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PubMed2005

Environmental exposure to cadmium at a level insufficient to induce renal tubular dysfunction does not affect bone density among female Japanese farmers.

Some recent research suggests that environmental exposure to cadmium, even at low levels, may increase the risk of osteoporosis, and that the bone demineralization is not just a secondary effect of renal dysfunction induced by high doses of cadmium as previously reported. To investigate the effect of exposure to cadmium at a level insufficient to induce kidney damage on bone mineral density (BMD) and bone metabolism, we conducted health examinations on 1380 female farmers from five districts in Japan who consumed rice contaminated by low-to-moderate levels of cadmium. We collected peripheral blood and urine samples and medical and nutritional information, and measured forearm BMD. Analysis of the data for subjects grouped by urinary cadmium level and age-related menstrual status suggested that cadmium accelerates both the increase of urinary calcium excretion around the time of menopause and the subsequent decrease in bone density after menopause. However, multivariate analyses showed no significant contribution of cadmium to bone density or urinary calcium excretion, indicating that the results mentioned above were confounded by other factors. These results indicate that environmental exposure to cadmium at levels insufficient to induce renal dysfunction does not increase the risk of osteoporosis, strongly supporting the established explanation for bone injury induced by cadmium as a secondary effect.

Agriculture↗

PubMed1996

Future research directions for evaluating human genetic and cancer risk from environmental exposures.

The utility of biomarkers for evaluating the genotoxicity of environmental exposures is well documented. Biomarkers of both exposure and effect provide bases for assessing human-genotoxicant interactions and may be indicative of future disease risk. At present, there is little information on the predictive value of these assays for either a population or the individuals tested. This paper describes some aspects of biomarker assays, the possible use of susceptibility measures in biomonitoring protocols, and the need for evaluation of disease relevance. A population study involving epidemiologists, geneticists, toxicologists, statisticians, and physicians is proposed to determine the disease relevance of these biomarkers.

Biomarkers↗

PubMed2000

Echocardiographic findings of pericardial involvement in patients with malignant pleural mesothelioma with a history of environmental exposure to asbestos and erionite.

OBJECTIVE: The aim of the present study was to evaluate the pericardial involvement in patients with malignant mesothelioma caused by exposure to different minerals. METHODOLOGY: Forty-two patients (mean age of 52 +/- 12 years) with malignant mesothelioma were examined with transthoracic echocardiography. Thirty-three (78.9%) patients had a history of environmental exposure to asbestos and nine (21.4%) had a history of environmental exposure to erionite. RESULTS: In 19 (45.2%) patients with malignant pericardial mesothelioma, pericardial involvement was determined by echocardiography. The other 23 (54.8%) patients had no pericardial involvement. Pericardial effusion was detected in nine (64.3%) patients and pericardial effusion was small in six (14.3%) patients, moderate in one (2.4%) patient and large in two patients. Thickening of the pericardium was observed in eight (19%) patients. In another two (7.1%) patients pericardial calcification was observed. Among the 33 patients who had been exposed to asbestos, 15 (45.5%) had pericardial involvement, and among the nine patients with a history of exposure to erionite, four (44.4%) had pericardial involvement. There was no difference in terms of pericardial involvement in different stages of the tumour (P > 0.05). CONCLUSIONS: Pericardial involvement is commonly seen in patients with malignant mesothelioma. Among patients exposed to asbestos or zeolite there was no difference in terms of pericardial involvement. Furthermore, pericardial involvement was not related with the stage of the tumour.

Adult↗

PubMed2006

Linking childhood cancer with potential environmental exposure determinants.

Childhood chronic diseases, especially cancer, are of growing concern. Research has focused on 2 developmental periods, prenatal and postnatal. While it is hypothesized that chemical contaminants in the physical environment may play a role in the development and exacerbation of many chronic diseases, the role of environmental exposures in the etiology of these conditions remains uncertain. This can be somewhat attributed to the fact that it is very difficult to efficiently link chronic health effects with environmental exposures that are likely to have occurred temporally and spatially distant from diagnosis. This study explored the utility of linking childhood cancer cases with their birth certificate data as a method for increasing the number of geo-referenced data points available for linking health effect data with environmental monitoring data. This would begin to quantify the transiency of 1 subset of the population, and provide a basis for characterizing and estimating potentials for exposure to numerous environmental contaminants during prenatal and postnatal periods. A total of 441 unduplicated cancer diagnosis records of children who were both born and diagnosed with cancer in Wisconsin between 1995 and 2002 were linked with birth records to explore the variability between address at birth and diagnosis. The majority of records were matched to a birth record file (81.0%). Of these matched records, 86% moved <1 mile from birth to time of diagnosis. The results suggest that administrative and public health surveillance data can be used to quantify transiency. Data from the sample tested indicate that during the given time period children do not move far from their birth homes, suggesting minimal changes in exposure potential related to residence location from birth to diagnosis. This background is useful for future epidemiological investigations linking environmental factors with chronic health effects.

Child↗

PubMed2003

trans,trans-Muconic acid excretion in relation to environmental exposure to benzene.

OBJECTIVES: Potential environmental sources of benzene exposure, and intake of foods and beverages susceptible to being preserved with sorbic acid, were investigated in relation to their contribution to the inter-individual variation in background urinary trans,trans-muconic acid ( t,t-MA) excretion among subjects non-occupationally exposed to benzene. METHODS: We measured urinary t,t-MA excretion in 65 subjects, 34 women and 31 men. A spot sample of morning urine was collected for each subject 10-12 h after they had consumed their last meal. Questionnaire information was collected on diet and possible sources of environmental benzene exposure in the surroundings of the subjects' residences. For each subject, an estimate of the average daily intake of sorbic acid with diet was calculated, based on questionnaire information and laboratory data on samples of local food items. RESULTS: The t,t-MA geometric mean was significantly higher among women (28.7 vs 11.5 microg/g creatinine, P<0.05) and among smokers (37.6 vs 15.6 microg/g creatinine, P<0.05), and increased by years of education among women, but not among men. In the multivariate analysis, smoking was the only significant predictor of elevated t,t-MA excretion. In our study, the average estimated daily sorbic-acid intake with diet was 0.33 ppm (standard deviation: 0.28), and it did not show a correlation with t,t-MA excretion. Urban traffic and residence within 100 m of a fuel station also did not show an association with elevated t,t-MA values. CONCLUSIONS: Our study confirms that, among subjects non-occupationally exposed to benzene, smoking contributes significantly to increased background t,t-MA excretion. Further studies should be addressed to confirm our observation of elevated t,t-MA levels among women.

Adult↗

PubMed2004

Low-level exposure to cadmium during the lifetime increases the risk of osteoporosis and fractures of the lumbar spine in the elderly: studies on a rat model of human environmental exposure.

In this study, based on a rat model of human environmental exposure to cadmium (Cd), it has been examined whether low-level lifetime Cd exposure increases the risk of vertebral osteoporosis and vertebrae fractures in the elderly. For this purpose, the lumbar vertebral bodies (L4 or L3) of control and Cd-exposed (1 mg Cd/l in drinking water for 24 months) female Wistar rats were assigned to densitometric, radiographic, biomechanical (compression test), and biochemical studies, as well as to assess their dimensions and chemical composition. The exposure to Cd affected the mineral status of the L4. The decreased mineral content, density (BMD) and bone mineral area of the vertebral body together with the unchanged ratio of non-organic and organic components indicate osteoporotic nature of the Cd-induced changes. The activity of alkaline phosphatase in the L3 decreased. Cd also influenced the mechanical properties of the L4. The yield load and ultimate load decreased indicating a weakness in the vertebral body compression strength. Stiffness of the L4 decreased and the displacement at ultimate increased suggesting its enhanced susceptibility to deformities. Indeed, in the Cd group vertebral deformities (in 30% of females) or even fractures (in 40% of females), including those with disruption of bone continuity were evident. Z-score values for the L4 BMD revealed vertebral osteopenia in 30% and osteoporosis in 70% of the Cd-exposed females. The results allow for the conclusion that low lifetime exposure to Cd may become an important factor increasing the risk of lumbar spine osteoporosis with vertebral deformities and fractures in the elderly.

Alkaline Phosphatase↗

PubMed2006

Environmental exposure to lead and progressive diabetic nephropathy in patients with type II diabetes.

Studies indicate that environmental exposure to lead is associated with reduced renal function. Whether lead affects progressive diabetic nephropathy is unclear. Eighty-seven patients with type II diabetes and diabetic nephropathy (serum creatinine of 1.5-3.9 mg/dl) with normal body lead burden and no lead exposure history were observed over a 12-month period. Thirty subjects with high normal body lead burdens (80-600 microg) were randomly assigned to a chelation and control group. For 3 months, the 15 chelation-group patients underwent lead-chelation therapy with calcium disodium ethylenediaminetetraacetic acid weekly until body lead burden fell <60 microg, and the 15 control group subjects received a weekly placebo. During the following 12 months, renal function was regularly assessed at 3-month intervals. The primary outcome was an elevation of serum creatinine to 1.5 times baseline value during the observation period. A secondary outcome was temporal changes in renal function following chelation therapy. Twenty-six patients achieved the primary outcome. Basal blood lead levels and body lead burden were the most important risk factors in predicting progressive diabetic nephropathy. Following chelation, the rates of decline in glomerular filtration rates in the chelation group and the control group, respectively, were 5.0+/-5.7 ml and 11.8+/-7.0 ml/min/year/1.73 m(2) of body surface area (P=0.0084) during follow-up, although both groups had similar rates of progression of renal function during the 12-month observation period. We concluded that low-level environmental lead exposure accelerates progressive diabetic nephropathy and lead-chelation therapy can decrease its rate of progression.

Adult↗

PubMed1999

Cryptococcal meningitis in renal transplant patients associated with environmental exposure.

Fungal infections in renal transplant recipients are less common than bacterial infections; however, the morbidity from fungal infections is high. There is limited information in the literature concerning post-transplantation cryptococcal infection due to environmental exposure of patients living in high-risk areas. We report three patients who were diagnosed with cryptococcal meningitis after kidney transplantation. Cryptococcal titers prior to transplant surgery were negative in all three patients. These patients all lived in rural areas and demonstrated evidence of environmental exposure leading to subsequent cryptococcal meningitis. All patients had exposure to pigeon and chicken excreta and, after treatment, two patients are alive and well with excellent allograft function. The third patient has marginal renal function but is currently not on dialysis. Early diagnosis is essential for salvage from these potentially lethal infections. Intense headache was a prominent feature in the clinical presentation of our patients, and should signal the need for early sampling and culture of spinal fluid. Meningismus was not present in any of our patients, even when other systemic symptoms were identified. We recommend a high index of suspicion post-transplantation for all patients who may have environmental or occupational exposure to cryptococcus. If infection is detected quickly and treatment instituted promptly, patient recovery and allograft survival are possible. Long-term therapy with fluconazole, a non-nephrotoxic agent, should permit eradication of the infection with preservation of kidney function.

Amphotericin B↗

PubMed2003

Use of stable isotopically labeled benzene to evaluate environmental exposures.

The use of stable, isotopically labeled compounds in controlled exposure experiments at environmentally relevant levels allows for the distinguishing of urinary metabolites associated with known exposure from background levels generally present in the urine. Exposures of volunteers to (13)C-benzene for 2 h at 40+/-10 p.p.b. were conducted after obtaining informed consent, and urinary phenol, catechol, hydroquinone and trans,trans- muconic acid were measured. Each isotopically labeled urinary metabolite was determined in the presence of significantly higher concentrations of the unlabeled metabolite. Following exposure, free and acid hydrolyzed phenol, acid hydrolyzed catechol and hydroquinone, and free trans,trans-muconic acid were determined by GC/MS. The percentage of trans,trans-muconic acid excreted was higher than reported following exposure at occupational levels. The use of isotopically labeled compounds has the potential to investigate the metabolism of common environmental contaminants for validation of toxicokinetic models and improve risk extrapolation from high concentration occupational exposures and animal studies to environmentally relevant pollutant levels.

Adult↗

PubMed2001

Biological monitoring of environmental exposure to polycyclic aromatic hydrocarbons in subjects living in the vicinity of a creosote impregnation plant.

OBJECTIVE: This study was undertaken to evaluate the environmental exposure to polycyclic aromatic hydrocarbons (PAHs) in nonsmoking adult subjects living in the vicinity of a creosote impregnation plant in Delson, Canada. Urinary metabolites of naphthalene, alpha- and beta-naphthol, and pyrene metabolite 1-hydroxypyrene (1-OHP), were used as biomarkers of exposure. METHODS: Morning and evening urine samples were collected in mid-August from 30 exposed individuals living at a distance of 50-360 m downwind of the plant and from a control group in the adjoining municipality residing at a distance of 1.9-2.7 km upwind of the plant. Metabolites were measured by gas chromatography/ mass spectrometry. RESULTS: Excretion values of alpha- and beta-naphthol were significantly higher in the exposed group than in controls (P < 0.04), after accounting for possible confounding variables by multivariate analyses. The respective geometric mean concentrations (5th and 95th percentiles) of alpha-naphthol for the exposed and nonexposed groups were 2.04 (0.55-6.00) and 1.37 (0.39-7.02) micromol/mol creatinine for evening samples, and 2.49 (0.77-8.43) and 1.17 (0.37-6.88) micromol/mol creatinine for morning samples. Corresponding values for beta-naphthol were 1.78 (0.82-3.67) and 1.36 (0.63-5.07) micromol/mol creatinine for evening samples, and 1.94 (1.03-4.96) and 1.08 (0.49-5.05) micromol/mol creatinine for morning samples. On the other hand, no significant difference in 1-OHP excretion was observed between the exposed and the control group (P>0.5). The respective geometric mean concentrations (5th and 95th percentiles) of 1-OHP for these groups were 0.05 (0.01-0.17) and 0.06 (0.01-0.48) micromol/mol creatinine for evening samples, and 0.05 (0.02-0.12) and 0.05 (0.01-0.42) micromol/mol creatinine for morning samples. CONCLUSIONS: The measurement of alpha- and beta-naphthol urinary concentrations appears to be an approach sufficiently sensitive to reveal differences in low exposure levels of volatile PAHs due to creosote impregnation plant emissions. However, uptake of pyrene due to the plant was too small to contribute significantly to 1-OHP excretion.

Adolescent↗

PubMed2005

[Research advance on environmental exposure and ecotoxicological effects of polybrominated diphenyl ethers (PBDEs)].

Polybrominated diphenyl ethers (PBDEs) are a group of new type organic pollutants with significant ecological risk. As flame retardants, they have been increasingly added to industrial products, and thus, resulted in more and more extensive pollution of air, water, sediment and soil as well as their relevant ecosystems. In view of the new environmental problem and based on limited available data, this paper approached the anthropogenic sources of PBDEs and their pathways of environmental exposure, and gave the possible occurrence and concentration of PBDEs in several living organisms and different human tissues. The toxic effects and ecological influences of PBDEs acting on animals and human beings, and their potential biological accumulation and magnification in ecosystems were analyzed in the aspects of hypothyroid, neurotoxicity, and reproductive and developmental toxicity, and the pivots of further researches on environmental exposure, ecological effects and human health influences of PBDEs were thus suggested.

Environmental Exposure↗

PubMed1980

The feasibility of using lead in hair concentration in monitoring environmental exposure in children.

The feasibility of lead in hair as an indicator of lead exposure has been compared to that of lead in blood and zinc protoporphyrin in blood levels in 1--3-year-old children living within 1 km of a lead smelter. Lead exposure was measured as lead in house dust, outdoor and indoor lead in air concentrations, outdoor and indoor lead depositions, and subjective assessment of indoor dustiness. Lead in blood ranged from 51-353 microgram/l and lead in hair from 0.8-114 microgram/g. It can be concluded that within the range of environmental exposure studied, and for the age group concerned, measurement of lead in blood and of the zinc protoporphyrin in blood levels appear to be better biological parameters to assess both total environmental exposure and health risk than measurement of lead in hair level alone.

Child, Preschool↗

PubMed1998

Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoflagellates.

BACKGROUND: At the beginning of autumn, 1996, fish with "punched-out" skin lesions and erratic behaviour associated with exposure to toxins produced by Pfiesteria piscicida or Pfiesteria-like dinoflagellate species were seen in the Pocomoke River and adjacent waterways on the eastern shore of the Chesapeake Bay in Maryland, USA. In August, 1997, fish kills associated with Pfiesteria occurred in these same areas. People who had had contact with affected waterways reported symptoms, including memory difficulties, which raises questions about the human-health impact of environmental exposure to Pfiesteria toxins. METHODS: We assessed 24 people who had been exposed. We collected data on exposure history and symptoms, did a complete medical and laboratory assessment (13 people), and carried out a neuropsychological screening battery. Performance on neuropsychological measures was compared with a matched control group. RESULTS: People with high exposure were significantly more likely than occupationally matched controls to complain of neuropsychological symptoms (including new or increased forgetfulness); headache; and skin lesions or a burning sensation of skin on contact with water. No consistent physical or laboratory abnormalities were found. However, exposed people had significantly reduced scores on the Rey Auditory Verbal Learning and Stroop Color-Word tests (indicative of difficulties with learning and higher cognitive function), and the Grooved Pegboard task. There was a dose-response effect with the lowest scores among people with the highest exposure. By 3-6 months after cessation of exposure, all those assessed had test scores that had returned to within normal ranges. INTERPRETATION: People with environmental exposure to waterways in which Pfiesteria toxins are present are at risk of developing a reversible clinical syndrome characterised by difficulties with learning and higher cognitive functions. Risk of illness is directly related to degree of exposure, with the most prominent symptoms and signs occurring among people with chronic daily exposure to affected waterways.

Adult↗

PubMed1991

Does environmental exposure to cadmium represent a health risk? Conclusions from the Cadmibel study.

Cadmium is a very dispersive pollutant which has progressively accumulated in the environment mainly in the areas where nonferrous smelters have been in operation. An important toxicological feature of cadmium is its exceptionally long biological half-life in the human body. For the general population mainly exposed to cadmium by the diet and smoking, the kidney is the main target organ. Some studies have also suggested that cadmium might play a role in the pathogenesis of hypertension. A cross-sectional study (called Cadmibel) was undertaken to assess whether environmental pollution by cadmium in Belgium might represent a health risk. This paper does not present the detailed results of this study which are published elsewhere but simply report its main conclusions. A total number of 2327 subjects (stratified according to age and sex) was randomly sampled in two urban (Liège and Charleroi) and two rural (Hechtel-Eksel and Noorderkempen) areas, with different environmental pollution by cadmium. After allowing for the various factors known to influence cadmium accumulation, it was estimated that the cadmium body burden of the residents of the most polluted district (Noorderkempen) was 50 to 85% higher than in the less polluted areas. No statistical association was found between environmental exposure to cadmium and blood pressure elevation or the prevalence of cardiovascular diseases. However, the study has shown that the environmental exposure of the general population to cadmium may induce slight renal tubular dysfunction and may probably also affect cadmium homeostasis. The probability of tubular dysfunction (as assessed by sensitive tests) is about 10% when cadmium in urine reaches 2 micrograms/day. The morbidity associated with the changes in the renal proximal tubule and the calcium metabolism observed when the body burden of cadmium exceeds this value remains to be assessed.

Adult↗

PubMedDate not supplied

Environmental exposures to lead and cadmium measured in human placenta.

Pregnant women exposed to even low levels of environmental lead and cadmium may experience adverse perinatal effects. To evaluate the usefulness of the placenta for monitoring environmental lead and cadmium exposure, concentrations of both metals were measured in placentas (n = 86) with atomic absorption spectrometry. Environmental exposure was assessed in accordance with the degree of industrial activity and transport pollution near the places of residence. The authors found significantly higher lead and cadmium levels in placentas of women living in urban-industrial areas than in placentas of women living in rural areas. Lead concentrations in placenta reflect environmental exposures; smoking during gestation explained a large portion of placental cadmium. This finding suggests that when a pregnant woman is a heavy smoker, tobacco exposure masks environmental cadmium exposure, especially in areas with low levels of cadmium pollution.

Adult↗

PubMed1998

Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress.

BACKGROUND: Most US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health symptom relationships. METHODS: Stratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were selected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) served as a comparison group. The study protocol included questionnaires, a neuropsychological test battery, an environmental interview, and psychological diagnostic interviews. This report focuses on self-reported health symptoms and exposures of participants who completed a 52-item health symptom checklist and a checklist of environmental exposures. RESULTS: The prevalence of reported symptoms was greater in both Persian Gulf-deployed cohorts compared to the Germany cohort. Analyses of the body-system symptom scores (BSS), weighted to account for sampling design, and adjusted by age, sex, and education, indicated that Persian Gulf-deployed veterans were more likely to report neurological, pulmonary, gastrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans. Using a priori hypotheses about the toxicant effects of exposure to specific toxicants, the relationships between self-reported exposures and body-system symptom groupings were examined through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesticides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased reporting of specific predicted BSS groupings. CONCLUSIONS: Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD.

Adult↗

PubMed2002

Role of environmental exposure to spider mites in the sensitization and the clinical manifestation of asthma and rhinitis in children and adolescents living in rural and urban areas.

BACKGROUND: Spider mites such as the citrus red mite and the two-spotted spider mite have been demonstrated to be important allergens for fruit cultivating farmers. OBJECTIVE: To evaluate the role of environmental exposure to spider mites in the sensitization and the clinical manifestations of asthma and rhinitis in children and adolescents living in urban and rural areas. METHODS: A total of 16,624 subjects (aged 7 to 18 years) living in urban (metropolitan and non-metropolitan) and rural areas (apple orchards and citrus orchards) in Korea were evaluated by questionnaire and skin prick test for 11 common aeroallergens, including citrus red mite (CRM) and two-spotted spider mite (TSM). RESULTS: The positive skin response rates to TSM were 4.2% of 1,563 metropolitan subjects, 3.8% of 5,568 non-metropolitan subjects and 6.5% of 1,464 subjects living nearby apple farms, and that to CRM 15.6% of 8,029 living nearby citrus farms. The prevalence of current wheeze and rhinitis as reported on a questionnaire was higher among those with a history of visiting fruit farms once or more per year than among those without it (10% vs. 7.1%, 32.8% vs. 26.7%, for wheezing and rhinitis, respectively). Among those with wheezing or rhinitis, the positive skin responses to TSM or CRM were also higher among those with a history of visiting fruit farms than among those without one (11.2% vs. 6.6%, 13.0% vs. 6.6%, respectively), although the positive skin responses to house dust mites were similar in the both groups. CONCLUSION: Spider mites are common sensitizing allergens in children and adolescents exposed to them, and environmental exposure to these mites may represent an important risk factor in the sensitization and the clinical manifestations of asthma and rhinitis in children and adolescents living in rural and urban areas.

Adolescent↗

PubMed2004

Inflammation, neurodegenerative diseases, and environmental exposures.

The etiology of neurodegenerative disorders is multifactorial and consists of an interaction between aging, environmental factors, and genetic predisposition. Neuronal cell loss in specific regions of the central nervous system and the resulting clinical symptoms are used to characterize different neurological syndromes. While the selectivity of neuronal cell death is not clearly understood, it is in part attributed to the physiological role and microenvironment of the impacted cells. In this review, innate immune responses in the central nervous system are described. Chronic upregulation of this pathway, orchestrated mainly by microglial cells, may jeopardize neuronal integrity through the prolonged production of toxic inflammatory mediators. Environmental exposures that further enhance the innate immune response may accelerate microglia-driven neurodegeneration. Environmental factors that can trigger inflammatory events in the central nervous system are lipopolysaccharide, aluminum, and particulate matter present in air pollution. These factors may enhance existing age-related inflammation in the central nervous system and thus accelerate neuronal toxicity.

Air Pollutants↗