Biologic Markers in Immunotoxicology (1992) / Chapter Skim
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9 Use of Biologic Markers in Controversial Areas of Environmental Health
9 Use of Biologic Markers in Controversial Areas of Environmental Health
Pages 127-140
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From page 127... ...
Nonetheless, the group's members decided to 127 devote a chapter to these issues, because it wig be necessary to use ~une-system biologic markers to detente whether the immune system is involved with these &orders; this is an area of mcreas~g nations concern, with significant but uncounted patient populations su~er~g morbidity add dis~bili.n~r' no matter what the cause; and the work of this subcommittee can be a steppe stone to a more definitive discussion by another group. Ike emphatic in this chapter is on health effects of exposure to airborne chemicals.
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From page 128... ...
air samples taken ~ the breathing zone of the subjects add ~ exhaled air at higher concentrations than found In the outdoor air of the two pities (Wallace et aL, 19~. The correlation between personal air samples and exhaled ~ measurements was better than that between outdoor air add exhaled air concentrations.
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From page 129... ...
to a lupus-like syndrome caused by laboratory exposure to hydrae (Chapter 43. Class B syndromes are those ~ which there is a variety of symptoms, sometimes highly subjective and difficult to quantitate, that result from exposure to several odorous chemicals.
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From page 130... ...
There have been several reports of chem~cal exposures that cause weB-charactenzed class A illnesses In patients at dose levels normally tolerated by the population at large. It Is wed documented that low-molecular-wei~ht organic compounds can cause allergic and autoimmlme diseases, as in the case of a laboratory worker who developed a disease similar to systemic lupus erythematosus after exposure to hydranne In the workplace (Reidenberg et aL, 1983~.
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From page 131... ...
novolac resim. A patient exposed in a blind study developed laryngeal edema that was verified by direct exm~tion of the vocal cords by video endoscopy of Me larynx Plasma histamine was measured before and after challenge, and it rose by a factor of 6.
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From page 132... ...
Some authorities surest that SBS is of psychologic origin or that it represents an anxiety state, mass hystena, or a conditioned reflex Investigators at the Karolinska Institutet in Sweden have demonstrated, however, that blinded passers-by exposed to a mobile breathing chamber fielded to the air supply of a "sick buildings e~enenced the came reactions to building air as had the buildups inhabitants (Berglund et al., 19843. Chem~caDy related syn~omes are distinct Mom syndromes assoaated we rborne microbiologic antigens associated with IgE-mediated outbreaks of respiratory illness In buildings (Solomon, 1990~.
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From page 133... ...
. Adaptatnre phenomena: chemistry sensitive individuals do not have acute reactions to chemical exposures while Cog in the chemical environment; during this phase, chronically ill.
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From page 134... ...
The study by Rea and his collaborators evaluated seven patients wad rheumatoid arthritis, 70 patients with "vascular dysfunction,. and 27 asthma patients.
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From page 135... ...
grouped patients by diagnosis, and the am normad values come reset Mom the underly~ng disorder, rather than chemical sensitivity. Rheumatoid arthritis or other speafic conditions are Educed by or exacerbated by exposure to xenobiotic substances according to these authors.
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From page 136... ...
BIOLOGIC MARKERS OF SENSITIVITY TO CHEMICALS Provocative Challenge Provocative challenge, ~ which individuals with alleged hypersensitivity are exposed to incriminated chemicals in a blinded fashion, is the standard in the field of human ~mmunotomcology. Ashford and Miller (1989)
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From page 137... ...
rhinitis, ca.cos~a as defined by Ryan et al. (19883, autoimmune diseases (including systemic lupus erythematosus3, laryngeal edema, depression, psychos~s, and other neurobehanoral disorders.
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From page 138... ...
Patients with multiple chemical sensitivity win be selected because of symptoms or signs related to chemical exposures at levels tolerated by the' population at large. The chemicals in
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From page 139... ...
Although many patients describe the onset of this syndrome with an acute tome chemical exposure, such ~ ~mdadug exposure Is not required for mcJusion. Patients tenth pre-e~nstent or concurrent diseases such as asthma, antis, and psychiatric illnesses are not to be ex~uded from study, because many believe that 139 chemical exposures play a role in inducing or exacerbating these conditions.
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