than alcohol. • Still fewer data on other compounds including manganese, fluoride. Problem: Most data obtained for a few chemicals. No data available for majority. EXPOSURE – blood lead, ug/dl DECLINING lead THRESHOLD OF HARM - LEAD 100 REPORTED HARM 10 1 0.1 1960 1970 1980 1990 2000 YEAR REPORTED Note: Exposures expressed in micrograms/deciliter (blood le The Significance of Small Effects: EFFECTS OF A SMALL SHIFT IN IQ DISTRIBUTION IN A POPULATION OF 260 MILLION mean 100 6.0 million "gifted" 6.0 million "mentally retarded" 40 80 60 70 100 I.Q. 120 140 130 160 5 Point Decrease in Mean IQ mean 95 57% INCREASE IN "Mentally Retarded” Population 2.4 million "gifted" 9.4 million "mentally retarded" 40 80 60 70 100 I.Q. 120 140 130 160 Lead Effects of Lead on Cognitive and Behavioral Traits ADHD LD hyperactivity reading, math impulsivity spelling distractibility pattern recognition dif. w. instructs word recognition conduct problems executive function attention/vigilance social skills OTHER fine motor visual motor aggressive antisocial off-task Percent Association of Teacher Ratings With Student Lead Burden Class Distractible Nonpersistent Dependent Not Organized Class 1 2 3 4 5 6 Dentine Lead (ppm) <5.1 5.1-8.1 8.2-11.8 11.9-17.1 17.2-27.0 >27 Class Blood Lead, (micrograms/dl) 7-10 11-12 13-16 17-32 Hyperactive Impulsive Percent 1 2 3 4 Class Distracted Persist Work Disorganized Hyperactive Impulsive Independent Organized Lead Blood lead levels in the U.S. population 1976 -1999 NHANES II, III, 99+ 18 Blood lead levels (mg/dL) 16 14 12 10 8 6 4 2 0 1974 1976 1978 1980 1982 1984 1986 1988 1990 Year 1992 1994 1996 1998 2000 An Overview of Mercury Dry Deposition Combustion Wet Deposition Industry & Incinerators Farming Runoff WasteWater Releases Volatilization Pesticides Fertilizers Rain & Streams Hg to HgCH3 to Groundwater Methylation to Streams, lakes, vegetation, soil Particulates & Vapor Volcanoes Landfills Groundwater Flow Sedimentation Bioaccumulation in Fish Mercury Mercury Effects of Higher Dose Prenatal Exposure • • • • • • • • Mental retardation Seizures Cerebral palsy Disturbances of vision, hearing, sensation Abnormal gait Abnormal speech Disturbances of swallowing and sucking Abnormal reflexes Mercury: Declining Threshold of Harm (micrograms/kg/day Hg) DAILY INTAKE 100 Level associated with harmful effect Regulatory standard (maximum safe exposure or high end exposure from allowed fish contamination) 10 1 FDA WHO ATSDR 0.1 EPA 0.01 1970 1980 1990 YEAR 2000 Mercury Effects of Low Dose Prenatal Exposure % Children children with low test Per cent of with 7 years at age 7 years at age scores lowestscores Percent of Children with Low Scores Children with low prenatal mercury << 15 15 mg/l exposure 40 15-30mg/l 15-300 mg/l 30-50 30-50 Children with high prenatal mercury > 50 >50 mg/l µg/l exposure 30 20 10 0 LANGUAGE ATTENTION MOTOR Source: Grandjean, et. al., "Cognitive Deficit in 7-yearOld Children with Prenatal Exposure to Methylmercury", Neurotoxicology and Teratology, Vol. 19, No. 6, 1997 VISUOSPATIAL MEMORY Figure shows prenatal mercury exposure levels of Faroese children with scores in the lowest quartile after adjustment for cofounders. For each of the five major cognitive functions, one neuropsychological test with a high psychometric validity Mercury Mercury Exposures Advised Exposure Limit • EPA Reference Dose (“safe” upper limit) – 0.1 microgram/kilogram/day • Equivalent consumption limit • Women: 1.5 oz. swordfish or 7 oz. tuna/week • Child: 1 oz. tuna per 20 lb. body weight/week Mercury Mercury Exposures Current exposures • >10% of women of reproductive age exceed Reference Dose (RfD) • 50% of women who eat fish exceed RfD on any given day • Higher risk: Subsistence fishers, immigrants, Native Americans PCBs From Factory to the Fetus Dioxins and PCBs: Pathways of Exposure and Neurodevelopmental Effects Dioxins: PVC Manufacturing Medical/Municipal Incinerators Dioxins PCBs AIR SOIL WATER FOOD PCBs: Transformers Landfills Hazardous Waste Sites Full-Scale IQ PCBs Prenatal Exposure to Polychlorinated Biphenyls (PCBs) ug/g of fat Reading Mastery -Word Comprehension PCBs Prenatal Exposure to Polychlorinated Biphenyls (PCBs) ug/g of fat PCBs PCBs: PERVASIVE DEVELOPMENTAL EFFECTS Infant • • • • Birth weight Head circumference Gestational age Performance on Brazelton Neonatal Behavioral Assessment (BNBA) - motor immaturity, poor lability, startle PCBs: PERVASIVE DEVELOPMENTAL EFFECTS Early Childhood • Memory, attention, verbal ability, information processing • Psychomotor development • Sustained activity, high level play • Withdrawn, depressed behavior • Hyperactivity Preteen • Word and reading comprehension • Full scale and verbal IQ • Memory and attention PCBs: Inadequate Margin of Safety PCB BLOOD LEVELS (ppb) REPORTED HUMAN EXPOSURES Great Lakes fish eaters Great Lakes non-fish eaters Midwest and Northeast US women Michigan mothers North Carolina mothers Wisconsin women 20 REPORTED HEALTH EFFECTS IN OFFSPRING 15 10 Decreased reflexes, memory, IQ, attention, & visual discrimination 5 Dutch mothers 0 Decreased attention, cognitive ability, high level play, & psychomotor development; Increased withdrawn/depressed, increased hyperactivity. PCBs PCB Effects on Thyroid Hormone • Altered thyroid hormone Mothers: Thyroid Hormone, Thyroid Stimulating Hormone (TSH) Infants: Thyroid Hormone, TSH Seals and Rats: Thyroid Hormone • Developmental Implications Elevated maternal TSH during pregnancy, with or without reductions of thyroid hormone, associated with reduced IQ at age 7-9 yrs. PCBs PCB Neurodevelopmental Effects: Possible Mechanisms • Altered neurotransmitter levels • Ah receptor mediated effects (dioxin-like PCBs) Disruption of production of growth factors and hormones including enzyme induction, modulation of growth factors, hormones • Interference with thyroid hormone metabolism through enzyme induction interference with thyroid-hormone-mediated gene transcription displacement of thyroxin from carrier protein Organohalogen Compounds in Breast Milk in Sweden 4.5 4.0 PBDE Total TEQ (PCDD/PCDF/PCB) PCB, polychlorinated biphenyl; PCDD, polychlorinated dibenzo-pdioxin; PCDF, polychlorinated dibenzofuran; PBDE, polybromonated diphenylether; TEQ, toxic equiv. 120 100 3.5 80 2.5 60 2.0 1.5 40 1.0 20 0.5 0.0 1970 1975 1980 1985 1990 Year 1995 2000 0 2005 TEQ (pg/g fat) PBDE (ng/g fat) 3.0 PBDE Levels in Humans 35 California (fat) Sweden (serum) Germany (whole blood) Canada (milk) Finland (milk) Japan (milk) Sweden (milk) PBDE-47 Concentration (ng/g fat) 30 25 20 15 10 5 0 1981 1983 1985 1987 1990 1992 1994 Year PBDE, polybrominated diphenylethers. (She et al., 2001) 1996 1998 2000