| | TOXICOLOGICAL PROFILE FOR STRONTIUM |
| | 3,08 | | MB |
| | 445 | | stron |
| | 3469 | | ID | Agency for Toxic Substances and Disease Registry |
| | 2004 | | rok |
| | CONTENTS |
| | DISCLAIMERii |
| | UPDATE STATEMENT.iii |
| | FOREWORD.. v |
| | QUICK REFERENCE FOR HEALTH CARE PROVIDERS..vii |
| | CONTRIBUTORS..xi |
| | PEER REVIEW .xiii |
| | CONTENTS.. xv |
| | LIST OF FIGURES .xix |
| | LIST OF TABLESxxi |
| | 1. PUBLIC HEALTH STATEMENT. 1 |
| | 1.1 WHAT IS STRONTIUM?.. 1 |
| | 1.2 WHAT HAPPENS TO STRONTIUM WHEN IT ENTERS THE ENVIRONMENT? . 3 |
| | 1.3 HOW MIGHT I BE EXPOSED TO STRONTIUM? 4 |
| | 1.4 HOW CAN STRONTIUM ENTER AND LEAVE MY BODY?.. 5 |
| | 1.5 HOW CAN STRONTIUM AFFECT MY HEALTH?. 6 |
| | 1.6 HOW CAN STRONTIUM AFFECT CHILDREN? . 8 |
| | 1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO STRONTIUM? 9 |
| | 1.8 IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN EXPOSED TO |
| | STRONTIUM? . 10 |
| | 1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO PROTECT |
| | HUMAN HEALTH?. 11 |
| | 1.10 WHERE CAN I GET MORE INFORMATION? 12 |
| | 2. RELEVANCE TO PUBLIC HEALTH .15 |
| | 2.1 BACKGROUND AND ENVIRONMENTAL EXPOSURES TO STRONTIUM IN THE UNITED |
| | STATES.. 15 |
| | 2.2 SUMMARY OF HEALTH EFFECTS.. 16 |
| | 2.3 MINIMAL RISK LEVELS . 23 |
| | 3. HEALTH EFFECTS.. 27 |
| | 3.1 INTRODUCTION.. 27 |
| | 3.2 DISCUSSION OF HEALTH EFFECTS OF STABLE STRONTIUM BY ROUTE OF EXPOSURE.. |
| | 31 |
| | 3.2.1 Inhalation Exposure . 33 |
| | 3.2.1.1 Death 33 |
| | 3.2.1.2 Systemic Effects. 33 |
| | 3.2.1.3 Immunological and Lymphoreticular Effects . 34 |
| | 3.2.1.4 Neurological Effects.34 |
| | 3.2.1.5 Reproductive Effects34 |
| | 3.2.1.6 Developmental Effects 34 |
| | 3.2.1.7 Cancer . 35 |
| | 3.2.2 Oral Exposure . 35 |
| | 3.2.2.1 Death 36 |
| | 3.2.2.2 Systemic Effects. 36 |
| | 3.2.2.3 Immunological and Lymphoreticular Effects . 58 |
| | 3.2.2.4 Neurological Effects.58 |
| | 3.2.2.5 Reproductive Effects58 |
| | 3.2.2.6 Developmental Effects 58 |
| | 3.2.2.7 Cancer . 59 |
| | 3.2.3 Dermal Exposure .. 59 |
| | 3.2.3.1 Death 60 |
| | 3.2.3.2 Systemic Effects. 60 |
| | 3.2.3.3 Immunological and Lymphoreticular Effects . 60 |
| | 3.2.3.4 Neurological Effects.60 |
| | 3.2.3.5 Reproductive Effects60 |
| | 3.2.3.6 Developmental Effects 60 |
| | 3.2.3.7 Cancer . 60 |
| | 3.2.4 Other Routes of Exposure. 60 |
| | 3.3 DISCUSSION OF HEALTH EFFECTS OF RADIOACTIVE STRONTIUM BY ROUTE OF |
| | EXPOSURE.. 62 |
| | 3.3.1 Inhalation Exposure . 63 |
| | 3.3.1.1 Death 64 |
| | 3.3.1.2 Systemic Effects. 65 |
| | 3.3.1.3 Immunological and Lymphoreticular Effects . 73 |
| | 3.3.1.4 Neurological Effects.74 |
| | 3.3.1.5 Reproductive Effects 74 |
| | 3.3.1.6 Developmental Effects 74 |
| | 3.3.1.7 Cancer . 74 |
| | 3.3.2 Oral Exposure . 76 |
| | 3.3.2.1 Death 77 |
| | 3.3.2.2 Systemic Effects. 80 |
| | 3.3.2.3 Immunological and Lymphoreticular Effects . 93 |
| | 3.3.2.4 Neurological Effects.94 |
| | 3.3.2.5 Reproductive Effects94 |
| | 3.3.2.6 Developmental Effects 95 |
| | 3.3.2.7 Cancer . 97 |
| | 3.3.3 External Exposure.. 100 |
| | 3.3.3.1 Death . 101 |
| | 3.3.3.2 Systemic Effects..101 |
| | 3.3.3.3 Immunological and Lymphoreticular Effects .. 108 |
| | 3.3.3.4 Neurological Effects..108 |
| | 3.3.3.5 Reproductive Effects.108 |
| | 3.3.3.6 Developmental Effects . 108 |
| | 3.3.3.7 Cancer .. 108 |
| | 3.3.4 Other Routes of Exposure..110 |
| | 3.4 GENOTOXICITY . 113 |
| | 3.5 TOXICOKINETICS. 118 |
| | 3.5.1 Absorption . 118 |
| | 3.5.1.1 Inhalation Exposure ..118 |
| | 3.5.1.2 Oral Exposure 120 |
| | 3.5.1.3 Dermal Exposure.123 |
| | 3.5.2 Distribution 125 |
| | 3.5.2.1 Inhalation Exposure ..125 |
| | 3.5.2.2 Oral Exposure 126 |
| | 3.5.2.3 Dermal Exposure.129 |
| | 3.5.3 Metabolism 129 |
| | 3.5.3.1 Inhalation Exposure ..130 |
| | 3.5.3.2 Oral Exposure 130 |
| | 3.5.3.3 Dermal Exposure.130 |
| | 3.5.4 Elimination and Excretion .130 |
| | 3.5.4.1 Inhalation Exposure ..130 |
| | 3.5.4.2 Oral Exposure 131 |
| | 3.5.4.3 Dermal Exposure.132 |
| | 3.5.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models. 132 |
| | 3.6 MECHANISMS OF ACTION 147 |
| | 3.6.1 Pharmacokinetic Mechanisms . 147 |
| | 3.6.2 Mechanisms of Toxicity .150 |
| | 3.6.3 Animal-to-Human Extrapolations.. 154 |
| | 3.7 TOXICITIES MEDIATED THROUGH THE NEUROENDOCRINE AXIS 155 |
| | 3.8 CHILDREN’S SUSCEPTIBILITY.. 156 |
| | 3.9 BIOMARKERS OF EXPOSURE AND EFFECT 162 |
| | 3.9.1 Biomarkers Used to Identify or Quantify Exposure to Strontium . 163 |
| | 3.9.2 Biomarkers Used to Characterize Effects Caused by Strontium 164 |
| | 3.10 INTERACTIONS WITH OTHER CHEMICALS 164 |
| | 3.11 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE 165 |
| | 3.12 METHODS FOR REDUCING TOXIC EFFECTS.. 167 |
| | 3.12.1 Reducing Peak Absorption Following Exposure.. 168 |
| | 3.12.2 Reducing Body Burden . 170 |
| | 3.12.3 Interfering with the Mechanism of Action for Toxic Effects . 173 |
| | 3.13 ADEQUACY OF THE DATABASE.. 173 |
| | 3.13.1 Existing Information on Health Effects of Strontium. 173 |
| | 3.13.2 Identification of Data Needs176 |
| | 3.13.3 Ongoing Studies 187 |
| | 4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION .. 189 |
| | 4.1 CHEMICAL IDENTITY 189 |
| | 4.2 PHYSICAL, CHEMICAL, AND RADIOLOGICAL PROPERTIES. 189 |
| | 5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL. 199 |
| | 5.1 PRODUCTION .. 199 |
| | 5.2 IMPORT/EXPORT .. 200 |
| | 5.3 USE.. 200 |
| | 5.4 DISPOSAL.. 201 |
| | 6. POTENTIAL FOR HUMAN EXPOSURE .. 205 |
| | 6.1 OVERVIEW 205 |
| | 6.2 RELEASES TO THE ENVIRONMENT.. 208 |
| | 6.2.1 Air . 208 |
| | 6.2.2 Water 213 |
| | 6.2.3 Soil 213 |
| | 6.3 ENVIRONMENTAL FATE.214 |
| | 6.3.1 Transport and Partitioning . 214 |
| | 6.3.2 Transformation and Degradation 217 |
| | 6.3.2.1 Air 219 |
| | 6.3.2.2 Water. 219 |
| | 6.3.2.3 Sediment and Soil ..219 |
| | 6.3.2.4 Other Media .. 220 |
| | 6.4 LEVELS MONITORED OR ESTIMATED IN THE ENVIRONMENT. 220 |
| | 6.4.1 Air . 220 |
| | 6.4.2 Water 222 |