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Teratogens

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Thomas Wakeling

on 26 February 2015

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Transcript of Teratogens

Tsutomu Yamaguchi was within 2 miles of the X in Hiroshima (August 6, 1945) and was within 1 mile of the X in Nagasaki (August 9, 1945). He's the only recognized double bomb survivor.

Yamaguchi and his wife had three children 10 years later and
all three were born without birth defects.
When they reached their teens, though, they said they got sick more often than their peers. The
two daughters are still alive and the son died from cancer at age 58.

Mrs. Yamaguchi died in 2008 of liver and kidney cancer when she was 88.
"The Nagasaki plutonium bomb probably caused both of her cancers, yes, " Sam writes, "b
ut at those ages it's conceivable that she would have gotten cancer anyway, for unrelated reasons. The Yamaguchi children were most likely born without defects because the fetuses weren't exposed to radiation in utero."

Tsutomu Yamaguchi died of stomach cancer on January 4, 2010 at the age of 93.
Ashley Bowman, Dolores J. Thackrah, Thomas Wakeling II, Heather Wissler
Non-ionizing Radiation
Air Pollution
The least amount of research and studies have been conducted and/or verified in this area

Sulfur Oxide, Carbon Monoxide, Nitrogen Oxides
Increase in Cardiac defects

Sources
American Family Physician. 2010 Sep 1;82(5):488-493.

Dolk, H., & Vrijheid, M. (2003, January 1). British Medical Bulletin. Retrieved November 28, 2014, from http://bmb.oxfordjournals.org/content/68/1/25.full

Radiation dosages. Univeristy of Waterloo. Retrieved from http://www.science.uwaterloo.ca/~cchieh/cact/nuctek/safetydose.html

HIV and fetal development. Mayo Clinic. (2014). Retrieved from http://www.mayoclinic.org/search/search-results?q=hiv%20and%20fetal%20development

Hepatitis Central. 2014. Retrieved from http://www.hepatitiscentral.com/hcv/hepatitis/pregnancy.html?ssrc=left_sidebar
Affects can vary depending on the stage of development, or "sensitive period"
2-4% of births have congenital abnormalities,


Cardiac
: >25%

Limb Abnormalities
: 20%

Chromosomal
: 15%

Urinary system
: 15%

Central Nervous system
: 10%

Oral Clefts
: 7%

Pollution
• Lead, Cadmium, Arsenic, Barium, Chromium, Mercury, Selenium, Silver
• Nitrates & Nitrites
• Fluoride
Increases Risk of Cardiac & Central Nervous System (But not Spina Bifida) Defects
• Chlorinated & Aromatic Solvents
Eyes, Ears, Nervous System, oral cleft, & chromosomal (mostly down syndrome) Abnormalities

Water Pollution
• 33% increase in risk of all non-chromosomal birth defects combined for residents living within 3 km of 21 hazardous waste landfill sites
• Can enter the body via drinking water, food, direct contact, or inhalation of solvents

Methyl Mercury
, commonly found in some grains, is damaging to the central nervous system during development

Furan
, which caused an epidemic in Rice Oil, resulted in low birth weight, neonatal jaundice, Melanin abnormality in skin, and a very high infant death rate

Ground Pollution
Non-ionizing radiation is not associated with significant risks so procedures utilizing such techniques are safe to perform during pregnancy
Ionizing Radiation
Particles of x-rays and gamma rays have more energy than light and have shorter wavelengths; thus, they're able to penetrate cellular structure. Deletion of DNA segments is the leading form of radiological damage.
Street Drugs & Pregnancy
A street drug is a drug that is against the law to have or use. About 1 in 20 women take street drugs during pregnancy. Street drugs include:

Cocaine or crack
Heroin
Methamphetamine
Ecstasy or other club drugs
Marijuana

Cocaine
Cocaine crosses the placenta and enters the baby's circulation. The elimination of cocaine is slower in a fetus.
Effects central nervous system and may change your sense of sight, sound and touch
Heart attack, stroke, respiratory failure, loss of appetite, severe weight loss, and infections like HIV or hepatitis.
Marijuana
Marijuana crosses the placenta to the baby.
Contains toxins that keep the baby from getting the proper supply of oxygen
Affects how your brain works.
Very fast heart rate, lung problems, trouble paying attention, memory problems, clumsiness
Problems Before Pregnancy
Infertility - not being able to become pregnant
Hormones needed to get pregnant
Menstrual Cycle - releasing ovaries
Sperm Count
Problems during Pregnancy
Placental abruption.
Placenta separates from the wall of the uterus before birth. Causes heavy bleeding and can be deadly for mother and baby.
Premature birth
.
This is birth that happens too early, before 37 weeks
Low birthweight.
This is when a baby is born weighing less than 5 pounds, 8 ounces
Miscarriage.
This is when a baby dies in the womb before 20 weeks of pregnancy.
Noenatal abstinence syndrome (NAS).
Baby is addicted to a drug before birth and then goes through withdrawal after birth.
Stillbirth.
This is when a baby dies in the womb before birth, but after 20 weeks of pregnancy.
Problems after Birth
Learning and behavior problems
Slower than normal growth
Sudden Infant death syndrome
Suffer withdrawal symptoms
Low birthweight babies are 20 times more likely to die in their first month
Increased risk of lifelong disabilities
Infectious Disease and Pregnancy
Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality. Infections can develop in the neonate transplacentally, perinatally (from vaginal secretions or blood), or postnatally (from breast milk or other sources).

Traditionally, the only viral infections of concern during pregnancy were those caused by rubella virus, CMV, and herpes simplex virus (HSV). Other viruses now known to cause congenital infections include parvovirus B19 (B19V), varicella-zoster virus (VZV), West Nile virus, measles virus, enteroviruses, adenovirus, and human immunodeficiency virus (HIV).
HIV can be transmitted from an HIV-positive woman to her child either during pregnancy, or during labor and delivery, or by breastfeeding. In Europe and the USA, about 15 to 20% of babies born to HIV-positive women who are not taking anti-HIV drugs are infected.

However, the risks of mother-to-child transmission of HIV can be reduced to below 1% by the appropriate use of HIV treatment during pregnancy and labor; by having a caesarean delivery if you have a high detectable viral load; and (when safe alternatives are available) by not breastfeeding.
Hepatitis C and Pregnancy
The risk of a pregnant woman passing the hepatitis C virus to her unborn child has been related to the levels of quantitative RNA levels in her blood, and also whether she is also HIV positive. The risk of transmission to the infant is less (0 to 18%) if the mother is HIV negative and if she has no history of i.v. drug use or of blood transfusions.

There is no preventive treatment at this time that can influence the rate of transmission of the virus from mother to infant.

However, if a newborn is exposed, the infection is usually mild and they will have a lifelong immunity to the disease.

HIV and Pregnancy
Infections known to produce congenital defects have been described with the acronym TORCH (Toxoplasma, others, rubella, cytomegalovirus [CMV], herpes). The "others" category has rapidly expanded to include several viruses known to cause neonatal disease, such as HIV.
Infectious Disease and Pregnancy
Fetal Dose >100 mSv
The lower for threshold doses for effects such as mental retardation and diminished IQ and school performance fall within this range. Overall, exposure at levels exceeding 100 mSv could be expected to result in a dose-related increased risk for deleterious effects.
Radiation can cause germ-line mutations, potentially affecting future generations. Although radiation is commonly believed to create bizarre new mutations, it merely increases the frequency of mutations occurring naturally in the general population.
If 10,000 persons were exposed to 100 mSv, 10 to 40 new genetic mutations would be induced.
Heroin
Very addictive drug that crosses the placenta to the baby
Affects the central nervous system and how your brain works.
Respiratory failure, heart and lung infections, HIV, hepatitis, kidney and liver disease
Methamphetamine & Club Drugs
Trouble sleeping, very fast heart beat, sweating, hallucinations, high blood pressure
Crosses the placenta to the baby
Raises heart rate of mom and baby
Less oxygen to baby
sources of everyday exposure
environmental
3 mSv
medical
2 mSv
industrial
1 mSv
The average American is exposed to about 6 mSv each year. This dose has not been shown to cause harm to humans.
Time:
The amount of radiation exposure increases and decreases with the time people spend near the source of radiation.

Distance:
The farther away people are from a radiation source, the less their exposure. The exposure of an individual sitting 4 feet from a radiation source will be 1/4 the exposure of an individual sitting 2 feet from the same source

Shielding:
The greater the shielding around a radiation source, the smaller the exposure.
Basic Protection
Iodizing radiation is capable of causing miscarriage, stunted growth, and mental retardation
Fetal Dose <10 mSv
There is no evidence supporting the increased incidence of any deleterious developmental effects on the fetus at diagnostic doses within this range.

Fetal Dose 10 - 100 mSv
The additional risk of gross congenital malformations, mental retardation, intrauterine growth retardation and childhood cancer is believed to be low compared to to the baseline risk.
Exposure in Hiroshima : 200-220 mSv of gamma radiation.
Exposure in Nagasaki :1600-2100 mSv of gamma radiation.
Persons exposed to the bombs at the time of detonation did show effects from ionizing radiation. Deaths from radiation began about a week after exposure and reached a peak in 3 to 4 weeks. They ceased to occur after 7 to 8 weeks.

Radiation ultimately caused the death of the few persons not killed by other effects and who were fully exposed to the bombs up to a distance of about 1/2 mile from X.

It's estimated that people in the open had a 50% chance of surviving the effects of radiation at 3/4 of a mile from X.

Today, Hiroshima and Nagasaki’s radiation levels match the world average background radiation of 0.87 mSv/a.
Nagasaki
Hiroshima
TIP: Delay non-urgent radiographs during the sensitive period of 10 to 17 weeks of gestation
Teratogens
Irradiation during this period may deplete cell populations at very high doses (over 500 mSv), but will not result in gross organ malformations.
The overall growth rate of the fetus has slowed. However, the
major organ systems are beginning to differentiate.

From a standpoint of future development, the fetus is in its most sensitive stage.
The incidence of gross congenital malformations and mental retardation are dose-related and appear to have thresholds; i.e. doses below which the incidence above "background" is not elevated.
The rate of fetal growth is very rapid and the fetus,
as an organism, is at its most radiation-sensitive stage.
The incidence of fetal mortality at this stage of gestation is not known, since
(a) many women were never aware they were pregnant at the time of the exposure or miscarriage,
and (b) the "background" rate of miscarriage is believed to be high (25-50% of conceptions).
It is believed that radiation injury during early gestation is an "all-or-nothing" effect.
Early Gestation / First Trimester
Second Trimester
Third Trimester
child infected with rubella
Full transcript