Medically Unexplained Physical Symptoms

Relationship to Polychlorinated Biphenyls

Patricia Anderson

Walden University

September 17, 2009

The agent this scholar has selected for research is named Polychlorinated Biphenyls (PCBs). According to sources, including the Agency for Toxic Substances and Disease Registry (ATSDR), (ATSDR, 2000), profile characteristics for PCBs include that they are a “group of synthetic organic chemicals” capable of causing a number of harmful effects. Reportedly, “there are no known natural sources of PCBs in the environment” and “PCBs are either oily liquids or solids and are colorless to light yellow” (ATSDR, 2000). “Exposure to each of these compounds is associated with different levels of risk for harmful effects” (ATSDR, ND). Bredhult, et al. (2007) report PCB exposure also caused “degenerative endothelial cells”, which suggests that “placental lesions may be causative factor of fetal death after PCB exposure in minks”.

PCBs can enter the body through food sources, during inhalation, and during several other common daily practices or exposures (ATSDR, 2000). A National report titled, “PCB National Report ” from the US Environmental Protection agency Office of Solid Waste (EPA) reveals all PCB activity Nationwide (EPA, 2009). A recent update to the report dated Tuesday, September 1, 2009 reported 812 facilities in the United States returned data. The geographic location of the majority of these facilities is in the Gulf Coast region. Affordable housing lures vulnerable groups to substandard living choices. Many authors suggest racism is implicated in toxic waste dumping ground locations (Couch, et al, 2003).

In a study entitled, “Caring for Medically Unexplained Physical Symptoms after Toxic Environmental Exposures: Effects of Contested Causation” by Engel, Adkins, and Cowan (2002), the term “MUPS” is introduced. MUPS are “persistent idiopathic symptoms that drive patients to seek medical care” and include “chronic fatigue syndrome, fibromyalgia syndrome, and multiple chemical sensitivities” (Engel, et al., 2002). Additionally, “treatable and frequently undiagnosed depressive and anxiety disorders often accompany MUPS and compound disability”. When MUPS diagnoses accompany environmental and occupational exposure, multidimensional approaches to assessment are needed. The aim of the study is to examine the role of contested causation. Results suggest “a supportive healthcare system offering an array of collaborative patient management options” (Engel, et al., 2002).

Baton Rouge, Louisiana and regions extending south along the Mississippi river, an area of high minority population, has been called, “cancer alley” or “the toxic corridor”. One of Louisiana’s largest hazardous waste dump sites is called the Devil’s Swamp, (Couch, et al., 2003). Determining the risks associated with exposure to living in these regions is assisted by the EPA Science Policy Council Handbook, “Risk Characterization” (EPA, 2000).

The aim of the Bredhult, et al (2007) investigation, was to identify possible effects of some chlorinated PCBs and their metabolites on myometrial cell proliferation. The conclusion of the investigation in combination with previous findings concerning gray seal myometrial cells showed that the proliferation of both human and gray seal myometrial cells “might be affected by some PCB metabolites in vitro”. Methods involved ethics committee approval, informed consents, and tissue sampling. However, according to the study, “metabolites are unlikely to be involved in leiomyoma development in the human uterus” (Bredhult, et al., 2007).

The goal of Ferriby et al. (2007) was to assess potential differences in mean total observed levels of tetrachlorodibenzo-p-dioxin (TCDD) in groups of individuals to determine serum reference concentrations PCBs in the general US population. “Complete details regarding the procedures, survey components, questionnaires, and examination are available at the CDC NCHS website: http://www.cdc.gov/nchs/nhanes.htm” (Ferriby, et al., 2007). Age, gender and lifetime accumulation of toxic PCBs were among the results compiled in the study of the researchers.

References:

Agency for Toxic Substances and Disease Registry (ATSDR). 2000. Toxicological profile for

polychlorinated biphenyls (PCBs). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

Agency for Toxic Substances and Disease Registry (ATSDR) ND Public health implication of

exposure to polychlorinated biphenyls (PCBs). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. Available: http://www.atsdr.cdc.gov/DT/pcb007.html

Bredhult, C., Bäcklin, B., & Olovsson, M. (2007, October). Effects of chlorinated biphenyls and

metabolites on human uterine myocyte proliferation. Human & Experimental Toxicology, 26(10), 801-809. Retrieved September 18, 2009, from Academic Search Premier database.

Couch, J., Williams, P., Halvorson, J., and Malone, K. 2003, Fall). Of racism and rubbish. The

geography of race and pollution in Mississippi. The Independent Review, v. VIII n2 Fall EBSCO Publishing.

Engel, C., Adkins, J. and Cowan, D. 2002. Caring for Medically Unexplained Physical

Symptoms after Toxic Environmental Exposures: Effects of Contested Causation. Environmental Health Perspectives. 110(4) pp 641-647.

Ferriby, L., Knutsen, J., Harris, M., Unice, K., Scott, P., Nony, P., et al. (2007, July). Evaluation

of PCDD/F and dioxin-like PCB serum concentration data from the 2001–2002 National Health and Nutrition Examination Survey of the United States population. Journal of Exposure Science & Environmental Epidemiology, 17(4), 358-371. Retrieved September 18, 2009, doi:10.1038/sj.jes.7500498

US Environmental Protection agency Office of Solid Waste (EPA) 2009. PCB National Report.

Retrieved September 15, 2009, from the U. S. Environmental Protection Agency Web site.

US Environmental Protection Agency (EPA) 2000. Office of Science Policy. Office of

Research and Development. Risk characterization handbook. Retrieved September 15, 2009, from the U. S. Environmental Protection Agency Web site: http://www.epa.gov/OSA/spc/pdfs/rchandbk.pdf

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