In-Home Toxic Exposures and the Community of Individuals Who Are Developmentally Disabled

Article excerpt

Environmental Exposures and Developmental Disabilities

Chemicals are ubiquitous in the environment, and human exposure to them is inevitable. A benchmark investigation of industrial chemicals, pollutants, and pesticides in umbilical cord blood indicated that humans are born with an average of 200 pollutants already present in their bodies.* The study found a total of 287 chemicals, of which, 180 are known human or animal carcinogens, 217 are neurotoxins, and 208 cause birth defects or abnormal development in animals. The dangers of prenatal exposure to this complex mixture of toxins and carcinogens have never been studied. There are over 80,000 chemicals in use or trade in the United States, and only about 200 of them have undergone full toxicological testing. Regulation lags behind science. The U.S. Centers for Disease Control and Prevention (CDC) recommends that public health actions be initiated when children's blood-lead levels (BLLs) rise above 10 [micro]g/dL, despite the emergence of studies now a few years old that indicate that BLLs below this recommended level may pose a hazard to children.

The Toxic Substances Control Act (TSCA) of 1976 in the United States uses risk assessment models derived from average adult populations, thereby inadequately protecting the most vulnerable populations. Vulnerable populations include children, the elderly, those with health impairments, and persons with developmental disabilities.

The risk of toxic exposures among persons with developmental disabilities increases with impaired communication skills and motor skills, possible nutrition problems, inappropriate behaviors, secondary physical health problems, possible mobility problems, and the use of pharmaceuticals. Persons with developmental disabilities may have fewer social supports and networks. Risk may also be increased when those with developmental disabilities are dependent on parental or caregiver choices and behaviors, such as smoking at home; food choices; the absence of carbon monoxide detectors; pesticide spraying; or use of other household cleaners. Caregivers may also bring home toxins on their clothing from work. In addition, individuals with developmental disabilities may not always recognize harmful conditions and may not complain about the poor conditions that they do recognize. Some individuals with developmental disabilities may live or work in poorly regulated residential and segregated work settings. Risk of exposure among those living independently may arise from their household choices and practices, as well as from their socioeconomic status (SES).

The population of individuals with developmental disabilities was formally recognized by the U.S. Agency for Healthcare Research and Quality (AHRQ) in 2003 as a priority population with clear health care disparities. Compared with the general population, this community is less educated, practices less preventative health behaviors, and adopts more risk behaviors.

On average, their diminished capacity to work, lowered income, and higher medical expenses leave people with developmental disabilities more economically disadvantaged than the general population. In addition, because of the difficulties they face in finding employment, many are often forced to take the unwanted jobs-those with more hazards and less protections-in addition to lower wages. There is also a higher rate of developmental disabilities among African Americans (24.3/1,000) versus Caucasians (13.6/1,000), although the discrepancy is associated more with poverty than race. Minorities and the economically disadvantaged persons not only have less access to health care but greater risks of exposure to environmental contaminants, further exacerbating health discrepancies.

This population is often not included in scientific research of environmental hazards, especially not as a separate study of a population of particular interest.

The plight of any segment of the population ultimately affects society as a whole. …