Chemistry Reference
In-Depth Information
pects for prevention. Ongoing and future studies were
described and discussed.
For each of the metals, initial recognition of neu-
rotoxicity occurred in the context of high-dose expo-
sure. For example, lead poisoning was fi rst recognized
in miners, smelters, and typesetters, methylmercury
poisoning in inhabitants of the fi shing community of
Minamata, and manganese poisoning in miners and
ferroalloy workers. Subsequent development of more
sensitive and sophisticated analytical instruments led
to the recognition of subclinical toxicity and develop-
mental neurotoxicity at progressively lower levels of
exposure. In each case the extent of toxicity was much
greater than initially appreciated and the size of the
affected population much larger. Many decades typi-
cally elapsed between the initial recognition of neuro-
toxicity and the initiation of programs for prevention.
Early warnings were frequently ignored and even
actively resisted.
The historical observation that long delays had
typically elapsed before the initiation of prevention
prompted extensive discussion at the Workshop about
the need to develop more effective strategies. From
this discussion, a series of recommendations emerged
on future directions for research and prevention of the
neurotoxicity of metals.
At the closing session of the International Workshop
at Brescia, the following recommendations on the Pre-
vention of the Neurotoxicity of Metals were adopted
by consensus:
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1.
Intensifi ed attention must be paid to early warnings of
neurotoxicity
. Clinical observations or toxicological
data suggesting the existence of neurotoxicity—
including subclinical and developmental toxicity—
must be taken very seriously. Such observations
should prompt consideration of prudent preventive
action.
2.
All uses of lead including recycling should be reviewed in
all nations
and uses contributing to environmental
and human exposures, such as uses in toys, paint,
water pipes, building materials, solder, electronics,
medications, and cosmetics ended. The transfer of
these products from one country to another should
also be avoided. This approach has been adopted
successfully in the EU and needs to be extended
worldwide.
3. In particular,
tetraalkyllead must be eliminated without
delay from the gasoline supplies of all nations
. The re-
moval of organic lead from gasoline has produced
declines of >90% in population mean blood lead lev-
els in industrially developed nations, and this suc-
cess is now being repeated in some of the develop-
ing nations. This action represents one of the great
THE DECLARATION OF BRESCIA
ON PREVENTION OF THE
NEUROTOXICITY OF METALS
Brescia, Italia
17-18 June 2006
On 17-18 June 2006, the Scientifi c Committee on
Neurotoxicology and Psychophysiology and the
Scientifi c Committee on the Toxicology of Metals of
the International Commission on Occupational Health
(ICOH) convened an International Workshop on
Neu-
rotoxic Metals: Lead, Mercury and Manganese—From
Research to Prevention (NTOXMET)
at the University of
Brescia. Scientists and physicians from 27 nations par-
ticipated.
Data were presented for each of the three metals on
environmental sources, fate, and distribution; human
exposure; clinical, subclinical, and developmental neu-
rotoxicity; epidemiology; risk assessment; and pros-
