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FINAL%20SFU%20HSC%20304%2010.20.11

FINAL%20SFU%20HSC%20304%2010.20.11 - Environmental...

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Bruce Lanphear, MD, MPH Child & Family Research Institute, BC Children’s Hospital Faculty of Health Sciences, Simon Fraser University Environmental Neurotoxicants and Endocrine Disruptors
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New Morbidities of Childhood 0 2 4 6 8 10 12 14 16 18 Autism Conduct Disorder Learning Disability ADHD Asthma Preterm Birth P r e v a l e n c e Boyle C, et al. Pediatrics 1994:93:399-403; Branum AM, et al. Paediatr Perinat Epidemiol 2002;16:8-15; Hedley AA, et al. JAMA 2004;291:2847-50. Lanphear BP, et al.Pediatrics 2001 http://www.pediatrics.org/cgi/content/full/107/6/e98. Froehlich T, et al. Arch Ped Adolesc Med 2007;161:857-864; Braun J, et al. (in press).
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Environmental Influences Social Inequities Nutrition Drugs Environmental toxicants Infections Hormonal environment
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Environmental Toxicants Most recognized toxicants were discovered only as a result of an environmental disaster Increasing evidence linking toxicants with cognitive deficits and behavioral problems at levels previously thought to be innocuous or safe Increasing evidence linking toxicants with child and adolescent psychopathology Need to revise regulations and reduce exposures to environmental chemicals and
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Environmental Disasters
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Lead Poisoning in Queensland
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Minamata Disease
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PCB Environmental Disasters Yusho (Oil) Disease, Japan, 1968 Yu Cheng (Oil) Disease, Taiwan, 1979 Pregnant women who suffered from Yusho gave birth to babies who were small and had dark brown pigmentation of the skin. Follow-up studies of these children found growth impairment, slow development, lack of physical endurance, clumsiness, and IQ’s averaging around 70.
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Routes of Exposure Respiratory Ingestion Dermal Fetal transmission
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Critical Windows of Vulnerability Adapted from Healthy Environment Primer: CPCHE Canada
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Measuring Exposure
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Biomarkers, Exposure and Susceptibility
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Environmental Neurotoxicants
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Atladottir HO, et al. Arch Pediatr Adolesc Med 2007;161:193-198. Trends in Neuropsychiatric Disorders among Children in Denmark (per 10,000), 1990 to 1999 Birth Cohorts
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Low-level Toxicity of Environmental Toxicants
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Examples of Exposure Response Relationships R e s p o n s e Exposure Linear, non-threshold Linear, with threshold Non-linear relationship
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The Ongoing Search for a Threshold of Low- Level Lead Toxicity Lanphear BP, et al. EHP 2005;113:894-899.
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Weisskopf MG. et al. Am J Epidemiol 2004:160:1184-1193 Adjusted differences in Change in the Mini-Mental State Examination Score by Patella Lead Level
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