This book evaluates the risk to human health and the environment posed by exposures to fluorides. It is widely known that fluoride has both positive and negative effects on human health, and there is a narrow range between intakes that are associated with these effects. Cases of skeletal fluorosis associated with the consumption of drinking water containing elevated levels of fluoride are reported. Fluoride is ubiquitous in the environment and virtually all foodstuffs contain at least trace amounts of fluoride. The amount of fluoride present naturally in non-fluoridated drinking water is highly variable, being dependent upon the individual geological environment. Also, fluorides, especially hydrogen fluoride, are important industrial compounds and they are used in aluminium production, glass manufacturing and so on. This document focuses on environmental exposure to fluoride derived mostly from inorganic sources and its effects on humans, animals and other biota.Data on hydrogen fluoride, calcium fluoride, sodium fluoride, sulfur hexafluoride and silicofluorides are covered, as these compounds are considered to be the most relevant of the inorganic fluorides on the basis of quantities released to the environment, environmental concentrations and toxicological effects on living organisms. A review of studies on the environmental fate and concentration of fluorides is also presented in this document.

This book evaluates the risks to human health and the environment posed by arsenic and arsenic compounds. Arsenic is widely distributed in the earth's crust and is emitted into the atmosphere by coal-fired power generation plants and volcanic activity. Inorganic arsenic of geological origin is found in groundwater, which is used as drinking-water in several parts of the world, e.g. Bangladesh. In these areas, drinking-water is the main source of arsenic intake, but elsewhere food is the principal source.

This book evaluates the risks to human health and the environment posed by the use of Bacillus thuringiensis (Bt) as a microbial agent for pest control. Products containing various Bt subspecies are increasingly used worldwide to control the larvae of several insect pests that threaten major agricultural crops and forests. Bt products are also being used to control the insect vectors of malaria onchocerciasis and other diseases of major public health importance. The bacterium is also a key source of genes for transgenic expression to provide pest resistance in plants and microorganisms. The report opens with an overview of the biological properties of Bt and commercial Bt products. Particular attention is given to the mechanisms by which sporulation produces inclusion bodies containing insecticidal crystalline proteins which are selectively toxic for insect species in the orders Coleoptera Diptera and Lepidoptera. Tables show the current classification of 67 Bt subspecies and the large number of genes coding for the insecticidal crystalline proteins. A review of Bt metabolites found in commercial products concludes that they pose no hazards to humans or the environment. Chapter two reviews data elucidating the mechanisms by which Bt exerts its toxic action on susceptible insect larvae. Data on insect populations that are resistant to Bt are also briefly considered. Chapter three which focuses on the survival and activity of Bt in the environment compares habitats where Bt subspecies occur naturally with treated habitats. Particular attention is given to the ability of Bt to form endospores that are resistant to inactivation by heat and desiccation and that persist in the environment under adverse conditions. A chapter on commercial production describes methods of production and general patterns of use in agriculture and forestry and in large-scale programmes to control the vectors of malaria and onchocerciasis. The most extensive chapter evaluates the large number of studies conducted to assess the toxicity of various preparations containing insecticidal crystalline proteins spores and vegetative cells. Laboratory studies in a range of species have failed to demonstrate toxic or pathogenic effects. Field studies have likewise failed to demonstrate adverse effects on birds earthworms fish other aquatic vertebrates and non-target aquatic invertebrates. An evaluation of effects on humans draws on studies in volunteers case reports from occupationally-exposed workers and extensive data from countries where Bt products are added to drinking-water for mosquito control or used to treat rivers for blackfly control. On the basis of this review the report concludes that Bt products are unlikely to pose any hazard to humans or other vertebrates or to the great majority of non-target invertebrates provided the commercial product is free from non-Bt microorganisms and biologically active products other than the insecticidal crystalline proteins. The report further concludes that Bt products can be safely used for the control of insect pests of agricultural and horticultural crops and forests. These products are likewise judged safe for use in aquatic environments including drinking-water reservoirs for the control of mosquito black fly and nuisance insect larvae. The report stresses however that vegetative Bt has the potential to produce Bacillus cereus-like toxins whose significance as a possible cause of human gastrointestinal disease remains unknown. ...one of the most thorough published reviews of Bacillus thuringiensis ... provides an array of pertinent background material... -- Integrated Pest Management Network

Evaluates the findings of close to 600 studies aimed at determining whether the health risks associated with tobacco use are enhanced by co-exposure to numerous chemical, biological, and physical agents commonly found in the workplace. Co-exposures in the domestic and general environment, which are especially important in newly industrializing countries, are also considered in this comprehensive review. Although all forms of tobacco use are covered, particular attention is given to risks arising from exposure to mainstream and sidestream smoke from cigarettes. The book has four chapters. The first summarizes what is known about the health risks caused by tobacco use. A brief overview of the history of tobacco use is followed by a detailed explanation of the chemistry of processed tobacco and the many toxic compounds found in tobacco and in mainstream and sidestream smoke. The chapter also includes an overview of all documented acute and chronic adverse effects of tobacco, including smokeless tobacco. The second and most extensive chapter evaluates the evidence on health effects caused by interactions between tobacco smoke and asbestos, non-asbestos fibres, seven inorganic chemicals, five organic chemical agents, including ethanol, four physical agents, and seven biological agents, including two widespread infectious agents. The chapter also includes an explanation of the concept of interaction and how it can be measured, a discussion of vector effects, whereby cigarettes become contaminated with toxic chemicals in the workplace, and a review of data indicating that tobacco smoking can alter the metabolism of therapeutic drugs and other chemicals. Chapter three considers whether adverseeffects following co-exposure to tobacco smoke and other agents are separate effects or possible interactions. The report found evidence for synergism in the production of adverse effects, including cancer, between tobacco smoking and exposure to asbestos, ethanol, silica, and radiation. The report also found evidence that tobacco smoking affects the health risks of exposure in coal mining, pesticide handling, and in the rubber and petroleum industries. In addition, tobacco smoking can increase the risk of byssinosis produced by exposure to cotton dust, and nasal cancer caused by exposure to wood dusts. On the basis of this evaluation, the final chapter concludes that all possible measures should be taken to eliminate tobacco use, particularly smoking. To avoid interaction with occupational exposure and to eliminate hazards arising from exposure to environmental tobacco smoke, the report concludes that smoking in the workplace should be prohibited.

Putting Health into Place draws together original works that collectively argue for a reinvention of medical geography. There is a growing interest worldwide in relationships between human health and the experience of place, an interest driven both by developments in sociocultural theory and observed health concerns. This book is a resource for those wishing to explore or to teach beyond the frontiers of conventional medical geography. As the first word of the book's title suggests, this is an active volume, one that contributes to situating health in the simultaneously tangible, negotiated, and experienced realities of place. Robin A. Kearns and Wilbert M. Gesler argue that medical issues are a necessary but insufficient focus in developing geographies of health and healing. This contention is supported by the authors of the thirteen substantive chapters who convey research findings from the Americas, Britain, and the Pacific. This book represents a collective commitment to exploring links between social and cultural theory, ideas about place, and discourses on health that will be of interest to readers across the social and health sciences.

This book offers an up-to-date guide to the concepts, procedures, statistical methods and models used to assess human exposure to environmental chemicals. Noting that exposure assessment is a comparatively new discipline of the environmental sciences, the book aims to encourage its use as a powerful tool for measuring actual levels of exposure and determining whether interventions are needed to protect public health. With this goal in mind, the book gives researchers expert advice on the design and conduct of studies, the interpretation of findings, and the best methods for ensuring the reliability and reproducibility of results. Throughout, emphasis is placed on the ways in which well-designed exposure assessments can enhance the practical value of findings from traditional epidemiological and toxicological investigations. The book has twelve chapters. The first six cover conceptual and methodological issues. Chapter one introduces basic concepts used in exposure assessment, and describes direct and indirect methods of measuring or estimating actual exposure and determining whether intervention is required. The uses of human exposure data are covered in chapter two, which explains how studies of human exposure can reduce the uncertainty of estimates used in epidemiology, risk assessment and risk management. Chapter three considers several generic study designs and approaches, and compares their advantages and limitations. Chapter four, on statistical methods, discusses selective applications of descriptive and inferential statistics, using data on lead exposure as an example. Subsequent chapters review methods for the collection and application of time-use data and introduce the principles, methods and data requirements of exposure modeling. Against this background, chapters in the second half of the book offer practical advice on the design and conduct of studies aimed at assessing exposure to chemicals in different environmental media. Separate chapters describe sampling methods used to analyze chemical concentrations in air, water, and food, and in soil and settled dust. Environmental allergens that can contribute to disease or alter susceptibility are considered in chapter nine, which concentrates on methods for measuring particles from house dust mites and their feces, allergens from pets and cockroaches, and allergens or toxins from fungi, bacteria and pollen. Subsequent chapters describe the use of biological markers in exposure assessment, and discuss issues surrounding the quality assurance of exposure studies and results. The final chapter presents brief summaries and examples of exposure studies in order to illustrate different study designs for different objectives, target pollutants, and populations. Studies that show how exposure assessment supports epidemiology and risk management, particularly in developing countries, are also included.

Summarizes current understanding of the complex interactions between chemicals, the immune system, and target organs that lead to manifestations of allergic hypersensitivity and autoimmunity. Noting that the incidence of allergic disorders has increased significantly in many countries, the book responds to the urgent need to improve methods for detecting potential allergens and predicting their effects in both individuals and populations. The need for better preventive strategies and therapeutic options is also considered, particularly in view of the high costs of allergic disorders in terms of health care and time lost from work. Addressed to researchers, the book concentrates on what is known about the mechanisms of sensitization and autoimmunity elicited by numerous industrial chemicals, adjuvant environmental factors, such as air pollution, tobacco smoke, and ultraviolet radiation, and food allergens with a proven involvement of the immune system. Although a large number of allergies are covered, particular attention is given to asthma and contact dermatitis as major occupational diseases undergoing intensive investigation. Throughout, a special effort is made to identify lines of investigation that will lead to a better understanding of fundamental mechanisms and thus improve the prospects for treatment and prevention. Over 1000 references to the literature are included. The book opens with a detailed explanation of the structure and functional processes of the immune system, followed by a discussion of the mechanisms by which chemicals can disrupt these functions. Also discussed are fundamental concepts of immunosuppression, immunodeficiency, and immunological tolerance that helpexplain the mechanistic basis of sensitization, allergic responses, and autoimmunity. Chapter two provides an overview of mechanisms involved in four major types of hypersensitivity and in autoimmunity. Mechanisms are illustrated with examples of diseases - from occupational asthma, through myasthenia gravis, to chronic beryllium disease - where exposure to environmental chemicals might play a role. The numerous hypotheses put forward to explain the mechanisms of autoimmune reactions are also critically assessed. Factors influencing allergenicity are covered in chapter three, which concentrates on the many complex endogenous and exogenous factors that govern the induction of allergic responses. Against this background, chapter four discusses clinical aspects of the most important allergic diseases. These include allergic contact dermatitis, atopic eczema, allergic rhinitis and conjunctivitis, allergic asthma caused by contact with chemicals, food allergy, and autoimmune diseases associated with drugs, chemicals, and environmental factors. Each disease is profiled in terms of its epidemiology, clinical manifestations, etiology, pathogenesis, diagnosis, and strategies for treatment and prevention. The remaining chapters review the epidemiology of asthma and allergic disease, including trends over time in different geographical regions, describe procedures for hazard identification through the demonstration of allergenicity, and explain how the principles of risk assessment can be applied to allergy. The book concludes with a glossary of terms, followed by 15 precise recommendations for the protection of human health and a list of priorities for further research.

This book evaluates the risks to human health and the environment posed by exposure to copper, a malleable metal found naturally in a wide variety of mineral salts and organic compounds, and in the metallic form. Copper is an essential element for all biota. It is widely used in cooking utensils and water distribution systems, in fertilizers, bactericides, fungicides, algicides, and antifouling paints, and in animal feed additives and growth promoters. Industrial applications include use as an activator in froth flotation and sulfide ores, in the production of wood preservatives, in electroplating, and in the manufacturing of azo-dyes.

A state-of-the-art review of methods and procedures for assessing the risks to human health posed by environmental chemicals. Addressed to regulatory authorities, risk managers and other decision-makers, the book aims to demystify the principles of risk assessment and thus encourage wider use of this powerful tool for protecting populations. Since the detection of chemical hazards may have socioeconomic and political consequences, the book gives particular attention to methods for the accurate identification of risks and determination of their severity. The book has four chapters covering each logical step in the process of risk assessment. The first, on hazard identification, explains how data on a chemical's toxicity and mode of action can be used to determine whether the chemical will cause adverse effects on health. The strengths and limitations of different types of data are discussed together with criteria commonly used to establish causality. Methods for assessing dose-response relationships are reviewed in chapter two, which explains how to characterize the relationship between the dose administered or received and the incidence of an adverse effect. Exposure assessment is covered in the next chapter, which describes methods for determining the nature and extent of contact with chemical substances and discusses the characteristics of exposure in the general environment, in the workplace, and from consumer products. The final chapter explains the procedure of risk characterization as a decision-making tool that brings together estimates of exposure levels and risks and summarizes sources of uncertainty in the scientific data. Practical options for risk management are presented asa range of regulatory, non-regulatory, economic, and technological measures.

Evaluates the carcinogenic risk to humans posed by exposure to fourteen industrial chemicals, including several having considerable commercial importance as the building blocks of widely used polymers and copolymers. While some of these chemicals are evaluated for the first time, the majority have been re-evaluated in the light of substantial new data and more precise methodological guidelines for the interpretation of findings. In view of the widespread industrial use of these chemicals, particular emphasis is placed on the risk of cancer in occupationally exposed workers. Over 1,800 studies were critically assessed. The most extensive monographs cover ethylene oxide, styrene, and acrylamide. Ethylene oxide is an important raw material for making major consumer goods in virtually all industrialized countries. On the basis of evidence of small but consistent excesses of lymphatic and haematopoietic cancer found in both human and animal studies, the monograph concludes that ethylene oxide is carcinogenic to humans. For styrene, one of the most important monomers worldwide, the evaluation concentrated on evidence of a link between exposure and the risk for lymphatic and haematopoietic cancer, concluding that styrene is possibly carcinogenic to humans. Acrylamide was classified as probably carcinogenic to humans. Among the other chemicals evaluated, styrene-7,8-oxide was classified as probably carcinogenic to humans. Propylene oxide, isoprene, 4-vinylcyclohexene, and 4-vinylcyclo-hexene diepoxide were classified as possibly carcinogenic. The remaining chemicals, ethylene, propylene, vinyl toluene, N-methylol-acrylamide, methyl methacrylate, and 2-ethylhexyl acrylate, could not be classified. For two of these, methyl methacrylate and vinyl toluene, experimental evidence indicated a lack of carcinogenicity.

A dissection of the Soviet Union's legacy of health and environmental disaster, this book examines a former country of 103 cities - home to 70 million people - where the air is unfit to breathe and pollution fouls 75 percent of the water.

Evaluates the risks to human health and the environment posed by exposure to alpha- and beta-hexachlorocyclohexanes (HCH). These two isomers are by-products in the manufacturing of lindane, and may be present in this pesticide as impurities. Alpha- and beta-HCH are also present in technical-grade HCH, which is used in agriculture and wood protection. Most environmental releases are linked to the use of technical-grade HCH and to the inappropriate disposal of residues produced when lindane is purified.

Evaluates the risks to human health and the environment posed by lindane, an isomer of hexachlorocyclohexane used, for more than four decades, as a broad-spectrum insecticide. Although most lindane is used in agriculture for the treatment of seeds and soils, other important applications include the protection of wood and timber, the treatment of veterinary ectoparasites, and the treatment of scabies and body lice in humans.

Evaluates the risks to human health and the environment posed by two partially halogenated chlorofluorocarbons: dichlorofluoromethane (HCFC 21) and chlorodifluoromethane (HCFC 22). These two methane derivatives were selected for evaluation because of their potential use as substitutes for those fully halogenated chlorofluorocarbons that are being phased out as a result of the 1987 Montreal Protocol on Substances that Deplete the Ozone Layer. The evaluation is intended to assist industry in its urgent search for acceptable substitute chemicals, most notably for use as refrigerants, as propellants in aerosols, and as blowing agents for the production of polystyrene. While data on human toxicity are thoroughly reviewed, the greatest challenge is to find the most accurate models for predicting levels of release to the environment and estimating the potential of these chemicals to deplete the ozone layer.

Evaluates occupational exposures to mists and vapours from strong inorganic acids: and other industrial chemicals.

Evaluates risks to human health and the environment posed by the use of beryllium, a brittle metal having major applications in the electronics and micro-electronics industries, in nuclear energy, and in the production of military devices, including satellites, missiles, atomic bombs, and other weapons. Beryllium has also proved its superiority as a structural material for aircraft and spacecraft.

Evaluates risks to human health and the environment posed by the production and use of tri-n-butyl phosphate. Tri-n-butyl phosphate is widely used worldwide as a solvent for cellulose esters, lacquers, and natural gums, as a primary plasticizer in the manufacture of plastics and vinyl resins, in the formulation of fire-resistant aircraft hydraulic fluids, and as an antifoaming agent, mainly in paper manufacturing plants.

Evaluates risks to human health and the environment posed by the widespread production and use of methyl isobutyl ketone as a solvent, with major applications in the production of lacquers and paint solvents, including car and industrial spray paints. Methyl isobutyl ketone also occurs naturally in food, is a permitted flavouring agent, and is used in food contact packaging materials. Sections concerned with the behaviour of methyl isobutyl ketone in the environment note its rapid evaporation into the atmosphere, rapid photo-transformation, ready biodegradation, and low potential for bioaccumulation. A review of data on metabolic pathways and toxicity to organisms concludes that production and use of this chemical pose no threat to wildlife or the environment, except in the case of accidental spills or inappropriate disposal of wastes.

Evaluates risks to human health and the environment posed by the production and use of dimethylformamide, an organic solvent produced in large quantities throughout the world. Dimethylformamide is widely used in the chemical industry as a solvent, an intermediate, and an additive, with the largest quantities used in the production of acrylic fibres and polyurethanes. Dimethylformamide is also used in the production of pharmaceutical products.

Evaluates risks to human health and the environment posed by the production, use, and disposal of hexachlorocyclopentadiene (HEX). HEX is a chemical used in the production of several pesticides, including heptachlor, chlordane, aldrin, dieldrin, endrin, mirex, pentac, and endosulfan. The compound is also used as an intermediate in the manufacturing of flame retardants and dyes.

Evaluates the risks to human health and the environment posed by n-hexane, a chemical isolated from natural gas and crude oil and used in food processing to extract vegetable oil from beans, nuts, and seeds. n-Hexane is also used as a solvent, a cleaning agent, in the rubber industry, and in the manufacture of pharmaceuticals.

Evaluates risks to human health and the environment posed by the production and use of triphenyl phosphate, a compound widely used as a flame retardant in phenolic and phenylene-oxide-based resins for the manufacture of electrical and automobile components. Triphenyl phosphate is also used as a non-flammable plasticizer in cellulose acetate for photographic films, and as a component of hydraulic fluids and lubricant oils.

Evaluates the risks to human health and the environment posed by the mining, refining, industrial use, and recycling of platinum and selected platinum compounds. Because of its exceptional catalytic properties, resistance to chemical corrosion, and high mechanical strength, platinum is widely used in the chemical and petroleum industries, most notably in the production of catalysts, including devices for reducing hazardous gas emissions. The growing use of catalytic converters to reduce pollution from automobile exhausts has caused a sharp increase in the world demand for this metal. Compounds such as cisplatin also have important therapeutic applications.

Evaluates the risks to human health and the environment posed by exposure to isobenzan. This cyclodiene insecticide was manufactured in the Netherlands from 1958 to 1965 and used from existing stocks for several years thereafter. Present sources of human and environmental exposure are restricted to the original waste-disposal sites and to polders which were built up using mud dredged from contaminated harbour areas. Although recent research on this insecticide has been limited, the report draws heavily on a number of proprietary toxicological studies made available by the manufacturer.

Evaluates the risks to human health and the environment posed by exposure to acrolein, a chemical produced in large quantities and used as an intermediate in the synthesis of several chemicals, most notably acrylic acid and its esters and DL-methionine, an essential amino acid used as a feed supplement for poultry and cattle. Acrolein also has direct application as an aquatic biocide used against algae, molluscs, and herbs in recirculating process water systems, irrigation channels, cooling water towers, and water treatment ponds. Acrolein accounts for about 3 to 10% of total automobile exhaust aldehydes, 1 to 13% of total wood-smoke aldehydes, and up to 7% of the aldehydes in cigarette smoke. The report notes that exposure of the general population occurs mainly via air, with mainstream and sidestream tobacco smoke representing the most important source. Other sources of exposure include inhalation of air polluted by vehicle exhausts, direct contact with acrolein-treated water, and consumption of alcoholic beverages and certain food items. Concerning effects on the environment, the report cites studies documenting adverse effects on crops grown on soil irrigated by acrolein-treated water, and a very high toxicity for bacteria, algae, crustacea, and fish, with bacteria being the most sensitive species. Acrolein is noted to threaten aquatic life at or near sites of industrial discharge or spills and in areas where acrolein is used as a biocide.