Air Home Contamination - LEUKEMIA
- and the Pesticide Chlordane
by Dr. Wayne Sinclair
Allergy, Asthma and Immunology, Vero Beach, Florida
Leukemia is being linked to home contamination
with the pesticide chlordane. Chlordane, a banned termite
pesticide, is still being found in the air 75% of homes built
before April of 1988 and was reported as a risk factor for
leukemia by researchers at the Department of Occupational
Medicine, Finland. Of even more concern, is the fact that
research by the U.S. Air Force and other agencies are finding
5-7% of pre-1988 homes contain levels of chlordane over the
maximum allowable "safe" level of 5 micrograms per
cubic meter of air set by the National Academy of Sciences. As cancers
such as leukemia and neuroblastoma have been on the rise since
chemical pesticides have been in use, it is certainly worthwhile to
investigate environmental circumstances suspected of causing either
of these these cancers that often afflict children. This information
also gives rise to the importance of having the air of homes tested
in which children have developed leukemia, neuroblastoma or
aplastic anemia.
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Report No. 1
The following abstract quote is
from the article entitled "Blood Dyscrasias and Childhood
Tumors and Exposure to Chlordane and Heptachlor," by
Peter F. Infante, D.D.S., Dr. P.H., Samuel S Epstein, M.D., and
William A. Newton, Jr., M.D. and was reported in the journal Scandinavian
Journal of Work & Environmental Health, 4:137-150, 1978.
ABSTRACT: In the United States, chlordane
and heptachlor are commonly used in pesticide formulations
for agricultural purposes and for termite eradication in the home.
Pathological conditions possibly associated with prior
exposure to such formulations are presented in this report.
Five recently diagnosed cases of neuroblastoma associated
with chlordane exposure during prenatal and postnatal development
have been identified. Three cases of aplastic anemia and
three cases of acute leukemia are also reported in
association with chlordane formulations. The cases suggesting association
between chlordane exposure and neuroblastoma are of interest
in view of recent data on the carcinogenicity and mutagenicity
of chlordane and heptachlor and in view of data on environmental
distributions and body burdens. The cases of aplastic anemia
and leukemia are of interest in view of previous literature reports
on associations between chlordane and similar chlorinated hydrocarbon
pesticides and blood dyscrasias, and in view of reports indicating
that some subjects with aplastic anemia convert to leukemia.
As previous studies are too limited to allow the development
of valid inferences regarding the neoplastic risk of chlordane,
there is need for formal epidemiologic study to evaluate health
risks associated with chlordane through home exposure and through
occupational exposure for termite exterminators, lawn care operators, and
for workers in the agricultural setting.
Report No. 2
The following abstract quote is from the
journal article entitled, "Leukemias and Blood
Dyscrasias Following Exposure to Chlordane and Heptachlor," by
Samuel Epstein and David Ozonoff, School of Public Health,
University of Illinois Medical Center, Chicago, Illinois;
Environmental Health Section, Boston University School of Public
Health, and was reported in the journal Teratogenesis,
Carcinogenesis, and Mutagenesis 7:527-540, 1987.
ABSTRACT: We present 25 new cases of
blood dyscrasias (blood abnormalities) including leukemias,
production defects, and thrombocytopenic purpura, generally
following home termite treatment with the chlorinated hydrocarbon
pesticides chlordane and heptachlor (C/H). These newly
reported cases are consistent with 34 previously published
case reports associating blood dyscrasias with C/H exposure.
Additionally, the newly reported leukemias are consistent
with epidemiologic evidence of excess risk of leukemia and
other cancers in C/H-exposed populations and with the carcinogenic
action of C/H in animals. The importance of case reports in
warning of the association of blood dyscrasias to C/H exposure
is emphasized. Until the voluntary halt in production in July 1987,
millions of homes in the United States were treated with chlordane
and heptachlor for termites even though their agriculturaly uses
were phased out in 1978, largely on the grounds of
"imminent hazard" because of carcinogenicity. In view
of the recognized myelotoxicity, carcinogenicity, and other
chronic toxic effects of these pesticides, a national program
for monitoring all homes treated is urgently needed to detect
persistent contamination.
Leukemia
Case Histories
CASE #1 - 41 Year Old Male Develops
Leukemia
SOURCE: Teratogenesis, Carcinogenesis, and Mutagenesis,
7:530,1987
A 41 year old white male (initials C.L.) was admitted for diagnostic work-up
to a community hospital in November 1980 by his family physician
after an office visit indicated mild anemia and thrombocytopenia.
He had a 5-month history of easy bruising and slow wound
healing, a 3 month history of easy fatiguability, and a 6-week
history of sore throat. Just prior to admission he developed severe apthous
ulcers. The patient had been rejected as a blood donor in
July 1980 because of "low hemoglobin." He informed
his physician that in July he had sprayed his house with chlordane.
No history of other toxic exposures was then elicited. He
worked as a diesel truck driver and had a 25 pack-year smoking history.
Prior to his presenting illness he had been in good health.
On admission his hemoglobin was 9 gm%; platelets, 40,000/mm3,
and WBC, 8,100 mm3 with 69% lymphocytes and 10% monocytes.
Megakaryocytes were average in frequency but showed no
significant platelet maturation. The pathologist's impression
was of a reactive phase following toxic depression, "probably
due to pronounced exposure to chlordane in July 1980."
The patient was discharged to a university medical center for
further therapy with a diagnosis of "bone marrow depression from
chlordane. . . most likely currently in a pre-leukemic
state."
A bone marrow aspirate 2 weeks later at the referral
hospital was hypercellular, with the erythroid series
decreased, an increase in myeloid series with a left shift (57%
myeloblasts, 11% progranulocytes), and a marked decrease of megakaryocytes.
His disease was diagnosed as acute myelocytic leukemia, later specified as
acute monomyelocytic leukemia on the basis of special
studies. He was treated with chemotherapy and achieved remission,
which has lasted to the resent (April 1987).
The only other pesticide exposure the patient remembered
was occasional malathion use in his garden. A more detailed
history revealed that in 1975, 5 years before the diagnosis
of leukemia, he had bought a 1-gallon bottle of chlordane concentrate
in a hardware store and used approximately half of it to
treat a utility room, a crawl space, and the perimeter of his
house for termites. At that time he used many gallons of a
solution prepared by mixing one tablespoon of chlordane with
a gallon of water in a pump sprayers. This work extended over
several days. He used no protective clothing or mask, but
showered after each application, In July 1980, he repeated
spraying his garage and outside the house, using a large portion
of the remaining half gallon.
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