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New CDC Chemical Exposure Report Begins to Fill Critical Information Gaps in Environmental Health for the U.S. Population

Data Show Exposure to Environmental Tobacco Smoke Down Dramatically and Levels of Blood Lead Continuing to Decline

The Centers for Disease Control and Prevention (CDC) today released the first National Report on Human Exposure to Environmental Chemicals, an important new research tool that will provide better information on levels of exposure to environmental chemicals, and over time what these levels mean for public health

Advances in a technology known as biomonitoring allow CDC to measure chemicals directly in blood and urine samples rather than estimating population exposures by measuring air, water, or soil samples. Based on this scientific advancement, the new report provides data on actual levels of chemicals in humans. As data are collected over the years, researchers will be better able to determine possible health effects and design appropriate public health strategies.

"This new resource is a significant development in the field of environmental health," said Health and Human Services Secretary Tommy G. Thompson. "It will help us to better track the exposures of Americans to chemicals in the environment and to measure the effectiveness of our public health efforts."

This first report initially measures the exposure of the U.S. population to 27 environmental chemicals. The report includes metals (e.g., lead and mercury), pesticide metabolites, phthalate metabolites and cotinine (which tracks exposure to tobacco smoke). Levels of environmental chemicals were measured in blood and urine samples collected from participants in CDC's National Health and Nutrition Examination Survey (NHANES) - an ongoing national health survey of the U.S. population. The Report provides results from the 1999 survey; data from future years will help confirm these findings.

"The Report is a major step toward assessing in the U.S. population which environmental chemicals are present in blood and urine samples, who is exposed, trends in exposure over time, and whether interventions to reduce exposure are working," said Richard J. Jackson, MD, MPH, Director of CDC's National Center for Environmental Health (NCEH).

Although the report does not include new information on health risks of exposures or on potential routes of exposures, this is the first time that national exposure levels of the U.S. population are known for 24 of these 27 chemicals. CDC previously assessed the population's exposure to three substances -- lead, cadmium, and cotinine, and the report provides new data for the 1999 calendar year. Previously, only limited data were available on which environmental chemicals were in the U.S. population and at what levels.

The presence of a chemical in blood or urine does not necessarily indicate that the chemical will cause disease. Additional research is required to determine whether the levels reported are a cause for health concern.

The first Report provides information on the exposure of the U.S. population to these 27 substances. The chemicals, grouped into four categories, are as follows:

  • Metals: lead, mercury, cadmium, cobalt, antimony, barium, beryllium, cesium, molybdenum, platinum, thallium, tungsten, and uranium.
  • Tobacco smoke: cotinine - a metabolite of nicotine that tracks tobacco smoke exposure.
  • Organophosphate pesticides (Six metabolite measurements representing exposure to 28 pesticides): dimethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylphosphate, diethylthiophosphate, and diethyldithiophosphate. These metabolites are generally formed by the breakdown of 28 pesticides, including chlorpyrifos, diazinon, fenthion, malathion, parathion, disulfoton, phosmet, phorate, temephos, and methyl parathion.
  • Phthalate metabolites: mono-ethyl phthalate, mono-butyl phthalate, mono-2-ethylhexyl phthalate, mono-cyclohexyl phthalate, mono-n-octyl phthalate, mono-isononyl phthalate, and mono-benzyl phthalate.

 

Highlights of the Report

Cotinine

Cotinine is a breakdown product of nicotine after it enters the body. Levels of cotinine in the body track the amount of exposure a person has to tobacco smoke. For a nonsmoker, cotinine tracks exposure to environmental tobacco smoke. CDC measured cotinine in nonsmokers in the U.S. population as part of a previous survey, and the Report presents new cotinine data for 1999.

"One significant finding was the more than 75 % decrease in serum cotinine levels for nonsmokers in the United States," said Jim Pirkle MD, PhD, of CDC’s Environmental Laboratory and co-author of the report, "This decrease documents a dramatic reduction in exposure of the U.S. population to environmental tobacco smoke since 1991. However, environmental tobacco smoke remains a major public health concern since more than half of American youth continue to be exposed to this known human carcinogen."

Lead
CDC has been measuring the population’s exposure to lead since 1976 through the NHANES surveys. CDC’s Childhood Lead Poisoning Prevention Program (www.cdc.gov/nceh/lead/lead.htm) works to reduce exposure of children in the United States to lead. The Report presents blood lead level measurements for U.S. children in 1999.

"The good news is that blood lead levels continue to decline among children overall," said Eric Sampson, PhD, of CDC’s Environmental Laboratory and also a co-author of the report, "However, other data show that children living in environments placing them at high risk for lead exposure remain a major public health concern."

Next Steps
Environmental health is one of the Leading Health Indicators in Healthy People 2010. Information on environmental chemical exposures will assist clinicians and public health officials to better understand the relationship between toxic exposures and health consequences and guide public health prevention efforts. CDC will add other substances to future reports on the basis of data obtained from samples collected in subsequent NHANES surveys. CDC will continue to measure the 27 original substances as well. The goal over the next few years is to expand the Report to provide information about 100 chemicals. CDC will monitor trends over time that may help scientists better understand the impact of environmental chemicals on our health. In the future, CDC will be able to report exposure levels for more specific population groups (e.g., children, minority populations, or women of childbearing age).

In addition, CDC will expand the Report to include exposure data from studies of people exposed from localized or point-source exposures (e.g., data on levels of mercury in people who eat mercury-contaminated fish from a polluted river). For more information on the Report data, log onto www.cdc.gov/nceh/dls/report or call 1-866-670-6052.

CDC protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

 

What Does this Report Tell Us?

The CDC’s report gives us a picture of the American public’s exposure to some common pollutants in our environment. There are many chemicals in our environment that we have little or no information regarding their long-term health effects. Obviously, we need to learn much more about how these chemicals are taken up from our environment and metabolized and stored in our bodies. Although this information is important to all Americans, it is especially important to those who are sensitive to these chemicals, pregnant women, infants and young children.

Public health experts and representatives from some of the nation's largest health, education, religious, environmental, children's, and women's organizations reacted with serious concern to this report because this report confirmsing the presence of multiple toxic chemicals in the bodies of ordinary citizens. The report found that chemicals commonly used by industry, in agriculture, and in some popular consumer products were present in the bodies of most of the 5,000 Americans tested.

"This report is a wake-up call," said Philip Landrigan, M.D., Professor of Pediatrics at the Mount Sinai School of Medicine and Chair of the Committee that produced the1993 National Academy of Sciences report, Pesticides in the Diets of Infants and Children. "Americans are clearly being exposed to an array of toxic chemicals, many of which can and should be avoided."

"The widespread exposure identified by the CDC is cause for concern" according to John Balbus, M.D., M.P.H., Director of the Center for Risk Science and Public Health at George Washington University. "We do know that some of these chemicals have been associated with various health effects at higher levels-including certain cancers, birth defects, and developmental and reproductive disabilities. What we don't know is what kinds of problems may be associated with these chemicals at the levels identified today. We should take these findings very seriously."

"What's really remarkable about the CDC's results is that in several instances the chemical exposure levels they measure in the real world are higher than levels predicted by scientific panels, the National Academy of Sciences, and other experts," said Michael McCally, Codirector of the Center for Children's Health and the Environment at the Mount Sinai School of Medicine.

Balbus and McCally were joined by other physicians and representatives of almost 20 national organizations highlighting the above conclusions of the report and calling for a national program of chemical exposure monitoring vastly larger than the pilot program which produced the results CDC announced today. ""There are 80,000 chemicals in commerce today, but only the 27 chemicals in today's report have been systematically monitored for," said Richard Levinson, M.D., associate executive director of the American Public Health Association. "We have to do a lot better," said Levinson.


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