Principles and Practice of Toxicology in Public Health Ira S. Richards, PhD Associate Professor Environmental and Occupational Health College of Public Health University of South Florida
World Headquarters Jones and Bartlett Publishers 40 Tall Pine Drive Sudbury, MA 01776 978-443-5000 info@jbpub.com www.jbpub.com Jones and Bartlett Publishers Canada 6339 Ormindale Way Mississauga, Ontario L5V 1J2 CANADA Jones and Bartlett Publishers International Barb House, Barb Mews London W6 7PA UK Jones and Bartlett s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-443-8000, or visit our Web site, www.jbpub.com. Substantial discounts on bulk quantities of Jones and Bartlett s publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and Bartlett via the above contact information or send an e-mail to specialsales@jbpub.com. Copyright 2008 by Jones and Bartlett Publishers, Inc. ISBN-13: 978-0-7637-3823-5 ISBN-10: 0-7637-3823-9 All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. This publication is designed to provide accurate and authoritative information in regard to the Subject Matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the service of a competent professional person should be sought. Library of Congress Cataloging-in-Publication Data Richards, Ira S. (Ira Steven), 1948- Principles and practice of toxicology in public health / Ira S. Richards. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-7637-3823-5 (pbk.) ISBN-10: 0-7637-3823-9 (pbk.) 1. Toxicology. I. Title. [DNLM: 1. Toxicology. 2. Health Policy. 3. Public Health Practice. 4. Risk Assessment. QV 600 R515p 2007] RA1211.R52 2007 615.9--dc22 2007014175 6048 Production Credits Publisher: Michael Brown Associate Editor: Katey Birtcher Production Director: Amy Rose Production Editor: Tracey Chapman Marketing Manager: Sophie Fleck Manufacturing Buyer: Therese Connell Composition: Arlene Apone Cover Design: Kristin Ohlin Photo Research Manager and Photographer: Kimberly Potvin Associate Photo Researcher and Photographer: Christine McKeen Cover Image: Stephen Strathdee/ShutterStock, Inc. Printing and Binding: Malloy, Inc. Cover Printing: Malloy, Inc. Printed in the United States of America 11 10 09 08 07 10 9 8 7 6 5 4 3 2 1
Dedication This book is dedicated to the memory of my parents for all that they have done for me and to Arun Kulkarni, teacher, scholar, and friend. iii
Contents Preface................................................ vii Acknowledgments........................................ ix SECTION I SECTION II INTRODUCTION Chapter 1 Toxicology and Its Roots as a Science......................... 3 Chapter 2 Chemical Properties and Information Resources on Hazardous Chemicals........................ 11 Chapter 3 Toxicity and the Factors That Modify Toxic Responses........... 45 Chapter 4 Biological Poisons: Plant and Animal Toxins................... 55 Chapter 5 Environmental Pollutants and Their Fate..................... 79 TOXICOLOGY PRINCIPLES Chapter 6 Dose and Response..................................... 105 Chapter 7 Absorption of Toxicants and Models of Disposition............ 115 Chapter 8 Distribution, Storage, and Elimination of Toxicants............ 129 Chapter 9 Biotransformation...................................... 139 v
vi C ONTENTS Chapter 10 Chemical-Induced Mutagenesis............................ 155 Chapter 11 Chemicals and Cancer................................... 167 SECTION III SYSTEMIC TOXICITY Chapter 12 Role of the Immune System............................... 193 Chapter 13 Skin................................................. 203 Chapter 14 The Liver and Kidneys................................... 213 Chapter 15 The Cardiovascular System............................... 225 Chapter 16 The Respiratory System.................................. 239 Chapter 17 The Nervous System..................................... 255 SECTION IV TOXICOLOGY PRACTICE Chapter 18 The Practice of Toxicology................................ 271 Chapter 19 Regulatory Considerations................................ 279 Chapter 20 Toxicity Testing........................................ 305 Chapter 21 Uses and Limitations of Product Labeling for Public Safety...................................... 351 Chapter 22 Toxicology Principles in the Management of Acute Poisonings................................... 365 Chapter 23 Risk Assessment and the Perception of Risk.................. 375 Chapter 24 Making Informed Decisions.............................. 393 Glossary of Terms...................................... 403 Index................................................ 447
Preface Toxicology deals with the harmful effects that may potentially result from exposures to chemical agents in humans and other organisms. Before 1970, there were virtually no academic programs of study in toxicology. Today, there are hundreds of colleges and universities with programs at the bachelor s level through the doctoral level, providing the requisite education for the student of toxicology. Recognition of the important role that the discipline plays in the protection of health and environment has also led to the development of programs in the interdisciplinary academic setting provided to students at schools and colleges of public health. A beginning course in toxicology here is typically graduate-level and attended by individuals with interests as diverse as environmental health, industrial hygiene, epidemiology, biostatistics, medicine, nursing, law, engineering, biology, and chemistry, as well as toxicology. Clearly, this is a very heterogeneous population of students, each viewing the practice of public health and dealing with public health issues from different perspectives. Although recognizing that the study of toxicology, at a level commensurate with earning a graduate degree in this concentration, may be beyond the scope of perhaps most students of public health, we should also recognize that most, and perhaps all, public health students should be at least exposed to some of its content. The content selected in Principles and Practice of Toxicology in Public Health is intended to provide to both groups of students an understanding of the nature and scope of the discipline. This is necessary to participate in a meaningful way in the often highly visible problem-solving and decision-making processes required of public health professionals. Whether we are dealing with issues as diverse as a workers compensation claim for a job-related exposure and injury or the removal of toxic wastes from an urban community, we must be able to communicate with each other, the public, and our political leaders concerning how chemicals can, and the conditions under which they may, realistically produce harm. Understanding is a requirement for establishing rational and better ways of protection and management for individuals, populations, communities, and our environment from the vii
viii P REFACE potentially harmful effects of chemical exposures. A required introduction to the scope and content of toxicology for public health students should therefore be viewed as not a punishment, but rather as an important part of a general education. Public health professionals working in municipal departments of public health are generally very well informed about biological agents and perhaps less informed about chemical exposures and toxicity. In our preparedness for the general public, and especially in these troubled times, we recognize that both biological and chemical agents constitute an important concern, and it is anticipated that this book will provide some additional background and information for you as well.
Acknowledgments The author wishes to acknowledge his family for their understanding and enormous patience during the time of this writing. Thank you Barbara, Charles, Jeffrey, and Elizabeth for all of the hours that otherwise would have been devoted to you. A very special thanks to Marie Bourgeois, for her enormous efforts in assisting me with this book. Without her planning, insight, and ability to deal with, at times, a cantankerous professor, it was doubtful that the book would have been completed within the allocated time. Thank you for ensuring that all went well. ix