Bioterrorism alleging use of anthrax and interim guidelines for management--United States, 1998.
From October 30 through December 23, 1998, CDC received reports of a series of bioterroristic threats of anthrax exposure. Letters alleged to contain anthrax were sent to health clinics on October 30, 1998, in Indiana, Kentucky, and Tennessee. During December 17-23 in California, a letter alleged to contain anthrax was sent to a private business, and three telephone threats of anthrax contamination of ventilation systems were made to private and public buildings. All threats were hoaxes and are under investigation by the Federal Bureau of Investigation (FBI) and local law enforcement officials. The public health implications of these threats were investigated to assist in developing national public health guidelines for responding to bioterrorism. This report summarizes the findings of these investigations and provides interim guidance for public health authorities on bioterrorism related to anthrax. (+info
The marginalization of hormesis.
Despite the substantial development and publication of highly reproducible toxicological data, the concept of hormetic dose-response relationships was never integrated into the mainstream of toxicological thought. Review of the historical foundations of the interpretation of the bioassay and assessment of competitive theories of dose-response relationships lead to the conclusion that multiple factors contributed to the marginalization of hormesis during the middle and subsequent decades of the 20th Century. These factors include the following: (a) the close association of hormesis with homeopathy, which led to the hostility of modern medicine toward homeopathy, thereby creating a guilt-by-association framework, and the carryover influence of that hostility toward hormesis in the judgements of medically based pharmacologists/toxicologists; (b) the emphasis of high-dose effects linked with a lack of appreciation of the significance of the implications of low-dose stimulatory effects; (c) the lack of an evolution-based mechanism(s) to account for hormetic effects; and (d) lack of appropriate scientific advocates to counter aggressive and intellectually powerful critics of the hormetic perspective. (+info
Chemical hormesis: its historical foundations as a biological hypothesis.
Despite the long history of hormesis-related experimental research, no systematic effort to describe its early history has been undertaken. The present paper attempts to reconstruct and assess the early history of such research and to evaluate how advances in related scientific fields affected the course of hormesis-related research. The purpose of this paper is not only to satisfy this gap in current knowledge but also to provide a foundation for the assessment of how the concept of hormetic dose-response relationships may have affected the nature of the bioassay, especially with respect to hazard assessment practices within a modern risk assessment framework. (+info
Migration patterns of children with cancer in Britain.
OBJECTIVES: To investigate the early migration patterns of children who later developed cancer. To test a prior hypothesis that some cancers are initiated by early exposures to toxic atmospheric pollutants from point sources. DESIGN: Address changes in children dying from cancer are examined in relation to potentially hazardous sites of several different types. The relative proximities of birth addresses and death addresses to these sites, are compared. The approach is based upon the premise that a local exposure, effective only at an early age, must be preferentially linked with an early address. SETTING AND SUBJECTS: Records of 22,458 children dying from leukaemia or other cancer under the age of 16 years in Great Britain between 1953 and 1980: including 9224 who moved house between birth and death. The migration analysis was based upon birth and death addresses, converted first to postcodes and thence to map coordinates. The geographical locations of potentially toxic industrial sites were obtained through direct map searches and from commercial directories. RESULTS: Systematic asymmetries were found between measured distances from birth and death addresses to sources emitting volatile organic compounds, or using large scale combustion processes. The children had more often moved away from these hazards than towards them. Many of the sources had already been identified as hazardous using other methods. There was also a birth association with areas of dense habitation; possibly because of unidentified toxic sources contained within them. All forms of cancer were involved although some effluents were associated preferentially with specific types. CONCLUSIONS: The main findings of an earlier study, based upon a different and independent method, were confirmed. Proximities to several types of industrial source, around the time of birth, were followed by a raised risk of childhood cancer. Combustion products and volatile organic compounds were especially implicated. Within the 16 year limit of the study, the increased risk did not decay with advancing age. Low atmospheric concentrations of many carcinogenic substances suggest that the mother acts as a cumulative filter and passes them to the fetus across the placenta or in breast milk. (+info
Emergency planning and the acute toxic potency of inhaled ammonia.
Ammonia is present in agriculture and commerce in many if not most communities. This report evaluates the toxic potency of ammonia, based on three types of data: anecdotal data, in some cases predating World War 1, reconstructions of contemporary industrial accidents, and animal bioassays. Standards and guidelines for human exposure have been driven largely by the anecdotal data, suggesting that ammonia at 5,000-10,000 parts per million, volume/volume (ppm-v), might be lethal within 5-10 min. However, contemporary accident reconstructions suggest that ammonia lethality requires higher concentrations. For example, 33,737 ppm-v was a 5-min zero-mortality value in a major ammonia release in 1973 in South Africa. Comparisons of secondary reports of ammonia lethality with original sources revealed discrepancies in contemporary sources, apparently resulting from failure to examine old documents or accurately translate foreign documents. The present investigation revealed that contemporary accident reconstructions yield ammonia lethality levels comparable to those in dozens of reports of animal bioassays, after adjustment of concentrations to human equivalent concentrations via U.S. Environmental Protection Agency (EPA) procedures. Ammonia levels potentially causing irreversible injury or impairing the ability of exposed people to escape from further exposure or from coincident perils similarly have been biased downwardly in contemporary sources. The EPA has identified ammonia as one of 366 extremely hazardous substances subject to community right-to-know provisions of the Superfund Act and emergency planning provisions of the Clean Air Act. The Clean Air Act defines emergency planning zones (EPZs) around industrial facilities exceeding a threshold quantity of ammonia on-site. This study suggests that EPZ areas around ammonia facilities can be reduced, thereby also reducing emergency planning costs, which will vary roughly with the EPZ radius squared. (+info
Health and safety practices among farmers and other workers: a needs assessment.
The development of appropriate health and safety interventions for farmers and agri-workers is important world-wide but data on present practices and attitudes to change are lacking. A representative quota sample (n = 1,938) of the Irish population was surveyed on lifestyle practices and workplace risk assessment and control measures, in relation to chemical exposure, manual handling and machinery. Focus group discussions were conducted also with 47 representatives of national farming organizations. As compared with the general workforce, farmers had a significantly (p < 0.01) lower level of assessment of risk hazards associated with manual handling and machinery. Both farmers and employees in workplaces with less than 20 employees reported a significantly lower level of safety training. Male farmers had a particularly negative health profile with only 18% reporting regular dental checks, 26% practising skin protection and 29% taking regular exercise. Discussions indicated that barriers to change included low perceived susceptibility, lack of time and resources. Mental health issues were particularly highlighted. We conclude farmers differ significantly in many instances from the rest of the workforce in regard to occupational health and safety issues and specific interventions in key areas are required for the agri-sector. (+info
Hazards of chemical weapons release during war: new perspectives.
The two major threat classes of chemical weapons are mustard gas and the nerve agents, and this has not changed in over 50 years. Both types are commonly called gases, but they are actually liquids that are not remarkably volatile. These agents were designed specifically to harm people by any route of exposure and to be effective at low doses. Mustard gas was used in World War I, and the nerve agents were developed shortly before, during, and after World War II. Our perception of the potency of chemical weapons has changed, as well as our concern over potential effects of prolonged exposures to low doses and potential target populations that include women and children. Many of the toxicologic studies and human toxicity estimates for both mustard and nerve agents were designed for the purpose of quickly developing maximal casualties in the least sensitive male soldier. The "toxicity" of the chemical weapons has not changed, but our perception of "toxicity" has. (+info
Mass psychogenic illness attributed to toxic exposure at a high school.
BACKGROUND AND METHODS: Mass psychogenic illness may be difficult to differentiate from illness caused by bioterrorism, rapidly spreading infection, or toxic substances. We investigated symptoms attributed to exposure to toxic gas at a high school in Tennessee. In November 1998, a teacher noticed a 'gasoline-like' smell in her classroom, and soon thereafter she had a headache, nausea, shortness of breath, and dizziness. The school was evacuated, and 80 students and 19 staff members went to the emergency room at the local hospital; 38 persons were hospitalized overnight. Five days later, after the school had reopened, another 71 persons went to the emergency room. An extensive investigation was performed by several government agencies. RESULTS: We were unable to find a medical or environmental explanation for the reported illnesses. The persons who reported symptoms on the first day came from 36 classrooms scattered throughout the school. The most frequent symptoms (in this group and the group of people who reported symptoms five days later) were headache, dizziness, nausea, and drowsiness. Blood and urine specimens showed no evidence of carbon monoxide, volatile organic compounds, pesticides, polychlorinated biphenyls, paraquat, or mercury. There was no evidence of toxic compounds in the environment. A questionnaire administered a month later showed that the reported symptoms were significantly associated with female sex, seeing another ill person, knowing that a classmate was ill, and reporting an unusual odor at the school. CONCLUSIONS: The illness attributed to toxic exposure had features of mass psychogenic illness - notably, widespread subjective symptoms thought to be associated with environmental exposure to a toxic substance in the absence of objective evidence of an environmental cause. Alleviation of the anxiety surrounding an episode of mass psychogenic illness requires prompt recognition and a detailed investigation. (+info