(Beyond Pesticides, June 20, 2011) In a study published this week in the journal Pediatrics, researchers report findings that link mothers’ exposure to organochlorine pesticides during pregnancy with infants’ sizes at birth. The trend shows that the more mothers are exposed to the pesticides during pregnancy, the higher the chances are for reduced birth weight and length of their newborns. Comprising a total of 494 women and infants in Valencia, Spain from the years 2003-2006, the study evaluates umbilical cord blood for residues of four pesticides or pesticide degradates: DDT, DDE, hexachlorobenzene (HCB), and beta-hexachlorocyclohexane. The results show that a 10-fold increase in pesticide concentrations in the blood corresponds to a reduction in birth weight of 2-4 ounces. Additional results are correlated to specific pesticides. Higher concentrations of DDT results in a reduction in head circumference of 0.26cm, which the researchers call a “significant decrease.” Additionally, a decrease of 0.39cm in birth length is correlated with each 10-fold increase in concentration of HCB. The researchers note several concerns related to the findings, aside from the results themselves. Since people are exposed to a wide variety of chemicals in general throughout their everyday lives, higher pesticide exposure could betray higher exposure […]

(Beyond Pesticides, May 9, 2011) The Endocrine Disruptor Exchange Inc. (TEDX), founded by Theo Colborn, PhD, has released a list of chemicals with the potential to affect the endocrine system. According to TEDX, every chemical on the TEDX List has one or more verified citations to published, accessible, primary scientific research demonstrating effects on the endocrine system. Endocrine disruptors are chemicals that impact traditional endocrine glands, their hormones and receptors such as estrogens, anti-androgens, and thyroid hormones. To date there are approximately 800 endocrine disruptors on the TEDX List. Download the TEDX List (Excel) Many everyday chemicals that people are exposed to can wreak havoc on the body’s endocrine system. Pesticides such as triclosan, atrazine, permethrin and many others have been associated with effects on the body’s hormone system. Visit the Pesticide Induced Disease Database for more on the chemicals linked to endocrine disruption. Endocrine effects include direct effects on traditional endocrine glands, their hormones and receptors such as estrogens, anti-androgens, and thyroid hormones, as well as signaling cascades that affect many of the body’s systems, including reproductive function and fetal development, the nervous system and behavior, the immune and metabolic systems, the liver, bones and many other organs, glands […]

(Beyond Pesticides, April 28, 2011) In recognition of the 3rd annual Save the Frogs Day, a “Save the Frogs/Ban Atrazine Rally” will be held tomorrow, Friday, April 29th in Washington, DC. The rally will take place at the steps of the U.S. Environmental Protection Agency (1200 Pennsylvania Ave, NW), and is intended to raise awareness of the rapid disappearance of frog species worldwide, and bring attention to the harmful effects of the endocrine disrupting herbicide atrazine. Amphibian populations worldwide have been declining at unprecedented rates, and nearly one-third of the world’s amphibian species are threatened with extinction. Up to 200 species have completely disappeared in recent years. Amphibians are faced with an onslaught of environmental problems, including climate change, infectious diseases, habitat loss, invasive species, and over-harvesting for the pet and food trades. Numerous studies have definitively linked pesticide use with significant effects on amphibians. Pesticides can cause abnormalities, diseases, injury and death in these frogs and other amphibians. Because amphibians breathe through their permeable skin, they are especially vulnerable to chemical contamination. Frog eggs float exposed on the water surface, where pesticides tend to concentrate, and hatched larvae live solely in aquatic environments for five to seven months before […]

(Beyond Pesticides, March 10, 2011) The American Public Health Association (APHA) recently adopted 17 new policies at its 138th Annual Meeting in Denver, addressing a broad range of public health concerns, including a new policy calling for greater government action to protect the public from endocrine-disrupting chemicals (EDCs). The policy statement follows official positions released earlier in 2010 by both the American Medical Association (AMA) and the Endocrine Society in that more needs to be done to protect the public from endocrine-disrupting chemicals, or those that interfere with hormone action. Specifically, APHA urges: ”¢ Support for the Endocrine Society and the American Medical Association in proclaiming that more needs to be done to protect the public from potential health risks of exposure to EDCs. ”¢ That given the magnitude and urgency of the public health threat and the recognition that collectively EDCs likely will have common or overlapping effects on the endocrine system, steps should therefore be taken by federal agencies with regulatory oversight for various individual EDCs to coordinate and find synergies among themselves to coordinate and find synergy among federal agencies with regulatory oversight over various individual EDCs. ”¢ Health professionals and scientists with expertise in various aspects […]

(Beyond Pesticides, February 16, 2011) Many agricultural pesticides —including some previously untested and commonly found in food— disrupt male hormones, according to new tests conducted by British scientists. Meanwhile, U.S. researchers at the National Institutes of Health have found that people who used two specific varieties of pesticide were 2.5 times as likely to develop Parkinson’s disease. Pesticides Impact Male Hormones Evidence suggests that there is widespread decline in male reproductive health and anti-androgenic pollutants, also known as endocrine disruptors, may play a significant role. Thirty out of 37 pesticides tested by the researchers at the University of London altered male hormones, including 16 that had no known hormonal activity until now. There was some previous evidence for the other 14. Most are fungicides applied to fruit and vegetable crops, including strawberries and lettuce. The study, “Widely Used Pesticides with Previously Unknown Endocrine Activity Revealed as in Vitro Anti-Androgens,” is published in Environmental Health Perspectives. The British researchers screened the chemicals using in vitro assays, which use human cells to check whether the pesticides activate or inhibit hormone receptors in cells that turn genes on and off. Scientists, however, are uncertain what actually happens in the human body at the […]

(Beyond Pesticides, December 8, 2010) A new study finds that oral contraceptives are not the main culprit in estrogenic pollution of U.S. rivers and drinking water. Instead, the contribution of contraceptives is quite small compared to other human, industrial and agricultural sources, including pesticides. Recent observed feminization of aquatic animals has raised concerns about estrogenic compounds in water supplies and the potential for these chemicals to reach drinking water. Public perception frequently attributes this feminization to oral contraceptives (OCs) in wastewater and raises concerns that exposure to OCs in drinking water may contribute to the recent rise in human reproductive problems. Studies have suggested that long-term exposure to low levels of estrogens in water may adversely affect human health. This new information eases concerns that contraceptives are a major factor contributing to feminized fish and frogs. This study, “Are Oral Contraceptives a Significant Contributor to the Estrogenicity of Drinking Water?” reviews the literature regarding various sources of estrogens, in surface, source and drinking water, to determine whether OCs were the source of estrogen in surface waters, with an emphasis on the active molecule that comes from OCs. The authors find that industrial and agricultural sources not only discharge estrogens, but […]

(Beyond Pesticides, November 18, 2010) Yesterday, the U.S. Environmental Protection Agency (EPA) announced that it has identified a list of 134 chemicals that will be screened for their potential to disrupt the endocrine system, along with a draft of the policies and procedures that the agency will follow for testing. Endocrine disruptors are chemicals that that interfere with the hormones produced or secreted by the human or animal endocrine system, which regulates development, metabolism, growth, and reproduction. These man-made chemicals are used in everyday materials but appearing in increasing levels throughout the environment. For years, scientists have noted strange anomalies in fish and wildlife in locations where endocrine disrupting chemicals (EDCs) are found. A recent study found that an astounding 100 percent of small mouth bass in certain sites of the Potomac River basin have exhibited both male and female organs, a characteristic linked to EDCs. According to a 2009 study by the U.S. Geologic Survey, the occurrence of “intersex” fish is now found to be nationwide. EPA is currently proceeding with endocrine disruptor screening on three fronts: 1) Developing and validating Tier 2 tests; 2) Selecting chemicals for screening and testing; and 3) Implementing the policies and procedures the […]

(Beyond Pesticides, September 14, 2010) A new study confirms that indoor uses of consumer products, including pesticides, are the primary sources of indoor exposure to endocrine disruptors —chemicals that disrupt hormones and cause adverse developmental, disease, and reproductive problems— and shows that indoor levels are higher than those outdoors. Researchers from Silent Spring Institute, Columbia University, and the University of California-Berkeley measured airborne concentrations of endocrine disruptors in two California communities: Bolinas, a rural, affluent coastal town, and Richmond, a working-class city ringed by oil refineries. The study is published online in the September 1, 2010 issue of Environmental Science & Technology. The researchers analyzed 104 chemicals in 50 homes, including both chemicals that penetrate indoors from outdoor industrial and transportation sources and those from indoor use of consumer products and building materials. Similar levels of contamination were found inside homes in both communities, but outdoor levels were higher in Richmond. Among the chemicals found were pesticides, phthalates, parabens, PBDE flame retardants, and PCBs. A total of 38 pesticides are evaluated, including banned organochlorines (e.g., DDT, PCP), and current use products such as carbamates (e.g., propoxur), organophosphates (e.g., chlorpyrifos), and pyrethroids (cypermethrin). Thirteen pesticides were detected outdoors and sixteen pesticides […]

(Beyond Pesticides, August 31, 2010) As the Environmental Protection Agency (EPA) continues its review of the popular herbicide atrazine, a new study shows that male rats prenatally exposed to low doses of the gender-bending chemical are more likely to develop prostate inflammation and to go through puberty later than non-exposed animals. The research adds to a growing body of literature on atrazine, an herbicide used in agriculture, especially in corn and sugar cane production, and on golf courses and residential lawns. Atrazine and its byproducts are known to be relatively persistent in the environment, potentially finding their way into water supplies. It has been linked to a myriad of health problems in humans including disruption of hormone activity, birth defects, and cancer. The research, “Effects of prenatal exposure to a low dose atrazine metabolite mixture on pubertal timing and prostate development of male Long-Evans rats,” which is available online and will be featured on the cover of Reproductive Toxicology (Vol. 30, # 4), found that the incidence of prostate inflammation went from 48 percent in the control group to 81 percent in the male offspring who were exposed to a mixture of atrazine and its breakdown products prenatally. The severity […]

(Beyond Pesticides, January 14, 2010) Stating that current water-quality criteria does not reflect the latest scientific knowledge, The Center for Biological Diversity petitioned the U.S. Environmental Protection Agency (EPA) to establish new water-quality criteria for numerous endocrine-disrupting chemicals (EDC) under the Clean Water Act. If adopted, it will be a big step in regulating and eliminating persistent and widespread chemicals that damage reproductive functions in wildlife and humans. The Center for Biological Diversity formally requested that the EPA publish water quality criteria and information taking into account overwhelming science about the effects of EDC pollution on January 11. It says that under the Clean Water Act, EPA has a duty to periodically update water quality criteria to reflect the latest scientific knowledge. The petition presents scientific information on endocrine disrupting chemical pollution found in our waters and requests that the EPA promptly update water quality criteria reflecting this scientific information. Last month, legislation was introduced into Congress to explore linkages between hormone disrupting chemicals in the environment and everyday products and the dramatic increase of autism, hyperactivity, diabetes, obesity, breast cancer, prostate cancer and other hormone related disorders. After the identification of endocrine disruptors, the bill, The Endocrine Disruption Prevention […]

(Beyond Pesticides, December 21, 2009) Earlier this month, Congressman Jim Moran of Northern Virginia and Senator John Kerry of Massachusetts introduced legislation to explore linkages between hormone disrupting chemicals in the environment and everyday products and the dramatic increase of autism, hyperactivity, diabetes, obesity, breast cancer, prostate cancer and other hormone related disorders. After the identification of endocrine disruptors, the legislation requires federal agencies with regulatory authority to report to Congress on the action it plans to take. For years, scientists have noted strange anomalies in fish and wildlife in locations where endocrine disrupting chemicals (EDCs) are found. A recent study found that an astounding 100 percent of small mouth bass in certain sites of the Potomac River basin have exhibited both male and female organs, a characteristic linked to EDCs. According to a 2009 study by the U.S. Geologic Survey, the occurrence of “intersex” fish is now found to be nationwide. “These fish are the proverbial ”˜canaries in the coal mine,’ a symptom of a larger sickness in our environment. The implications for humans are real and deeply troubling,” said U.S. Representative Moran, who worked with experts for roughly a year to craft the legislation. “We need facts driven […]

(Beyond Pesticides, December 15, 2009) Exposure to the endocrine-disrupting herbicide atrazine triggers the release of stress hormones in rats, according to a new study published in the December 2009 issue of the journal Toxicological Sciences. The researchers believe this may explain how the popular weed killer produces some its harmful reproductive effects. The study, “Characterization of the Hypothalamic-Pituitary-Adrenal Axis Response to Atrazine and Metabolites in the Female Rat,” was conducted by the Environmental Protection Agency’s (EPA) National Health and Environmental Effects Research Laboratory. According to a December 4 analysis by Environmental Health Sciences, a foundation-funded journalism organization, the researchers discovered that female rats fed atrazine at the time of ovulation released a flow of stress hormones that are known to interfere with hormones essential for reproduction. The findings reveal one way atrazine may impact female reproduction. Elevated stress hormones can disrupt the hormone signals that spur ovulation. Such a stress response to atrazine could partially explain why previous studies find that the herbicide inhibits reproduction. The stress reaction is similar to that seen when the animals are restrained against their will. One of the most widely used agricultural pesticides in the U.S., atrazine can currently legally be applied before and […]

(Beyond Pesticides, November 17, 2009) According to a new study by researchers at the University of Wisconsin-Madison, exposure to low levels of the organophosphate insecticide chorpyrifos during pregnancy can impair learning, change brain function and alter thyroid levels of offspring into adulthood for tested mice, especially females. The study, “Long-term sex selective hormonal and behavior alterations in mice exposed to low doses of chlorpyrifos in utero,” was led by Beyond Pesticides board member and professor of zoology and environmental toxicology, Warren Porter, PhD. Read the full analysis of the study on the Rodale Institute website. On June 8, 2000, the Environmental Protection Agency (EPA) and Dow AgroSciences, reached an agreement to stop the sale of most home, lawn and garden uses for chlorpyrifos because of its health risks to children. However, its use continues in agriculture. According to advocates, this new study provides further evidence for the need to ban chlorpyrifos and fully protect farmworkers, their families, and rural communities from the toxic hazards of this outdated, unnecessary pesticide. According to the Rodale Institute, which provided part of the funding for the study, “The new animal study accentuates the risk of ultra-low levels of the common pesticide chlorpyrifos to cause […]

(Beyond Pesticides, October 21, 2009) The U.S. Environmental Protection Agency (EPA) is making available the battery of scientific assays and test guidelines for conducting the assays for each of 67 chemicals included for Tier 1 testing for endocrine disrupting effects during the next three months. This comes after the Office of Management and Budget (OMB) instructed EPA to use existing toxicity data rather than require companies to conduct new tests to determine whether chemicals can damage the human endocrine system. With the availability of the assays and test guidelines, EPA will move forward with issuing test orders to manufacturers to compel the generation of the needed data. However, acquisition of new, relevant data may be limited. This is because after EPA submitted the request for additional information for OMB approval, the Office issued a directive that approved EPA’s request to collect additional data for the 67 chemicals but warned the agency that it should “to the greatest extent possible” accept existing data to satisfy test requirements. The OMB directive, which observers say contains unusually strong language, is being hailed by industry groups that had been concerned about the prospects for expensive testing mandates. But many environmental groups and scientists say […]

(Beyond Pesticides, September 18, 2009) Previously documented in the Potomac River, which flows through downtown Washington, DC, the occurrence of “intersex” fish is now found to be nationwide. U.S. Geological Survey (USGS) researchers published their study, “Widespread occurrence of intersex in black basses from U.S. rivers” in the online edition of Aquatic Toxicology. USGS researchers examined 16 different species of fish across the U.S. between 1995 and 2004. The condition of intersex fish, male fish producing eggs, is most commonly found in smallmouth and largemouth bass. One third of male smallmouth bass and one fifth of the male largemouth bass are intersex. Scientists tested sites in the Apalachicola, Colorado, Columbia, Mobile, Mississippi, Pee Dee, Rio Grande, Savannah, and Yukon River basins. Research shows intersex fish in approximately one-third of all examined sites. The only site where researchers found no intersex fish is the Yukon River basin. While the study did not look for the causes for intersex fish, scientists believe endocrine disruptors, chemicals that interfere with the body’s hormonal systems, are certainly to blame. “We know that endocrine-active compounds have been associated with intersex in fish, but we lack information on which fish species are most sensitive to such compounds, […]

(Beyond Pesticides, July 31, 2009) A group of advocates and experts is warning that pesticide pollution from farm fields and households is contributing to the Chesapeake Bay’s decline, and may well be linked to declines in frogs across the region and intersex fish seen in the Potomac River. In a report released yesterday, the group calls on federal, state and local government to accelerate research into what threats pesticide contamination may pose to the bay, and to step up efforts to reduce such toxic pollution. “The thing that alarms us the most are the endocrine disruptors and the findings that have come out about intersex fish and frogs with reproductive problems,” said Robert SanGeorge, director of the Pesticides and the Chesapeake Bay Watershed Project. Endocrine disruptors are chemicals that mimic the natural hormones in humans or animals and can disrupt their growth and reproduction. The project is a partnership between the Maryland Pesticides Network and the Johns Hopkins Center for a Livable Future. The group’s warning and recommendations are the product of a two-year study, in consultation with scientists, public health experts, government officials, watermen, environmentalists, farmers and pest management industries. The report comes as federal and state governments attempt […]

(Beyond Pesticides, April 29, 2009) The U.S. Environmental Protection Agency (EPA) announced earlier this month that it is finally ready to move forward with preliminary testing of 67 active and inert pesticide ingredients for possible endocrine disrupting effects. But, according to prominent researcher and author Theo Colborn, PhD, these tests are outdated, insensitive, crude, and narrowly limited, and will fail to detect many serious effects on human development. In an eye-opening opinion-editorial published in Environmental Health News, Dr. Colborn, founder and president of The Endocrine Disruption Exchange, and Co-author of Stolen Future, says that EPA’s testing protocol is “a pitiful skeleton” of what it needs to be. The tests to be used by EPA were first recommended in 1998. Since then the science has made progress and become more sophisticated. Current research is based on different assumptions than the toxicological assumptions that first drove the EPA test designs. However, EPA has not updated its protocol. Each of EPA’s tests and assays was designed under the surveillance of corporate lawyers who had bottom lines to protect and assorted toxicologists who were not trained in endocrinology and developmental biology. For over a decade, EPA ignored the vast wealth of information on endocrine […]

(Beyond Pesticides, April 17, 2009) Thirteen years after the Food Quality Protection Act (FQPA) ordered EPA to develop a screening process for endocrine disrupting chemicals, the Environmental Protection Agency (EPA) has released a final list of chemicals to be included in Tier 1 testing for endocrine disrupting effects of pesticides in use. While the list has been reduced from the 73 chemicals announced two years ago, trials will begin this summer to determine human risk from some of the chemicals to which we are most commonly exposed. “Endocrine disruptors can cause lifelong health problems, especially for children,” stated EPA Administrator Lisa Jackson. “Gathering this information will help us work with communities and industry to protect Americans from harmful exposure.” EPA’s recent announcement of these chemicals can be found on EPA’s Endocrine Disruptor Screening Program (EDSP) page. According to EPA, “The Agency deleted 6 chemicals from the draft list of 73 based upon recent information showing that the chemicals are no longer expected to be found in 3 exposure pathways.” To be included on the initial list, EPA established that chemicals need to be found in three of EPA’s four exposure pathways: food, drinking water, residential use, and occupational exposure. Azinphos-methyl […]

(Beyond Pesticides, February 19, 2009) The Endocrine Exchange (TEDX) has released a new database on the prenatal origins of endocrine disruption, called Critical Windows of Development. It compares human development in the womb with laboratory research showing where and when low-dose exposures to chemicals have effects. The timeline currently charts three chemicals: dioxin, bisphenol A (BPA), and phthalates. TEDX plans to expand the database to include PCBs, PBDEs, DDT, and other endocrine-disrupting pesticides. Examples of conclusions from the prenatal exposure research include: BPA affects development of the male and female reproductive systems, increases susceptibility to breast cancer and alters behavior in adult animals; Phthalates decrease sperm production and increase body weight; and, dioxin affects male reproduction and the immune system. Before a baby is born it is exposed to a myriad of endocrine disrupting chemicals (EDCs). EDCs interfere with the delicate system of vital hormones, glands and organs that control how a baby develops and functions throughout life. EDCs such as BPA, dioxin and phthalates can penetrate the womb and cause adverse effects at extremely low exposure levels. These chemicals are found in water bottles, food cans, dental resins, cleaning products, cosmetics, fragrances, packaging and construction material, cars, planes, recreational […]

(Beyond Pesticides, January 22, 2009) A new English study has found that chemicals found in rivers and waste waters could be linked to male infertility. These chemicals, known as anti-androgens, block the action of the male sex-hormone testosterone and could impact the development of male reproductive organs in humans. The study entitled, “Statistical Modeling Suggests That Anti-Androgens in Wastewater Treatment Works Effluents Are Contributing Causes of Widespread Sexual Disruption in Fish Living in English Rivers,” and published in the journal Environmental Health and Perspectives identifies a group of river pollutants that cause testosterone to stop working. These chemicals, released from wastewater treatment operations into rivers and other surface waters are responsible for the feminization of male fish and abnormalities in male reproductive organs. Previous studies have attributed these problems in male fish to estrogenic compounds also found in surface waters. However, this study is the first to identify anti-androgens with the feminization of male fish. It also indicates that male feminization may be the result of a rather more complicated interaction taking place between different classes of pollutants, resulting in an endocrine disrupting chemical cocktail. “We have identified a new group of chemicals in our study on fish, but we […]

(Beyond Pesticides, December 2, 2008) Tributyltin (also known as TBT), a ubiquitous pollutant that has a potent effect on gene activity, could be promoting obesity, according to an article in the December issue of BioScience, the journal of the American Institute of Biological Sciences. The chemical is used in antifouling paints for boats, as a wood and textile preservative, and as a pesticide on high-value food crops, among many other applications. Tributyltin affects sensitive receptors in the cells of animals, from water fleas to humans, at very low concentrations–a thousand times lower than pollutants that are known to interfere with sexual development of wildlife species. Tributyltin and its relatives are highly toxic to mollusks, causing female snails to develop male sexual characteristics, and it bioaccumulates in fish and shellfish. Recent research has found it in deep-sea squids and octopods, and it has been banned for maritime use by an international treaty. The harmful effects of the chemical on the liver and the nervous and immune systems in mammals are well known, but its powerful effects on the cellular components known as retinoid X receptors (RXRs) in a range of species are a recent discovery. When activated, RXRs can migrate into […]

(Beyond Pesticides, September 23, 2008) According to the Minnesota Department of Agriculture’s 2007 Water Quality Monitoring Report, released in August 2008, the endocrine disrupting herbicide atrazine is detected in pristine lakes in northern Minnesota far from the agricultural fields where it is applied. Metolachlor, acetochlor and dimethenamid are also frequent contaminants, according to the statewide sampling. The report, which uses data collected by a collaborative program between the U.S. Environmental Protection Agency, the Minnesota Department of Agriculture and the Minnesota Pollution Control Agency, analyzed samples from 55 of the state’s lakes. Atrazine was detected in approximately 87% of the 2007 samples, an increase from 2006. The presence of atrazine in such a large percentage of the lakes, many of which are located in non-agricultural areas of northern Minnesota, suggests widespread atmospheric deposition of this chemical (movement through wind and rain). “To some people, it is a bit of a surprise, but the concentrations are low, very low,” Steven Heiskary, a research scientist with the Minnesota Pollution Control Agency (MPCA) told the Star Tribune. Unfortunately, this is not very reassuring, given the fact that many of the developmental impacts linked to atrazine are seen at very low levels, sometimes at just […]

(Beyond Pesticides, September 22, 2008) A study published in the September issue of Environmental Health Perspectives finds that low-dose, short-term exposure to esfenvalerate, a synthetic pyrethroid pesticide, delays the onset of puberty in rats at doses two times lower than U.S. EPA’s stated no observable effect level (NOEL) of 2.0 mg/kg/day. Synthetic pyrethroids are used for everything from lawn care and household insecticides, to mosquito control and agriculture. There are currently 348 pesticide products registered by the U.S. EPA. The researchers conclude: “Although the exact mechanism of action is unknown at this time, we observed the effects at dosage levels below the NOEL established through chronic dietary exposure studies in rats. The U.S. EPA (1998) http://www.epa.gov/fedrgstr/EPA-PEST/1998/April/Day-29/p11372.htm stated that ”˜There is no evidence of additional sensitivity to young rats or rabbits following pre- or postnatal exposure to esfenvalerate.’ The present study shows that immature female rats exposed to 1.0 mg/kg/day are sensitive to this pesticide, as evidenced by their delay in the onset of puberty. Delayed pubertal onset in humans has been associated with low bone mass density (Ho and Kung 2005), and estrogen is necessary for bone mineral acquisition in both girls and boys (Yilmaz et al. 2005). Importantly, a […]