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Environmental Perchlorate Exposure and Human Health: from Newborn to Cancer

Environmental Perchlorate Exposure and Human Health: from Newborn to Cancer. Structure of Perchlorate. ClO 4 -. T 4 (Thyroxine) Synthesis. NIS. History of Perchlorate’s Clinical Use. · 1952-1965 Treatment of Grave’s Disease 200 mg TID to 600 mg TID

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Environmental Perchlorate Exposure and Human Health: from Newborn to Cancer

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  1. Environmental Perchlorate Exposure and Human Health: from Newborn to Cancer

  2. Structure of Perchlorate ClO4-

  3. T4 (Thyroxine) Synthesis NIS

  4. History of Perchlorate’s Clinical Use · 1952-1965 Treatment of Grave’s Disease 200 mg TID to 600 mg TID · 1960-1965 Case reports of agranulocytosis and of aplastic anemia at 1,000 mg/day (+) · 1980-current Treatment for amiodarone toxicity 900 mg/day initiation 100 mg/day maintenance

  5. Industrial Use

  6. US Map Showing Perchlorate Sites in Southwest

  7. Environmental Contamination by Perchlorate · CDHS 1985 study at a Sacramento aerospace site was rejected by CDC as the assay was only sensitive to 0.4 ppm ClO4-. · CDHS in April 1997 reported a more sensitive assay at 0.004 ppm (or 4 ppb) ClO4-. · Sacramento contamination level was found to be 0.3 ppm or 300 ppb. · Southern California waters found to be at 5 – 8 ppb ClO4- or 0.01-0.16 mg/day. Why the contamination? Is it important?

  8. Map of Southern California Water Distribution

  9. Known Human Health Effects of Perchlorate • Known Toxicity: • Bone marrow effects occur at 1000 (+) mg/day. • Transient neonatal goiter seen at 600 mg/day. • Treatment Dosages: • Initiation dose at 900 mg/day • Predominant dose of 600 mg/day • Maintenance dose at 100 mg/day Note: Animal studies essentially show no non-thyroidal perchlorate effect.

  10. Pathologic and Therapeutic Exposure Ranges (mg/day)

  11. Unknown Health Effects of Perchlorate · Effect on workers at occupational levels? What are the occupational levels? · Effect on neonate, children, and adults at Environmental levels? · Increased risk of thyroid cancer at Environmental levels?

  12. Occupational Study

  13. Occupational Study ResultsHormone Level vs Exposure

  14. Occupational Study ResultsHormone (T4) Level vs Exposure

  15. Pathologic, Therapeutic, and Occupational Exposure Ranges (mg/day)

  16. Environmental Exposures

  17. Counties in California and Nevada with Perchlorate in Drinking Water

  18. Congenital Hypothyroidism inCalifornia and Nevada

  19. Transient Neonatal (T4) Hypothyroidism in Nevada

  20. Transient Neonatal (TSH) Hypothyroidism in Nevada

  21. Transient Neonatal (T4) Hypothyroidism by Dosage

  22. Transient Neonatal (T4) Hypothyroidism by Age (days)

  23. Transient Neonatal (TSH) Hypothyroidism in Chile

  24. Pediatric Hypothyroidism in Chile(School-aged 6-8 year/olds)

  25. Adult Thyroid DiseaseMedical data from demographically similar areas

  26. Adult Hypothyroid DiseaseMedical data from demographically similar areas

  27. Thyroid Cancer

  28. The Thyroid and Environmental Perchlorate Exposure

  29. Pathologic, Therapeutic, Occupational and Environmental Exposure Ranges (mg/day) Why do we find “safe” levels?

  30. Pharmacology of Perchlorate

  31. Laboratory Exposure Study of Perchlorate in Water

  32. Laboratory Exposure Study of Perchlorate in Water

  33. Laboratory Exposure Study of Perchlorate in Water

  34. Summary

  35. Human Health and Perchlorate Exposure Ranges

  36. Acknowledgements • Martha Doemland, PhD • Zili Li, MD, MPH • Feng Xiao Li, MD, PhD • Dan Byrd, PhD • Gloria Deyhle, RN • David Sesser, BA • Michael Skeels, PhD, MPH • Arnold Engel, MD • Lisa Mims, MPA • James Howgate, MPH • Leslie Butler, MPH

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