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Review
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| A Case for Revisiting the Safety of Pesticides: A Closer Look at Neurodevelopment Theo Colborn1,2 1University of Florida, Gainesville, Florida, USA; 2TEDX
(The Endocrine Disruption Exchange) Inc., Paonia, Colorado, USA Abstract The quality and quantity of the data about the risk posed to humans by individual pesticides vary considerably. Unlike obvious birth defects, most developmental effects cannot be seen at birth or even later in life. Instead, brain and nervous system disturbances are expressed in terms of how an individual behaves and functions, which can vary considerably from birth through adulthood. In this article I challenge the protective value of current pesticide risk assessment strategies in light of the vast numbers of pesticides on the market and the vast number of possible target tissues and end points that often differ depending upon timing of exposure. Using the insecticide chlorpyrifos as a model, I reinforce the need for a new approach to determine the safety of all pesticide classes. Because of the uncertainty that will continue to exist about the safety of pesticides, it is apparent that a new regulatory approach to protect human health is needed. Key words: adverse effects, behavior, chlorpyrifos, fetal development, human function, neurodevelopment, pesticides, toxicity. Environ Health Perspect 114:10-17 (2006) . doi:10.1289/ehp.7940 available via http://dx.doi.org/ [Online 7 September 2005]
Address correspondence to T. Colborn, PO Box 1253, Paonia, CO 81428, USA. Telephone: (970) 527-6548. E-mail: colborn@tds.net I thank the three anonymous reviewers for their comments. This study was supported by The Starry Night Foundation, The Organic Center, the New York Community Trust, the Mitchell Kapor Foundation, and the Winslow Foundation. The author is employed by The Endocrine Disruption Exchange, Inc., a nonprofit organization whose goal is to reduce exposure to substances that interfere with development and function. Received 17 January 2005 ; accepted 7 September 2005. |
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The U.S. Environmental Protection Agency’s
(EPA) Office of Pesticide Programs (OPP) estimated
that 891 pesticide active ingredients were registered
in 1997 (Aspelin and Grube 1999) and that 888
million pounds of pesticide active ingredients
were used in the United States in 2001 (Kiely
et al. 2004). Few of these chemicals are applied
alone but rather are applied in formulations
using different combinations of several pesticide
active ingredients (MeisterPRO 2004).It is not
uncommon for many classes of pesticides, such
as insecticides, herbicides, and fungicides,
to be used on the same crop (National Agricultural
Statistics Service 2005). In the case of insecticides,
an adjuvant is often added to the formulations
to enhance the intensity of the lethal effect.
In the case of herbicides, due to the increasing
incidence of plant tolerance to a specific pesticide,
some formulations now have as many as three active
ingredients (MeisterPRO 2004). Each active ingredient
has a specific mode of action for controlling
a pest, and each active ingredient has its own
possible side effects on the wildlife and humans
exposed to it. It is impossible to determine
the cumulative risk posed to wildlife and humans
as the result of releasing vast amounts of pesticide
mixtures into the environment.
The quality and quantity of the data about
the risk posed to humans by individual pesticides
vary considerably. In some instances there are
numerous studies about the health effects of
a particular pesticide in humans and laboratory
animals, and for others there are very few. In
general, the longer the active ingredient has
been on the market, the greater the number of
citations in the peer-reviewed literature. Data
are sparse when linking pesticides with neurodevelopmental
effects other than for the insecticides chlorpyrifos
(CPF), parathion, and 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane
(DDT).
Unlike obvious structural defects, most neurodevelopmental
effects cannot be seen at birth or even later
in life. Instead, adverse effects on the nervous
system are expressed in terms of how an individual
behaves or functions. Behavior and function vary
considerably from birth through adulthood. Functional
deficits are not “on” and “off” conditions
but instead range from inconsequential through
very mild to very severe to totally debilitating.
Consequently, it is difficult to quantify neurodevelopmental
impairment. Some of the end points used in the
laboratory to detect functional impairment of
the brain and nervous system are measured at
the gene, cell, biochemical, and/or physiologic
levels and often require high-tech instrumentation
to quantify. At the human level, a battery of
tests is continuing to evolve to measure with
increasing sensitivity psychomotor, psychologic,
clinical, and psychiatric symptoms to better
quantify functional impairment.
In this article I have two principal purposes
in discussingthe inherent risks of using pesticides,
the limitations of testing techniques, and the
intrinsic incompleteness of all scientific evidence: a)
to encourage the use of the open literature about
the neurodevelopmental effects of all classes
of pesticides when setting the criteria for determining
their safety and b) to encourage a more
rigorous regulatory approach to protect human
and environmental health in the absence of complete
scientific certainty. I begin by presenting unequivocal
evidence of pesticide exposure to numerous classes
of pesticides during development. This is followed
by a section on human epidemiology where only
weak data are available linking neurodevelopmental
impairment with pesticides. Next, I present a
case study of how CPF cryptically interferes
with brain development one stage after another.
This is followed with selected laboratory studies
demonstrating that other insecticides as well
as other pesticide classes target prenatal brain
development similar to CPF and share similar
and sometimes diverse impacts on the construction
and function of the brain. As the data reveal,
not only insecticides but other classes of pesticides,
such as herbicides and fungicides, can also interfere
with neurodevelopment. In the “Discussion” I
challenge the protective value of current pesticide
risk assessment strategies in light of the vast
numbers of pesticide products on the market with
untold numbers of targets and mechanisms of action
that can cause neurodevelopmental damage.
Evidence of Exposure to Pesticides
Improvements in analytical laboratory equipment
and testing procedures have made it easier to
detect pesticides and their metabolites at very
low concentrations in almost all human tissue.
From routinely detecting parts per million (milligrams
per kilogram) and more recently to as low as
parts per trillion (picograms per kilogram),
some laboratories are now able to measure concentrations
down to parts per quintillion (femtograms per
kilogram). The development of noninvasive sampling
methods, such as testing for pesticides and their
metabolites in urine, has made it possible to
monitor pesticide exposure in infants and children.
It is fairly safe to say that every child conceived
today in the Northern hemisphere is exposed to
pesticides from conception throughout gestation
and lactation regardless of where it is born.
The herbicide 2,4-dichlorophenoxyacetic acid
(2,4-D) was found in approximately 50% of semen
samples provided by 97 Ontario, Canada, farmers
(Arbuckle et al. 1999). The herbicides atrazine,
metolachlor, alachlor, and 2,4-D and the insecticides
diazinon and the CPF analyte 3,5,6-trichloro-2-pyridinol
(TCP) were found in semen of men in central Missouri
and in urban Minneapolis, Minnesota (Swan et
al. 2003); the insecticides chlordane, dichlorodiphenyldichloroethylene
(DDE), heptachlor epoxide, and hexachlorobenzene
(HCB) were found in ovarian follicular fluid
from women undergoing in vitro fertilization
in Halifax, Hamilton, and Vancouver, Canada (Jarrell
et al. 1993); hexachlorocyclohexane and p,p´-DDE
were found in amniotic fluid of women undergoing
routine amniocentesis in Los Angeles, California
(Foster et al. 2000); and nonpersistent pesticides
were found in the amniotic fluid of women referred
for amniocentesis in the agricultural San Joaquin
Valley, California (Bradman et al. 2003). Pesticides
were also found in maternal blood, placental,
and umbilical cord blood from women experiencing
normal births and stillbirths in India (Saxena
et al. 1983), from urban and rural mothers during
Caesarian section in the Atoya River basin, Nicaragua
(Dorea et al. 2001), and from mothers delivering
normal and subnormal weight babies (Siddiqui
et al. 2003). In addition, pesticides were found
in the breast milk of mothers who delivered by
Caesarian section in Nicaragua (Dorea et al.
2001), native Alaskan mothers living an indigenous
lifestyle (Simonetti et al. 2001), and women
living in southwest Greece (Schinas et al. 2000).
A median of 8.26 µg/mL CPF (range, 0.40-458.04 µg/mL)
was discovered in the meconium of newborns in
Manila, Philippines (Ostrea et al. 2002). Six
organophosphate (OP) pesticide metabolites were
found in the meconium of 20 newbornsin New York
City (Whyatt and Barr 2001). The babies’ first
bowel movements held concentrations 10-100
times higher than their cord blood. One metabolite,
diethylthiophosphate, was found in all 20 samples;
another, diethylphosphate, was found in 19 of
20 samples. Both are metabolites of diazinon,
CPF, and several other OP insecticides.
An eastern Washington State research team surveyed
OP metabolites in the urine of 210 farmworkers
and their children and in dust from their homes
and vehicles (Coronado et al. 2004). They segregated
farm chores into several classes: harvesting
and picking, thinning, loading, transplanting,
and pruning. Azinphos-methyl, an OP, was more
often found in dust in thinners’ homes
(92.1% vs. 72.7%) and vehicles (92.6% vs. 76.5%)
than in those of workers who did no thinning.
Thinners’ children had higher concentrations
of OP metabolites in their urine, and the metabolites
were found more frequently in the children (91.9%
detectable in urine), compared to the adults
(81.3% detectable; p = 0.002).
In Seattle, Washington, investigators measured
five OP metabolites in 24-hr urine samples of
preschool children (2-5 years of age) who
were raised on either a predominantly organic
(n = 18) or predominantly conventional
diet (n = 21) (Curl et al. 2003). Pesticide
use was also recorded for each home. Median total
dimethylphosphate metabolites (0.06 µmol/L)
were significantly higher than median total diethyl
alkylphosphates (0.02 µmol/L; p =
0.0001) in the urine. Those children on a conventional
diet had levels of dimethylphosphate metabolites
six times higher than those of children on an
organic diet (medians = 0.17 and 0.03 µmol/L,
respectively; p = 0.0003). Median concentrations
of both metabolites were almost an order of magnitude
higher in the conventionally fed children (0.34 µmol/L
vs. 0.04 µmol/L). There were no age differences
in the children in the two groups. Home use of
pesticides varied, with seven conventional-diet
families using OPs versus three organic-diet
families using OPs. Although the study group
was small and there were difficulties collecting
urine samples, this research provides the first
empirical data comparing urinary levels of pesticides
in youngsters consuming predominantly organic
versus conventional diets.
Determining a link between fetal exposure to
a specific chemical and long-term expression
of a change in health poses a monumental challenge
when designing epidemiologic studies. For example,
one human epidemiologic study uncovered weak
but statistically significant associations between
neurodevelopmental impairment as a result of
exposure to two pesticides during gestation.
In a large study of live births (n = 1,532),
including 536 children fathered by pesticide
applicators, Garry et al. (2002) discovered that “adverse
neurologic and neurobehavioral developmental
effects clustered among the children born to
applicators of the fumigant phosphine [odds ratio
(OR) = 2.48; 95% confidence interval (CI), 1.2-5.1].” They
also discovered an OR for the herbicide glyphosate
(Roundup) of 3.6 (95% CI, 1.3-9.6). Among
the children in the phosphine group (n =
290), two were diagnosed with autism, which is
high compared with the prevalence nationwide,
and five were diagnosed with attention deficit
disorder/attention deficit hyperactivity disorder
(ADD/ADHD). It took years of close interaction
with the families in this study to be able to
track their pesticide exposure without having
to resort to recall and to follow the children’s
functional development (Garry VF, personal communication).
The investigators were cautious about their findings
and asked for confirmation.
Another study suggests that CPF might have
an effect on head circumference related to the
activity of paraoxonase (PON1), an enzyme that
can detoxify CPF before it can inhibit acetylcholinesterase
(Berkowitz et al. 2004). Babies with a small
reduction in head circumference were from mothers
whose TCP concentrations were above the detection
limit, and their PON1 activity was in the lowest
tertile (p = 0.014). Mothers and their
infants (n = 404) were recruited from
East Harlem and other sections of New York City.
In a more recent study, Young et al. (2005)
looked at the relationship between maternal OP
urine metabolites and infant neurodevelopment.
They employed a battery of tests using the Brazelton
Neonatal Behavioral Assessment Scale for habituation,
orientation, motor performance, range of state,
regulation of state, autonomic stability, and
reflex in 381 infants younger than 62 days of
age. Young et al. (2005) found a significant
association between increasing total concentrations
of maternal urine OP metabolites representing “approximately
80% of OPs used in the Salinas Valley” and
increasing numbers of abnormal reflexes in the
infants from days 3 to 62. The median age for
testing the infants was day 3. Mothers’ urine
was tested at 14 and 26 weeks during gestation
and at day 7 postpartum. The median urine levels
of dialkyl phosphate (DAP), dimethyl phosphate,
and diethyl phosphate, respectively, were 132,
97, and 21 mol/L during gestation and 222, 160,
and 27 nmol/L after delivery. DAP represents
the total of diethyl and dimethyl phosphate metabolites.
The dimethyl metabolites could reflect exposure
to malathion, oxydemeton-methyl, dimethoate,
naled, and methidathion, and the diethyl metabolites
could reflect exposure to diazinon, CPF, and
disulfoton used in the Salinas Valley. It is
important to keep in mind that the OPs are readily
metabolized, and exposure can vary considerably
and most often is transient and unpredictable.
The authors noted that there were large within-person
variations in urine levels in this study.
A Case Study: The Cryptic Neurodevelopmental
Effects of CPF
The insecticide CPF is an OP pesticide that
has been on the market since 1965 to control
insects in agriculture, gardens, building construction,
and households. In 2002 the use of CPF was restricted
to only agricultural applications, and all domestic
use was to be completely phased out by 1 January
2005. The metabolites of CPF have been widely
reported in human tissue. In a study based on
data from the Centers for Disease Control and
Prevention’s (CDC 2001) first National
Report on Human Exposure to Environmental Chemicals, Hill
et al. (1995) found the CPF analyte TCP in 82%
of urine samples (n = 1,000) from a broad
sample of the U.S. population between the ages
of 20 and 59 years from all regions of the country.
The CDC’s Second National Report on
Human Exposureto Environmental Chemicals (CDC
2003) states that the levels of TCP were similar
to levels presented in the first National
Report on Human Exposure to Environmental Chemicals (CDC
2001) but gave no statistics concerning the extent
of exposure across the population. Like the other
OP insecticides, CPF inhibits the enzyme acetylcholinesterase,
which destroys acetylcholine, the neurotransmitter
that activates cholinergic neurons. These are
an important group of nerve cells that control
signals in the peripheral nervous system and
in the brain and spinal cord. If acetylcholine
is not inactivated immediately by the activity
of acetylcholinesterase, it overstimulates the
neurons, and tremors, convulsions and death can
follow.
As scientists probed deeper into the activity
of CPF, a wealth of information surfaced from
laboratory studies about its effects on the development
and function of the brain and nervous system
in embryos, fetuses, and young animals. Although
many of the studies were performed on rats and
there are differences in the ontogeny of specific
parts of the brain between rats and humans, the
development of the rat brain through postnatal
day (PND) 21 provides a model for the development
of the human brain through to birth.
A series of reports starting in 1991 confirmed
that CPF is a cholinesterase inhibitor and that
neonatal rats were more sensitive than adults
when exposed to a single maximum tolerated dose
(Pope and Chakraborti 1992; Pope et al. 1991,
1992). These studies also confirmed that the
fetus recovers quicker than the adult from cholinesterase
inhibition, suggesting that the fetus would be
protected from CPF if all the adverse effects
were due to cholinesterase inhibition alone.
Lassiter et al. (1998), however, wrote that although
the fetus could recover faster between repeated
doses of CPF, this was only an “illusion
that the fetal compartment is less affected than
the maternal compartment.” Realizing that
something other than cholinesterase inhibition
was affecting the fetus, a team from Duke University
led by Theodore Slotkin gradually began to demonstrate
that other mechanisms of action of CPF alter
prenatal development of the brain and behavior
and that the embryo and fetus are sensitive to
cholinesterase inhibition at doses that would
not be toxic to an adult (Qiao et al. 2003; Slotkin
2004). These studies provided information about
how the brain develops and functions and also
provided a chronology of how CPF interferes at
successional stages of brain development (Qiao
et al. 2002). This team also demonstrated that
CPF-oxon, the active metabolite of CPF, is the
compound that causes cholinesterase inhibition
and that the actual neuroteratogen is CPF (see
Slotkin 2004 for a step-by-step description of
how their CPF research progressed).
Slotkin and colleagues demonstrated that as
the brain and nervous system are constructed
and programmed, there are numerous points in
time and at sites where CPF could interfere.
CPF attacks the neurons that appear in the earliest
stage of brain and central nervous system (CNS)
development (Qiao et al. 2004). Neurons process
information and are the signaling or transmitting
elements in the nervous system. Damage to neurons
at this early stage may not be expressed until
years later. For example, a brief subtoxic dose
of CPF [1 or 5 mg/kg body weight (bw)/day] during
neurulation can cause behavioral alterations
during adolescence and adulthood (Icenogle et
al. 2004). And, although some early symptoms
of CPF exposure disappear during certain stages
of development, different neurologic symptoms
can appear later in life (Qiao et al. 2002, 2003,
2004).
Glial cells that appear later than neurons
during early development were shown to be more
vulnerable than neurons to CPF (Qiao et al. 2002;
Roy et al. 2004). There are more than twice as
many glial cells (> 200 billion) in the body
than neurons. Glial cells come in many varieties;
they are supportive cells critical for normal
development and function and serve as a “scaffold” for
migration of cells during tissue construction
[see Barone et al. (2000) on brain development].
Glial cells also provide nutrition to the neurons
and provide a link with the immune system, responding
to damage by acting as scavengers of pathogens
and neuronal debris. CPF preferentially targets
the glial cells among the cells it attacks (Garcia
et al. 2002).
Slotkin and colleagues repeatedly demonstrated
that CPF toxicity is not limited to cholinesterase
inhibition alone but can act by other mechanisms.
For example, in vitro and in vivo studies
at three levels of development from DNA to the
cell and the whole animal revealed that CPF is
far more toxic than previously thought because
of this wider range of activity (Crumpton et
al. 2000). CPF impairs the binding to DNA of
nuclear transcription factors (AP-1 and Sp1)
that modulate cell replication and differentiation.
When undifferentiated and differentiated neurons
were exposed to CPF, the response of some transcription
factors varied. Although the activity of one
set of cells might not be affected, the activity
of another set of cells might be significantly
reduced. An independent study at Johns Hopkins
University (Schuh et al. 2002) confirmed the
ability of CPF to alter the activity of another
nuclear transcription factor in cortical neurons,
the Ca2+/cAMP response element binding
protein (CREB), which is critical for cell survival
and differentiation during development and is
critical for memory. CPF increased the activated
level of CREB at 0.01 nM, well below the level
at which cholinesterase inhibition is expressed
and below the typical level of human exposure.
Schuh et al. (2002) also demonstrated that CPF-oxon
did not cause the alteration, supporting the
conclusion of Crumpton et al. (2000) that CPF
is more than a cholinesterase inhibitor. Crumpton
et al. (2000) also demonstrated that the CPF
effects on the development of the forebrain in
the rat, which reaches its peak stage of development
during gestation, were not as severe as the effects
on the cerebellum, which reaches its peak 2 weeks
after birth. The cerebellar changes in the later
stages of development, however, could not have
been the result of cholinesterase inhibition
because the cerebellum is not innervated with
cholinergic receptors like the forebrain is (Crumpton
et al. 2000).
Much of the research undertaken by Slotkin
and colleagues demonstrated that models of adult
toxicity do not extrapolate to fetuses and would
not predict the vulnerability of the embryo to
TCP and CPF (Aldridge et al. 2004, 2005a). The
ever-changing state of the embryo makes it a
more sensitive model for toxicity and a better
predictor of long-term, delayed effects. Slotkin
and colleagues have demonstrated that the embryo
and fetus reveal innumerable mechanisms of action
of toxicity that could not be detected in an
adult animal. For example, in a series of in
vitro studies, a 25% increase in reactive
oxygen species (ROS) was found 10 min after undifferentiated
glial C6 cells were exposed to CPF (Garcia SJ
et al. 2001). During some stages of development,
selected regions of the brain are vulnerable
to CPF by interference with the G-protein in
the adenylyl cyclase (AC) cascade by disrupting
nuclear transcription DNA binding (Meyer et al.
2003; Slotkin 1999). CPF caused abnormal tissue/cell
development in cultured rat embryos through vacuolation
of the cytoplasm (Roy et al. 1998). CPF, CPF-oxon,
and TCP inhibit DNA synthesis in PC12 cells (typical
neuronal cells) and C6 cells (typical glial cells),
having a greater effect on the glial cells, with
the exception of the TCP (Qiao et al. 2001).
Qiao et al. (2001) also showed that CPF is a
stronger DNA synthesis inhibitor than CPF-oxon,
although it is a weaker cholinesterase inhibitor.
Confirming again that certain regions of the
developing brain were more susceptible than others,
Qiao et al. (2001) found that CPF and TCP suppress
DNA synthesis in the epithelium of the forebrain
and inhibit neural cell replication. These studies
also revealed that serum binding proteins can
be protective of DNA antimitotic activity, but
because fetuses and newborns have lower concentrations
of serum proteins than adults, they could be
more vulnerable.
In a series of whole-animal studies looking
at damage in rats from the embryo to the adult,
Slotkin and colleagues demonstrated again that
assays using adult animals cannot predict the
long-term delayed effects in the offspring. For
example, within hours after 9.5-day-old embryos
were exposed to CPF, they showed clear signs
of damage that was restricted to the primordial
brain (Roy et al. 1998). Upon histologic examination,
Roy et al. (1998) found apoptosis and altered
mitotic figures, along with gross disruption
of the architecture of the developing brain,
all in the absence of any gross morphologic defects
in the other parts of the embryo. As these animals
matured, CPF damage was demonstrable in a wide
variety of brain regions. The most vulnerable
target was the hippocampus, with the damage expressed
both as deficits in nerve activity and as corresponding
behavioral abnormalities (Icenogle et al. 2004).
Dosing an adult animal similarly would not have
provoked these effects of fetal origin.
The complexity of the toxicity of CPF became
more apparent as sex-related differences began
to appear in in vivo assays. The sex-related
changes occur when CPF exposure takes place during
gestation days (GD) 17-20 (late gestation)
and PND1-4 and again at PND11-14.
The timing of this exposure in the rat is comparable
to human brain development during the perinatal
and neonatal period (Aldridge et al. 2004; Meyer
et al. 2004a; Slotkin et al. 2001). Late prenatal
exposure to CPF has also been shown to cause
long-term sex-specific changes in cognitive performance
(Levin et al. 2002). Adolescent and adult females
were more vulnerable to CPF, based on their number
of errors during working- and reference-memory
tasks. Levin et al. (2002) also found profound
differences between animals exposed to 1 mg/kg
and 5 mg/kg CPF, reflecting a U-shaped dose curve.
The lowest dose was the most potent in this case,
although the highest dose caused the most inhibition
of fetal brain cholinesterase. The non-monotonic
dose-response curve discovered in the assay,
combined with the fact that the results were
not dependent on cholinesterase inhibition, raises
questions about indirect effects of CPF and its
metabolites on the endocrine system via the brain.
However, as Slotkin (personal communication)
pointed out, hormesis cannot be ruled out until
further research proves otherwise. In light of
their findings, Levin et al. (2002) noted the
need for childhood and adolescent maturation
studies and for the development of more sex-selected
end points.
At a concentration somewhat higher than human
exposure, 50 µg/mL CPF in vitro induces
the release of norepinephrine from rat brain
synaptosomes (Dam et al. 1999). Studies using
whole animals confirmed that the release of norepinephrine
inhibits synaptogenesis, a condition that persists
to adulthood and is sex specific, long after
exposure ceases and cholinesterase activity is
restored (Levin et al. 2002). Aldridge et al.
(2004) showed that CPF administered during GD9-12
up-regulated serotonin (5-hydroxytryptamine;
5-HT) receptors (5-HT-1 and 5-HT-2) and interfered
with the 5-HT protein transporter from the neural
tube stage through to adulthood. But during GD17-20,
CPF initiated larger effects in regions with
greater numbers of 5-HT nerve terminals, which
were found more in males. This response continued
through PND1-4. In contrast, the 5-HT protein
transporter was downregulated in females (Aldridge
et al. 2004). Aldridge et al. (2005a,b) performed
studies demonstrating abnormalities of 5-HT-related
behaviors in developing rats exposed to CPF.
The research that preceded this report mapped
out the ontogeny of serotonin receptors in the
brainstem and forebrain (Aldridge et al. 2003).
The authors pointed out that serotonin disruption
has been linked to appetitive and affective disorders,
and the biologic significance of these findings
needs to be clarified. These disorders have been
the focus of increasing research attention in
recent years as the result of the increasing
use of prescription and and illicit mind-altering
drugs.
Other Pesticide Products That Interfere
with Neurodevelopment
There are numerous opportunities during gestation
where insecticides and products from several
other chemical classes can alter the purpose
of a cell, tissue, organ, or system function
in the brain or CNS, much like the discoveries
presented for CPF.
Herbicides. Over the past 15
years, an Argentinian research team has produced
a series of reports on 2,4-D that is comparable
to the research on CPF. This team discovered
that exposure during lactation to the herbicide
2,4-DBE (the butyl ester of 2,4-D) can alter
brain production of 5-HT and its metabolite,
5-hydroxyindoleacetic acid (5-HIAA), in adulthood
(Bortolozzi et al. 2001; Evangelista de Duffard
et al. 1990; Garcia G et al. 2001). Concentrations
of both dopamine and serotonin changed transiently
if the animals were exposed only through birth
(69 mg/kg bw/day from GD6 to birth; 15 days)
and permanently if delivered to the offspring
through breastfeeding as well from GD6 to weaning
(30 days). Duffard et al. (1996) and Rosso et
al. (2000) found that 2,4-D interfered with myelination
in the brain as the result of lactational exposure.
This caused changes in behavior patterns that
included apathy, reduced social interaction,
repetitive movements, tremors, and immobility
in pups exposed to 2,4-D (Bortolozzi et al. 1999;
Evangelista de Duffard et al. 1995). They also
discovered that the serotoninergic and dopaminergic
effects occurred during postnatal brain development,
similar to the effects of CPF. Bortolozzi et
al. (1999) and Evangelista de Duffard et al.
(1995) also found 2,4-D in breast milk of 2,4-D-fed
mothers and in the stomach content, brain, and
kidney of 4-day-old pups (Sturtz et al. 2000).
Insecticides. Cassidy et al.
(1994) reported that the lowest dose of chlordane
used in their studies (100, 500, 5,000 ng/g/day
both prenatally and postnatally) caused a dose-
dependent reduction in testosterone levels in females in adulthood. The lowest
dose they used was 10 times lower than the U.S. EPA’s lowest observed
adverse effect level (LOAEL) for neurologic effects (1,000 ng/g) and 50 times
lower than the U.S. EPA’s LOAEL for developmental effects (5,000 ng/g)
of chlordane (Cassidy et al. 1994). Females exhibited improved spatial abilities
and auditory startle-evoked responses more similar to male responses, and slight
increases in body weight. Changes in male mating behavior included shortening
of latency to intromission and increased intromissions. The authors speculated
that pesticides structurally similar to chlordane cause masculinization of
function and behavior in both sexes because the pesticides mimic the sex steroids
or change their plasma levels through other enzyme systems. The two lower doses
in this study prompted greater change than the highest dose for auditory startle
response, mating behavior, and body weight.
Methoxychlor (MXC), an insecticide whose toxicity
depends on its conversion to several metabolites,
was considered to be an estrogen for many years
and only recently was discovered to have antiestrogenic
and androgenic properties as well. To measure
neurodevelopmental impacts, Palanza et al. (2002)
fed pregnant CD-1 mice environmentally relevant
doses of MXC (0.02, 0.2, and 2.0 µg/g mother
bw/day) from GD11 to GD17 and examined them on
postpartum days 2-15. Mothers fed the lowest
dose spent less time nursing than the controls,
possibly reflecting the inverted U-shaped dose-response
curve expressed by endocrine disruptors. At late
adolescence the pups exhibited a reduction in
novelty seeking (both the environment and objects),
with a difference between males and females (Palanza
et al. 1999). Male sexual aggression was reduced
at puberty but returned to normal in adulthood.
The reduction in aggressive behavior in the periadolescent
male CD-1 mouse as a result of MXC exposure (20 µg/kg/day)
occurred at a dose 100 times lower than the dose
at which the Agency for Toxic Substances and
Disease Registry (ATSDR 2002) deemed would cause
no harm to humans in 1994. The ATSDR recently
withdrew this minimum risk level in light of
new evidence on MXC.
Dopaminergic neurons in the substantia nigra
project to and release dopamine to the corpus
striatum of the brain. This section of the brain
integrates neuromuscular and behavioral information
and is involved in the control of locomotor activity,
exploration, and novelty-induced behavior. It
also influences social-sexual interactions
such as aggression and maternal behavior. The
loss of dopamine function in the neurons connecting
the corpus striatum with the midbrain of humans
is the cause of Parkinson disease. Male offspring
of mice exposed to 20 µg/kg/day MXC had
fewer dopaminelike receptors in their corpus
striatum and were less active than control females
(vom Saal et al. 2003). Females exposed to the
same concentrations showed a malelike profile
in reactivity to novelty. Similar changes in
males and females were seen in mice exposed to o,p´-DDT
in the same study. In an unrelated study, Lamberson
et al. (2001) discovered increased locomotor
behavior in offspring of Sprague-Dawley rats
administered 0.5 mg/kg/day MXC throughout gestation.
Prenatal exposure to aldrin also causes delayed
neurologic impairment that extends through to
adulthood. Castro et al. (1992) administered
1 mg/kg aldrin subcutaneously to female rats
daily from conception to birth and tested their
pups on PND1-2 and again on PND90. On PND90,
the animals showed loss of locomotor control
and behavioral change(s). Aldrin was not measurable
in the animals at the time they were tested.
Paraoxon is the oxidized metabolite of parathion
and a potent OP cholinesterase inhibitor. Chronic
paraoxon exposure (0.1, 0.15, or 0.2 mg/kg subcutaneously)
during a stage of rapid cholinergic brain development
from PND8 to PND20 in male Wistar rats led to
reduced dendritic spine density in the hippocampus
without obvious toxic cholinergic signs in any
of the animals (Santos et al. 2004). Some animals
in the two highest dose groups died in the early
days of the study. All doses caused retarded
perinatal growth, and brain cholinesterase activity
was reduced 60% by PND21.
Johansson et al. (1995) showed that a single
exposure to a pesticide before or shortly after
birth can sensitize the offspring to low doses
of other pesticides later in life, even though
there are no immediate changes in the structure
and function of the nervous system at the time
of exposure. Only as the exposed individual matures
do irreversible alterations in structure and
function become evident. The researchers exposed
mice to one dose of DDT (0.5 mg/kg bw orally)
on PND10 and then at 5 months of age exposed
them to bioallethrin (0.7 mg/kg bw) (Johansson
et al. 1995) or paraoxon (0.7 or 1.4 mg/kg bw)
for 7 days (Johansson et al. 1996). When tested
2 months later, at 7 months of age, the offspring
exhibited changes in spontaneous behavior and
cholinergic muscarinic receptor density in the
cerebral cortex, which led to impairment in learning
and memory (Eriksson and Talts 2000). Again,
the neurodevelopmental damage was not seen immediately,
but instead took 2 months to be expressed. PND10
in the mouse is equivalent to the end of the
second trimester in the human. It is during this
stage, from the third trimester of pregnancy
through 2 years of age in humans, when the neurotransmitter
system in the CNS goes through a growth spurt
(Eriksson 1997). Throughout these studies the
animals showed no clinical signs of toxic symptoms,
and the doses used for adult treatment in these
studies had no immediate effect on the adult.
The dose of DDT used in this studyis in the range
that human infants might be exposed to during
lactation today (Smith 1999). Even though the
functional and structural outcomes in the above
studies are similar, it should be remembered
that they were caused by different mechanisms.
For example, bioallethrin causes harm by prolonging
sodium channel openings, whereas paraoxon inhibits
acetylcholinesterase activity; but they both
caused similar neuronal changes, which raises
questions about the combined effects of pesticide
mixtures on development. These studies support
the premise that the differences in susceptibility
of adults to pesticides may not be genetic, but
rather that susceptibility to pesticides can
be acquired by low-dose pesticide exposure earlier
in life.
Insecticide and acaricide. Rat
pups displayed deficits in learning and retention
of memory after exposure to the organochlorine
insecticide and acaricide endosulfan (6 mg/kg
bw) on PND2-25 (Lakshmana and Raju 1994).
The concentrations of the neurotransmitters,
noradrenalin, dopamine, and serotonin in the
olfactory bulb, hippocampus, visual cortex, brainstem,
and cerebellum either increased or decreased
depending on the days of examination, PND10 and
PND25.The authors ruled out acetylcholinesterase
inhibition as the cause of the alterations in
the production of the neurotransmitters because
they found no differences in acetylcholine activity
in any of the regions of the brain used in the
study. They suggested that endosulfan directly
led to a “re-altering” of the construction
of those parts of the brain. By PND25, as the
differentiation and organization of the observed
tissues proceeded in the presence of endosulfan,
the rats’ performance became significantly
compromised.
Fungicides. Gray and Ostby (1998)
provided an excellent overview of how prenatal
exposure to a fungicide can alter sexual behavior
and function in adulthood, even though growth
and viability are not compromised. The neurobehavioral
alterations quantified in the studies they reviewed
include activity level, aggression, mounting
frequency, and completed intromissions. In a
study using the fungicide vinclozolin, Gray et
al. (1994) reported that 100% of the exposed
males failed to attain intromission, although
there was no reduction in mounting behavior.
In subsequent studies, newborn male and female
rats were injected on PND2 and PND3 with 200
mg/kg vinclozolin and observed for social behavior
on PND36 and PND37 (Hotchkiss et al. 2002). Both
males and females exhibited changes in play behavior.
Females became involved in increased rough-and-tumble
play, a behavior imprinted by male hormones in
the brain during early development. Conversely,
the males’ rough-and-tumble play was reduced,
and they behaved more like unexposed females.
Because only one dose was used, this study does
not indicate the lowest dose needed to initiate
these changes. More recently, on PND34 Colbert
et al. (2005) found significantly increased nape
contact, pounce, pin, and wrestle play behavior
in male offspring of females exposed to 6 and
12 mg/kg bw/day vinclozolin from GD14 to PND3.
At a maternal dose of 1.5 mg/kg bw/day vinclozolin,
there was a significant increase in penile dysfunction
in adulthood. Future studies should include more
than one dose, preferably over several orders
of magnitude, to take into account the susceptibility
and sensitivity of the developing animal.
There is a great deal of uncertainty about
the neurodevelopmental effects of pesticides
among the human studies presented here. Exposure
has become too complex because of the hundreds
of pesticide active ingredients on the market,
confounded by background exposure to industrial
chemicals that share similar effects. In addition,
functional changes are expressed over a continuum,
making it difficult to document the damage which
often is expressed as more than one lesion and
at different intervals or stages of development.
The pesticides discussed here, with the exception
of DDT, are still widely used in the United States
despite these data. Although this information
is available, the U.S. EPA has rarely used the
open literature in its risk assessments, generally
using only data submitted by manufacturers. Industry
continues to use traditional toxicologic protocols
that test for cancer, reproductive outcome, mutations,
and neurotoxicity, all crude end points in light
of what is known today about functional end points.
In using manufacturer data, the U.S. EPA misses
almost all delayed developmental, morphologic,
and functional damage of fetal origin and, in
the case of CPF and all OPs, continues to rely
primarily on blood cholinesterase inhibition
data in risk assessments (Zheng et al. 2000).
The U.S. EPA should accept nonguideline, open
literature to determine the toxicity of a chemical.
For example, Brucker-Davis (1998) published a
comprehensive review of the open literature in
which she found 63 pesticides that interfere
with the thyroid system--a system known
for more than a century to control brain development,
intelligence, and behavior. Yet, to date, the
U.S. EPA has never taken action on a pesticide
because of its interference with the thyroid
system.
It would be difficult to find another pesticide
in use today that has been as systematically
studied as CPF. The amazing litany of diverse
mechanisms discovered in the series of CPF studies
raises serious questions about the safety of
not only CPF and the other OPs but all pesticides
in use today. Most astounding is the fact that
a large part of CPF’s toxicity is not the
result of cholinesterase inhibition, but of other
newly discovered mechanisms that alter the development
and function of a number of regions of the brain
and CNS. These findings send a warning that even
though an OP pesticide like CPF may have a very
high EC50 (concentration that produces
50% of the maximum possible effective response)for
acute toxicity as a result of cholinesterase
inhibition, it may have other toxic strategies
that are far more egregious than cholinesterase
inhibition. This raises a question about the
value of using EC50 values if they
do not represent the most sensitive end point.
Qiao et al. (2003) warn that “developmental
neurotoxicity consequent to fetal or childhood
CPF exposure may occur in settings in which immediate
symptoms of intoxification are absent.” They
also point out that in the case of CPF, damage
is not always global (referring to the entire
brain) but may only interfere in specific regions
of the brain during development, which could
increase the difficulty of detecting the damage.
S.J. Garcia et al. (2001) state that “measurement
just of cholinesterase activity is a questionable
approach in assigning an appropriate index of
safety.”
The knowledge gained from a decade of the CPF/brain
studies by Slotkin and colleagues and the 2,4-D/brain
studies by Evangelista de Duffard and co-workersnot
only demonstrates the insidious nature of CPF
and 2,4-D exposure, but it also demonstrates
the weaknesses in current standard practices
for determining the safety of a pesticide or
any other synthetic chemical. These discoveries
demonstrate that a much larger battery of tests
must be used when determining the safety of commercial
pesticides. Even a U.S. EPA analysis of developmental
neurotoxicity studies stated that the U.S. EPA’s
current developmental neurotoxicologic testing
protocol is “not a sensitive indicator
of toxicity to the offspring” and urged
the U.S. EPA “to further consider if it
will use literature data” (Makris et al.
1998). In this case, “literature data” refers
to all of the peer-reviewed reports concerning
the pesticide impacts on neurodevelopment that
heretofore have not been used for risk assessment
by the agency. In the case of CPF and 2,4-D,
it appears that those who reviewed the data failed
to understand its significance or had other reasons
to ignore it. The U.S. EPA needs to convene a
panel of independent experts to review these
studies for applicability to determine if and
how they can be used for registration.
Laboratory studies have clearly revealed neurologic
damage after exposure to specific pesticides
and in some studies at concentrations equivalent
to ambient exposure. Even so, the animal testing
for regulatory purposes that takes place today
does not attempt to detect adverse health effects
at the concentrations at which humans are exposed.
Instead, the highest concentrations of chemicals
tested are those that can be used without killing
the animals or reducing the test mother’s
weight and her reproductive ability.In most animal
studies the pesticides are administered at high
oral or subcutaneous doses orally, not reflecting
that, for most humans and wildlife, exposure
could in many instances be dermal or via inhalation
and, in many cases, over a long period of time
at low doses. The U.S. EPA currently requires
chronic toxicity studies, but it is locked into
using high doses to elicit effects and has not
overcome the difficulty of detecting effects
from chronic or ambient exposure or low doses.
In addition, the human pharmacokinetics of pesticide
exposure can either enhance or reduce the health
impacts depending on individual variations. In
some cases the major or minor metabolites are
more toxic than the parent compound, which is
listed as the active ingredient.
In a recent study, Bowers et al. (2004) found
a different profile of developmental neurotoxicity
between polychlorinated biphenyls (PCBs; such
as Aroclor 1254) alone and with a mixture of
organochlorine pesticides. Very low doses of
the chemicals together delayed ear opening, affected
geotaxis, and reduced grip strength. Ultimately,
mortality, growth, thyroid function, and neurobehavioral
development were affected. It is safe to say
that there are very few people in the developed
world today who are not carrying PCBs in their
bodies. If animal testing continues to be used
for determining the safety of pesticides, at
least one group of the test animals should be
exposed to PCBs before testing the pesticides
for their ability to cause unpredictable interactive
effects such as those described above.
It should be pointed out that the same signaling
systems (AC cAMP) involved in the sex-selective
changes in brain development have also been shown
to alter heart and liver function in adulthood
(Meyer et al. 2004a, 2004b). The AC system is
ubiquitous throughout the body. In the future,
the most efficient, comprehensive assays will
take advantage of the fact that most chemicals
have more than one effect in one system. Cross-disciplinary
teams will be required to design these assays
so that every organ system is carefully screened
for damage. And most important, this will reduce
by thousands the numbers of animals needed for
testing. However, improved neurodevelopmental
tests with laboratory animals will not fulfill
their greatest potential if they are not backed
up by better batteries of tests to detect functional
disabilities in children. Such new, sophisticated
quantitative tests are now available and are
being updated regularly. These tests go beyond
diagnostic testing to “performance evaluation” and
are designed to detect the subtle effects of
chronic, low-dose exposure (Davidson et al. 2000).
In conclusion, an entirely new approach to
determine the safety of pesticides is needed.
It is evident that contemporary acute and chronic
toxicity studies are not protective of future
generations. The range of doses used in future
studies must be more realistic, based on levels
found in the environment and human tissue. In
this new approach, functional neurologic and
behavioral end points should have high priority,
as well as the results published in the open
literature. In every instance, the impacts of
transgenerational exposure on all organ systems
must be meticulously inventoried through two
generations on all contemporary-use pesticides
and new pesticide coming on the market. To protect
human health, however, a new regulatory approach
is also needed that takes into consideration
this vast new knowledge about the neurodevelopmental
effects of pesticides, not allowing the uncertainty
that accompanies scientific research to serve
as an impediment to protective actions. |
|
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Last Updated: February 9, 2006
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