PCBs, Pollution and Detoxification

v) Discussion

Initial evaluations of our patients showed that inadvertently exposed adult residents in Semic have accumulated PCBs and possibly other xenobiotics in sufficient quantities to reach the range of occupationally exposed workers (Figure A-1). Extrapolating, younger persons and breast-fed children may have accumulated similar amounts of these compounds. Even if no further exposure occurs in their lifetimes (an unlikely event), the current chemical burdens could endanger these individuals' health (Jacobson et al., 1985;lb) Rogan t al. 1980; Skaare et al., 1988; Spyker, 1975).

Figure A-4: Changes in the Self-Rated Severity of Symptoms During the Pilot Study. Patients rated severity of symptoms on a scale of 0 to 5 (O = none, 1 = slight, 2 = mild, 3 = moderate, 4 =severe, and 5 = very severe). Pre, post, and F-up as for Figure A-3. Mean values for each assessment period are plotted. (a) Treated Patients (n = ll), (b) Untreated Controls (n = 12).

Second, a distinct gas chromatographic pattern of PCB congeners was found to be characteristic for exposed persons of the polluted region (Figure A-2). The identification of enhanced levels of congeners specific to this pattern in the farmer, who had not lived in Semic and had never traveled there, supports the conclusion that the PCB contamination was extensive. Since the congener pattern found in Semic differs markedly from the pattern present in samples of unexposed persons, it may serve as a fingerprint of this polluted environment. It should be noted that the array of chemicals utilized in this industrial setting complicates assessment of the causation of health effects. Clinical improvements in the treated patients were more pronounced than the reductions in PCBS, suggesting that other chemicals were co-causative agents. In order to determine which chemicals might be causative agents within the myriad of compounds used, it would be necessary to assess comprehensive body burdens in these workers, and, more importantly, to understand the interactions of these chemicals within the biological context. The latter alone is a research project of some magnitude. Regardless, in cases where a chemical cause of symptoms is anticipated, detoxification is warranted. Our study showed that detoxification reduced body burdens of accumulated chemicals and improved both the clinical picture and the immune status.

Appendix B

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