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PBB homologs in sera of Michigan dairy farmers and Michigan chemical workers.

In November, 1976 the Environmental Sciences Laboratory of the Mount Sinai School of Medicine, examined 1029 persons in Michigan for the potential health effects of exposure to PBB. Included in this group were 55 persons from Michigan Chemical Corporation and 237 farming families. Blood serum was analyzed for PBB. FireMaster FF-1 contains several bromobiphenyl components, the major constituent being approximately 60% 2,4,4,2'4'4'-hexabromobiphenyl. Other PBB homologs identifiable as peaks by gas chromatography--mass spectrometry include two pentabromobiphenyl peaks, three additional hexabromobiphenyl peaks, and two heptabromobiphenyl peaks. The relative concentrations, with respect to the major hexabromobiphenyl peak, of these minor constituents (1--20%) of PBB were different for persons from Michigan Chemical Corporation and for farmers. Penta-, hexa-, and hepta-bromobiphenyl components in serum samples analyzed from farming families from Michigan Chemical Corporation employees were compared with relative concentrations of these homologs in FireMaster mixture and in tissue and blood samples from rats fed FireMaster FF-1. Varying concentrations of these PBB components are attributed to different routes of exposure and the relative ease of metabolism and excretion of one pentabromobiphenyl component.

Animal Feed

Liver function tests among Michigan and Wisconsin dairy farmers.

Serum activity of SGOT, SGPT, LDH, and alkaline phosphatase was measured in 614 Michigan adults exposed to PBB and 141 Wisconsin adults not so exposed. The Michigan group had higher prevalence of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.005). A clear sex difference was observed. Michigan men had a higher prevalence of abnormal SGPT (p less than 0.005) and LDH (p less than 0.005) than Michigan women, and a higher prevalence than Wisconsin men of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.01). These differences could not be ascribed to differing patterns of alcohol consumption, laboratory error, or choice of criteria for normality/abnormality. Seven Michigan subgroups were defined on the basis of the criteria by which they had been selected to participate. The two subgroups who were essentially self-invited did not differ from the remaining five randomly selected subgroups combined in prevalence of these abnormal liver function tests. Based on 364 serum PBB analyses thus far analyzed of the 614 Michigan participants, no obvious relationship between serum PBB values and liver function tests was observed. However, this is a tentative conclusion that will be further evaluated when remaining serum PBB analyses are completed. The greater prevalence of abnormal SGPT and SGOT among Michigan dairy farm residents compared to the Wisconsin dairy farm residents is tentatively ascribed to the former group's exposure to PBB.

Adolescent

Unanticipated prevalence of symptoms among dairy farmers in Michigan and Wisconsin.

Adverse human health effects resulting from exposure to polychlorinated biphenyls (PBBs) were unknown until the accidental contamination of Michigan dairy farm animal feed in 1973-1974. Human exposure resulted from the consumption of contaminated meat, milk, dairy products, and eggs. In November 1976, the Environmental Sciences Laboratory conducted comprehensive examinations of 933 farmers and residents in Mighigan who were likely to have consumed farm products contaminated with PBB. A comparison group of 229 Wisconsin dairy farmers were examined in March 1977 and the same scientific and medical staffs that conducted the Michigan survey were responsible and the same procedures used. A complete history of symptomatology by organ system, including year of first onset, duration, frequency, and severity of each symptom was obtained by a physician on all adults examined. Statistical analysis of the prevalence of symptoms at the time of examination or during the preceding year in the Michigan and Wisconsin populations studied found the Michigan group to have a significantly higher prevalence of skin, neurological and musculoskeletal symptoms. The increase was seen among the younger age groups 16-35 and 36-55. Michigan females had a higher prevalence of neurological symptoms than the Michigan males. The existing differences could not be explained without considering an etiologic role for exposure to PBB.

Adolescent

Comparison of hospital admissions for cerebrovascular disease in Michigan and North Carolina.

Hospital admission rates and death rates for cerebrovascular disease differ markedly between states. Hospital admission data were analyzed: (a) to ascertain why death rates from this disease group are lower in Michigan than in North Carolina and (b) to clarify whether hospital care in either state has inadequacies that can be corrected quickly. Among both whites and blacks of the same age, case-fatality ratios were higher in North Carolina than in Michigan. Subarachnoid and cerebral hemorrhages were diagnosed more often in the southern state. For both areas, the records showed a marked underreporting of hypertension and diabetes mellitus as secondary conditions in the hospital admissions; elevated blood pressures were about equally common in each state but were treated more vigorously in Michigan. Secondary diagnoses of respiratory disease and use of anti-infective agents were reported more frequently in North Carolina. In contrast, diabetes mellitus was more prevalent in Michigan admissions. Some reasons for these findings are advanced, particularly as they relate to diagnostic and treatment patterns. Finally, the need for more detailed research is emphasized to create guidelines for better hospital care of cerebrovascular disease.

Aged

Breast-milk monitoring to measure Michigan's contamination with polybrominated biphenyls.

In 1973 and 1974, several thousand Michigan dairy farms were contaminated by polybrominated biphenyls (P.B.B.) as the result of an industrial accident. An unknown quantity of contaminated meat and dairy products entered the food chain before contaminated farms were quarantined. To determine the extent of human exposure, P.B.B. concentrations were measured in human breast milk, which was collected in a random-sample survey from nursing mothers throughout Michigan. 96% of 53 samples from Michigan's lower peninsula and 43% of 42 samples from the less densely populated upper peninsula contained detectable levels of P.B.B. These data indicate that about 8 million of Michigan's 9.1 million residents have detectable body burdens of P.B.B.

Accidents, Occupational

Immunologic dysfunction among PBB-exposed Michigan dairy farmers.

In 1973 inadvertent contamination occurred in a special farm feed supplement for lactating cows. Polybrominated biphenyls (PBBs) were used in place of magnesium oxide resulting in serious harm to farm animals, including cattle, chickens, geese, ducks. Farm families, accustomed to eating their own products, were most heavily exposed. To further study the impact of PBBs, 45 adult Michigan farm residents who were originally examined in a clinical field survey were further studied with respect to their immunologic status. For comparison, 46 dairy farm residents in Wisconsin, who had not eaten PBB-contaminated food, were examined, as were 79 healthy subjects in New York City. Abnormalities in the Michigan group included significant decrease in absolute numbers and percentages of T and B-lymphocytes and increased number of lymphocytes with no detectable surface markers ("null cells"). Significant reduction of in vitro immune function was noted in 35--40% of the Michigan farm residents who had eaten food containing PBB. Despite the absence of any apparent numerical reduction, both T and B lymphocyte subpopulations of peripheral blood lymphocytes showed evidence of functional defect. Ten of the 45 Michigan farmers studied showed impaired PHA-induced blastogeneic response, due to the decreased number and percent of T-cells in the PBLs. The decreased immune function detected among the PBB-exposed farm residents tended to affect families as a unit and was independent of exposed individuals' age or sex, speaking against the possibility of genetic predisposition.

Accidents

Polybrominated biphenyl (PBB) contamination of the Pine River, Gratiot, and Midland Counties, Michigan.

Michigan Chemical Corporation, St. Louis, Michigan manufactured PBB from 1970 until November 20, 1974. Studies in 1974 showed significant quantities of PBB in effluent discharged from the facility and in water, fish, ducks, and sediments from the Pine River. Fish uptake rates and bioconcentration factors were estimated. Followup surveys over the three year period since the termination of PBB production indicate a decline in PBB loadings to the river but no significant corresponding decline of PBB levels in sediments, fish and duck tissue. A Michigan Department of Public Health warning against consumption of Pine River fish from St. Louis downstream to its confluence with Chippewa River remains in effect.

Animals

Carcinoembryonic antigen (CEA) plasma levels in Michigan and Wisconsin dairy farmers.

Carcionogenic embryonic antigen (CEA) titers were determined for 611 Michigan farmers exposed to PBB and a control nonexposed population of 139 Wisconsin farmers. The overall prevalence of elevated CEA titers was slightly higher in the Michigan study group, but the difference was not statistically significant. Smoking and/or significant past or present conditions (inflammatory bowel disease, ulcers, polyps, liver disease, chronic lung disease, or malignancies) were found to result in higher prevalence of elevated CEA titers, in both the Michigan study group and the Wisconsin control group, thus confirming previous reports. In addition, serum PBB concentrations appeared to be positively correlated with CEA titers. The possibility that the effect of PBB concentrations appeared to be positively correlated with CEA titers. The possibility that the effect of PBB may be additive to that of other factors which are known to result in an increased prevalence of elevated CEA titers is discussed.

Adolescent

Impaired immune function and identification of polybrominated biphenyls (PBB) in blood compartments of exposed Michigan dairy farmers and chemical workers.

In 1973 PBB's were accidentally mixed into animal feed, resulting in marked toxic effects. Meat and dairy products were widely consumed in Michigan. To determine the impact of PBB's, 55 exposed Michigan farm residents, 11 Michigan chemical workers and 46 non-exposed Wisconsin farmers were examined. Abnormalities included decreased number of T-lymphocytes with concomitant increase of lymphocytes with no detectable surface markers, "null cells", and altered lymphocyte function. Data obtained from skin testing using standard recall antigens, showed no consistent correlation between the delayed cutaneous hypersensitivity response and the impaired lymphocyte function. PBB (hexa) in separated white blood cells and red cells was positively identified and quantified by gas chromatography-mass spectrometry. PBB and immunological abnormalities were not detected in non-exposed Wisconsin dairy farm residents.

Agricultural Workers' Diseases

Unintentional deaths from carbon monoxide poisoning--Michigan, 1987-1989.

Deaths from unintentional carbon monoxide (CO) poisoning in the United States result primarily from exposure to motor-vehicle exhaust and occur more often during the cold months of the year and in northern and midwestern states (1-3). In Michigan, from 1987 through 1989, 103 deaths were related to unintentional CO poisoning. To identify approaches for prevention of unintentional CO poisoning in Michigan, the Michigan Council on Injury Control (MCIC) studied death records and medical examiner (ME) records to determine the manner of deaths related to unintentional CO poisoning in that state from 1987 through 1989. This report summarizes findings of the investigation.

Accidents

On the decrease in the life expentancy of black males in Michigan.

The 1970 census reported that there were slightly more than 1 million nonwhites among Michigan's 8,875,000 residents. Ninety-five percent of these nonwhites are black, and 75 percent live within the city limits of Detroit, compared with 10 percent of the State's white residents. Between 1959-61 and 1969-71, life expectancy at birth increased about 1 year for black and white females, essentially remained unchanged for white males, and decreased more than 3 years for black males. In 1969-71, life expectancy was 61 years for black males, 68 years for white males, 69 years for black females, and 75 years for white females. Much of this growing disparity noted resulted from a dramatic rise in deaths of black males in the 15-44 year age group. Two-thirds of this increase was caused by a major rise in mortality from two causes--accidents and homicides. While death rates for black males decreased for a number of other leading causes, these generally remained higher than similar figures for each of the other three race-sex groups. Given current rates, one of eight black males in Michigan ultimately will die from an accident or from homicide. This probability is 1 of 17 for white males, 1 of 30 for white females, and 1 of 26 for nonwhite females. Homicides reduced the life expectancy of black males by 2.3 years, compared with 0.2 year for white males, less than 0.005 year for white females, and 0.5 year for black females. More than three-quarters of all homicides of black males in Michigan in 1973 were caused by handguns.

Accidents

Baseline concentrations of polychlorinated biphenyls and DDT in Lake Michigan fish, 1971.

Responding to the recommendations of the Lake Michigan Interstate Pesticide Committee, the author aimed to establish baseline baseline data on polychlorinated biphenyls (PCB's) and DDT in Lake Michigan fish in 1971. Because the past 2 years had witnessed unprecedented legislative action to protect food resources and other aquatic species near the top of the food chain from persistent hazardous chemicals, the author also attempted to gauge the impact of cooperative legislative action on the quality of large lakes. Thirteen species of fish taken from 14 regions of Lake Michigan in the fall of 1971 were analyzed for PCB's and DDT analogs. Mean wet-weight concentrations of PCB's similar to Aroclor 1254 ranged from 2.7 ppm in rainbow smelt to 15 ppm in lake trout. Most trout and salmon longer than 12 inches contained PCB's at concentrations greater than the tolerance level of 5 ppm established by the Food and Drug Administration, U.S. Department of Health, Education, and Welfare. Mean concentrations of total DDT ranged from less than 1 ppm in suckers to approximately 16 ppm in large lake trout. The presence of the major chlorinated hydrocarbons was confirmed by gas-liquid chromatography/mass spectrometry; additional PCB confirmations were obtained through perchlorination. The most abundant PCB's were tetra, penta-, hexa-, and hepatchlorobiphenyls which are similar to commercially prepared Aroclor 1254; lesser chlorinated PCB's were present in fish from nearshore waters.

Animals

Influenza B-associated Reye's syndrome: incidence in Michigan and potential for prevention.

Prospective surveillance for Reye's syndrome in Michigan revealed the occurrence of 46 cases between December 15, 1973 and June 1, 1974. In an attempt to determine the incidence of influenza B-associated Reye's syndrome, a randomized point-prevalence survey of 1,041 schoolchildren was done in a county in Michigan where there had been simultaneous outbreaks of influenza B and Reye's syndrome. Of the children tested, 20% had titers of hemagglutination-inhibiting antibody to influenza virus B/Hong Kong/5/72 of greater than or equal 1:20. Based upon this countywide survey, the incidence of Reye's syndrome following influenza B was estimated as between 30.8 and 57.8 cases of Reye's syndrome per 100,000 cases of influenza B. A detailed epidemiologic investigation of the patients who developed Reye's syndrome indicated that the syndrome occurred four times more frequently in children living in rural areas than in children in the urban areas of the state. These studies indicate that, in addition to antecedent viral infections such as influenza B, factor(s) that are most likely extrinsic or environmental also play a role in the pathogenesis of Reye's syndrome.

Adolescent

Comparison of findings among residents on Michigan dairy farms and consumers of produce purchased from these farms.

Consumers who had purchased farm products from both quarantined and nonquarantined farms were examined during the cross-sectional clinical survey of 1,029 Michigan residents. Since PBB had inadvertently contaminated cattle and other farm animals, ingestion of meat, milk, eggs and other farm products was thought to have possibly resulted in significant PBB body burdens in some consumers. Findings were considered in comparison with those made among farm residents. Prevalence of symptoms in consumers of farm products from quarantined farms (CQ) was similar to that found in farmers on quarantined farms (FQ); the prevalence was lower in consumers of products from nonquarantined farms (CNQ). Liver function abnormalities were found with similar prevalence in dairy farmers and consumers. Distribution, mean and median values of PBB serum levels in consumers were found to be similar to those of dairy farmers. These results indicate that significant body burdens of PBB had been accumulated by some consumers of farm products in Michigan and that prevalence of symptoms and liver function abnormalities resembled those found among dairy farm residents.

Biphenyl Compounds

Relation of DDE and PBB serum levels in farm residents, consumers, and Michigan Chemical Corporation employees.

Results of serum PBB determinations on 524 Michigan diary farm residents and consumers of products from the farms, 55 chemical workers, and 56 Wisconsin farm residents are reported. Mean and median values were highest for the chemical workers, followed by consumers from and residents of quarantined and nonquarantined farms. Serum DDE was higher among chemical workers, but was similar for all other groups. Statistical analysis of serum of PPB and serum DDE levels was done with respect to quarantine status, age, sex, and obesity. The most significant correlate with PBB was quarantine status. Serum DDE, age, sex, or obesity were not consistently correlated with serum PBB. For DDE, age was invariably the most significant correlate. Both serum PBB and DDE were higher in males than females in husband-wife pairs in most cases, although the differences occurred less frequently among older age groups. These results support the hypothesis that PBB exposure was a recent interim exposure whereas DDE exposure has been cumulative throughout a person's lifetime. Higher PBB and DDE mean concentrations in serum of Michigan Chemical workers suggests an occupational exposure to these chemicals.

Adolescent

Investigation of the health status of Michigan chemical corporation employees.

Clinical findings are reported for a group of 55 employees of the Michigan Chemical Corporation which manufactured FireMaster BP-6 from 1970 to 1974, in addition to a variety of other halogenated fire retardant chemicals. The results are compared with those from a group of male farm residents and consumers from Michigan examined at the same time. An increased prevalence of chest and skin symptoms was observed, compared with farmers. Skin symptoms were more prevalent among former PBB production personnel. Musculosketal symptoms were less prevalent among these workers than among farmers. Serum PBB concentrations are signicantly higher than among farmers. Blood chemistry results were similar for workers and farmers. However, both groups exhibited a significantly higher prevalence of elevated liver function tests (SGOT, SPGT) than a control population of nonexposed farmers. Both farmers and chemical workers showed an association of elevated CEA with serum PBB greater than 10 ppb.

Adult