Re: Landrigan Chat - Dursban  May 22,2000

Environmental Health Network

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 Welcome to today's chat about Dursban. I would expect that we will begin shortly. All we need now is our featured guest and we are ready to go. Anyone that has preliminary questions, please feel free  to throw them out at any time.
  Sue, what do you do at your non-profit forpesticide alternatives and hazards education?
  Welcome Dr. Landrigan.
  We try to get organizations to commit to using alternatives and then research what alternatives are available. I am glad that you found time in your hectic schedule to join us today. Dr. Landrigan has approximately 30 minutes to help us understand Dursban and the effects of chlorpyrifos on the  human body and our environment. Anyone with a specific question should  feel free to fire away.
  I am pleased to be here today. Philip Landrigan
  What are the effects on children's health that are of
 greatest concern?
  Are they endocrine disrupters?
  Our local PTA has been working on grassroots
 efforts to minimize the use of all pesticides in our school district.
 Dursban was the pesticide of choice for a number of years. How do we document that the children who are sick, got sick from the exposure to Dursban which was sprayed once a month in their often windowless schools?
  I have children who were poisoned by Dursban, is there anything I can do now to counter act the poisoning?
  These are all great questions. Keep in mind that
 Dr. Landrigan only has two hands and it is still early in the morning.
 I am sure that he will address all of your concerns promptly.
  asthma is the leading cause of admission of American
 children to hospital. environmental factors make an important
 contribution to causation. cancer is the second leading cause of death in American children after injuries. again environmental factors contribute. developmental disabilities are a third category of concern .  The best way to document that Dursban is present in  schools is (1) to obtain records on how much Dursban is applied in the  school, (2) to do actual measurements of Dursban in samples of either  air or dust from the school.
In response to Sue Carroll, the best way to counteract
 Dursban poisoning is to restrict use of the compound and thus prevent
> exposure.
> What will it take to get Dursban banned?
> Dr. Landrigan, Are you familiar with Professor Abo
 Donia's (sp?) work with a new test to determine organophosphate
 poisoning years later?
  Nancy, a group of 12 scientists including myself have  recently written to the Administrator of EPA asking that she take  strong action against Dursban on two fronts: (1) to apply the full  third tenfold safety factor for agricultural use, and (2) to ban all  residential use including use in homes, schools, and daycare centers  and other institutions frequented by children.
  We know Dursban was used thru records, however we  have been denied samples from the schools. That still will not help us  to link. They (administration) admits use, but we are having trouble  establishing cause and effect. Are you aware of the recent research by Dr. Clemente
 Furlong that explains that the parent chemical of certain
organophosphate, including Dursban and diazinon are activated into the
 toxic oxone form in the body. Additionally his research shows that
 newborns have very low levels of PON 1 enzyme that cuts these
 pesticides and even then, it is possible that they will fall into the
 class of individuals that have low PON1 levels for their entire lives.
 I am asking because I have copies of his research and will be happy to
 mail copies to any interested person. After reading the about the
 research, one could say that to expose newborns to these pesticides is
 unforgivable.
  I'm new to online chats last two comments  unassigned were from me.
  Veronika, to make the link and document that children  in schools actually became sick as a result of exposure to Dursban, it will be necessary that a physician obtain samples of blood and urine
 from these children immediately at the time of their acute illness.
 The blood samples need to be tested for levels of the enzyme acetyl
 cholinesterase and the urine samples tested for chlorpyrifos
 metabolites.
  Don't worry, Veronika, the program automatically names your comments - there's no need for you to write your name  before your comment.
Cynthia, you are quite correct that newborns have
extremely low levels of the enzyme that detoxifies organophosphates.
 For that reason organophosphates persist in the bloodstream of newborn infants many times longer than in the bloodstream of an adult and therefore, can cause more toxic injury.
Cynthia, I would be very interested in receiving the  research. Sue Lets talk later, OK?  I would like a copy as well . We could not wait for the Federal Government to restrict Dursban. In 1997 Montgomery County Maryland stopped using Dursban (and other toxic pesticides and went to a Marcia, part of your sentence was cut off?
  That will be fine. Dr. Furlong just sent me a packet
 of his papers that I'm having copied today. He has more that are being
 reviewed now, that he will be forwarding later. Please e-mail me your
 addresses. I'm new to this chatting ...and I don't want to lose you.
  Dr. Landrigan, is there a link between Dursban and
 neurodegenerative disorders like Parkinson's  Dr. Landrigan, Not many people know what tests to do to determine cholinesterase - including doctors. Is there any effort to educate Doctors and parents. If parents know and test, it seems schools would be less likely to use these products.
  continued - in 1997 Montgomery County, MD stopped using
 Dursban and other toxic pesticides and went to a strict IPM program-
 Dursban had been used everywhere - including day care centers. For
 more information call Jeff Marks 240-777-60009. In 1991 Dr.
  continued - correction phone Jeff Marks - 240-777-6009
 to get a copy of contract.
  Our biggest problem since this began for us is that doctors don't know or think to test for pesticide poisoning...are there any efforts in include these types of tests for children that present with health issues
> Gloria, recent evidence from newborn laboratory animals indicates that low doses of chlorpyrifos can cause loss of brain cells, and this loss of brain cells results in developmental retardation in the baby animals. We strongly suspect that these data have implications for human development but whether it translates to long-term effects like Parkinson's Disease is unknown at this time. In light of this new information about the impact of chlorpyrifos on the developing brain, it would certainly appear prudent to minimize exposure of pregnant women and newborn infants to chlorpyrifos.
> Sue, if doctors need information on this point they should contact Dr. Robert Amler of CDC in Atlanta at 404-639-0700. he has set up a national network of pediatric environmental health referral centers which physicians are invited to contact.
> Why does action take twenty plus years? It was in 1991 that Dr. Sherman first wrote about the dangers of Dursban. Veronika, you are correct that many physicians have not been trained to think about pesticide poisoning. However, the American Academy of Pediatrics has begun educational programs to counteract this problem and in November 1999 the Academy published a "Handbook of Pediatric Environmental Health" which is now available to all pediatricians in North America. I know you deal mostly with children but shouldn't we all be concerned about exposure to these pesticides?
This book tells physicians to not take parents seriously if they question their schools environment. I was very disappointed by
 many statements in this book.
  Marcia, regulatory action takes many years because it almost always involves differences of opinion between parties with opposing views. It has taken nearly 100 years to deal with the problem of lead paint poisoning. It has taken 50 years to deal with the problem of asbestos. This is the slow nature of democracy but as Winston Churchill said, democracy is much better than the alternative.
  How can we help to get DURSBAN BANNED?
  Sue, the AAP Handbook is certainly not perfect but it is light years ahead of anything that existed previously. As one of the co-authors, I disagree strongly with your statement that it advises pediatricians not to take parents seriously. We have always taught our pediatricians that a diagnosis of environmentally related disease begins with the doctor obtaining a careful history of exposure and of symptoms from the parent(s).
> Dr. Landrigan ...in regard to chlorpyrifos and exposure to newborns and pregnant women ...what about other organophosphate exposures to newborns and pregnant women. I'm asking because of reading Dr. Furlong's research. Dr. Landrigan, What do you think about the development of multiple chemical sensitivity after Dursban exposure?
> Yes, it does take a long time for action on the federal level. Living in Washington, I know the process too well. We all must work on the local level to get our Counties to use a strict IPM program When obtaining the careful history, for school age children you must involve the school health room in documenting temperature, obvious symptoms, where did the child spend time that day. Lung capacity. The school must help to document...the parents words are not good enough.
Cynthia, research on the effects on newborn infants of
 other organophosphates beyond chlorpyrifos is just beginning. The
 focus on chlorpyrifos is probably a reflection of its current
 extensive use in the United States.
  Carl Falco
  Pardon me for interrupting, but I wanted to advise the chat administrator that this is happening: I am receiving private
messages from several people. however, the applet screens are blank
 and I cannot read their messages. -- Dr. Landrigan.
  Why is Dursban considered worse than the other organophosphates? Don't they all give reason for concern?
  (Marcia Marks) We cannot wait for all the scientific data. There are less risky alternatives to be used now. REVENTION is best.
  The key to successful IPM is awareness. There is sometimes just as much resistance from uninformed parents as there is from administrators. Environmental Awareness programs must go hand in hand with implementation of true IPM programs.
  Cathryn, I do not know whether chlorpyrifos is worse than other organophosphates because comparative research on their
 neurodevelopmental effects has not been undertaken. however, I do know that chlorpyrifos is used very extensively and therefore has become a focus of public health concern.
  To the room: If you wish to speak with Dr. Landrigan, please address him in the main room - not with a private window.
  In our neighborhood, we are planning to canvass
 neighbors each Spring asking them not to use any pesticides ,
 explaining why and offering alternative information.
  Marcia, I agree that prevention is best and that
 implementation of Integrated Pest Management (IPM) programs is a very logical way to achieve prevention.
  Dr. Landrigan, just close those private windows
 if they interfere with the chat.> Thank you, Administrator.
  Laura, you may be interested to know that in some cities and counties in the U.S., a homeowner or a landlord is now required to notify the neighbors 24 or 48 hours in advance of any commercial application of pesticides.
  Many states have 'Pesticide Sensitive Individual Notification Programs'. Parents who suspect their children are reacting to pesticide exposures or who just wish not to have their children exposed - should get their children's names on these notification lists. This is a great place to start. Programs are usually run through the Department of Agriculture (at the State Level).
  Dr. Landrigan, What got you interested in the effects of
 pesticides?
  What kinds of alternatives are offered in place of pesticide
 use?
  Louis, my work as Chair of the National Academy of Sciences Committee on Pesticides in the Diets of Infants and Children.
The report of that Committee can be obtained from the National
 Academy's Press, 2100 Constitution Avenue, Washington, DC.
  test. Does Dursban affect a person's ability to detoxify other
 chemicals and cause multiple chemical sensitivity?
  Rachel, there is an extensive literature on Integrated
 Pest Management (IPM). Approaches included within this broad heading of IPM are sealing up cracks and crevices that are conduits for
 cockroaches and other pests, carefully cleaning up all food residues,
 and using low toxicity pesticides. for further information, I suggest
 you visit your library because this literature is really quite
 extensive.
  Thank you.
  Once a child is hyper-sensitive to pesticides, is there anyway to 'detox' them - or are they required to lead a restricted lifestyle of avoidance and isolation. if one finds out about the use of this chemical in
 ones school should the EPA or someone be contacted
  Veronika, the best approach is prevention. I would be interested in researching the low toxicity pesticides, as I have children. IPM techniques have come a long way. We have two schools in our district that are practicing 'pesticide free' IPM...there are others. IPM does work. (Marcia Marks) If anyone would like to see a contract
 for strict IPM in Montgomery County MD government buildings (a county of almost a million) call Jeff Marks at 240-777-4251 (no relation) Jeremy, the best approach is to work with local
 legislators to secure passage of legislation that require school
 authorities to notify parents in advance of pesticide application. For
 example, last year the state legislature in Connecticut passed such a
 law. For details on the Connecticut story, you may wish to contact Dr.
 John Wargo at Yale University.
  Dr. Landrigan. Dr. Furlong's research then is profound. He has identified the pathway that both Dursban and diazinon follow. Both of these pesticides become the toxic oxone form of their parent chemical in the body as a result of P450 activation. Now that he has recognized that the oxone form of these pesticides is formed in the body, he can easily test other organophosphates. He has said until now, neither the EPA nor DOW knew that the oxone forms were activated in the body. Now they know.
  Cynthia, I am not familiar with Dr. Furlong's research. Is it in the peer-reviewed biomedical literature?
  To the room: We have about 10 minutes left, so besure to ask your questions now to give Dr. Landrigan time to answer them.
  Considerable information on IPM in schools is available on the Univ. of Florida Web site @ http://www.ifas.ufl.edu/~schoolipm/
  Why is it taking the EPA so long to review the pesticides
 even with so many years worth of back up suggesting their negative
 impact?
  To all, here are some citations for research that Irely on: Cambell C, et al. Chlorpyrifos interferes with celldevelopment in rat brain regions. Brain Research Bulletin 43:179-189,1997. Cosenza M, et al. Effects of chlorpyrifos on neuronaldevelopment in rat embryo midbrain micromass cultures. Veterinary &Human Toxicology 37:118-121, 1995. Eskenazi et al. Exposures of children to organophosphate pesticides and their potential adverse health effects. Environmental Health Perspectives 107:409-419, 1999.
  Why not ask for restricting all chlorinated organophosphates? One pesticide at a time will bring us to the next millennium - and industry will invent new poisons before we can get the old one restricted.
  What is the EPA's position with respect to the
 precautionary principle? It will take years to review each chemical
 one at a time. We can't wait that long to protect our children.
  Cathryn, EPA's regulatory delay reflects the fact that
 there exists strongly opposing points of view, as I discussed
 previously.
  (Last note was from Marcia Dr. Landrigan Yes, it is. I don't know which literature because I'm not a scientist, but his works have been peer reviewed and published. He works directly with the EPA. I can send you the packet that he so kindly sent to me. I was referred to him for my daughter by another scientist who was a speaker at a Rachel Carson symposium in Washington DC.
Administrator: Is there any way to print out this dialogue? And does the fact that I am on a Mac rather than a PC make a difference?
  Cynthia, I appreciate your respect for Dr. Furlong, but if his work has not yet received the approval of his scientific peers, then with all due respect it would have to be considered preliminary. it is important to note that there is a world of difference between the thoroughly peer-reviewed biomedical literature and other printed reports.
  I don't think there is a difference between a mac
 or pc in this instance. I will publish a transcript of this chat this
 afternoon - you can find it at: http://chat.enn.com/transcript.asp Or
 you can email me at dskillman@enn.com and I will send you a
 transcript.
  (Marcia Marks) Everyone needs to vote in all elections
 -to get legislators who will care about future generations and speed
 up the regulatory process.
  Room: We have about 5 minutes left in the chat.
 If you have any final thoughts or questions please ask or state them
 now.
  Marcia, under the Food Quality Protection Act, EPA is
 required to assess the effects of cumulative exposure to multiple
 pesticides. This represents a new approach for EPA, and they are just
 beginning to come to grips with it. how long do you think it takes to get well from pesticide poisoning?
  Dr. Landrigan, is this new testing including testing on the
 inerts?
LRC, the time required to recover from pesticide
 poisoning depends upon the pesticide involved, the dose, and the type
 and the timing of the treatment provided. Please everyone get your US Senator and Representative to vote in favor of the School Environment Act of 1999 (s.1716)
  Would like to commend Dr. Landrigan on his work. that was the School Environment Protection Act of 1999 (s. 1716) - this is right to know and IPM Thank you Dr. Landrigan for all you have done
  Dr. Landrigan, I have MCS - I am 9 years old - I was exposed to
 dursban and I wonder how long it will take to get over this?
  Peter, "inert" ingredients in pesticide formulations are the chemicals in the mix other than the active pesticide ingredient. These "inerts" can include solvents, diesel fuel, and other toxic and noxious materials.
  thank you. this was great & informative.
  Ok everyone - great chat today - thanks for
 coming. Dr. Landrigan, thank you very much for your time today and
 good luck in your efforts.
  (Marcia Marks) As Rachel Carson said it is the chemicals in the environment in partnership with radiation that cause ill health. That was 38 years ago. Veronika and all others, you are most welcome. --
 Philip Landrigan, MD How long will it take?
  Dr. Landrigan I apologize if I used incorrect terminology. I believe his work has been thoroughly peer-reviewed. Like I mentioned earlier, I will have a transcript published this afternoon.
   

  Thanks for coming today. Cheers all. Dr. Landrigan, again, I thank you for your time and hope to have you on again at a later date.
  Thank you very much, Administrator. -- Philip
Landrigan, MD

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