De Rosa Christopher T, Hicks Heraline E, Ashizawa Annette E, Pohl Hana R, Mumtaz M Moiz
Division of Toxicology and Environmental Medicine, Agency for Toxic Substances and Disease Registry, CDC, Atlanta, GA 30333, USA.
Ann N Y Acad Sci. 2006 Sep;1076:829-38. doi: 10.1196/annals.1371.028.
In the United States, some 80,000 commercial and industrial chemicals are now in use of which over 30,000 are produced or used in the Great Lakes region. Thus, the environmental quality within the Great Lakes basin has been compromised particularly with respect to persistent toxic substances (PTS). Information derived from wildlife studies, prospective epidemiological and toxicological studies, databases, demographics, and Geographical Information Systems (GIS) demonstrate significant public health implications. Studies of human populations indicate: (a) elevated body burden levels of PTSs, (b) decrease in gestational age, (c) low birth weight (LBW), (d) greater risk of male children with birth defects (OR = 3.01), (e) developmental and neurological deficits, (f) increased risk of infertility, (g) changes in sex ratio, and (h) fluctuations in thyroid hormones. These findings have been identified in vulnerable populations, such as the developing fetus, children, minorities, and men and women of reproductive age who are more susceptible because of their physiologic sensitivity and/or elevated exposure to toxic chemicals. Typically such health effects are assessed on a chemical specific basis; however, most human populations are exposed to hazardous chemicals as mixtures in air, water, soil, and biota. In this article we present an assessment of the potential for joint toxic action of these substances in combinations in which they are typically found. These evaluations represent an integration of all available scientific evidence in accordance with the "NAS paradigm" for risk assessment. In aggregate, our evaluations have demonstrated a need for community-based frameworks and computational techniques to track patterns of environmentally related exposures and associated health effects.
在美国，目前约有80,000种商业和工业化学品正在使用，其中30,000多种在五大湖地区生产或使用。因此，五大湖流域的环境质量已受到损害，尤其是在持久性有毒物质（PTS）方面。来自野生动物研究、前瞻性流行病学和毒理学研究、数据库、人口统计学以及地理信息系统（GIS）的信息表明，这对公众健康具有重大影响。对人群的研究表明：（a）PTS的体内负荷水平升高；（b）孕周缩短；（c）低出生体重（LBW）；（d）男童出生缺陷风险更高（OR = 3.01）；（e）发育和神经功能缺陷；（f）不孕风险增加；（g）性别比例变化；（h）甲状腺激素波动。这些发现已在弱势群体中得到确认，例如发育中的胎儿、儿童、少数族裔以及育龄男女，他们由于生理敏感性和/或接触有毒化学物质的程度较高而更易受到影响。通常，此类健康影响是基于特定化学物质进行评估的；然而，大多数人群接触的有害化学物质是空气、水、土壤和生物群中的混合物。在本文中，我们对这些物质在通常发现的组合中的联合毒性作用潜力进行了评估。这些评估是根据风险评估的“NAS范式”对所有现有科学证据的整合。总体而言，我们的评估表明需要基于社区的框架和计算技术来跟踪与环境相关的接触模式及相关健康影响。
