Taking an Exposure History


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Environmental Medicine


Book Description

People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" "Is it safe to live near power lines?" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions. This book discusses six competency based learning objectives for all medical school students, discusses the relevance of environmental health to specific courses and clerkships, and demonstrates how to integrate environmental health into the curriculum through published case studies, some of which are included in one of the book's three appendices. Also included is a guide on where to obtain additional information for treatment, referral, and follow-up for diseases with possible environmental and/or occupational origins.




Forging a Poison Prevention and Control System


Book Description

Poisoning is a far more serious health problem in the U.S. than has generally been recognized. It is estimated that more than 4 million poisoning episodes occur annually, with approximately 300,000 cases leading to hospitalization. The field of poison prevention provides some of the most celebrated examples of successful public health interventions, yet surprisingly the current poison control "system" is little more than a loose network of poison control centers, poorly integrated into the larger spheres of public health. To increase their effectiveness, efforts to reduce poisoning need to be linked to a national agenda for public health promotion and injury prevention. Forging a Poison Prevention and Control System recommends a future poison control system with a strong public health infrastructure, a national system of regional poison control centers, federal funding to support core poison control activities, and a national poison information system to track major poisoning epidemics and possible acts of bioterrorism. This framework provides a complete "system" that could offer the best poison prevention and patient care services to meet the needs of the nation in the 21st century.




Taking an Exposure History


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Monitoring Human Tissues for Toxic Substances


Book Description

The National Human Monitoring Program (NHMP) identifies concentrations of specific chemicals in human tissues, including toxicologic testing and risk assessment determinations. This volume evaluates the current activities of the NHMP; identifies important scientific, technical, and programmatic issues; and makes recommendations regarding the design of the program and use of its products.




Inevitably Toxic


Book Description

Not a day goes by that humans aren’t exposed to toxins in our environment—be it at home, in the car, or workplace. But what about those toxic places and items that aren’t marked? Why are we warned about some toxic spaces' substances and not others? The essays in Inevitably Toxic consider the exposure of bodies in the United States, Canada and Japan to radiation, industrial waste, and pesticides. Research shows that appeals to uncertainty have led to social inaction even when evidence, e.g. the link between carbon emissions and global warming, stares us in the face. In some cases, influential scientists, engineers and doctors have deliberately "manufactured doubt" and uncertainty but as the essays in this collection show, there is often no deliberate deception. We tend to think that if we can’t see contamination and experts deem it safe, then we are okay. Yet, having knowledge about the uncertainty behind expert claims can awaken us from a false sense of security and alert us to decisions and practices that may in fact cause harm. In the epilogue, Hamilton and Sarathy interview Peter Galison, a prominent historian of science whose recent work explores the complex challenge of long term nuclear waste storage.




Contaminated Water Supplies at Camp Lejeune


Book Description

In the early 1980s, two water-supply systems on the Marine Corps Base Camp Lejeune in North Carolina were found to be contaminated with the industrial solvents trichloroethylene (TCE) and perchloroethylene (PCE). The water systems were supplied by the Tarawa Terrace and Hadnot Point watertreatment plants, which served enlisted-family housing, barracks for unmarried service personnel, base administrative offices, schools, and recreational areas. The Hadnot Point water system also served the base hospital and an industrial area and supplied water to housing on the Holcomb Boulevard water system (full-time until 1972 and periodically thereafter). This book examines what is known about the contamination of the water supplies at Camp Lejeune and whether the contamination can be linked to any adverse health outcomes in former residents and workers at the base.




Veterans and Agent Orange


Book Description

Have U.S. military personnel experienced health problems from being exposed to Agent Orange, its dioxin contaminants, and other herbicides used in Vietnam? This definitive volume summarizes the strength of the evidence associating exposure during Vietnam service with cancer and other health effects and presents conclusions from an expert panel. Veterans and Agent Orange provides a historical review of the issue, examines studies of populations, in addition to Vietnam veterans, environmentally and occupationally exposed to herbicides and dioxin, and discusses problems in study methodology. The core of the book presents What is known about the toxicology of the herbicides used in greatest quantities in Vietnam. What is known about assessing exposure to herbicides and dioxin. What can be determined from the wide range of epidemiological studies conducted by different authorities. What is known about the relationship between exposure to herbicides and dioxin, and cancer, reproductive effects, neurobehavioral disorders, and other health effects. The book describes research areas of continuing concern and offers recommendations for further research on the health effects of Agent Orange exposure among Vietnam veterans. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans organizations, researchers, and health professionals.




Exposure


Book Description

“For Erin Brockovich fans, a David vs. Goliath tale with a twist” (The New York Times Book Review)—the incredible true story of the lawyer who spent two decades building a case against DuPont for its use of the hazardous chemical PFOA, uncovering the worst case of environmental contamination in history—affecting virtually every person on the planet—and the conspiracy that kept it a secret for sixty years. The story that inspired Dark Waters, the major motion picture from Focus Features starring Mark Ruffalo and Anne Hathaway, directed by Todd Haynes. 1998: Rob Bilott is a young lawyer specializing in helping big corporations stay on the right side of environmental laws and regulations. Then he gets a phone call from a West Virginia farmer named Earl Tennant, who is convinced the creek on his property is being poisoned by runoff from a neighboring DuPont landfill, causing his cattle and the surrounding wildlife to die in hideous ways. Earl hasn’t even been able to get a water sample tested by any state or federal regulatory agency or find a local lawyer willing to take the case. As soon as they hear the name DuPont—the area’s largest employer—they shut him down. Once Rob sees the thick, foamy water that bubbles into the creek, the gruesome effects it seems to have on livestock, and the disturbing frequency of cancer and other health problems in the area, he’s persuaded to fight against the type of corporation his firm routinely represents. After intense legal wrangling, Rob ultimately gains access to hundreds of thousands of pages of DuPont documents, some of them fifty years old, that reveal the company has been holding onto decades of studies proving the harmful effects of a chemical called PFOA, used in making Teflon. PFOA is often called a “forever chemical,” because once in the environment, it does not break down or degrade for millions of years, contaminating the planet forever. The case of one farmer soon spawns a class action suit on behalf of seventy thousand residents—and the shocking realization that virtually every person on the planet has been exposed to PFOA and carries the chemical in his or her blood. What emerges is a riveting legal drama “in the grand tradition of Jonathan Harr’s A Civil Action” (Booklist, starred review) about malice and manipulation, the failings of environmental regulation; and one lawyer’s twenty-year struggle to expose the truth about this previously unknown—and still unregulated—chemical that we all have inside us.




Biologic Markers in Urinary Toxicology


Book Description

Diseases of the kidney, bladder, and prostate exact an enormous human and economic toll on the population of the United States. This book examines prevention of these diseases through the development of reliable markers of susceptibility, exposure, and effect and the promise that new technologies in molecular biology and sophisticated understanding of metabolic pathways, along with classical approaches to the study of nephrotoxicants and carcinogens, can be developed and prevention of the diseases achieved. The specific recommendations included in this book complement those made in the previous three volumes on biomarkers, Biologic Markers in Reproductive Toxicology (1989), Biologic Markers in Pulmonary Toxicology (1989), and Biologic Markers in Immunotoxicology (1991).