La maladie de Parkinson au Canada (serveur d'exploration)

Attention, ce site est en cours de développement !
Attention, site généré par des moyens informatiques à partir de corpus bruts.
Les informations ne sont donc pas validées.

Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia

Identifieur interne : 000928 ( Pmc/Corpus ); précédent : 000927; suivant : 000929

Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia

Auteurs : Stephen J. Genuis ; Kasie L. Kelln

Source :

RBID : PMC:4334623

Abstract

Juxtaposed alongside the ongoing rise in the incidence and prevalence of dementia, is the surge of recent research confirming widespread exposure and bioaccumulation of chemical toxicants. Evidence from sources such as the Centers for Disease Control reveals that most people have accrued varying degrees of assorted toxic pollutants including heavy metals, flame retardants, and pesticide residues within their bodies. It has been well established that many of these toxicants have neurodegenerative as well as neurodevelopmental impact as a result of various pathophysiologic mechanisms including neuronal mitochondrial toxicity and disruption of neurotransmitter regulation. Elimination of stockpiled toxicants from the body may diminish adverse toxicant impact on human biology and allow restoration of normal physiological function. Incorporating a review of medical literature on toxicant exposure and dementia with a case history of a lead-exposed individual diagnosed with dementia, this paper will discuss a much overlooked and potentially widespread cause of declining brain function and dementia.


Url:
DOI: 10.1155/2015/620143
PubMed: 25722540
PubMed Central: 4334623

Links to Exploration step

PMC:4334623

Le document en format XML

<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia</title>
<author>
<name sortKey="Genuis, Stephen J" sort="Genuis, Stephen J" uniqKey="Genuis S" first="Stephen J." last="Genuis">Stephen J. Genuis</name>
<affiliation>
<nlm:aff id="I1">Faculty of Medicine at the University of Calgary, Calgary, AB, Canada T2N 4N1</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kelln, Kasie L" sort="Kelln, Kasie L" uniqKey="Kelln K" first="Kasie L." last="Kelln">Kasie L. Kelln</name>
<affiliation>
<nlm:aff id="I2">Faculty of Medicine at the University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">25722540</idno>
<idno type="pmc">4334623</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334623</idno>
<idno type="RBID">PMC:4334623</idno>
<idno type="doi">10.1155/2015/620143</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">000928</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000928</idno>
</publicationStmt>
<sourceDesc>
<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia</title>
<author>
<name sortKey="Genuis, Stephen J" sort="Genuis, Stephen J" uniqKey="Genuis S" first="Stephen J." last="Genuis">Stephen J. Genuis</name>
<affiliation>
<nlm:aff id="I1">Faculty of Medicine at the University of Calgary, Calgary, AB, Canada T2N 4N1</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kelln, Kasie L" sort="Kelln, Kasie L" uniqKey="Kelln K" first="Kasie L." last="Kelln">Kasie L. Kelln</name>
<affiliation>
<nlm:aff id="I2">Faculty of Medicine at the University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Behavioural Neurology</title>
<idno type="ISSN">0953-4180</idno>
<idno type="eISSN">1875-8584</idno>
<imprint>
<date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>Juxtaposed alongside the ongoing rise in the incidence and prevalence of dementia, is the surge of recent research confirming widespread exposure and bioaccumulation of chemical toxicants. Evidence from sources such as the Centers for Disease Control reveals that most people have accrued varying degrees of assorted toxic pollutants including heavy metals, flame retardants, and pesticide residues within their bodies. It has been well established that many of these toxicants have neurodegenerative as well as neurodevelopmental impact as a result of various pathophysiologic mechanisms including neuronal mitochondrial toxicity and disruption of neurotransmitter regulation. Elimination of stockpiled toxicants from the body may diminish adverse toxicant impact on human biology and allow restoration of normal physiological function. Incorporating a review of medical literature on toxicant exposure and dementia with a case history of a lead-exposed individual diagnosed with dementia, this paper will discuss a much overlooked and potentially widespread cause of declining brain function and dementia.</p>
</div>
</front>
<back>
<div1 type="bibliography">
<listBibl>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Weuve, J" uniqKey="Weuve J">J. Weuve</name>
</author>
<author>
<name sortKey="Hebert, L E" uniqKey="Hebert L">L. E. Hebert</name>
</author>
<author>
<name sortKey="Scherr, P A" uniqKey="Scherr P">P. A. Scherr</name>
</author>
<author>
<name sortKey="Evans, D A" uniqKey="Evans D">D. A. Evans</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Dijkers, M P J M" uniqKey="Dijkers M">M. P. J. M. Dijkers</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Baltazar, M T" uniqKey="Baltazar M">M. T. Baltazar</name>
</author>
<author>
<name sortKey="Dinis Oliveira, R J" uniqKey="Dinis Oliveira R">R. J. Dinis-Oliveira</name>
</author>
<author>
<name sortKey="Bastos, M D L" uniqKey="Bastos M">M. D. L. Bastos</name>
</author>
<author>
<name sortKey="Tsatsakis, A M" uniqKey="Tsatsakis A">A. M. Tsatsakis</name>
</author>
<author>
<name sortKey="Duarte, J A" uniqKey="Duarte J">J. A. Duarte</name>
</author>
<author>
<name sortKey="Carvalho, F" uniqKey="Carvalho F">F. Carvalho</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Mah, L" uniqKey="Mah L">L. Mah</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Cannon, J R" uniqKey="Cannon J">J. R. Cannon</name>
</author>
<author>
<name sortKey="Greenamyre, J T" uniqKey="Greenamyre J">J. T. Greenamyre</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Schofield, P" uniqKey="Schofield P">P. Schofield</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Visvanathan, R" uniqKey="Visvanathan R">R. Visvanathan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Richardson, J" uniqKey="Richardson J">J. Richardson</name>
</author>
<author>
<name sortKey="Roy, A" uniqKey="Roy A">A. Roy</name>
</author>
<author>
<name sortKey="Shalat, S" uniqKey="Shalat S">S. Shalat</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lu, J" uniqKey="Lu J">J. Lu</name>
</author>
<author>
<name sortKey="Miao, J" uniqKey="Miao J">J. Miao</name>
</author>
<author>
<name sortKey="Su, T" uniqKey="Su T">T. Su</name>
</author>
<author>
<name sortKey="Liu, Y" uniqKey="Liu Y">Y. Liu</name>
</author>
<author>
<name sortKey="He, R" uniqKey="He R">R. He</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lu, Y" uniqKey="Lu Y">Y. Lu</name>
</author>
<author>
<name sortKey="He, H J" uniqKey="He H">H. J. He</name>
</author>
<author>
<name sortKey="Zhou, J" uniqKey="Zhou J">J. Zhou</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Rizak, J D" uniqKey="Rizak J">J. D. Rizak</name>
</author>
<author>
<name sortKey="Ma, Y" uniqKey="Ma Y">Y. Ma</name>
</author>
<author>
<name sortKey="Hu, X" uniqKey="Hu X">X. Hu</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Yang, M" uniqKey="Yang M">M. Yang</name>
</author>
<author>
<name sortKey="Lu, J" uniqKey="Lu J">J. Lu</name>
</author>
<author>
<name sortKey="Miao, J" uniqKey="Miao J">J. Miao</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Yang, M" uniqKey="Yang M">M. Yang</name>
</author>
<author>
<name sortKey="Miao, J" uniqKey="Miao J">J. Miao</name>
</author>
<author>
<name sortKey="Rizak, J" uniqKey="Rizak J">J. Rizak</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Billioti De Gage, S" uniqKey="Billioti De Gage S">S. Billioti de Gage</name>
</author>
<author>
<name sortKey="Begaud, B" uniqKey="Begaud B">B. Begaud</name>
</author>
<author>
<name sortKey="Bazin, F" uniqKey="Bazin F">F. Bazin</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Gatto, N M" uniqKey="Gatto N">N. M. Gatto</name>
</author>
<author>
<name sortKey="Henderson, V W" uniqKey="Henderson V">V. W. Henderson</name>
</author>
<author>
<name sortKey="Hodis, H N" uniqKey="Hodis H">H. N. Hodis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Al Mousa, F" uniqKey="Al Mousa F">F. Al-Mousa</name>
</author>
<author>
<name sortKey="Michelangeli, F" uniqKey="Michelangeli F">F. Michelangeli</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jin, C F" uniqKey="Jin C">C. F. Jin</name>
</author>
<author>
<name sortKey="Haut, M" uniqKey="Haut M">M. Haut</name>
</author>
<author>
<name sortKey="Ducatman, A" uniqKey="Ducatman A">A. Ducatman</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Mariussen, E" uniqKey="Mariussen E">E. Mariussen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Tilson, H A" uniqKey="Tilson H">H. A. Tilson</name>
</author>
<author>
<name sortKey="Rao, P" uniqKey="Rao P">P. Rao</name>
</author>
<author>
<name sortKey="Kodavanti, S" uniqKey="Kodavanti S">S. Kodavanti</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Rother, H A" uniqKey="Rother H">H.-A. Rother</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Liu, K S" uniqKey="Liu K">K.-S. Liu</name>
</author>
<author>
<name sortKey="Hao, J H" uniqKey="Hao J">J.-H. Hao</name>
</author>
<author>
<name sortKey="Zeng, Y" uniqKey="Zeng Y">Y. Zeng</name>
</author>
<author>
<name sortKey="Dai, F C" uniqKey="Dai F">F.-C. Dai</name>
</author>
<author>
<name sortKey="Gu, P Q" uniqKey="Gu P">P.-Q. Gu</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Walker, B" uniqKey="Walker B">B. Walker</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Carpenter, D O" uniqKey="Carpenter D">D. O. Carpenter</name>
</author>
<author>
<name sortKey="Nevin, R" uniqKey="Nevin R">R. Nevin</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bondy, S C" uniqKey="Bondy S">S. C. Bondy</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lucchini, R" uniqKey="Lucchini R">R. Lucchini</name>
</author>
<author>
<name sortKey="Zimmerman, N" uniqKey="Zimmerman N">N. Zimmerman</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Barnham, K J" uniqKey="Barnham K">K. J. Barnham</name>
</author>
<author>
<name sortKey="Bush, A I" uniqKey="Bush A">A. I. Bush</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Brewer, G J" uniqKey="Brewer G">G. J. Brewer</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Squitti, R" uniqKey="Squitti R">R. Squitti</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Squitti, R" uniqKey="Squitti R">R. Squitti</name>
</author>
<author>
<name sortKey="Siotto, M" uniqKey="Siotto M">M. Siotto</name>
</author>
<author>
<name sortKey="Polimanti, R" uniqKey="Polimanti R">R. Polimanti</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Exley, C" uniqKey="Exley C">C. Exley</name>
</author>
<author>
<name sortKey="Vickers, T" uniqKey="Vickers T">T. Vickers</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Van Wijngaarden, E" uniqKey="Van Wijngaarden E">E. van Wijngaarden</name>
</author>
<author>
<name sortKey="Campbell, J R" uniqKey="Campbell J">J. R. Campbell</name>
</author>
<author>
<name sortKey="Cory Slechta, D A" uniqKey="Cory Slechta D">D. A. Cory-Slechta</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Patterson, C" uniqKey="Patterson C">C. Patterson</name>
</author>
<author>
<name sortKey="Feightner, J W" uniqKey="Feightner J">J. W. Feightner</name>
</author>
<author>
<name sortKey="Garcia, A" uniqKey="Garcia A">A. Garcia</name>
</author>
<author>
<name sortKey="Hsiung, G Y R" uniqKey="Hsiung G">G.-Y. R. Hsiung</name>
</author>
<author>
<name sortKey="Macknight, C" uniqKey="Macknight C">C. MacKnight</name>
</author>
<author>
<name sortKey="Sadovnick, A D" uniqKey="Sadovnick A">A. D. Sadovnick</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bleecker, M L" uniqKey="Bleecker M">M. L. Bleecker</name>
</author>
<author>
<name sortKey="Ford, D P" uniqKey="Ford D">D. P. Ford</name>
</author>
<author>
<name sortKey="Lindgren, K N" uniqKey="Lindgren K">K. N. Lindgren</name>
</author>
<author>
<name sortKey="Hoese, V M" uniqKey="Hoese V">V. M. Hoese</name>
</author>
<author>
<name sortKey="Walsh, K S" uniqKey="Walsh K">K. S. Walsh</name>
</author>
<author>
<name sortKey="Vaughan, C G" uniqKey="Vaughan C">C. G. Vaughan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Stewart, W F" uniqKey="Stewart W">W. F. Stewart</name>
</author>
<author>
<name sortKey="Schwartz, B S" uniqKey="Schwartz B">B. S. Schwartz</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Rossignol, D A" uniqKey="Rossignol D">D. A. Rossignol</name>
</author>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Frye, R E" uniqKey="Frye R">R. E. Frye</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Grandjean, P" uniqKey="Grandjean P">P. Grandjean</name>
</author>
<author>
<name sortKey="Landrigan, P" uniqKey="Landrigan P">P. Landrigan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Grandjean, P" uniqKey="Grandjean P">P. Grandjean</name>
</author>
<author>
<name sortKey="Landrigan, P J" uniqKey="Landrigan P">P. J. Landrigan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Coury, D" uniqKey="Coury D">D. Coury</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Kanthasamy, A" uniqKey="Kanthasamy A">A. Kanthasamy</name>
</author>
<author>
<name sortKey="Jin, H" uniqKey="Jin H">H. Jin</name>
</author>
<author>
<name sortKey="Anantharam, V" uniqKey="Anantharam V">V. Anantharam</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Block, M L" uniqKey="Block M">M. L. Block</name>
</author>
<author>
<name sortKey="Elder, A" uniqKey="Elder A">A. Elder</name>
</author>
<author>
<name sortKey="Auten, R L" uniqKey="Auten R">R. L. Auten</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Reis, J" uniqKey="Reis J">J. Reis</name>
</author>
<author>
<name sortKey="Roman, G C" uniqKey="Roman G">G. C. Román</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Sabbath, E L" uniqKey="Sabbath E">E. L. Sabbath</name>
</author>
<author>
<name sortKey="Gutierrez, L A" uniqKey="Gutierrez L">L.-A. Gutierrez</name>
</author>
<author>
<name sortKey="Okechukwu, C A" uniqKey="Okechukwu C">C. A. Okechukwu</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Sears, M E" uniqKey="Sears M">M. E. Sears</name>
</author>
<author>
<name sortKey="Schwalfenberg, G" uniqKey="Schwalfenberg G">G. Schwalfenberg</name>
</author>
<author>
<name sortKey="Hope, J" uniqKey="Hope J">J. Hope</name>
</author>
<author>
<name sortKey="Bernhoft, R" uniqKey="Bernhoft R">R. Bernhoft</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Hope, J" uniqKey="Hope J">J. Hope</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Welshons, W V" uniqKey="Welshons W">W. V. Welshons</name>
</author>
<author>
<name sortKey="Thayer, K A" uniqKey="Thayer K">K. A. Thayer</name>
</author>
<author>
<name sortKey="Judy, B M" uniqKey="Judy B">B. M. Judy</name>
</author>
<author>
<name sortKey="Taylor, J A" uniqKey="Taylor J">J. A. Taylor</name>
</author>
<author>
<name sortKey="Curran, E M" uniqKey="Curran E">E. M. Curran</name>
</author>
<author>
<name sortKey="Vom Saal, F S" uniqKey="Vom Saal F">F. S. vom Saal</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Steenland, K" uniqKey="Steenland K">K. Steenland</name>
</author>
<author>
<name sortKey="Tinker, S" uniqKey="Tinker S">S. Tinker</name>
</author>
<author>
<name sortKey="Shankar, A" uniqKey="Shankar A">A. Shankar</name>
</author>
<author>
<name sortKey="Ducatman, A" uniqKey="Ducatman A">A. Ducatman</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Frisbee, S J" uniqKey="Frisbee S">S. J. Frisbee</name>
</author>
<author>
<name sortKey="Shankar, A" uniqKey="Shankar A">A. Shankar</name>
</author>
<author>
<name sortKey="Knox, S S" uniqKey="Knox S">S. S. Knox</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Belyaeva, E A" uniqKey="Belyaeva E">E. A. Belyaeva</name>
</author>
<author>
<name sortKey="Sokolova, T V" uniqKey="Sokolova T">T. V. Sokolova</name>
</author>
<author>
<name sortKey="Emelyanova, L V" uniqKey="Emelyanova L">L. V. Emelyanova</name>
</author>
<author>
<name sortKey="Zakharova, I O" uniqKey="Zakharova I">I. O. Zakharova</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Chen, Y W" uniqKey="Chen Y">Y. W. Chen</name>
</author>
<author>
<name sortKey="Huang, C F" uniqKey="Huang C">C. F. Huang</name>
</author>
<author>
<name sortKey="Yang, C Y" uniqKey="Yang C">C. Y. Yang</name>
</author>
<author>
<name sortKey="Yen, C C" uniqKey="Yen C">C. C. Yen</name>
</author>
<author>
<name sortKey="Tsai, K S" uniqKey="Tsai K">K. S. Tsai</name>
</author>
<author>
<name sortKey="Liu, S H" uniqKey="Liu S">S. H. Liu</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Huang, Q" uniqKey="Huang Q">Q. Huang</name>
</author>
<author>
<name sortKey="Zhang, J" uniqKey="Zhang J">J. Zhang</name>
</author>
<author>
<name sortKey="Martin, F L" uniqKey="Martin F">F. L. Martin</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Weiss, B" uniqKey="Weiss B">B. Weiss</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Guerrero Bosagna, C" uniqKey="Guerrero Bosagna C">C. Guerrero-Bosagna</name>
</author>
<author>
<name sortKey="Skinner, M K" uniqKey="Skinner M">M. K. Skinner</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Orrenius, S" uniqKey="Orrenius S">S. Orrenius</name>
</author>
<author>
<name sortKey="Nicotera, P" uniqKey="Nicotera P">P. Nicotera</name>
</author>
<author>
<name sortKey="Zhivotovsky, B" uniqKey="Zhivotovsky B">B. Zhivotovsky</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bloom, G S" uniqKey="Bloom G">G. S. Bloom</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lasley, S M" uniqKey="Lasley S">S. M. Lasley</name>
</author>
<author>
<name sortKey="Gilbert, M E" uniqKey="Gilbert M">M. E. Gilbert</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Kjeldsen, L S" uniqKey="Kjeldsen L">L. S. Kjeldsen</name>
</author>
<author>
<name sortKey="Ghisari, M" uniqKey="Ghisari M">M. Ghisari</name>
</author>
<author>
<name sortKey="Bonefeld J Rgensen, E C" uniqKey="Bonefeld J Rgensen E">E. C. Bonefeld-Jørgensen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Sears, M E" uniqKey="Sears M">M. E. Sears</name>
</author>
<author>
<name sortKey="Schwalfenberg, G" uniqKey="Schwalfenberg G">G. Schwalfenberg</name>
</author>
<author>
<name sortKey="Hope, J" uniqKey="Hope J">J. Hope</name>
</author>
<author>
<name sortKey="Bernhoft, R" uniqKey="Bernhoft R">R. Bernhoft</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Redgrave, T G" uniqKey="Redgrave T">T. G. Redgrave</name>
</author>
<author>
<name sortKey="Wallace, P" uniqKey="Wallace P">P. Wallace</name>
</author>
<author>
<name sortKey="Jandacek, R J" uniqKey="Jandacek R">R. J. Jandacek</name>
</author>
<author>
<name sortKey="Tso, P" uniqKey="Tso P">P. Tso</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ross, G H" uniqKey="Ross G">G. H. Ross</name>
</author>
<author>
<name sortKey="Sternquist, M C" uniqKey="Sternquist M">M. C. Sternquist</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jandacek, R J" uniqKey="Jandacek R">R. J. Jandacek</name>
</author>
<author>
<name sortKey="Heubi, J E" uniqKey="Heubi J">J. E. Heubi</name>
</author>
<author>
<name sortKey="Buckley, D D" uniqKey="Buckley D">D. D. Buckley</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Birkholz, D" uniqKey="Birkholz D">D. Birkholz</name>
</author>
<author>
<name sortKey="Rodushkin, I" uniqKey="Rodushkin I">I. Rodushkin</name>
</author>
<author>
<name sortKey="Beesoon, S" uniqKey="Beesoon S">S. Beesoon</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jandacek, R J" uniqKey="Jandacek R">R. J. Jandacek</name>
</author>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Egner, P A" uniqKey="Egner P">P. A. Egner</name>
</author>
<author>
<name sortKey="Chen, J G" uniqKey="Chen J">J. G. Chen</name>
</author>
<author>
<name sortKey="Zarth, A T" uniqKey="Zarth A">A. T. Zarth</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Liu, Y" uniqKey="Liu Y">Y. Liu</name>
</author>
<author>
<name sortKey="Genuis, Q I T" uniqKey="Genuis Q">Q. I. T. Genuis</name>
</author>
<author>
<name sortKey="Martin, J W" uniqKey="Martin J">J. W. Martin</name>
</author>
<author>
<name sortKey="Kanda, T" uniqKey="Kanda T">T. Kanda</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Adams, J B" uniqKey="Adams J">J. B. Adams</name>
</author>
<author>
<name sortKey="Baral, M" uniqKey="Baral M">M. Baral</name>
</author>
<author>
<name sortKey="Geis, E" uniqKey="Geis E">E. Geis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Adams, J B" uniqKey="Adams J">J. B. Adams</name>
</author>
<author>
<name sortKey="Baral, M" uniqKey="Baral M">M. Baral</name>
</author>
<author>
<name sortKey="Geis, E" uniqKey="Geis E">E. Geis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bredesen, D E" uniqKey="Bredesen D">D. E. Bredesen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Porru, S" uniqKey="Porru S">S. Porru</name>
</author>
<author>
<name sortKey="Alessio, L" uniqKey="Alessio L">L. Alessio</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bradberry, S" uniqKey="Bradberry S">S. Bradberry</name>
</author>
<author>
<name sortKey="Sheehan, T" uniqKey="Sheehan T">T. Sheehan</name>
</author>
<author>
<name sortKey="Vale, A" uniqKey="Vale A">A. Vale</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bradberry, S" uniqKey="Bradberry S">S. Bradberry</name>
</author>
<author>
<name sortKey="Vale, A" uniqKey="Vale A">A. Vale</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Sears, M E" uniqKey="Sears M">M. E. Sears</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Wedeen, R P" uniqKey="Wedeen R">R. P. Wedeen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Hernberg, S" uniqKey="Hernberg S">S. Hernberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Arnold, W N" uniqKey="Arnold W">W. N. Arnold</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Shamberger, R J" uniqKey="Shamberger R">R. J. Shamberger</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Liu, J" uniqKey="Liu J">J. Liu</name>
</author>
<author>
<name sortKey="Lewis, G" uniqKey="Lewis G">G. Lewis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Mah, L" uniqKey="Mah L">L. Mah</name>
</author>
<author>
<name sortKey="Kohli, M" uniqKey="Kohli M">M. Kohli</name>
</author>
<author>
<name sortKey="Chan, G" uniqKey="Chan G">G. Chan</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
<author>
<name sortKey="Schwalfenberg, G" uniqKey="Schwalfenberg G">G. Schwalfenberg</name>
</author>
<author>
<name sortKey="Siy, A K J" uniqKey="Siy A">A.-K. J. Siy</name>
</author>
<author>
<name sortKey="Rodushkin, I" uniqKey="Rodushkin I">I. Rodushkin</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Needleman, H" uniqKey="Needleman H">H. Needleman</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Casas, M" uniqKey="Casas M">M. Casas</name>
</author>
<author>
<name sortKey="Chevrier, C" uniqKey="Chevrier C">C. Chevrier</name>
</author>
<author>
<name sortKey="Hond, E D" uniqKey="Hond E">E. D. Hond</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Archibeque Engle, S L" uniqKey="Archibeque Engle S">S. L. Archibeque-Engle</name>
</author>
<author>
<name sortKey="Tessari, J D" uniqKey="Tessari J">J. D. Tessari</name>
</author>
<author>
<name sortKey="Winn, D T" uniqKey="Winn D">D. T. Winn</name>
</author>
<author>
<name sortKey="Keefe, T J" uniqKey="Keefe T">T. J. Keefe</name>
</author>
<author>
<name sortKey="Nett, T M" uniqKey="Nett T">T. M. Nett</name>
</author>
<author>
<name sortKey="Zheng, T" uniqKey="Zheng T">T. Zheng</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Yu, G W" uniqKey="Yu G">G. W. Yu</name>
</author>
<author>
<name sortKey="Laseter, J" uniqKey="Laseter J">J. Laseter</name>
</author>
<author>
<name sortKey="Mylander, C" uniqKey="Mylander C">C. Mylander</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jandacek, R J" uniqKey="Jandacek R">R. J. Jandacek</name>
</author>
<author>
<name sortKey="Anderson, N" uniqKey="Anderson N">N. Anderson</name>
</author>
<author>
<name sortKey="Liu, M" uniqKey="Liu M">M. Liu</name>
</author>
<author>
<name sortKey="Zheng, S" uniqKey="Zheng S">S. Zheng</name>
</author>
<author>
<name sortKey="Yang, Q" uniqKey="Yang Q">Q. Yang</name>
</author>
<author>
<name sortKey="Tso, P" uniqKey="Tso P">P. Tso</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Rappaport, S M" uniqKey="Rappaport S">S. M. Rappaport</name>
</author>
<author>
<name sortKey="Smith, M T" uniqKey="Smith M">M. T. Smith</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Roberts, J R" uniqKey="Roberts J">J. R. Roberts</name>
</author>
<author>
<name sortKey="Reigart, J R" uniqKey="Reigart J">J. R. Reigart</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Gehle, K S" uniqKey="Gehle K">K. S. Gehle</name>
</author>
<author>
<name sortKey="Crawford, J L" uniqKey="Crawford J">J. L. Crawford</name>
</author>
<author>
<name sortKey="Hatcher, M T" uniqKey="Hatcher M">M. T. Hatcher</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Kilburn, K H" uniqKey="Kilburn K">K. H. Kilburn</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Genuis, S J" uniqKey="Genuis S">S. J. Genuis</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Rhodes, D" uniqKey="Rhodes D">D. Rhodes</name>
</author>
<author>
<name sortKey="Spiro, A" uniqKey="Spiro A">A. Spiro</name>
</author>
<author>
<name sortKey="Aro, A" uniqKey="Aro A">A. Aro</name>
</author>
<author>
<name sortKey="Hu, H" uniqKey="Hu H">H. Hu</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Hendriks, H S" uniqKey="Hendriks H">H. S. Hendriks</name>
</author>
<author>
<name sortKey="Antunes Fernandes, E C" uniqKey="Antunes Fernandes E">E. C. Antunes Fernandes</name>
</author>
<author>
<name sortKey="Bergman, " uniqKey="Bergman ">Å. Bergman</name>
</author>
<author>
<name sortKey="Van Den Berg, M" uniqKey="Van Den Berg M">M. van den Berg</name>
</author>
<author>
<name sortKey="Westerink, R H S" uniqKey="Westerink R">R. H. S. Westerink</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Goldman, S M" uniqKey="Goldman S">S. M. Goldman</name>
</author>
<author>
<name sortKey="Quinlan, P J" uniqKey="Quinlan P">P. J. Quinlan</name>
</author>
<author>
<name sortKey="Ross, G W" uniqKey="Ross G">G. W. Ross</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jevtovic Todorovic, V" uniqKey="Jevtovic Todorovic V">V. Jevtovic-Todorovic</name>
</author>
<author>
<name sortKey="Absalom, A R" uniqKey="Absalom A">A. R. Absalom</name>
</author>
<author>
<name sortKey="Blomgren, K" uniqKey="Blomgren K">K. Blomgren</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Behav Neurol</journal-id>
<journal-id journal-id-type="iso-abbrev">Behav Neurol</journal-id>
<journal-id journal-id-type="publisher-id">BN</journal-id>
<journal-title-group>
<journal-title>Behavioural Neurology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0953-4180</issn>
<issn pub-type="epub">1875-8584</issn>
<publisher>
<publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25722540</article-id>
<article-id pub-id-type="pmc">4334623</article-id>
<article-id pub-id-type="doi">10.1155/2015/620143</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Genuis</surname>
<given-names>Stephen J.</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kelln</surname>
<given-names>Kasie L.</given-names>
</name>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1">
<sup>1</sup>
Faculty of Medicine at the University of Calgary, Calgary, AB, Canada T2N 4N1</aff>
<aff id="I2">
<sup>2</sup>
Faculty of Medicine at the University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5</aff>
<author-notes>
<corresp id="cor1">*Stephen J. Genuis:
<email>sgenuis@ualberta.ca</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Gianfranco Spalletta</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>4</day>
<month>2</month>
<year>2015</year>
</pub-date>
<volume>2015</volume>
<elocation-id>620143</elocation-id>
<history>
<date date-type="received">
<day>25</day>
<month>11</month>
<year>2014</year>
</date>
<date date-type="rev-recd">
<day>31</day>
<month>12</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>31</day>
<month>12</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2015 S. J. Genuis and K. L. Kelln.</copyright-statement>
<copyright-year>2015</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Juxtaposed alongside the ongoing rise in the incidence and prevalence of dementia, is the surge of recent research confirming widespread exposure and bioaccumulation of chemical toxicants. Evidence from sources such as the Centers for Disease Control reveals that most people have accrued varying degrees of assorted toxic pollutants including heavy metals, flame retardants, and pesticide residues within their bodies. It has been well established that many of these toxicants have neurodegenerative as well as neurodevelopmental impact as a result of various pathophysiologic mechanisms including neuronal mitochondrial toxicity and disruption of neurotransmitter regulation. Elimination of stockpiled toxicants from the body may diminish adverse toxicant impact on human biology and allow restoration of normal physiological function. Incorporating a review of medical literature on toxicant exposure and dementia with a case history of a lead-exposed individual diagnosed with dementia, this paper will discuss a much overlooked and potentially widespread cause of declining brain function and dementia.</p>
</abstract>
</article-meta>
</front>
<body>
<sec id="sec1">
<title>1. Introduction</title>
<p>The rising incidence and prevalence of dementia has become an enormous public health challenge. At the 2009 International Conference on Alzheimer's disease in Vienna, Dr. William Thies, Chief Medical and Scientific Officer for the Alzheimer's Association, summarized the challenge with his comment: “The number of people affected by Alzheimer's and dementia is growing at an epidemic pace, and the skyrocketing financial and personal costs will devastate the world's economies and health care systems, and far too many families” [
<xref rid="B1" ref-type="bibr">1</xref>
].</p>
<p>A diagnosis of dementia has profound personal and social implications for patients and their loved ones. The most common type of dementia, Alzheimer's disease (AD), occurs in about one in every nine people aged 65 and over, with a continued rise in incidence anticipated in the coming years [
<xref rid="B2" ref-type="bibr">2</xref>
]. Dementia is associated with high rates of morbidity and mortality and is accompanied by enormous personal suffering for patients, as well as challenging management problems for families, physicians, and health care systems [
<xref rid="B3" ref-type="bibr">3</xref>
]. It appears that efforts at prevention and treatment of dementia for the last two decades have had little effect on the rising prevalence of this health problem or the quality of life for many patients suffering with this disorder [
<xref rid="B3" ref-type="bibr">3</xref>
]. By integrating information from the medical and scientific literature with clinical outcomes from a case history of an individual diagnosed with dementia, this paper will discuss toxicant exposure and bioaccumulation, a much overlooked and potentially modifiable cause of declining brain function and dementia.</p>
</sec>
<sec id="sec2">
<title>2. Sources of Information</title>
<p>This review was prepared by assessing medical and scientific literature from MEDLINE/PubMed, several books and toxicology journals, conference proceedings, government publications, and environmental health periodicals. References cited in identified publications were examined for additional relevant writings. Searching techniques included keyword searches with terms related to chemical exposure and dementia, toxicants and AD (Alzheimer's disease), pollutants and neurodegenerative disease, environmental health sciences and the elderly, neurotoxicity with poisoning, and detoxification.</p>
<p>A primary observation was that limited scientific literature exists on the link between neurodegenerative processes and toxicant bioaccumulation, on the pathogenesis involved, as well as the management of degenerative states associated with toxicant accrual. The first author's professional observations and published research as an environmental health physician were also incorporated into the discussion of management strategies. The format of an integrated clinical review was chosen as such reviews play a pivotal role in scientific research and professional practice in emerging medical issues with limited primary study and uncharted clinical territory [
<xref rid="B4" ref-type="bibr">4</xref>
].</p>
</sec>
<sec id="sec3">
<title>3. Background</title>
<p>Recent evidence has emerged linking the development of dementia with various inorganic and organic toxicants in our environment [
<xref rid="B5" ref-type="bibr">5</xref>
<xref rid="B9" ref-type="bibr">9</xref>
]. For example, a recent report from
<italic> JAMA Neurology</italic>
found that elevated serum levels of the toxicant DDE (dichlorodiphenyldichloroethylene), a direct reflection of brain DDE levels [
<xref rid="B10" ref-type="bibr">10</xref>
], are associated with increased susceptibility for developing Alzheimer's disease [
<xref rid="B10" ref-type="bibr">10</xref>
]. DDE is a persistent metabolite of the organochlorine compound DDT (dichlorodiphenyltrichloroethane), a pesticide widely used following World War II. DDT was banned in most countries in the early 1970's because of persistence within the human organism and the environment and the consequent adverse health effects associated with exposure and bioaccumulation [
<xref rid="B11" ref-type="bibr">11</xref>
]. Metabolic byproducts of DDT such as DDE continue to be found in serum samples of 75–80% of the population due to its long half life and continued exposure. People remain at risk of exposure by consuming imported foods from countries where DDT is still used as well as from pollution in soil and water sources [
<xref rid="B11" ref-type="bibr">11</xref>
,
<xref rid="B12" ref-type="bibr">12</xref>
].</p>
<p>A growing body of evidence has recently implicated many other exposures to organic chemicals as potential determinants in the development of dementia (
<xref ref-type="table" rid="tab1">Table 1</xref>
). Formaldehyde, a common indoor air pollutant off-gassing from wood products and various other sources within the home, has been linked to dementia [
<xref rid="B13" ref-type="bibr">13</xref>
<xref rid="B15" ref-type="bibr">15</xref>
] Exposure to methanol, a potential contaminant of ambient air and some foodstuffs, has also been associated with neurodegeneration in animals [
<xref rid="B16" ref-type="bibr">16</xref>
,
<xref rid="B17" ref-type="bibr">17</xref>
]. Some common pharmaceutical exposures including ongoing use of benzodiazepines have been linked to an increased risk of Alzheimer's disease [
<xref rid="B18" ref-type="bibr">18</xref>
]. Various common components of air pollution, a widespread problem in many areas of the world, have also been implicated in the escalating pandemic of dementia [
<xref rid="B19" ref-type="bibr">19</xref>
].</p>
<p>Many other classes of common bioaccumulative organic compounds have also been recognized to have neurotoxic effects including brominated flame retardants (PBDEs) [
<xref rid="B20" ref-type="bibr">20</xref>
], solvents [
<xref rid="B21" ref-type="bibr">21</xref>
], “nonstick” perfluorinated compounds [
<xref rid="B22" ref-type="bibr">22</xref>
], polychlorinated biphenyls (PCBs) [
<xref rid="B23" ref-type="bibr">23</xref>
], and various types of pesticides [
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B24" ref-type="bibr">24</xref>
]. With further research, it remains to be seen which organic pollutants alone or in combination will be significant determinants of the growing epidemic of dementia.</p>
<p>As well as organic compounds, the scientific literature highlights the myriad adverse effects of various inorganic toxic elements such as mercury [
<xref rid="B25" ref-type="bibr">25</xref>
<xref rid="B27" ref-type="bibr">27</xref>
], aluminum [
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B28" ref-type="bibr">28</xref>
], arsenic [
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B27" ref-type="bibr">27</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
], copper [
<xref rid="B30" ref-type="bibr">30</xref>
<xref rid="B33" ref-type="bibr">33</xref>
], and particularly lead [
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B34" ref-type="bibr">34</xref>
]. Elevated levels of lead have been implicated in hypertension and linked to vascular causes of memory impairment and dementia [
<xref rid="B35" ref-type="bibr">35</xref>
,
<xref rid="B36" ref-type="bibr">36</xref>
]. The acquisition, storage, and retrieval of verbal information also appears to be affected by cumulative exposure to lead [
<xref rid="B37" ref-type="bibr">37</xref>
]. After years of research on the effects of lead, Stewart and Schwartz suggest the following: “a significant proportion of what is considered to be normal age-related cognitive decline may, in fact, be due to past exposure to neurotoxicants such as lead” [
<xref rid="B38" ref-type="bibr">38</xref>
]. While lead is an established neurotoxicant that is associated with neurodevelopmental deficits in children, recent evidence suggests that even low levels of ambient lead exposure in the air also appears to increase the risk of neurodegenerative disease [
<xref rid="B6" ref-type="bibr">6</xref>
]. </p>
<p>
<italic>(i) Toxicant Exposure and Bioaccumulation.</italic>
The problem of toxicant exposure and bioaccumulation in the population appears to be rising rapidly, yet this escalating health threat remains insufficiently recognized by many within the medical community. A recent study by the Centers for Disease Control reveals that most American adults and children of both genders have bioaccumulated numerous toxic pollutants in their body [
<xref rid="B39" ref-type="bibr">39</xref>
]. A similar epidemiological study in Canada also reveals a widespread accrual of assorted toxicants [
<xref rid="B40" ref-type="bibr">40</xref>
]. Furthermore, a recent cord-blood study on infants revealed that at birth, most neonates have already accumulated assorted toxicants reflecting maternal exposure [
<xref rid="B107" ref-type="bibr">41</xref>
]. The neurodevelopmental sequelae of such exposures can be observed in the swelling pandemic of autism [
<xref rid="B42" ref-type="bibr">42</xref>
] and other neurodevelopmental disorders [
<xref rid="B43" ref-type="bibr">43</xref>
,
<xref rid="B44" ref-type="bibr">44</xref>
]. Yet, while most people are aware of the risks associated with toxicant exposure and accrual from pollutants such as nicotine and cadmium found in cigarettes, many are not yet apprised of the adverse outcomes of exposures to various other chemical agents that are at least as harmful as what is found in tobacco.</p>
<p>Groups such as the Pediatric Academic Societies have begun to speak out regarding pediatric toxicant exposure announcing that “low level exposure to environmental toxicity may be impacting the functioning of the current generation” [
<xref rid="B45" ref-type="bibr">45</xref>
]. However, there has been little appreciation within the medical community of neurodegenerative toxicants and their potential impact on the maturing adult segment of the population. As well as dementia, research continues to elucidate the relationship between environmental toxicant exposure and the development of other neurodegenerative diseases including Parkinson's Disease, Multiple Sclerosis, and Amyotrophic Lateral Sclerosis [
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B28" ref-type="bibr">28</xref>
,
<xref rid="B30" ref-type="bibr">30</xref>
,
<xref rid="B46" ref-type="bibr">46</xref>
<xref rid="B48" ref-type="bibr">48</xref>
].
<xref ref-type="table" rid="tab1">Table 1</xref>
provides an overview of some of the chemical toxicants that have been directly associated with neurodegenerative disease.</p>
<p>Many assume that, in the absence of ongoing exposure, toxicants are eliminated efficiently. It has recently been recognized, however, that many toxicants including some solvents, pesticides, petrochemicals, mycotoxins, and assorted synthetic chemical agents are persistent pollutants with half-lives that can last for many years or even decades [
<xref rid="B49" ref-type="bibr">49</xref>
<xref rid="B51" ref-type="bibr">51</xref>
]. Accordingly, the problem of neural decline may be the result of exposures that occurred long ago. With stockpiled toxicants persistently disrupting normal human processes and physiology, it is understandable that the resulting pathophysiology may induce chronic disease.</p>
<p>Some challenge the idea that apparently miniscule doses of toxicant exposures can have such a profound impact on physiological function; there are two important considerations in response to this misguided claim. First, toxicant exposures do not usually occur as single isolated events. Many people, through occupation or habitat environments, are repeatedly exposed to chemical toxicants and are therefore accruing persistent pollutants on an ongoing basis, some of which will remain in tissues for decades. This is of particular note with the potential degree of exposure via polluted air, as the average adult inhales about 10 thousand liters of air per day. Whereas single exposures may be less problematic and perhaps harmless depending on the particular toxic agent and the dose, the repeated exposure to toxic agents presents an accumulated burden or total load to the intricate physiological functioning of the body [
<xref rid="B50" ref-type="bibr">50</xref>
].</p>
<p>Second, it is noteworthy that standard biochemicals within our inherent physiology, as well as prescribed pharmaceutical agents, are bioactive at levels of parts per billion (ppb) and some at parts per trillion (ppt). For example, ethinyl estradiol in the birth control pill maintains contraceptive efficacy at serum levels below 62 to 83 ppt (parts per trillion) [
<xref rid="B52" ref-type="bibr">52</xref>
]. It is hardly surprising, therefore, that serum concentrations of various toxicant chemicals often measured in ppb (one thousand times higher than ppt), or parts per million, (an order of magnitude one million times higher than ppt), might have biological impact on the human organism. In review, various toxicants can have extremely potent physiological impact at seemingly miniscule doses [
<xref rid="B53" ref-type="bibr">53</xref>
], with incremental impact for some pollutants at increasing levels of accrual [
<xref rid="B54" ref-type="bibr">54</xref>
,
<xref rid="B55" ref-type="bibr">55</xref>
].</p>
<p>
<italic>(ii) Toxicant Mechanisms of Harm.</italic>
Environmental pollutants may disrupt biological function through various destructive pathways. Pathophysiological mechanisms of harm include mitochondrial damage [
<xref rid="B68" ref-type="bibr">56</xref>
], oxidative stress [
<xref rid="B69" ref-type="bibr">57</xref>
], cell death [
<xref rid="B70" ref-type="bibr">58</xref>
], neurotransmitter dysregulation [
<xref rid="B68" ref-type="bibr">56</xref>
], endocrine disruption [
<xref rid="B67" ref-type="bibr">59</xref>
], and epigenetic modification [
<xref rid="B71" ref-type="bibr">60</xref>
]. Toxicant induced mitochondrial dysfunction appears to be a primary mechanism of harm in neurodegenerative diseases such as AD [
<xref rid="B7" ref-type="bibr">7</xref>
]. Oxidative stress is also an early contributor to neurodegeneration as markers of oxidative stress have been found in neurons of AD patients as well as those with mild cognitive impairment [
<xref rid="B7" ref-type="bibr">7</xref>
]. Toxicant induced cell death via apoptosis, autophagy, and necrosis may initiate or exacerbate the neurodegenerative process [
<xref rid="B72" ref-type="bibr">61</xref>
]. Cell death, for example, is a known consequence of accrual of PBDEs [
<xref rid="B20" ref-type="bibr">20</xref>
].</p>
<p>As plaques formed by deposition of the beta-amyloid peptide within the brain have been routinely observed in postmortem assessments of AD patients [
<xref rid="B73" ref-type="bibr">62</xref>
], it has been hypothesized that Alzheimer's' dementia may be the result of amyloid plaque buildup around neurons, often resulting in cell apoptosis. It has been recently recognized, however, that development of such peptide plaques is often the result of exposure and bioaccumulation of toxicants such as PBDEs [
<xref rid="B20" ref-type="bibr">20</xref>
]. As the brain contains considerable amounts of fatty tissue, this organ accrues lipophilic compounds such as PBDEs which are among the most common toxicant exposures since PBDEs have been used extensively to reduce flammability in everyday consumer products such as mattresses and furniture (which then off-gas and contaminate individuals).</p>
<p>There is emerging evidence that lead, in particular, impairs cell-to-cell communication with neurotransmitters such as acetylcholine and glutamate by blocking neuronal calcium and potassium channels [
<xref rid="B26" ref-type="bibr">26</xref>
]. Rat models have shown that lead exposure specifically affects the hippocampus by decreasing potassium stimulation and release of glutamate and GABA [
<xref rid="B56" ref-type="bibr">63</xref>
]. Lead has also been shown to increase the permeability of the blood brain barrier leaving the brain vulnerable to a variety of other insults [
<xref rid="B26" ref-type="bibr">26</xref>
]. Alterations in the blood brain barrier have been implicated in neurodegenerative diseases including Parkinson's Disease, Amyotrophic Lateral Sclerosis, and Alzheimer's Dementia [
<xref rid="B7" ref-type="bibr">7</xref>
].</p>
<p>Many toxicants are known endocrine disruptors: some of the most notable disruptors are pesticides such as DDE [
<xref rid="B74" ref-type="bibr">64</xref>
] and plasticizers such as Bisphenol A and phthalates [
<xref rid="B67" ref-type="bibr">59</xref>
]. These latter toxicants have also been implicated in neurotoxicity as a result of their hormonal impact on neurological function [
<xref rid="B67" ref-type="bibr">59</xref>
]. Moreover, it has been suggested that epigenetic alterations resulting from histone modification from exposure to these plasticizers may be a causative mechanism in toxicant induced neurodegeneration [
<xref rid="B46" ref-type="bibr">46</xref>
]. Furthermore, toxicant induced epigenetic modification has recently been recognized to have transgenerational effects that may impact future generations [
<xref rid="B71" ref-type="bibr">60</xref>
]. In review, through assorted pathophysiological mechanisms, toxicants have become a ubiquitous but poorly recognized cause of ill-health in the 21st century [
<xref rid="B75" ref-type="bibr">65</xref>
].</p>
<p>
<italic>(iii) Potential Treatments.</italic>
With recent recognition that various pollutants are neurotoxicants, there is emerging consideration of outcomes that might be achieved if measures are taken to eliminate the toxicant burden [
<xref rid="B76" ref-type="bibr">66</xref>
]. Recent research has highlighted assorted interventions that can be used to eliminate accrued persistent pollutants [
<xref rid="B77" ref-type="bibr">67</xref>
<xref rid="B84" ref-type="bibr">74</xref>
]. Evidence of neuropsychiatric improvement has been observed with individuals receiving treatment to facilitate toxicant elimination of retained pollutants such as lead [
<xref rid="B80" ref-type="bibr">70</xref>
] and mercury [
<xref rid="B85" ref-type="bibr">75</xref>
]. Preliminary evidence also suggests significant amelioration of morbidity following interventions to clear toxicants in autistic children contaminated with inorganic pollutants [
<xref rid="B86" ref-type="bibr">76</xref>
,
<xref rid="B87" ref-type="bibr">77</xref>
]. Assorted other medical states have improved following treatment to eliminate persistent toxicants from the body [
<xref rid="B77" ref-type="bibr">67</xref>
,
<xref rid="B78" ref-type="bibr">68</xref>
], Bredesen reports on the reversal of cognitive decline through a personalized therapeutic program which incorporates the exclusion of heavy metal toxicity in patients with AD [
<xref rid="B88" ref-type="bibr">78</xref>
]. Lowering serum free copper with zinc therapy has been shown to protect against memory impairment in older adults [
<xref rid="B31" ref-type="bibr">31</xref>
] and Squitti et al. further advocate that using low-copper diets may help prevent neurodegenerative memory impairment associated with Alzheimer's disease [
<xref rid="B32" ref-type="bibr">32</xref>
,
<xref rid="B33" ref-type="bibr">33</xref>
].</p>
<p>These findings have enormous clinical significance for patients suffering with dementia. As the development of dementia may follow environmental exposure to and accrual of chemical toxicants, a potential approach for patients with dementia might involve assessing for and eliminating stockpiled toxicants. The following case history demonstrates how investigating for and then addressing the underlying toxicant burden improved the quality of life and cognitive function of a patient with dementia.</p>
</sec>
<sec id="sec4">
<title>4. Case History</title>
<p>A 69-year-old married, retired male with complaints of diminishing cognitive function, severe memory impairment, and profound fatigue was brought to an environmental health physician by his wife and daughter (a nurse). The patient had seen a neurologist and following the clinical assessment, an MRI and a CT scan, a diagnosis of dementia was given. There was no history of brain injury, seizures, stroke, or substance abuse.</p>
<p>The family indicated that the patient moved to Canada from Europe in excellent health in his midtwenties and took a job in a glass shop making stained-glass windows. Soon after commencing this work, which involved the heating of metal rims in a confined space with inadequate ventilation, the patient began experiencing progressive mental health problems and was diagnosed with bipolar disorder. Although he left his job making stained-glass windows, he continued to suffer with recurrent episodes of depression and manic episodes for the next 35 years. Under the care of a psychiatrist, he had been treated with lithium for 25 years, as well as with antidepressants and mood stabilizers for the bipolar illness.</p>
<p>Over the last five years, however, the patient displayed increasing cognitive decline, with escalating memory impairment and social isolation. He had become increasingly dependent on his family for care and support. By the time he presented to the environmental health clinic, he barely spoke and was not attentive to discussions about his health. With a diagnosis of irreversible dementia, discussion ensued between family and caregivers about potential placement in an extended care facility for the remainder of his life. His medications at the time of presentation included Quetiapine and Divalproex.</p>
<p>Other than signs of profound cognitive decline, physical examination did not reveal any objective findings except a chronic fungal infection of the patient's toenails. Various investigations were undertaken as part of the assessment at the environmental health facility. Noteworthy laboratory results after provocation testing revealed a significant burden of the toxic metal lead, most likely from exposure while heating lead-containing metal rims in an inadequately ventilated room as part of the process of making stained-glass windows in his previous employment. His tests also revealed elevated ferritin, immunoglobulin E, C-reactive protein, and positive antinuclear antibody, all common findings in patients with toxicant bioaccumulation. As well, his creatinine was elevated and glomerular filtration rate was decreased, likely the result of years of lithium use.</p>
<p>The family was intrigued by the evidence for lead accumulation. They presented the information to the psychiatrist who refused to believe there was evidence of lead accrual. Disparaging in his comments, he suggested that this was nonsense and indicated he would prove this by testing. He did a blood and urine level for lead and confirmed minimal amounts of lead on such testing. The family presented this information to the environmental health physician prior to commencing any treatment. As was explained to the family in detail, the body has different compartments. It is well recognized that lead and many other toxicants sequester in locations such as bone, brain, and adipose tissue and do not typically remain in the blood [
<xref rid="B25" ref-type="bibr">25</xref>
]. That is, there may be an absence of lead in blood or urine testing with considerable retained stores in tissues. Testing for lead accumulation within tissues requires provocation testing where stores are first mobilized, and agents such as DMSA or EDTA are then used to bind the lead and release it into urine and stool [
<xref rid="B89" ref-type="bibr">79</xref>
,
<xref rid="B90" ref-type="bibr">80</xref>
].</p>
<p>With evidence of lead bioaccumulation, therapies to diminish the body burden of this toxic metal were commenced. Various toxicant elimination interventions including skin depuration [
<xref rid="B80" ref-type="bibr">70</xref>
], oral DMSA [
<xref rid="B91" ref-type="bibr">81</xref>
], and EDTA [
<xref rid="B92" ref-type="bibr">82</xref>
] by rectal suppository were used to get the lead out. Nutritional supplementation was provided to prevent mineral deficiency, a potential occurrence with treatments to eliminate toxic elements. The patient and his spouse were educated to make changes in their lives to preclude ongoing exposure to various potential toxicants.</p>
<p>Within six months, the patient noticed considerable improvement in memory and mood. Within one year of treatment, friends and family concluded he had made a dramatic recovery and observed a restoration of his distinctive sense of humor. The chronic fungal infection in the patient's toenails resolved spontaneously within 18 months of treatment. Repeated follow-up provocative metal testing revealed that excretion of lead had diminished considerably, likely reflecting a decline in the total body burden. Lab values of ferritin and immunoglobulin E subsequently returned to normal range within two years. The patient and his family were happy with the results, but when the patient felt well and was able to function, he became less compliant and eventually discontinued further treatment to eliminate the total burden of lead. Six years after his initial visit for environmental health assessment, the patient continues to feel well, now living independently with his spouse and enjoying a good quality of life.</p>
</sec>
<sec id="sec5">
<title>5. Discussion</title>
<p>Cognitive decline associated with lead exposure has been recognized for centuries. The earliest known descriptions of lead poisoning in literature originate from the Greek physician and poet Nikander of Colophon circa 200 BC, with descriptions of health damage due to occupational exposure to this toxic metal [
<xref rid="B61" ref-type="bibr">83</xref>
]. Recent discussion has also considered the impact of lead exposure on some historical events. It has been hypothesized by some historians, for example, that the fall of the Roman Empire may have been influenced by an epidemic of lead exposure among Roman aristocracy due to the presence of this toxic element in pottery, utensils, water piping, and drinking vessels for wine [
<xref rid="B60" ref-type="bibr">84</xref>
]. Renowned artist Vincent Van Gogh was believed to have suffered lead toxicity from eating chips of lead-based paint while creating his well-known works of art [
<xref rid="B93" ref-type="bibr">85</xref>
], and, after researchers discovered lead deposited in his hair and bones [
<xref rid="B94" ref-type="bibr">86</xref>
], lead toxicity may have been a major determinant in the mental health and auditory afflictions suffered by the celebrated composer Ludwig van Beethoven.</p>
<p>While the effects of high levels of lead exposure are well understood, a growing body of literature has raised concern with very low levels of lead bioaccumulation as well [
<xref rid="B62" ref-type="bibr">87</xref>
,
<xref rid="B95" ref-type="bibr">88</xref>
]. Manifestations of lead stockpiling may be silent for many years, and it is now known that even blood levels below 10 ug/dL can result in renal dysfunction, hypertension, and essential tremor [
<xref rid="B62" ref-type="bibr">87</xref>
]. Such low levels of lead were previously considered acceptable and safe; new evidence highlighting the adverse effects of very low levels of lead on human health has resulted in a significant shift downward in what is considered to be acceptable levels of exposure [
<xref rid="B61" ref-type="bibr">83</xref>
]. This recognition has recently been affirmed with the finding that even ambient lead exposure from air pollution has been associated with developing Alzheimer's disease as demonstrated by MRI imaging showing hippocampal and entorhinal cortex atrophy [
<xref rid="B108" ref-type="bibr">89</xref>
].</p>
<p>Although many public health initiatives have been undertaken to decrease toxic element exposure in the population, the bioaccumulation of lead and resulting health problems are still surprisingly prevalent and patients continue to be exposed from a variety of sources [
<xref rid="B62" ref-type="bibr">87</xref>
]. In fact, a recent study done by the CDC found that 13% of pregnant women had blood lead levels above acceptable limits [
<xref rid="B58" ref-type="bibr">90</xref>
], possibly related in some cases to exposure from contaminated prenatal supplements [
<xref rid="B96" ref-type="bibr">91</xref>
]. With a prolonged half-life, lead may persist in the body for many years even after absence of continued exposure [
<xref rid="B59" ref-type="bibr">92</xref>
]. </p>
<p>
<italic>Neurodegenerative Disease and Toxicant Exposure.</italic>
As toxicants have the potential to greatly affect neurological function [
<xref rid="B7" ref-type="bibr">7</xref>
], the increasing rates of neurodegenerative diseases in the population may not be solely due to people surviving longer, but also due to the increasing toxicity from chemicals in our environment [
<xref rid="B29" ref-type="bibr">29</xref>
]. Air pollutants, particularly ozone, particulate matter, and nitrogen dioxide have been linked to cognitive decline in older adults living in Los Angeles [
<xref rid="B19" ref-type="bibr">19</xref>
]. Although not yet fully understood, it has been proposed that air pollution may contribute to brain inflammation, microglia activation, and white matter abnormalities [
<xref rid="B47" ref-type="bibr">47</xref>
]. While exposure to endocrine disrupting chemicals like brominated flame retardants, perfluorinated compounds, phthalates, and phenols during gestation or early life has been correlated with neurotoxic effects in children [
<xref rid="B63" ref-type="bibr">93</xref>
], active research is now exploring the impact of these toxicants on physiologic neurogenesis in older populations and the associated risk for neurodegeneration [
<xref rid="B67" ref-type="bibr">59</xref>
].</p>
<p>Given that the prevalence of dementia is expected to increase by 40 percent over the next decade, it may be clinically indicated to assess for toxicant bioaccumulation in patients presenting with cognitive decline. One of the main challenges with assessments for toxicant accrual with the central nervous system, however, is that serum measurements and even adipose tissue biopsies may underestimate and not be reflective of the burden of pollutants within other tissues such as brain [
<xref rid="B83" ref-type="bibr">73</xref>
,
<xref rid="B97" ref-type="bibr">94</xref>
,
<xref rid="B98" ref-type="bibr">95</xref>
]. Accordingly, techniques for mobilization of tissue-based toxicants such as caloric restriction [
<xref rid="B99" ref-type="bibr">96</xref>
], thermal therapy, and exercise may need to be incorporated into toxicant panel biomonitoring [
<xref rid="B42" ref-type="bibr">42</xref>
].</p>
<p>If toxicant bioaccumulation is evident, interventions should be undertaken to eliminate the toxicant burden. This may not only ameliorate symptoms of dementia and cognitive decline, but also may have a positive impact on a variety of other body systems and help prevent further neurodegeneration. Such interventions have the potential to greatly impact quality of life for both patients and their families. Since rates of hospitalization for patients with dementia are three times higher per year as compared to other older patients without dementia [
<xref rid="B2" ref-type="bibr">2</xref>
], the potential benefits to the health care system are also evident. </p>
<p>
<italic>Medical Education.</italic>
As recent evidence suggests that 70–90% of chronic disease is likely related to environmental determinants [
<xref rid="B100" ref-type="bibr">97</xref>
], ample understanding of environmental health science is required for the practice of contemporary health care [
<xref rid="B101" ref-type="bibr">98</xref>
]. Although high dose acute poisoning may be easy to recognize and the effects of such exposures are well known, more subtle low dose and cumulative chronic exposures can be challenging to identify and clinical care requires knowledge and skills about environmental sources of toxicants [
<xref rid="B102" ref-type="bibr">99</xref>
]. While a call to incorporate environmental medicine into the medical curricula has been in the literature for some time [
<xref rid="B103" ref-type="bibr">100</xref>
], such education remains largely absent from medical school programs [
<xref rid="B102" ref-type="bibr">99</xref>
]. Many physicians are thus ill-equipped to provide environmental health services including toxicant assessment and elimination to patients presenting with diverse complaints including neurodegenerative illness [
<xref rid="B103" ref-type="bibr">100</xref>
].</p>
<p>Formalizing basic environmental medicine education as part of medical school curricula, specialty training, and continuing medical education for practitioners would help equip physicians with the knowledge and skills necessary to correctly identify varying toxicant exposures in patients. Such training would also allow health providers to incorporate evidence-based interventions to facilitate elimination of toxicants. Furthermore, this knowledge would allow physicians to identify patients at risk and provide education regarding prevention of exposure.</p>
</sec>
<sec id="sec6">
<title>6. Conclusion</title>
<p>Exposure to and bioaccumulation of various chemical pollutants is increasingly being established as a widespread determinant in the development of neurodegenerative illness such as Alzheimer's Disease. Despite this recognition, chemical toxicant accrual as an etiological and potential reversible cause of illness has generally been overlooked in medicine, neurology, public health, and psychiatry [
<xref rid="B48" ref-type="bibr">48</xref>
,
<xref rid="B104" ref-type="bibr">101</xref>
]. While most people recognize that high-dose exposure to various chemical agents can alter brain function, there is not yet widespread recognition (other than with cigarettes) that ongoing exposure to low levels of toxic pollutants and chronic bioaccumulationcan of these agents can cause sustained disruption of physiologic function including brain biology. In keeping with recent evidence that the majority of chronic illness is not primarily genetic, but environmental in origin [
<xref rid="B100" ref-type="bibr">97</xref>
], a lack of etiology-centered medicine is sometimes allowing the underlying causes of disease to go unnoticed while clinicians focus on symptomatic management [
<xref rid="B105" ref-type="bibr">102</xref>
].</p>
<p>Exposure to toxic substances has historically been recognized as one of the five fundamental etiologies of chronic illness [
<xref rid="B106" ref-type="bibr">103</xref>
]. Identification and eradication of underlying toxicant burdens can be life-changing for patients and their families [
<xref rid="B9" ref-type="bibr">9</xref>
]. Prior to his treatment and recovery, the patient discussed in the case history presented in this paper was being considered for transfer to a long-term care facility in order to meet his increasing needs for assistance. His remarkable recovery is now allowing him to live independently with his wife and to enjoy a productive life.</p>
<p>Despite expanding attention in major public health and toxicology journals to the field of toxicant exposures as determinants of chronic illness, there continues to be a constant stream of new potential pollutants being introduced into the environment. With inadequate scrutiny and regulation prior to release, there is often insufficient knowledge of the implications that such toxicants may have on individual and public health [
<xref rid="B29" ref-type="bibr">29</xref>
]. Increasing exploration of the potential impact of environmental toxicants on current and future generations must be a priority [
<xref rid="B26" ref-type="bibr">26</xref>
].</p>
<p>Our culture has increasingly equated advanced age with sickness and disability. If we continue to neglect the impact of a lifetime of environmental pollutants on aging populations, we may forego a future of healthy and capable older adults, as is evidenced by the expanding contemporary challenge of neurodegenerative illness. Taking a precautionary approach and having strategies for prevention of exposure is of paramount importance [
<xref rid="B26" ref-type="bibr">26</xref>
]. Furthermore, integrating toxicant etiology-centered approaches to illness may reveal the true underlying cause of the illness [
<xref rid="B106" ref-type="bibr">103</xref>
] and allow physicians to effectively treat or even reverse disease. The potential to limit or reverse a condition such as dementia might have considerable impact on individuals, families, and population groups.</p>
<p>Comprised of about sixty percent fat, a concentration higher than is found in any organ in healthy individuals, the human brain is a magnet for lipophilic persistent toxicants. In an age of unprecedented and ubiquitous chemical exposure and bioaccumulation, as confirmed by medical organizations such as the Centers for Disease Control [
<xref rid="B39" ref-type="bibr">39</xref>
] and government agencies such as Health Canada [
<xref rid="B40" ref-type="bibr">40</xref>
], it is recommended that all patients with inexplicable cognitive decline and dementia be investigated for evidence of accrued pollutants and treated when diagnosed to considerably diminish their toxicant burden [
<xref rid="B83" ref-type="bibr">73</xref>
].</p>
</sec>
</body>
<back>
<sec sec-type="conflict">
<title>Conflict of Interests</title>
<p>The authors declare that there is no conflict of interests regarding the publication of this paper.</p>
</sec>
<sec>
<title>Authors' Contribution</title>
<p>Stephen J. Genuis and Kasie L. Kelln have contributed to the preparation of this paper.</p>
</sec>
<ref-list>
<ref id="B1">
<label>1</label>
<element-citation publication-type="confproc">
<article-title>Alzheimer's incidence accelerates among the oldest old</article-title>
<conf-name>Proceedings of the Alzheimer's Association International Conference on Alzheimer's Disease (ICAD '09)</conf-name>
<conf-date>2009</conf-date>
<conf-loc>Vienna, Austria</conf-loc>
<comment>
<ext-link ext-link-type="uri" xlink:href="http://www.medpagetoday.com/MeetingCoverage/ICAD/15075">http://www.medpagetoday.com/MeetingCoverage/ICAD/15075</ext-link>
</comment>
</element-citation>
</ref>
<ref id="B2">
<label>2</label>
<element-citation publication-type="book">
<source>
<italic>2014 Alzheimer's Disease Facts and Figures</italic>
</source>
<year>2014</year>
<publisher-name>Alzheimer's Association</publisher-name>
</element-citation>
</ref>
<ref id="B3">
<label>3</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Weuve</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Hebert</surname>
<given-names>L. E.</given-names>
</name>
<name>
<surname>Scherr</surname>
<given-names>P. A.</given-names>
</name>
<name>
<surname>Evans</surname>
<given-names>D. A.</given-names>
</name>
</person-group>
<article-title>Deaths in the United States among persons with Alzheimer's disease (2010–2050)</article-title>
<source>
<italic>Alzheimer's & Dementia</italic>
</source>
<year>2014</year>
<volume>10</volume>
<issue>2</issue>
<fpage>e40</fpage>
<lpage>e46</lpage>
<pub-id pub-id-type="other">2-s2.0-84897519875</pub-id>
<pub-id pub-id-type="doi">10.1016/j.jalz.2014.01.004</pub-id>
</element-citation>
</ref>
<ref id="B4">
<label>4</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Dijkers</surname>
<given-names>M. P. J. M.</given-names>
</name>
</person-group>
<article-title>The value of ‘traditional’ reviews in the era of systematic reviewing</article-title>
<source>
<italic>The American Journal of Physical Medicine and Rehabilitation</italic>
</source>
<year>2009</year>
<volume>88</volume>
<issue>5</issue>
<fpage>423</fpage>
<lpage>430</lpage>
<pub-id pub-id-type="doi">10.1097/phm.0b013e31819c59c6</pub-id>
<pub-id pub-id-type="other">2-s2.0-68049137342</pub-id>
<pub-id pub-id-type="pmid">19630127</pub-id>
</element-citation>
</ref>
<ref id="B5">
<label>5</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Baltazar</surname>
<given-names>M. T.</given-names>
</name>
<name>
<surname>Dinis-Oliveira</surname>
<given-names>R. J.</given-names>
</name>
<name>
<surname>Bastos</surname>
<given-names>M. D. L.</given-names>
</name>
<name>
<surname>Tsatsakis</surname>
<given-names>A. M.</given-names>
</name>
<name>
<surname>Duarte</surname>
<given-names>J. A.</given-names>
</name>
<name>
<surname>Carvalho</surname>
<given-names>F.</given-names>
</name>
</person-group>
<article-title>Pesticides exposure as etiological factors of Parkinson's disease and other neurodegenerative diseases—a mechanistic approach</article-title>
<source>
<italic>Toxicology Letters</italic>
</source>
<year>2014</year>
<volume>230</volume>
<fpage>85</fpage>
<lpage>103</lpage>
<pub-id pub-id-type="other">2-s2.0-84894050872</pub-id>
<pub-id pub-id-type="doi">10.1016/j.toxlet.2014.01.039</pub-id>
<pub-id pub-id-type="pmid">24503016</pub-id>
</element-citation>
</ref>
<ref id="B6">
<label>6</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mah</surname>
<given-names>L.</given-names>
</name>
</person-group>
<article-title>Efficacy and safety of the anti-PD-1 monoclonal antibody MK-3475 in 411 patients (pts) with melanoma (MEL)</article-title>
<source>
<italic>Journal of Clinical Oncology</italic>
</source>
<year>2014</year>
<volume>32</volume>
<issue>5, supplement</issue>
<comment>2014 ASCO Annual Meeting, Abstract no. LBA9000</comment>
</element-citation>
</ref>
<ref id="B7">
<label>7</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cannon</surname>
<given-names>J. R.</given-names>
</name>
<name>
<surname>Greenamyre</surname>
<given-names>J. T.</given-names>
</name>
</person-group>
<article-title>The role of environmental exposures in neurodegeneration and neurodegenerative diseases</article-title>
<source>
<italic>Toxicological Sciences</italic>
</source>
<year>2011</year>
<volume>124</volume>
<issue>2</issue>
<fpage>225</fpage>
<lpage>250</lpage>
<pub-id pub-id-type="doi">10.1093/toxsci/kfr239</pub-id>
<pub-id pub-id-type="other">2-s2.0-81855199724</pub-id>
<pub-id pub-id-type="pmid">21914720</pub-id>
</element-citation>
</ref>
<ref id="B8">
<label>8</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Schofield</surname>
<given-names>P.</given-names>
</name>
</person-group>
<article-title>Dementia associated with toxic causes and autoimmune disease</article-title>
<source>
<italic>International Psychogeriatrics</italic>
</source>
<year>2005</year>
<volume>17</volume>
<issue>1</issue>
<fpage>S129</fpage>
<lpage>S147</lpage>
<pub-id pub-id-type="doi">10.1017/S1041610205001997</pub-id>
<pub-id pub-id-type="other">2-s2.0-33644818714</pub-id>
<pub-id pub-id-type="pmid">16240488</pub-id>
</element-citation>
</ref>
<ref id="B9">
<label>9</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Visvanathan</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Is it truly dementia?</article-title>
<source>
<italic>The Lancet</italic>
</source>
<year>2001</year>
<volume>357</volume>
<issue>9257, article 684</issue>
<pub-id pub-id-type="doi">10.1016/s0140-6736(00)04133-7</pub-id>
<pub-id pub-id-type="other">2-s2.0-0035799088</pub-id>
</element-citation>
</ref>
<ref id="B10">
<label>10</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Richardson</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Roy</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Shalat</surname>
<given-names>S.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Elevated serum pesticide levels and risk for Alzheimer disease</article-title>
<source>
<italic>Journal of American Medical Association Neurology</italic>
</source>
<year>2014</year>
<volume>71</volume>
<fpage>E1</fpage>
<lpage>E7</lpage>
</element-citation>
</ref>
<ref id="B11">
<label>11</label>
<element-citation publication-type="other">
<comment>Dichlorodiphenyltrichloroethane (DDT): Centers for Disease Control and Prevention, 2009</comment>
</element-citation>
</ref>
<ref id="B12">
<label>12</label>
<element-citation publication-type="other">
<comment>
<italic>Pesticide Monitoring Program—FY 2008</italic>
, Food and Drug Administration, 2008</comment>
</element-citation>
</ref>
<ref id="B13">
<label>13</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lu</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Miao</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Su</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>He</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Formaldehyde induces hyperphosphorylation and polymerization of Tau protein both
<italic>in vitro</italic>
and
<italic>in vivo</italic>
</article-title>
<source>
<italic>Biochimica et Biophysica Acta (BBA)—General Subjects</italic>
</source>
<year>2013</year>
<volume>1830</volume>
<issue>8</issue>
<fpage>4102</fpage>
<lpage>4116</lpage>
<pub-id pub-id-type="doi">10.1016/j.bbagen.2013.04.028</pub-id>
<pub-id pub-id-type="other">2-s2.0-84877841177</pub-id>
<pub-id pub-id-type="pmid">23628704</pub-id>
</element-citation>
</ref>
<ref id="B14">
<label>14</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lu</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>He</surname>
<given-names>H. J.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>J.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Hyperphosphorylation results in tau dysfunction in DNA folding and protection</article-title>
<source>
<italic>Journal of Alzheimer's Disease</italic>
</source>
<year>2013</year>
<volume>37</volume>
<issue>3</issue>
<fpage>551</fpage>
<lpage>563</lpage>
<pub-id pub-id-type="doi">10.3233/jad-130602</pub-id>
<pub-id pub-id-type="other">2-s2.0-84892747392</pub-id>
</element-citation>
</ref>
<ref id="B15">
<label>15</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rizak</surname>
<given-names>J. D.</given-names>
</name>
<name>
<surname>Ma</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Hu</surname>
<given-names>X.</given-names>
</name>
</person-group>
<article-title>Is formaldehyde the missing link in AD pathology? The differential aggregation of amyloid-beta with APOE isoforms in vitro</article-title>
<source>
<italic>Current Alzheimer Research</italic>
</source>
<year>2014</year>
<volume>11</volume>
<issue>5</issue>
<fpage>461</fpage>
<lpage>468</lpage>
<pub-id pub-id-type="doi">10.2174/1567205011666140425112043</pub-id>
<pub-id pub-id-type="pmid">24766729</pub-id>
</element-citation>
</ref>
<ref id="B16">
<label>16</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Lu</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Miao</surname>
<given-names>J.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Alzheimer's disease and methanol toxicity (part 1): chronic methanol feeding led to memory impairments and tau hyperphosphorylation in mice</article-title>
<source>
<italic>Journal of Alzheimer's disease</italic>
</source>
<year>2014</year>
<volume>41</volume>
<issue>4</issue>
<fpage>1117</fpage>
<lpage>1129</lpage>
<pub-id pub-id-type="doi">10.3233/JAD-131529</pub-id>
</element-citation>
</ref>
<ref id="B17">
<label>17</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Miao</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Rizak</surname>
<given-names>J.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Alzheimer's disease and methanol toxicity (part 2): lessons from four rhesus macaques (
<italic>Macaca mulatta</italic>
) chronically fed methanol</article-title>
<source>
<italic>Journal of Alzheimer's Disease</italic>
</source>
<year>2014</year>
<volume>41</volume>
<issue>4</issue>
<fpage>1131</fpage>
<lpage>1147</lpage>
<pub-id pub-id-type="doi">10.3233/JAD-131532</pub-id>
</element-citation>
</ref>
<ref id="B18">
<label>18</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Billioti de Gage</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Begaud</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Bazin</surname>
<given-names>F.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Benzodiazepine use and risk of dementia: prospective population based study</article-title>
<source>
<italic>British Medical Journal</italic>
</source>
<year>2014</year>
<volume>349</volume>
<pub-id pub-id-type="publisher-id">e6231</pub-id>
</element-citation>
</ref>
<ref id="B19">
<label>19</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gatto</surname>
<given-names>N. M.</given-names>
</name>
<name>
<surname>Henderson</surname>
<given-names>V. W.</given-names>
</name>
<name>
<surname>Hodis</surname>
<given-names>H. N.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Components of air pollution and cognitive function in middle-aged and older adults in Los Angeles</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2014</year>
<volume>40</volume>
<fpage>1</fpage>
<lpage>7</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2013.09.004</pub-id>
<pub-id pub-id-type="other">2-s2.0-84887696014</pub-id>
<pub-id pub-id-type="pmid">24148924</pub-id>
</element-citation>
</ref>
<ref id="B20">
<label>20</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Al-Mousa</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Michelangeli</surname>
<given-names>F.</given-names>
</name>
</person-group>
<article-title>Some commonly used brominated flame retardants cause Ca
<sup>2+</sup>
-atpase inhibition, beta-amyloid peptide release and apoptosis in SH-SY5Y neuronal cells</article-title>
<source>
<italic>PLoS ONE</italic>
</source>
<year>2012</year>
<volume>7</volume>
<issue>4</issue>
<pub-id pub-id-type="publisher-id">e33059</pub-id>
<pub-id pub-id-type="other">2-s2.0-84859242331</pub-id>
<pub-id pub-id-type="doi">10.1371/journal.pone.0033059</pub-id>
</element-citation>
</ref>
<ref id="B21">
<label>21</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jin</surname>
<given-names>C. F.</given-names>
</name>
<name>
<surname>Haut</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Ducatman</surname>
<given-names>A.</given-names>
</name>
</person-group>
<article-title>Industrial solvents and psychological effects</article-title>
<source>
<italic>Clinics in Occupational and Environmental Medicine</italic>
</source>
<year>2004</year>
<volume>4</volume>
<issue>4</issue>
<fpage>597</fpage>
<lpage>620</lpage>
<pub-id pub-id-type="doi">10.1016/j.coem.2004.03.009</pub-id>
<pub-id pub-id-type="other">2-s2.0-4744372059</pub-id>
<pub-id pub-id-type="pmid">15465471</pub-id>
</element-citation>
</ref>
<ref id="B22">
<label>22</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mariussen</surname>
<given-names>E.</given-names>
</name>
</person-group>
<article-title>Neurotoxic effects of perfluoroalkylated compounds: mechanisms of action and environmental relevance</article-title>
<source>
<italic>Archives of Toxicology</italic>
</source>
<year>2012</year>
<volume>86</volume>
<issue>9</issue>
<fpage>1349</fpage>
<lpage>1367</lpage>
<pub-id pub-id-type="doi">10.1007/s00204-012-0822-6</pub-id>
<pub-id pub-id-type="other">2-s2.0-84866139342</pub-id>
<pub-id pub-id-type="pmid">22456834</pub-id>
</element-citation>
</ref>
<ref id="B23">
<label>23</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tilson</surname>
<given-names>H. A.</given-names>
</name>
<name>
<surname>Rao</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Kodavanti</surname>
<given-names>S.</given-names>
</name>
</person-group>
<article-title>The neurotoxicity of polychlorinated biphenyls</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>1998</year>
<volume>19</volume>
<issue>4-5</issue>
<fpage>517</fpage>
<lpage>525</lpage>
<pub-id pub-id-type="other">2-s2.0-0031669025</pub-id>
<pub-id pub-id-type="pmid">9745906</pub-id>
</element-citation>
</ref>
<ref id="B24">
<label>24</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rother</surname>
<given-names>H.-A.</given-names>
</name>
</person-group>
<article-title>Communicating pesticide neurotoxicity research findings and risks to decision-makers and the public</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2014</year>
<volume>45</volume>
<fpage>327</fpage>
<lpage>337</lpage>
<pub-id pub-id-type="other">2-s2.0-84897121664</pub-id>
<pub-id pub-id-type="doi">10.1016/j.neuro.2014.03.001</pub-id>
<pub-id pub-id-type="pmid">24642183</pub-id>
</element-citation>
</ref>
<ref id="B25">
<label>25</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>K.-S.</given-names>
</name>
<name>
<surname>Hao</surname>
<given-names>J.-H.</given-names>
</name>
<name>
<surname>Zeng</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Dai</surname>
<given-names>F.-C.</given-names>
</name>
<name>
<surname>Gu</surname>
<given-names>P.-Q.</given-names>
</name>
</person-group>
<article-title>Neurotoxicity and biomarkers of lead exposure: a review</article-title>
<source>
<italic>Chinese Medical Sciences Journal</italic>
</source>
<year>2013</year>
<volume>28</volume>
<issue>3</issue>
<fpage>178</fpage>
<lpage>188</lpage>
<pub-id pub-id-type="other">2-s2.0-84885577343</pub-id>
<pub-id pub-id-type="doi">10.1016/s1001-9294(13)60045-0</pub-id>
<pub-id pub-id-type="pmid">24074621</pub-id>
</element-citation>
</ref>
<ref id="B26">
<label>26</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Walker</surname>
<given-names>B.</given-names>
<suffix>Jr.</suffix>
</name>
</person-group>
<article-title>Neurotoxicity in human beings</article-title>
<source>
<italic>Journal of Laboratory and Clinical Medicine</italic>
</source>
<year>2000</year>
<volume>136</volume>
<issue>3</issue>
<fpage>168</fpage>
<lpage>180</lpage>
<pub-id pub-id-type="doi">10.1067/mlc.2000.108940</pub-id>
<pub-id pub-id-type="other">2-s2.0-0033797077</pub-id>
<pub-id pub-id-type="pmid">10985495</pub-id>
</element-citation>
</ref>
<ref id="B27">
<label>27</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Carpenter</surname>
<given-names>D. O.</given-names>
</name>
<name>
<surname>Nevin</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Environmental causes of violence</article-title>
<source>
<italic>Physiology & Behavior</italic>
</source>
<year>2010</year>
<volume>99</volume>
<issue>2</issue>
<fpage>260</fpage>
<lpage>268</lpage>
<pub-id pub-id-type="doi">10.1016/j.physbeh.2009.09.001</pub-id>
<pub-id pub-id-type="other">2-s2.0-72649090413</pub-id>
<pub-id pub-id-type="pmid">19758571</pub-id>
</element-citation>
</ref>
<ref id="B28">
<label>28</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bondy</surname>
<given-names>S. C.</given-names>
</name>
</person-group>
<article-title>Prolonged exposure to low levels of aluminum leads to changes associated with brain aging and neurodegeneration</article-title>
<source>
<italic>Toxicology</italic>
</source>
<year>2014</year>
<volume>315</volume>
<issue>1</issue>
<fpage>1</fpage>
<lpage>7</lpage>
<pub-id pub-id-type="doi">10.1016/j.tox.2013.10.008</pub-id>
<pub-id pub-id-type="other">2-s2.0-84888801106</pub-id>
<pub-id pub-id-type="pmid">24189189</pub-id>
</element-citation>
</ref>
<ref id="B29">
<label>29</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lucchini</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Zimmerman</surname>
<given-names>N.</given-names>
</name>
</person-group>
<article-title>Lifetime cumulative exposure as a threat for neurodegeneration: need for prevention strategies on a global scale</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2009</year>
<volume>30</volume>
<issue>6</issue>
<fpage>1144</fpage>
<lpage>1148</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2009.10.003</pub-id>
<pub-id pub-id-type="other">2-s2.0-71049161520</pub-id>
<pub-id pub-id-type="pmid">19835910</pub-id>
</element-citation>
</ref>
<ref id="B30">
<label>30</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Barnham</surname>
<given-names>K. J.</given-names>
</name>
<name>
<surname>Bush</surname>
<given-names>A. I.</given-names>
</name>
</person-group>
<article-title>Biological metals and metal-targeting compounds in major neurodegenerative diseases</article-title>
<source>
<italic>Chemical Society Reviews</italic>
</source>
<year>2014</year>
<volume>43</volume>
<issue>19</issue>
<fpage>6727</fpage>
<lpage>6749</lpage>
<pub-id pub-id-type="doi">10.1039/c4cs00138a</pub-id>
<pub-id pub-id-type="pmid">25099276</pub-id>
</element-citation>
</ref>
<ref id="B31">
<label>31</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Brewer</surname>
<given-names>G. J.</given-names>
</name>
</person-group>
<article-title>Alzheimer's disease causation by copper toxicity and treatment with zinc</article-title>
<source>
<italic>Frontiers in Aging Neuroscience</italic>
</source>
<year>2014</year>
<volume>6, article 92</volume>
<pub-id pub-id-type="other">2-s2.0-84901312587</pub-id>
<pub-id pub-id-type="doi">10.3389/fnagi.2014.00092</pub-id>
</element-citation>
</ref>
<ref id="B32">
<label>32</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Squitti</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Copper subtype of Alzheimer's disease (AD): meta-analyses, genetic studies and predictive value of non-ceruloplasmim copper in mild cognitive impairment conversion to full AD</article-title>
<source>
<italic>Journal of Trace Elements in Medicine and Biology</italic>
</source>
<year>2014</year>
<volume>28</volume>
<issue>4</issue>
<fpage>482</fpage>
<lpage>485</lpage>
<pub-id pub-id-type="doi">10.1016/j.jtemb.2014.06.018</pub-id>
<pub-id pub-id-type="pmid">25066791</pub-id>
</element-citation>
</ref>
<ref id="B33">
<label>33</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Squitti</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Siotto</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Polimanti</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Low-copper diet as a preventive strategy for Alzheimer's disease</article-title>
<source>
<italic>Neurobiology of Aging</italic>
</source>
<year>2014</year>
<volume>35</volume>
<issue>supplement 2</issue>
<fpage>S40</fpage>
<lpage>S50</lpage>
<pub-id pub-id-type="doi">10.1016/j.neurobiolaging.2014.02.031</pub-id>
<pub-id pub-id-type="other">2-s2.0-84901740202</pub-id>
<pub-id pub-id-type="pmid">24913894</pub-id>
</element-citation>
</ref>
<ref id="B34">
<label>34</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Exley</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Vickers</surname>
<given-names>T.</given-names>
</name>
</person-group>
<article-title>Elevated brain aluminium and early onset Alzheimer's disease in an individual occupationally exposed to aluminium: a case report</article-title>
<source>
<italic>Journal of Medical Case Reports</italic>
</source>
<year>2014</year>
<volume>8</volume>
<issue>1, article 41</issue>
<pub-id pub-id-type="other">2-s2.0-84893653060</pub-id>
<pub-id pub-id-type="doi">10.1186/1752-1947-8-41</pub-id>
</element-citation>
</ref>
<ref id="B35">
<label>35</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>van Wijngaarden</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Campbell</surname>
<given-names>J. R.</given-names>
</name>
<name>
<surname>Cory-Slechta</surname>
<given-names>D. A.</given-names>
</name>
</person-group>
<article-title>Bone lead levels are associated with measures of memory impairment in older adults</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2009</year>
<volume>30</volume>
<issue>4</issue>
<fpage>572</fpage>
<lpage>580</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2009.05.007</pub-id>
<pub-id pub-id-type="other">2-s2.0-67651001604</pub-id>
<pub-id pub-id-type="pmid">19477197</pub-id>
</element-citation>
</ref>
<ref id="B36">
<label>36</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Patterson</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Feightner</surname>
<given-names>J. W.</given-names>
</name>
<name>
<surname>Garcia</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Hsiung</surname>
<given-names>G.-Y. R.</given-names>
</name>
<name>
<surname>MacKnight</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Sadovnick</surname>
<given-names>A. D.</given-names>
</name>
</person-group>
<article-title>Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease</article-title>
<source>
<italic>Canadian Medical Association Journal</italic>
</source>
<year>2008</year>
<volume>178</volume>
<issue>5</issue>
<fpage>548</fpage>
<lpage>556</lpage>
<pub-id pub-id-type="doi">10.1503/cmaj.070796</pub-id>
<pub-id pub-id-type="other">2-s2.0-40949105521</pub-id>
<pub-id pub-id-type="pmid">18299540</pub-id>
</element-citation>
</ref>
<ref id="B37">
<label>37</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bleecker</surname>
<given-names>M. L.</given-names>
</name>
<name>
<surname>Ford</surname>
<given-names>D. P.</given-names>
</name>
<name>
<surname>Lindgren</surname>
<given-names>K. N.</given-names>
</name>
<name>
<surname>Hoese</surname>
<given-names>V. M.</given-names>
</name>
<name>
<surname>Walsh</surname>
<given-names>K. S.</given-names>
</name>
<name>
<surname>Vaughan</surname>
<given-names>C. G.</given-names>
</name>
</person-group>
<article-title>Differential affects of lead exposure on components of verbal memory</article-title>
<source>
<italic>Occupational and Environmental Medicine</italic>
</source>
<year>2005</year>
<volume>62</volume>
<issue>3</issue>
<fpage>181</fpage>
<lpage>187</lpage>
<pub-id pub-id-type="doi">10.1136/oem.2003.011346</pub-id>
<pub-id pub-id-type="other">2-s2.0-14544269876</pub-id>
<pub-id pub-id-type="pmid">15723883</pub-id>
</element-citation>
</ref>
<ref id="B38">
<label>38</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Stewart</surname>
<given-names>W. F.</given-names>
</name>
<name>
<surname>Schwartz</surname>
<given-names>B. S.</given-names>
</name>
</person-group>
<article-title>Effects of lead on the adult brain: a 15-year exploration</article-title>
<source>
<italic>The American Journal of Industrial Medicine</italic>
</source>
<year>2007</year>
<volume>50</volume>
<issue>10</issue>
<fpage>729</fpage>
<lpage>739</lpage>
<pub-id pub-id-type="doi">10.1002/ajim.20434</pub-id>
<pub-id pub-id-type="other">2-s2.0-36849086904</pub-id>
<pub-id pub-id-type="pmid">17311281</pub-id>
</element-citation>
</ref>
<ref id="B39">
<label>39</label>
<element-citation publication-type="book">
<collab>Centers for Disease Control and Prevention: Department of Health and Human Services</collab>
<source>
<italic>Fourth National Report on Human Exposure to Environmental Chemicals: Updated Tables</italic>
</source>
<year>2013</year>
<publisher-loc>Atlanta, Ga, USA</publisher-loc>
<publisher-name>Centers for Disease Control and Prevention: Department of Health and Human Services</publisher-name>
<comment>
<ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/exposurereport/pdf/FourthReport_UpdatedTables_Mar2013.pdf">http://www.cdc.gov/exposurereport/pdf/FourthReport_UpdatedTables_Mar2013.pdf</ext-link>
</comment>
</element-citation>
</ref>
<ref id="B40">
<label>40</label>
<element-citation publication-type="other">
<collab>Health Canada</collab>
<article-title>Second report on human biomonitoring of environmental chemicals in Canada</article-title>
<comment>2013,
<ext-link ext-link-type="uri" xlink:href="http://occupationalcancer.ca/wp-content/uploads/2013/05/2ndHumanBiomonitoringReport.pdf">http://occupationalcancer.ca/wp-content/uploads/2013/05/2ndHumanBiomonitoringReport.pdf</ext-link>
</comment>
</element-citation>
</ref>
<ref id="B107">
<label>41</label>
<element-citation publication-type="other">
<collab>Environmental Working Group</collab>
<article-title>Toxic Chemicals Found In Minority Cord Blood</article-title>
<comment>2009,
<ext-link ext-link-type="uri" xlink:href="http://www.ewg.org/news/news-releases/2009/12/02/toxic-chemicals-found-minority-cord-blood">http://www.ewg.org/news/news-releases/2009/12/02/toxic-chemicals-found-minority-cord-blood</ext-link>
</comment>
</element-citation>
</ref>
<ref id="B42">
<label>42</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rossignol</surname>
<given-names>D. A.</given-names>
</name>
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Frye</surname>
<given-names>R. E.</given-names>
</name>
</person-group>
<article-title>Environmental toxicants and autism spectrum disorders: a systematic review</article-title>
<source>
<italic>Translational Psychiatry</italic>
</source>
<year>2014</year>
<volume>4, articel e360</volume>
<pub-id pub-id-type="doi">10.1038/tp.2014.4</pub-id>
</element-citation>
</ref>
<ref id="B43">
<label>43</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Grandjean</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Landrigan</surname>
<given-names>P.</given-names>
</name>
</person-group>
<article-title>Developmental neurotoxicity of industrial chemicals</article-title>
<source>
<italic>The Lancet</italic>
</source>
<year>2006</year>
<volume>368</volume>
<issue>9553</issue>
<fpage>2167</fpage>
<lpage>2178</lpage>
<pub-id pub-id-type="doi">10.1016/s0140-6736(06)69665-7</pub-id>
<pub-id pub-id-type="other">2-s2.0-33845424655</pub-id>
</element-citation>
</ref>
<ref id="B44">
<label>44</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Grandjean</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Landrigan</surname>
<given-names>P. J.</given-names>
</name>
</person-group>
<article-title>Neurobehavioural effects of developmental toxicity</article-title>
<source>
<italic>The Lancet Neurology</italic>
</source>
<year>2014</year>
<volume>13</volume>
<issue>3</issue>
<fpage>330</fpage>
<lpage>338</lpage>
<pub-id pub-id-type="other">2-s2.0-84894029844</pub-id>
<pub-id pub-id-type="doi">10.1016/S1474-4422(13)70278-3</pub-id>
<pub-id pub-id-type="pmid">24556010</pub-id>
</element-citation>
</ref>
<ref id="B45">
<label>45</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Coury</surname>
<given-names>D.</given-names>
</name>
</person-group>
<article-title>Pediatric Academic societies annual meeting. April 28-May 1, 2001. Baltimore, Maryland, USA. Abstracts</article-title>
<source>
<italic>Pediatric Research</italic>
</source>
<year>2001</year>
<volume>49</volume>
<issue>4, part 2, supplement</issue>
</element-citation>
</ref>
<ref id="B46">
<label>46</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kanthasamy</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Jin</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Anantharam</surname>
<given-names>V.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Emerging neurotoxic mechanisms in environmental factors-induced neurodegeneration</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2012</year>
<volume>33</volume>
<issue>4</issue>
<fpage>833</fpage>
<lpage>837</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2012.01.011</pub-id>
<pub-id pub-id-type="other">2-s2.0-84864507010</pub-id>
<pub-id pub-id-type="pmid">22342404</pub-id>
</element-citation>
</ref>
<ref id="B47">
<label>47</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Block</surname>
<given-names>M. L.</given-names>
</name>
<name>
<surname>Elder</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Auten</surname>
<given-names>R. L.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>The outdoor air pollution and brain health workshop</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2012</year>
<volume>33</volume>
<issue>5</issue>
<fpage>972</fpage>
<lpage>984</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2012.08.014</pub-id>
<pub-id pub-id-type="other">2-s2.0-84867230254</pub-id>
<pub-id pub-id-type="pmid">22981845</pub-id>
</element-citation>
</ref>
<ref id="B48">
<label>48</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Reis</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Román</surname>
<given-names>G. C.</given-names>
</name>
</person-group>
<article-title>Environmental neurology: a promising new field of practice and research</article-title>
<source>
<italic>Journal of the Neurological Sciences</italic>
</source>
<year>2007</year>
<volume>262</volume>
<issue>1-2</issue>
<fpage>3</fpage>
<lpage>6</lpage>
<pub-id pub-id-type="doi">10.1016/j.jns.2007.06.017</pub-id>
<pub-id pub-id-type="other">2-s2.0-34548548715</pub-id>
<pub-id pub-id-type="pmid">17651758</pub-id>
</element-citation>
</ref>
<ref id="B49">
<label>49</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sabbath</surname>
<given-names>E. L.</given-names>
</name>
<name>
<surname>Gutierrez</surname>
<given-names>L.-A.</given-names>
</name>
<name>
<surname>Okechukwu</surname>
<given-names>C. A.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Time may not fully attenuate solvent-associated cognitive deficits in highly exposed workers</article-title>
<source>
<italic>Neurology</italic>
</source>
<year>2014</year>
<volume>82</volume>
<issue>19</issue>
<fpage>1716</fpage>
<lpage>1723</lpage>
<pub-id pub-id-type="doi">10.1212/wnl.0000000000000413</pub-id>
<pub-id pub-id-type="pmid">24821933</pub-id>
</element-citation>
</ref>
<ref id="B50">
<label>50</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Sears</surname>
<given-names>M. E.</given-names>
</name>
<name>
<surname>Schwalfenberg</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Hope</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Bernhoft</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Clinical detoxification: elimination of persistent toxicants from the human body</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2013</year>
<volume>2013</volume>
<fpage>3</fpage>
<pub-id pub-id-type="publisher-id">238347</pub-id>
<pub-id pub-id-type="doi">10.1155/2013/238347</pub-id>
<pub-id pub-id-type="other">2-s2.0-84879291359</pub-id>
</element-citation>
</ref>
<ref id="B51">
<label>51</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hope</surname>
<given-names>J.</given-names>
</name>
</person-group>
<article-title>A review of the mechanism of injury and treatment approaches for illness resulting from exposure to water-damaged buildings, mold, and mycotoxins</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2013</year>
<volume>2013</volume>
<fpage>20</fpage>
<pub-id pub-id-type="publisher-id">767482</pub-id>
<pub-id pub-id-type="doi">10.1155/2013/767482</pub-id>
<pub-id pub-id-type="other">2-s2.0-84877304724</pub-id>
</element-citation>
</ref>
<ref id="B52">
<label>52</label>
<element-citation publication-type="other">
<collab>Drugs.com</collab>
<article-title>Levonorgestrel and ethinyl estradiol. TABLE I: Mean (SD) Pharmacokinetic parameters of Levonorgestrel and Ethinyl Estradiol tablets over a 21-day dosing period</article-title>
<comment>2014,
<ext-link ext-link-type="uri" xlink:href="http://www.drugs.com/pro/levonorgestrel-and-ethinyl-estradiol.html">http://www.drugs.com/pro/levonorgestrel-and-ethinyl-estradiol.html</ext-link>
</comment>
</element-citation>
</ref>
<ref id="B53">
<label>53</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Welshons</surname>
<given-names>W. V.</given-names>
</name>
<name>
<surname>Thayer</surname>
<given-names>K. A.</given-names>
</name>
<name>
<surname>Judy</surname>
<given-names>B. M.</given-names>
</name>
<name>
<surname>Taylor</surname>
<given-names>J. A.</given-names>
</name>
<name>
<surname>Curran</surname>
<given-names>E. M.</given-names>
</name>
<name>
<surname>vom Saal</surname>
<given-names>F. S.</given-names>
</name>
</person-group>
<article-title>Large effects from small exposures. I. Mechanisms for endocrine-disrupting chemicals with estrogenic activity</article-title>
<source>
<italic>Environmental Health Perspectives</italic>
</source>
<year>2003</year>
<volume>111</volume>
<issue>8</issue>
<fpage>994</fpage>
<lpage>1006</lpage>
<pub-id pub-id-type="doi">10.1289/ehp.5494</pub-id>
<pub-id pub-id-type="other">2-s2.0-0038015544</pub-id>
<pub-id pub-id-type="pmid">12826473</pub-id>
</element-citation>
</ref>
<ref id="B54">
<label>54</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Steenland</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Tinker</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Shankar</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Ducatman</surname>
<given-names>A.</given-names>
</name>
</person-group>
<article-title>Association of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with uric acid among adults with elevated community exposure to PFOA</article-title>
<source>
<italic>Environmental Health Perspectives</italic>
</source>
<year>2010</year>
<volume>118</volume>
<issue>2</issue>
<fpage>229</fpage>
<lpage>233</lpage>
<pub-id pub-id-type="doi">10.1289/ehp.0900940</pub-id>
<pub-id pub-id-type="other">2-s2.0-77249103036</pub-id>
<pub-id pub-id-type="pmid">20123605</pub-id>
</element-citation>
</ref>
<ref id="B55">
<label>55</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Frisbee</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Shankar</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Knox</surname>
<given-names>S. S.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Perfluorooctanoic acid, perfluorooctanesulfonate, and serum lipids in children and adolescents: results from the C8 health project</article-title>
<source>
<italic>Archives of Pediatrics and Adolescent Medicine</italic>
</source>
<year>2010</year>
<volume>164</volume>
<issue>9</issue>
<fpage>860</fpage>
<lpage>869</lpage>
<pub-id pub-id-type="doi">10.1001/archpediatrics.2010.163</pub-id>
<pub-id pub-id-type="other">2-s2.0-77956365708</pub-id>
<pub-id pub-id-type="pmid">20819969</pub-id>
</element-citation>
</ref>
<ref id="B68">
<label>56</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Belyaeva</surname>
<given-names>E. A.</given-names>
</name>
<name>
<surname>Sokolova</surname>
<given-names>T. V.</given-names>
</name>
<name>
<surname>Emelyanova</surname>
<given-names>L. V.</given-names>
</name>
<name>
<surname>Zakharova</surname>
<given-names>I. O.</given-names>
</name>
</person-group>
<article-title>Mitochondrial electron transport chain in heavy metal-induced neurotoxicity: effects of cadmium, mercury, and copper</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2012</year>
<volume>2012</volume>
<fpage>14</fpage>
<pub-id pub-id-type="publisher-id">136063</pub-id>
<pub-id pub-id-type="doi">10.1100/2012/136063</pub-id>
<pub-id pub-id-type="other">2-s2.0-84861016336</pub-id>
</element-citation>
</ref>
<ref id="B69">
<label>57</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>Y. W.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>C. F.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>C. Y.</given-names>
</name>
<name>
<surname>Yen</surname>
<given-names>C. C.</given-names>
</name>
<name>
<surname>Tsai</surname>
<given-names>K. S.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>S. H.</given-names>
</name>
</person-group>
<article-title>Inorganic mercury causes pancreatic
<italic>β</italic>
-cell death via the oxidative stress-induced apoptotic and necrotic pathways</article-title>
<source>
<italic>Toxicology and Applied Pharmacology</italic>
</source>
<year>2010</year>
<volume>243</volume>
<issue>3</issue>
<fpage>323</fpage>
<lpage>331</lpage>
<pub-id pub-id-type="doi">10.1016/j.taap.2009.11.024</pub-id>
<pub-id pub-id-type="other">2-s2.0-77049091785</pub-id>
<pub-id pub-id-type="pmid">20006636</pub-id>
</element-citation>
</ref>
<ref id="B70">
<label>58</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Huang</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Martin</surname>
<given-names>F. L.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Perfluorooctanoic acid induces apoptosis through the p53-dependent mitochondrial pathway in human hepatic cells: a proteomic study</article-title>
<source>
<italic>Toxicology Letters</italic>
</source>
<year>2013</year>
<volume>223</volume>
<issue>2</issue>
<fpage>211</fpage>
<lpage>220</lpage>
<pub-id pub-id-type="doi">10.1016/j.toxlet.2013.09.002</pub-id>
<pub-id pub-id-type="other">2-s2.0-84886303120</pub-id>
<pub-id pub-id-type="pmid">24035753</pub-id>
</element-citation>
</ref>
<ref id="B67">
<label>59</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Weiss</surname>
<given-names>B.</given-names>
</name>
</person-group>
<article-title>The intersection of neurotoxicology and endocrine disruption</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2012</year>
<volume>33</volume>
<issue>6</issue>
<fpage>1410</fpage>
<lpage>1419</lpage>
<pub-id pub-id-type="doi">10.1016/j.neuro.2012.05.014</pub-id>
<pub-id pub-id-type="other">2-s2.0-84871715915</pub-id>
<pub-id pub-id-type="pmid">22659293</pub-id>
</element-citation>
</ref>
<ref id="B71">
<label>60</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Guerrero-Bosagna</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Skinner</surname>
<given-names>M. K.</given-names>
</name>
</person-group>
<article-title>Environmentally induced epigenetic transgenerational inheritance of phenotype and disease</article-title>
<source>
<italic>Molecular and Cellular Endocrinology</italic>
</source>
<year>2012</year>
<volume>354</volume>
<issue>1-2</issue>
<fpage>3</fpage>
<lpage>8</lpage>
<pub-id pub-id-type="doi">10.1016/j.mce.2011.10.004</pub-id>
<pub-id pub-id-type="other">2-s2.0-84857797150</pub-id>
<pub-id pub-id-type="pmid">22020198</pub-id>
</element-citation>
</ref>
<ref id="B72">
<label>61</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Orrenius</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Nicotera</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Zhivotovsky</surname>
<given-names>B.</given-names>
</name>
</person-group>
<article-title>Cell death mechanisms and their implications in toxicology</article-title>
<source>
<italic>Toxicological Sciences</italic>
</source>
<year>2011</year>
<volume>119</volume>
<issue>1</issue>
<fpage>3</fpage>
<lpage>19</lpage>
<pub-id pub-id-type="doi">10.1093/toxsci/kfq268</pub-id>
<pub-id pub-id-type="other">2-s2.0-78650527416</pub-id>
<pub-id pub-id-type="pmid">20829425</pub-id>
</element-citation>
</ref>
<ref id="B73">
<label>62</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bloom</surname>
<given-names>G. S.</given-names>
</name>
</person-group>
<article-title>Amyloid-
<italic>β</italic>
and tau: the trigger and bullet in Alzheimer disease pathogenesis</article-title>
<source>
<italic>JAMA Neurology</italic>
</source>
<year>2014</year>
<volume>71</volume>
<issue>4</issue>
<fpage>505</fpage>
<lpage>508</lpage>
<pub-id pub-id-type="doi">10.1001/jamaneurol.2013.5847</pub-id>
<pub-id pub-id-type="other">2-s2.0-84899019792</pub-id>
<pub-id pub-id-type="pmid">24493463</pub-id>
</element-citation>
</ref>
<ref id="B56">
<label>63</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lasley</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Gilbert</surname>
<given-names>M. E.</given-names>
</name>
</person-group>
<article-title>Rat hippocampal glutamate and GABA release exhibit biphasic effects as a function of chronic lead exposure level</article-title>
<source>
<italic>Toxicological Sciences</italic>
</source>
<year>2002</year>
<volume>66</volume>
<issue>1</issue>
<fpage>139</fpage>
<lpage>147</lpage>
<pub-id pub-id-type="doi">10.1093/toxsci/66.1.139</pub-id>
<pub-id pub-id-type="other">2-s2.0-0036190004</pub-id>
<pub-id pub-id-type="pmid">11861981</pub-id>
</element-citation>
</ref>
<ref id="B74">
<label>64</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kjeldsen</surname>
<given-names>L. S.</given-names>
</name>
<name>
<surname>Ghisari</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Bonefeld-Jørgensen</surname>
<given-names>E. C.</given-names>
</name>
</person-group>
<article-title>Currently used pesticides and their mixtures affect the function of sex hormone receptors and aromatase enzyme activity</article-title>
<source>
<italic>Toxicology and Applied Pharmacology</italic>
</source>
<year>2013</year>
<volume>272</volume>
<issue>2</issue>
<fpage>453</fpage>
<lpage>464</lpage>
<pub-id pub-id-type="other">2-s2.0-84884135242</pub-id>
<pub-id pub-id-type="doi">10.1016/j.taap.2013.06.028</pub-id>
<pub-id pub-id-type="pmid">23871939</pub-id>
</element-citation>
</ref>
<ref id="B75">
<label>65</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>The chemical erosion of human health: adverse environmental exposure and in-utero pollution—determinants of congenital disorders and chronic disease</article-title>
<source>
<italic>Journal of Perinatal Medicine</italic>
</source>
<year>2006</year>
<volume>34</volume>
<issue>3</issue>
<fpage>185</fpage>
<lpage>195</lpage>
<pub-id pub-id-type="doi">10.1515/jpm.2006.033</pub-id>
<pub-id pub-id-type="other">2-s2.0-33645773914</pub-id>
<pub-id pub-id-type="pmid">16602837</pub-id>
</element-citation>
</ref>
<ref id="B76">
<label>66</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Sears</surname>
<given-names>M. E.</given-names>
</name>
<name>
<surname>Schwalfenberg</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Hope</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Bernhoft</surname>
<given-names>R.</given-names>
</name>
</person-group>
<article-title>Clinical detoxification: elimination of persistent toxicants from the human body</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2013</year>
<volume>2013</volume>
<fpage>3</fpage>
<pub-id pub-id-type="publisher-id">238347</pub-id>
<pub-id pub-id-type="other">2-s2.0-84879291359</pub-id>
<pub-id pub-id-type="doi">10.1155/2013/238347</pub-id>
</element-citation>
</ref>
<ref id="B77">
<label>67</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Redgrave</surname>
<given-names>T. G.</given-names>
</name>
<name>
<surname>Wallace</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Jandacek</surname>
<given-names>R. J.</given-names>
</name>
<name>
<surname>Tso</surname>
<given-names>P.</given-names>
</name>
</person-group>
<article-title>Treatment with a dietary fat substitute decreased Arochlor 1254 contamination in an obese diabetic male</article-title>
<source>
<italic>The Journal of Nutritional Biochemistry</italic>
</source>
<year>2005</year>
<volume>16</volume>
<issue>6</issue>
<fpage>383</fpage>
<lpage>384</lpage>
<pub-id pub-id-type="doi">10.1016/j.jnutbio.2004.12.014</pub-id>
<pub-id pub-id-type="other">2-s2.0-20144383859</pub-id>
<pub-id pub-id-type="pmid">15936651</pub-id>
</element-citation>
</ref>
<ref id="B78">
<label>68</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ross</surname>
<given-names>G. H.</given-names>
</name>
<name>
<surname>Sternquist</surname>
<given-names>M. C.</given-names>
</name>
</person-group>
<article-title>Methamphetamine exposure and chronic illness in police officers: significant improvement with sauna-based detoxification therapy</article-title>
<source>
<italic>Toxicology and Industrial Health</italic>
</source>
<year>2012</year>
<volume>28</volume>
<issue>8</issue>
<fpage>758</fpage>
<lpage>768</lpage>
<pub-id pub-id-type="doi">10.1177/0748233711425070</pub-id>
<pub-id pub-id-type="other">2-s2.0-84864842459</pub-id>
<pub-id pub-id-type="pmid">22089658</pub-id>
</element-citation>
</ref>
<ref id="B79">
<label>69</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jandacek</surname>
<given-names>R. J.</given-names>
</name>
<name>
<surname>Heubi</surname>
<given-names>J. E.</given-names>
</name>
<name>
<surname>Buckley</surname>
<given-names>D. D.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Reduction of the body burden of PCBs and DDE by dietary intervention in a randomized trial</article-title>
<source>
<italic>Journal of Nutritional Biochemistry</italic>
</source>
<year>2014</year>
<volume>25</volume>
<issue>4</issue>
<fpage>483</fpage>
<lpage>488</lpage>
<pub-id pub-id-type="doi">10.1016/j.jnutbio.2014.01.002</pub-id>
<pub-id pub-id-type="other">2-s2.0-84896895025</pub-id>
<pub-id pub-id-type="pmid">24629911</pub-id>
</element-citation>
</ref>
<ref id="B80">
<label>70</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Birkholz</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Rodushkin</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Beesoon</surname>
<given-names>S.</given-names>
</name>
</person-group>
<article-title>Blood, urine, and sweat (BUS) study: monitoring and elimination of bioaccumulated toxic elements</article-title>
<source>
<italic>Archives of Environmental Contamination & Toxicology</italic>
</source>
<year>2011</year>
<volume>61</volume>
<issue>2</issue>
<fpage>344</fpage>
<lpage>357</lpage>
<pub-id pub-id-type="doi">10.1007/s00244-010-9611-5</pub-id>
<pub-id pub-id-type="other">2-s2.0-79960464099</pub-id>
<pub-id pub-id-type="pmid">21057782</pub-id>
</element-citation>
</ref>
<ref id="B81">
<label>71</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jandacek</surname>
<given-names>R. J.</given-names>
</name>
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>An assessment of the intestinal lumen as a site for intervention in reducing body burdens of organochlorine compounds</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2013</year>
<volume>2013</volume>
<fpage>10</fpage>
<pub-id pub-id-type="publisher-id">205621</pub-id>
<pub-id pub-id-type="doi">10.1155/2013/205621</pub-id>
<pub-id pub-id-type="other">2-s2.0-84874547943</pub-id>
</element-citation>
</ref>
<ref id="B82">
<label>72</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Egner</surname>
<given-names>P. A.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>J. G.</given-names>
</name>
<name>
<surname>Zarth</surname>
<given-names>A. T.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Rapid and sustainable detoxication of airborne pollutants by broccoli sprout beverage: results of a randomized clinical trial in China</article-title>
<source>
<italic>Cancer Prevention Research</italic>
</source>
<year>2014</year>
<volume>7</volume>
<issue>8</issue>
<fpage>813</fpage>
<lpage>823</lpage>
<pub-id pub-id-type="doi">10.1158/1940-6207.CAPR-14-0103</pub-id>
<pub-id pub-id-type="pmid">24913818</pub-id>
</element-citation>
</ref>
<ref id="B83">
<label>73</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>Elimination of persistent toxicants from the human body</article-title>
<source>
<italic>Human and Experimental Toxicology</italic>
</source>
<year>2011</year>
<volume>30</volume>
<issue>1</issue>
<fpage>3</fpage>
<lpage>18</lpage>
<pub-id pub-id-type="doi">10.1177/0960327110368417</pub-id>
<pub-id pub-id-type="other">2-s2.0-78650198287</pub-id>
<pub-id pub-id-type="pmid">20400489</pub-id>
</element-citation>
</ref>
<ref id="B84">
<label>74</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Genuis</surname>
<given-names>Q. I. T.</given-names>
</name>
<name>
<surname>Martin</surname>
<given-names>J. W.</given-names>
</name>
<name>
<surname>Kanda</surname>
<given-names>T.</given-names>
</name>
</person-group>
<article-title>Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series</article-title>
<source>
<italic>PLoS ONE</italic>
</source>
<year>2014</year>
<volume>9</volume>
<issue>12</issue>
<pub-id pub-id-type="publisher-id">e114295</pub-id>
<pub-id pub-id-type="doi">10.1371/journal.pone.0114295</pub-id>
</element-citation>
</ref>
<ref id="B85">
<label>75</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>Toxic causes of mental illness are overlooked</article-title>
<source>
<italic>NeuroToxicology</italic>
</source>
<year>2008</year>
<volume>29</volume>
<issue>6</issue>
<fpage>1147</fpage>
<lpage>1149</lpage>
<pub-id pub-id-type="other">2-s2.0-56249086068</pub-id>
<pub-id pub-id-type="doi">10.1016/j.neuro.2008.06.005</pub-id>
<pub-id pub-id-type="pmid">18621076</pub-id>
</element-citation>
</ref>
<ref id="B86">
<label>76</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Adams</surname>
<given-names>J. B.</given-names>
</name>
<name>
<surname>Baral</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Geis</surname>
<given-names>E.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part A—medical results</article-title>
<source>
<italic>BMC Clinical Pharmacology</italic>
</source>
<year>2009</year>
<volume>9, article 16</volume>
<pub-id pub-id-type="doi">10.1186/1472-6904-9-16</pub-id>
<pub-id pub-id-type="other">2-s2.0-70450261738</pub-id>
</element-citation>
</ref>
<ref id="B87">
<label>77</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Adams</surname>
<given-names>J. B.</given-names>
</name>
<name>
<surname>Baral</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Geis</surname>
<given-names>E.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part B—behavioral results</article-title>
<source>
<italic>BMC Clinical Pharmacology</italic>
</source>
<year>2009</year>
<volume>9, article 1472</volume>
<pub-id pub-id-type="doi">10.1186/1472-6904-9-17</pub-id>
<pub-id pub-id-type="other">2-s2.0-70450280618</pub-id>
</element-citation>
</ref>
<ref id="B88">
<label>78</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bredesen</surname>
<given-names>D. E.</given-names>
</name>
</person-group>
<article-title>Reversal of cognitive decline: a novel therapeutic program</article-title>
<source>
<italic>Aging</italic>
</source>
<year>2014</year>
<volume>6</volume>
<issue>9</issue>
<fpage>707</fpage>
<lpage>717</lpage>
<pub-id pub-id-type="pmid">25324467</pub-id>
</element-citation>
</ref>
<ref id="B89">
<label>79</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Porru</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Alessio</surname>
<given-names>L.</given-names>
</name>
</person-group>
<article-title>The use of chelating agents in occupational lead poisoning</article-title>
<source>
<italic>Occupational Medicine</italic>
</source>
<year>1996</year>
<volume>46</volume>
<issue>1</issue>
<fpage>41</fpage>
<lpage>48</lpage>
<pub-id pub-id-type="doi">10.1093/occmed/46.1.41</pub-id>
<pub-id pub-id-type="other">2-s2.0-0030069013</pub-id>
<pub-id pub-id-type="pmid">8672793</pub-id>
</element-citation>
</ref>
<ref id="B90">
<label>80</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bradberry</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Sheehan</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Vale</surname>
<given-names>A.</given-names>
</name>
</person-group>
<article-title>Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning</article-title>
<source>
<italic>QJM: An International Journal of Medicine</italic>
</source>
<year>2009</year>
<volume>102</volume>
<issue>10</issue>
<fpage>721</fpage>
<lpage>732</lpage>
<pub-id pub-id-type="other">2-s2.0-70349682356</pub-id>
<pub-id pub-id-type="doi">10.1093/qjmed/hcp114</pub-id>
<pub-id pub-id-type="pmid">19700440</pub-id>
</element-citation>
</ref>
<ref id="B91">
<label>81</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bradberry</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Vale</surname>
<given-names>A.</given-names>
</name>
</person-group>
<article-title>Dimercaptosuccinic acid (succimer; DMSA) in inorganic lead poisoning</article-title>
<source>
<italic>Clinical Toxicology</italic>
</source>
<year>2009</year>
<volume>47</volume>
<issue>7</issue>
<fpage>617</fpage>
<lpage>631</lpage>
<pub-id pub-id-type="doi">10.1080/15563650903174828</pub-id>
<pub-id pub-id-type="other">2-s2.0-69149087793</pub-id>
<pub-id pub-id-type="pmid">19663612</pub-id>
</element-citation>
</ref>
<ref id="B92">
<label>82</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sears</surname>
<given-names>M. E.</given-names>
</name>
</person-group>
<article-title>Chelation: harnessing and enhancing heavy metal detoxification—a review</article-title>
<source>
<italic>The Scientific World Journal</italic>
</source>
<year>2013</year>
<volume>2013</volume>
<fpage>13</fpage>
<pub-id pub-id-type="publisher-id">219840</pub-id>
<pub-id pub-id-type="doi">10.1155/2013/219840</pub-id>
<pub-id pub-id-type="other">2-s2.0-84878344952</pub-id>
</element-citation>
</ref>
<ref id="B61">
<label>83</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wedeen</surname>
<given-names>R. P.</given-names>
</name>
</person-group>
<article-title>Lead poisoning: the evolving definition</article-title>
<source>
<italic>International Journal of Occupational and Environmental Medicine</italic>
</source>
<year>2011</year>
<volume>2</volume>
<issue>1</issue>
<fpage>1</fpage>
<lpage>3</lpage>
<pub-id pub-id-type="other">2-s2.0-79952457625</pub-id>
<pub-id pub-id-type="pmid">23022811</pub-id>
</element-citation>
</ref>
<ref id="B60">
<label>84</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hernberg</surname>
<given-names>S.</given-names>
</name>
</person-group>
<article-title>Lead poisoning in a historical perspective</article-title>
<source>
<italic>American Journal of Industrial Medicine</italic>
</source>
<year>2000</year>
<volume>38</volume>
<issue>3</issue>
<fpage>244</fpage>
<lpage>254</lpage>
<pub-id pub-id-type="doi">10.1002/1097-0274(200009)38:360;244::aid-ajim362;3.3.co;2-6</pub-id>
<pub-id pub-id-type="pmid">10940962</pub-id>
</element-citation>
</ref>
<ref id="B93">
<label>85</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Arnold</surname>
<given-names>W. N.</given-names>
</name>
</person-group>
<article-title>The illness of Vincent van Gogh</article-title>
<source>
<italic>Journal of the History of the Neurosciences</italic>
</source>
<year>2004</year>
<volume>13</volume>
<issue>1</issue>
<fpage>22</fpage>
<lpage>43</lpage>
<pub-id pub-id-type="doi">10.1080/09647040490885475</pub-id>
<pub-id pub-id-type="other">2-s2.0-4944248944</pub-id>
<pub-id pub-id-type="pmid">15370335</pub-id>
</element-citation>
</ref>
<ref id="B94">
<label>86</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shamberger</surname>
<given-names>R. J.</given-names>
</name>
</person-group>
<article-title>Validity of hair mineral testing</article-title>
<source>
<italic>Biological Trace Element Research</italic>
</source>
<year>2002</year>
<volume>87</volume>
<issue>1–3</issue>
<fpage>1</fpage>
<lpage>28</lpage>
<pub-id pub-id-type="doi">10.1385/bter:87:1-3:001</pub-id>
<pub-id pub-id-type="other">2-s2.0-0035986091</pub-id>
<pub-id pub-id-type="pmid">12117220</pub-id>
</element-citation>
</ref>
<ref id="B62">
<label>87</label>
<element-citation publication-type="journal">
<collab>Centers for Disease Control and Prevention (CDC)</collab>
<article-title>Very high blood lead levels among adults—United States, 2002–2011</article-title>
<source>
<italic>Morbidity & Mortality Weekly Report</italic>
</source>
<year>2002</year>
<volume>62</volume>
<issue>47</issue>
<fpage>967</fpage>
<lpage>971</lpage>
</element-citation>
</ref>
<ref id="B95">
<label>88</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Lewis</surname>
<given-names>G.</given-names>
</name>
</person-group>
<article-title>Environmental toxicity and poor cognitive outcomes in children and adults</article-title>
<source>
<italic>Journal of Environmental Health</italic>
</source>
<year>2014</year>
<volume>76</volume>
<issue>6</issue>
<fpage>130</fpage>
<lpage>138</lpage>
<pub-id pub-id-type="other">2-s2.0-84899444464</pub-id>
<pub-id pub-id-type="pmid">24645424</pub-id>
</element-citation>
</ref>
<ref id="B108">
<label>89</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mah</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Kohli</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Chan</surname>
<given-names>G.</given-names>
</name>
</person-group>
<article-title>Ambient lead exposure is associated with greater risk of conversion to Alzheimer's disease and hippocampal atrophy in individuals with amnestic mild cognitive impairment</article-title>
<source>
<italic>The American Journal of Geriatric Psychiatry</italic>
</source>
<year>2014</year>
<volume>22</volume>
<issue>3</issue>
<fpage>S117</fpage>
<lpage>S118</lpage>
<pub-id pub-id-type="doi">10.1016/j.jagp.2013.12.135</pub-id>
</element-citation>
</ref>
<ref id="B58">
<label>90</label>
<element-citation publication-type="journal">
<collab>Centers for Disease Control and Prevention (CDC)</collab>
<article-title>Lead exposure among females of childbearing age—United States, 2004</article-title>
<source>
<italic>Morbidity & Mortality Weekly Report</italic>
</source>
<year>2007</year>
<volume>56</volume>
<issue>16</issue>
<fpage>397</fpage>
<lpage>400</lpage>
<pub-id pub-id-type="other">2-s2.0-34247600694</pub-id>
<pub-id pub-id-type="pmid">17464282</pub-id>
</element-citation>
</ref>
<ref id="B96">
<label>91</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Schwalfenberg</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Siy</surname>
<given-names>A.-K. J.</given-names>
</name>
<name>
<surname>Rodushkin</surname>
<given-names>I.</given-names>
</name>
</person-group>
<article-title>Toxic element contamination of natural health products and pharmaceutical preparations</article-title>
<source>
<italic>PLoS ONE</italic>
</source>
<year>2012</year>
<volume>7</volume>
<issue>11</issue>
<pub-id pub-id-type="publisher-id">e49676</pub-id>
<pub-id pub-id-type="doi">10.1371/journal.pone.0049676</pub-id>
<pub-id pub-id-type="other">2-s2.0-84869848861</pub-id>
</element-citation>
</ref>
<ref id="B59">
<label>92</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Needleman</surname>
<given-names>H.</given-names>
</name>
</person-group>
<article-title>Low level lead exposure: history and discovery</article-title>
<source>
<italic>Annals of Epidemiology</italic>
</source>
<year>2009</year>
<volume>19</volume>
<issue>4</issue>
<fpage>235</fpage>
<lpage>238</lpage>
<pub-id pub-id-type="doi">10.1016/j.annepidem.2009.01.022</pub-id>
<pub-id pub-id-type="other">2-s2.0-63149105431</pub-id>
<pub-id pub-id-type="pmid">19344860</pub-id>
</element-citation>
</ref>
<ref id="B63">
<label>93</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Casas</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Chevrier</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Hond</surname>
<given-names>E. D.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Exposure to brominated flame retardants, perfluorinated compounds, phthalates and phenols in European birth cohorts: ENRIECO evaluation, first human biomonitoring results, and recommendations</article-title>
<source>
<italic>International Journal of Hygiene and Environmental Health</italic>
</source>
<year>2013</year>
<volume>216</volume>
<issue>3</issue>
<fpage>230</fpage>
<lpage>242</lpage>
<pub-id pub-id-type="doi">10.1016/j.ijheh.2012.05.009</pub-id>
<pub-id pub-id-type="other">2-s2.0-84875372722</pub-id>
<pub-id pub-id-type="pmid">22795704</pub-id>
</element-citation>
</ref>
<ref id="B97">
<label>94</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Archibeque-Engle</surname>
<given-names>S. L.</given-names>
</name>
<name>
<surname>Tessari</surname>
<given-names>J. D.</given-names>
</name>
<name>
<surname>Winn</surname>
<given-names>D. T.</given-names>
</name>
<name>
<surname>Keefe</surname>
<given-names>T. J.</given-names>
</name>
<name>
<surname>Nett</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Zheng</surname>
<given-names>T.</given-names>
</name>
</person-group>
<article-title>Comparison of organochlorine pesticide and polychlorinated biphenyl residues in human breast adipose tissue and serum</article-title>
<source>
<italic>Journal of Toxicology and Environmental Health</italic>
</source>
<year>1997</year>
<volume>52</volume>
<issue>4</issue>
<fpage>285</fpage>
<lpage>293</lpage>
<pub-id pub-id-type="other">2-s2.0-0030662512</pub-id>
<pub-id pub-id-type="doi">10.1080/009841097159584</pub-id>
<pub-id pub-id-type="pmid">9354175</pub-id>
</element-citation>
</ref>
<ref id="B98">
<label>95</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yu</surname>
<given-names>G. W.</given-names>
</name>
<name>
<surname>Laseter</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Mylander</surname>
<given-names>C.</given-names>
</name>
</person-group>
<article-title>Persistent organic pollutants in serum and several different fat compartments in humans</article-title>
<source>
<italic>Journal of Environmental and Public Health</italic>
</source>
<year>2011</year>
<volume>2011</volume>
<fpage>8</fpage>
<pub-id pub-id-type="publisher-id">417980</pub-id>
<pub-id pub-id-type="doi">10.1155/2011/417980</pub-id>
<pub-id pub-id-type="other">2-s2.0-79959251729</pub-id>
</element-citation>
</ref>
<ref id="B99">
<label>96</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jandacek</surname>
<given-names>R. J.</given-names>
</name>
<name>
<surname>Anderson</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Zheng</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Tso</surname>
<given-names>P.</given-names>
</name>
</person-group>
<article-title>Effects of yo-yo diet, caloric restriction, and olestra on tissue distribution of hexachlorobenzene</article-title>
<source>
<italic>American Journal of Physiology—Gastrointestinal and Liver Physiology</italic>
</source>
<year>2005</year>
<volume>288</volume>
<issue>2</issue>
<fpage>G292</fpage>
<lpage>G299</lpage>
<pub-id pub-id-type="doi">10.1152/ajpgi.00285.2004</pub-id>
<pub-id pub-id-type="other">2-s2.0-12344332482</pub-id>
<pub-id pub-id-type="pmid">15513954</pub-id>
</element-citation>
</ref>
<ref id="B100">
<label>97</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rappaport</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Smith</surname>
<given-names>M. T.</given-names>
</name>
</person-group>
<article-title>Environment and disease risks</article-title>
<source>
<italic>Science</italic>
</source>
<year>2010</year>
<volume>330</volume>
<issue>6003</issue>
<fpage>460</fpage>
<lpage>461</lpage>
<pub-id pub-id-type="doi">10.1126/science.1192603</pub-id>
<pub-id pub-id-type="other">2-s2.0-77958192172</pub-id>
<pub-id pub-id-type="pmid">20966241</pub-id>
</element-citation>
</ref>
<ref id="B101">
<label>98</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>Medical practice and community health care in the 21st century: a time of change</article-title>
<source>
<italic>Public Health</italic>
</source>
<year>2008</year>
<volume>122</volume>
<issue>7</issue>
<fpage>671</fpage>
<lpage>680</lpage>
<pub-id pub-id-type="doi">10.1016/j.puhe.2008.04.002</pub-id>
<pub-id pub-id-type="other">2-s2.0-45049084866</pub-id>
<pub-id pub-id-type="pmid">18534645</pub-id>
</element-citation>
</ref>
<ref id="B102">
<label>99</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Roberts</surname>
<given-names>J. R.</given-names>
</name>
<name>
<surname>Reigart</surname>
<given-names>J. R.</given-names>
</name>
</person-group>
<article-title>Environmental health education in the medical school curriculum</article-title>
<source>
<italic>Ambulatory Pediatrics</italic>
</source>
<year>2001</year>
<volume>1</volume>
<issue>2</issue>
<fpage>108</fpage>
<lpage>111</lpage>
<pub-id pub-id-type="other">2-s2.0-0035295657</pub-id>
<pub-id pub-id-type="doi">10.1367/1539-4409(2001)00160;0108:eheitm62;2.0.co;2</pub-id>
<pub-id pub-id-type="pmid">11888382</pub-id>
</element-citation>
</ref>
<ref id="B103">
<label>100</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gehle</surname>
<given-names>K. S.</given-names>
</name>
<name>
<surname>Crawford</surname>
<given-names>J. L.</given-names>
</name>
<name>
<surname>Hatcher</surname>
<given-names>M. T.</given-names>
</name>
</person-group>
<article-title>Integrating environmental health into medical education</article-title>
<source>
<italic>American Journal of Preventive Medicine</italic>
</source>
<year>2011</year>
<volume>41</volume>
<issue>4</issue>
<fpage>S296</fpage>
<lpage>S301</lpage>
<pub-id pub-id-type="doi">10.1016/j.amepre.2011.06.007</pub-id>
<pub-id pub-id-type="other">2-s2.0-80053315000</pub-id>
<pub-id pub-id-type="pmid">21961679</pub-id>
</element-citation>
</ref>
<ref id="B104">
<label>101</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kilburn</surname>
<given-names>K. H.</given-names>
</name>
</person-group>
<article-title>Why is chemical brain injury ignored? Pondering causes and risks</article-title>
<source>
<italic>Archives of Environmental Health</italic>
</source>
<year>2003</year>
<volume>58</volume>
<issue>3</issue>
<fpage>132</fpage>
<lpage>134</lpage>
<pub-id pub-id-type="other">2-s2.0-0141781136</pub-id>
<pub-id pub-id-type="pmid">14535571</pub-id>
</element-citation>
</ref>
<ref id="B105">
<label>102</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>Back to the future of healthcare: aetiology-centred medicine</article-title>
<source>
<italic>The New Zealand Medical Journal</italic>
</source>
<year>2005</year>
<volume>118</volume>
<issue>1215</issue>
<pub-id pub-id-type="publisher-id">U1467</pub-id>
</element-citation>
</ref>
<ref id="B106">
<label>103</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genuis</surname>
<given-names>S. J.</given-names>
</name>
</person-group>
<article-title>What's out there making us sick?</article-title>
<source>
<italic>Journal of Environmental and Public Health</italic>
</source>
<year>2012</year>
<volume>2012</volume>
<fpage>10</fpage>
<pub-id pub-id-type="publisher-id">605137</pub-id>
<pub-id pub-id-type="doi">10.1155/2012/605137</pub-id>
<pub-id pub-id-type="other">2-s2.0-84855261141</pub-id>
</element-citation>
</ref>
<ref id="B57">
<label>104</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rhodes</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Spiro</surname>
<given-names>A.</given-names>
<suffix>III</suffix>
</name>
<name>
<surname>Aro</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Hu</surname>
<given-names>H.</given-names>
</name>
</person-group>
<article-title>Relationship of bone and blood lead levels to psychiatric symptoms: the normative aging study</article-title>
<source>
<italic>Journal of Occupational and Environmental Medicine</italic>
</source>
<year>2003</year>
<volume>45</volume>
<issue>11</issue>
<fpage>1144</fpage>
<lpage>1151</lpage>
<pub-id pub-id-type="doi">10.1097/01.jom.0000094995.23808.7b</pub-id>
<pub-id pub-id-type="other">2-s2.0-0242582994</pub-id>
<pub-id pub-id-type="pmid">14610395</pub-id>
</element-citation>
</ref>
<ref id="B64">
<label>105</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hendriks</surname>
<given-names>H. S.</given-names>
</name>
<name>
<surname>Antunes Fernandes</surname>
<given-names>E. C.</given-names>
</name>
<name>
<surname>Bergman</surname>
<given-names>Å.</given-names>
</name>
<name>
<surname>van den Berg</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Westerink</surname>
<given-names>R. H. S.</given-names>
</name>
</person-group>
<article-title>PCB-47, PBDE-47, and 6-OH-PBDE-47 differentially modulate human GABAA and alpha4beta2 nicotinic acetylcholine receptors</article-title>
<source>
<italic>Toxicological Sciences</italic>
</source>
<year>2010</year>
<volume>118</volume>
<issue>2</issue>
<fpage>635</fpage>
<lpage>642</lpage>
<pub-id pub-id-type="doi">10.1093/toxsci/kfq284</pub-id>
<pub-id pub-id-type="other">2-s2.0-78549249545</pub-id>
<pub-id pub-id-type="pmid">20861069</pub-id>
</element-citation>
</ref>
<ref id="B65">
<label>106</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Goldman</surname>
<given-names>S. M.</given-names>
</name>
<name>
<surname>Quinlan</surname>
<given-names>P. J.</given-names>
</name>
<name>
<surname>Ross</surname>
<given-names>G. W.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Solvent exposures and Parkinson disease risk in twins</article-title>
<source>
<italic>Annals of Neurology</italic>
</source>
<year>2012</year>
<volume>71</volume>
<issue>6</issue>
<fpage>776</fpage>
<lpage>784</lpage>
<pub-id pub-id-type="doi">10.1002/ana.22629</pub-id>
<pub-id pub-id-type="other">2-s2.0-84862765771</pub-id>
<pub-id pub-id-type="pmid">22083847</pub-id>
</element-citation>
</ref>
<ref id="B66">
<label>107</label>
<element-citation publication-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jevtovic-Todorovic</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Absalom</surname>
<given-names>A. R.</given-names>
</name>
<name>
<surname>Blomgren</surname>
<given-names>K.</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar</article-title>
<source>
<italic>British Journal of Anaesthesia</italic>
</source>
<year>2013</year>
<volume>111</volume>
<issue>2</issue>
<fpage>143</fpage>
<lpage>151</lpage>
<pub-id pub-id-type="doi">10.1093/bja/aet177</pub-id>
<pub-id pub-id-type="other">2-s2.0-84878601588</pub-id>
<pub-id pub-id-type="pmid">23722106</pub-id>
</element-citation>
</ref>
</ref-list>
</back>
<floats-group>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Exposures potentially associated with neurodegenerative disease.</p>
</caption>
<table frame="hsides" rules="groups">
<tbody>
<tr>
<td align="left" rowspan="8" colspan="1">Metals</td>
<td align="left" rowspan="1" colspan="1">Lead [
<xref rid="B6" ref-type="bibr">6</xref>
<xref rid="B9" ref-type="bibr">9</xref>
,
<xref rid="B25" ref-type="bibr">25</xref>
<xref rid="B27" ref-type="bibr">27</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
,
<xref rid="B35" ref-type="bibr">35</xref>
,
<xref rid="B37" ref-type="bibr">37</xref>
,
<xref rid="B38" ref-type="bibr">38</xref>
,
<xref rid="B47" ref-type="bibr">47</xref>
,
<xref rid="B48" ref-type="bibr">48</xref>
,
<xref rid="B56" ref-type="bibr">63</xref>
,
<xref rid="B61" ref-type="bibr">83</xref>
,
<xref rid="B60" ref-type="bibr">84</xref>
,
<xref rid="B62" ref-type="bibr">87</xref>
,
<xref rid="B58" ref-type="bibr">90</xref>
,
<xref rid="B59" ref-type="bibr">92</xref>
,
<xref rid="B57" ref-type="bibr">104</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mercury [
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B25" ref-type="bibr">25</xref>
<xref rid="B27" ref-type="bibr">27</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Aluminum [
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B28" ref-type="bibr">28</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Zinc overload [
<xref rid="B7" ref-type="bibr">7</xref>
] </td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Manganese [
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
,
<xref rid="B47" ref-type="bibr">47</xref>
] </td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Arsenic [
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B27" ref-type="bibr">27</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Tin [
<xref rid="B8" ref-type="bibr">8</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Copper [
<xref rid="B30" ref-type="bibr">30</xref>
<xref rid="B33" ref-type="bibr">33</xref>
] </td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="11" colspan="1">Pesticides</td>
<td align="left" rowspan="1" colspan="1">Dichlorodiphenyldichloroethylene [
<xref rid="B10" ref-type="bibr">10</xref>
] (DDE)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Aldrin [
<xref rid="B29" ref-type="bibr">29</xref>
] </td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Chlordane [
<xref rid="B29" ref-type="bibr">29</xref>
] </td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Heptachlor [
<xref rid="B29" ref-type="bibr">29</xref>
] </td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Rotenone [
<xref rid="B5" ref-type="bibr">5</xref>
,
<xref rid="B7" ref-type="bibr">7</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Dieldrin [
<xref rid="B5" ref-type="bibr">5</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Methyl parathion [
<xref rid="B26" ref-type="bibr">26</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Organophosphates [
<xref rid="B5" ref-type="bibr">5</xref>
,
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B26" ref-type="bibr">26</xref>
,
<xref rid="B46" ref-type="bibr">46</xref>
,
<xref rid="B48" ref-type="bibr">48</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Maneb [
<xref rid="B5" ref-type="bibr">5</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Paraquat [
<xref rid="B5" ref-type="bibr">5</xref>
,
<xref rid="B7" ref-type="bibr">7</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
,
<xref rid="B46" ref-type="bibr">46</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Pyrethroids [
<xref rid="B5" ref-type="bibr">5</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Flame retardants</td>
<td align="left" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Hexabromocyclododecane [
<xref rid="B20" ref-type="bibr">20</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Tetrabromobisphenol-A [
<xref rid="B20" ref-type="bibr">20</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"> Brominated [
<xref rid="B63" ref-type="bibr">93</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Decabromodiphenyl ether [
<xref rid="B20" ref-type="bibr">20</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">6-Hydroxy-2,2′,4,4′-tetrabromodiphenyl ether [
<xref rid="B64" ref-type="bibr">105</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1"> Chlorinated </td>
<td align="left" rowspan="1" colspan="1">2,2′,4,4′-tetrachlorobiphenyl [
<xref rid="B64" ref-type="bibr">105</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Trichloroethylene [
<xref rid="B7" ref-type="bibr">7</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Carbon disulfide [
<xref rid="B26" ref-type="bibr">26</xref>
,
<xref rid="B29" ref-type="bibr">29</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Solvents [
<xref rid="B48" ref-type="bibr">48</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Toluene [
<xref rid="B26" ref-type="bibr">26</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Perchloroethylene (PERC) [
<xref rid="B65" ref-type="bibr">106</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">Pharmaceuticals</td>
<td align="left" rowspan="1" colspan="1">Anesthetic agents [
<xref rid="B66" ref-type="bibr">107</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Benzodiazepines [
<xref rid="B18" ref-type="bibr">18</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="5" colspan="1">Air pollution [
<xref rid="B6" ref-type="bibr">6</xref>
,
<xref rid="B47" ref-type="bibr">47</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Particulate matter [
<xref rid="B19" ref-type="bibr">19</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ozone [
<xref rid="B19" ref-type="bibr">19</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Nitrogen dioxide [
<xref rid="B19" ref-type="bibr">19</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Second hand smoke [
<xref rid="B27" ref-type="bibr">27</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Carbon monoxide [
<xref rid="B8" ref-type="bibr">8</xref>
,
<xref rid="B48" ref-type="bibr">48</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="2" colspan="1">Plasticizers</td>
<td align="left" rowspan="1" colspan="1">Phthalate esters [
<xref rid="B67" ref-type="bibr">59</xref>
,
<xref rid="B63" ref-type="bibr">93</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Bisphenol A [
<xref rid="B67" ref-type="bibr">59</xref>
,
<xref rid="B63" ref-type="bibr">93</xref>
]</td>
</tr>
<tr>
<td align="center" colspan="2" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="7" colspan="1">Others</td>
<td align="left" rowspan="1" colspan="1">Perfluorooctanesulfonic acid (PFOS) [
<xref rid="B63" ref-type="bibr">93</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Perfluoroctanoic acid (PFOA) [
<xref rid="B63" ref-type="bibr">93</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Organochlorine compounds [
<xref rid="B7" ref-type="bibr">7</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Acrylamide [
<xref rid="B29" ref-type="bibr">29</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Dioxins [
<xref rid="B25" ref-type="bibr">25</xref>
,
<xref rid="B27" ref-type="bibr">27</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Formaldehyde [
<xref rid="B13" ref-type="bibr">13</xref>
<xref rid="B15" ref-type="bibr">15</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Methanol [
<xref rid="B16" ref-type="bibr">16</xref>
,
<xref rid="B17" ref-type="bibr">17</xref>
]</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Canada/explor/ParkinsonCanadaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000928 | SxmlIndent | more

Ou

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000928 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Canada
   |area=    ParkinsonCanadaV1
   |flux=    Pmc
   |étape=   Corpus
   |type=    RBID
   |clé=     PMC:4334623
   |texte=   Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i   -Sk "pubmed:25722540" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a ParkinsonCanadaV1 

Wicri

This area was generated with Dilib version V0.6.29.
Data generation: Thu May 4 22:20:19 2017. Site generation: Fri Dec 23 23:17:26 2022