Environmental health occupies a unique place in perinatal and reproductive health counseling
The United States manufactures and imports chemicals at voluminous rates. The US Environmental Protection Agency (EPA) has a chemical inventory of tens of thousands of chemicals; nearly 3,000 of these are produced or imported at > 1 million lb per year and only a scant minority are evaluated for toxic effects on brain development.1-4Â To focus efforts on reducing these toxic exposures, a group of expert toxicologists, health professionals, and patient advocates called Project TENDR (Targeting Environmental Neuro-Developmental Risk) developed consensus on highlighting six prime examples.5These six toxic exposures include chemicals widely used in consumer products, those present in the home setting, and broad public space exposures. They are: organophosphate pesticides, polybrominated diphenyl ether (PBDE) flame retardants, combustion-related air pollutants, lead, mercury, and polychlorinated biphenyls (often used in carbonless copy paper). Each of these has been deemed contributory to neurodevelopmental disorders including learning disabilities, attention deficit hyperactivity disorder (ADHD), autism, and behavioral or intellectual impairment.5For more on exposures:Â Toxic environmental exposures in maternal, fetal, and reproductive health
1. US EPA (U.S. Environmental Protection Agency). 2006. 2006 Inventory Update Reporting: Data Summary. Available at: http://www.epa.gov/sites/production/files/documents/2006_data_summary.pdf Accessed August 15, 2018.2. US EPA. 2012. 2012 Chemical Data Reporting Results. 2018. Available at: http://www.epa.gov/chemical-data-reporting/2012-chemical-data-reporting-results Accessed August 15, 2018.3. Grandjean P, Landrigan PJ. Developmental neurotoxicity of industrial chemicals. Lancet. 2006;368(9553):2167â2178.4. Grandjean P, Landrigan PJ. Neurobehavioural effects of developmental toxicity. Lancet Neurol. 2014;13(3):330â338.5. Project TENDR: Targeting Environmental Neuro-Developmental Risks. The TENDR Consensus Statement. Environ Health Perspect. 2016 July 1;124(7):A118-122.
Organophosphate (OP) pesticides
Found as residues in some foods, particularly conventionally grown produce; occupational exposures; exposure to pesticides used in the home.
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Polybrominated diphenyl ether (PBDE) flame retardants
Found in house dust, especially when old foam furniture is crumbling; also found in the plastics for electronics and some fatty foods.
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Combustion-related air pollutants (Generally includes: PAHs, nitrogen dioxide and particulate matter, and other air pollutants for which nitrogen dioxide and particulate matter are markers)
Air pollution in the home, outdoor environment, and in occupational settings
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Found in house dust, especially in older homes with lead paint; also can be found in water and in contaminated soil, such as gardens in urban or near-urban areas, and in some imported ethnic products such as herbal remedies, cosmetics, candies, and jewelry.
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Found in fish, especially larger fish in the top of the food chain. Less common exposures are from broken thermometers, occupational and industrial sources.
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