(Beyond Pesticides, April 18, 2022) Industrial poultry operations—generally indoors and with crowded conditions—provide the perfect incubator for pandemic influenza. According to the United Nations Food and Agriculture Organization (FAO), “These involve the congregation of large numbers of genetically identical animals of the same age (young) and sex, with rapid turnover and ‘all-in, all-out’ systems.” The U.S. Department of Agriculture (USDA) is delaying the adoption of organic rules that would require meaningful outdoor access and prevent indoor crowding. Influenza pandemics have killed millions of people—between 20 and 40 million people died in the 1918 pandemic, one million in 1957, and one to three million in 1968. According to the World Health Organization (WHO), “Influenza type A viruses are of most significance to public health due to their potential to cause an influenza pandemic.” There are several subtypes of type A influenza, which originates in birds. According to the Centers for Disease Control (CDC), there were 700 human cases of the H5N1 subtype since 2003, and only 40% survived. Tell USDA to promulgate a strong Organic Livestock and Poultry Standard. Tell USDA to protect against flu pandemics by applying the same rules to all poultry. Because avian flu poses a risk to […]

The organic solutions to problems highlighted in the latest issue of Pesticides and You—based on the importance of healthy ecosystems and public health protection—are within reach, and the data creates an imperative for action now that phases out pesticides within a decade, while ensuring food productivity, resilient land management, and safe food, air, and water. (Beyond Pesticides, April 15, 2022) The current issue of Pesticides and You, RETROSPECTIVE 2021: A Call to Urgent Action, is a look at a year of science, policy, and advocacy that informs both the existential problems that the U.S. and the world are facing due to toxic pesticide dependency, and solutions that can be adopted now. The information in this issue captures the body of science that empowers action at the local, state, and federal level, and provides a framework for challenging toxic pesticide use and putting alternatives in place. The issue finds that 2021 was a pivotal year in both defining the problem and advancing the solution. This year in review is divided into nine sections that provide an accounting of scientific findings documenting serious pesticide-induced health and environmental effects, disproportionate risk to people of color and those with preexisting conditions, regulatory failures, at the same time […]

(Beyond Pesticides, March 11, 2022) With a history of unenforceable and impractical pesticide label restrictions resulting in U.S. Environmental Protection Agency (EPA) findings of ludicrously small or no risk, the agency is at it again with its latest announcement that allows the continued use of the deadly organophosphate insecticide malathion. This just the latest example of what advocates see as an irresponsible federal agency falling far short, as the nation and world sit on the brink of biodiversity collapse and deadly pesticide-induced diseases.   In a head-spinning development, the U.S. Fish and Wildlife Service (FWS) announced on March 8 its final Biological Opinion (BiOp) on malathion, which opinion claims that the commonly used insecticide poses no extinction risk to any protected animal or plant. The FWS review and BiOp are part of EPA’s evaluation of whether malathion — an organophosphate insecticide that causes serious damage to many organisms — should retain its registration. The Executive Summary of the BiOp concludes: “Our findings suggest that no proposed species or candidate species would experience species-level effects from the action [i.e., registration and thus, permitted use of malathion], and, therefore, are not likely to be jeopardized. We also conclude the proposed action is not […]

(Beyond Pesticides, March 10, 2022) Glyphosate and glyphosate-based herbicides (GBH) like Roundup® induce DNA damage and alter biological mechanisms (gene regulatory microRNAs [miRNAs or miRs]) associated with cancer development. According to the study published in Toxicological Sciences, DNA damage mainly occurs through oxidative stress from GBH exposure. Moreover, DNA damage and other biological mechanisms that cause carcinogenicity (cancer) occur at doses assumed “safe” by pesticide regulators such as the U.S. Environmental Protection Agency (EPA). Glyphosate is the most commonly used active ingredient worldwide, appearing in many herbicide formulas, not just Bayer’s (formerly Monsanto) Roundup®. The use of this chemical has been increasing since the inception of crops genetically modified to tolerate glyphosate over two decades ago. The toxic herbicide readily contaminates the ecosystem with residues pervasive in food and water commodities. In addition to this study, literature proves time and time again that glyphosate has an association with cancer development, as well as human, biotic, and ecosystem harm.  Study lead author Michael Antoniou, Ph.D., cautions, “Our results are the first to simultaneously show glyphosate and Roundup toxicity in a whole mammalian animal model system and provide a mechanism – oxidative stress – by which DNA damage has been observed in other systems, such as mammalian […]

(Beyond Pesticides, March 2, 2022) Covid (SARS-CoV-2) is being detected in wastewater, sludge, and biosolids, providing a “safe haven” for the virus and creating a health risk for wastewater workers and farmers. Published in Geoscience Frontiers, an international team of researchers systematically reviewed the available literature on the prevalence of pandemic coronavirus in wastewater in order to better determine risks to workers and public health. The timely review comes as many communities and states are reevaluating their use reclaimed human effluent due to a range of toxic contaminants, including per and polyfluoroalkyl substances (PFAS). Researchers found 20 articles from published literature that met the criteria for their review. Each of three environmental materials –wastewater effluent, sludge, and biosolids were analyzed for the presence of Covid. Effluent is the liquid that remains after a sewage treatment process, sludge is organic matter separated from effluent, and biosolids are the fully processed product that is then often applied to farm fields. Of the three materials, sludge contained the highest prevalence of covid RNA, followed by biosolids and then effluent, according to modeling of the data employed by researchers. Covid amounts were found to be related to the number of infected individuals living within […]

(Beyond Pesticides, February 15, 2022) A synthetic weed killer linked to cancer, endocrine (hormone) disruption, reproductive harm and birth defects can be found in the bodies of 1 in 3 Americans, according to research published in Environmental Health by scientists at George Washington University. The chemical in question is not glyphosate (though current data indicate similar results are likely) but 2,4-D, an herbicide that is increasingly used when weeds growing near genetically engineered  (GE) crops have developed resistance to the repeated use of Roundup and other glyphosate-based weed killers. “Our study suggests human exposures to 2,4-D have gone up significantly and they are predicted to rise even more in the future,” Marlaina Freisthler, a PhD student and researcher at the George Washington University, said. “These findings raise concerns with regard to whether this heavily used weed-killer might cause health problems, especially for young children who are very sensitive to chemical exposures.” Researchers conducted their analysis based on data from the National Health and Nutrition Examination Survey, which includes urinary concentrations of 2,4-D from 14,395 participants spanning 2001 to 2014. Between those years, the use of 2,4-D increased rapidly from its relative low point at the beginning of the century. “Roundup […]

(Beyond Pesticides, February 10, 2022) A National Institute of Environmental Health Sciences (NIEHS)-funded study finds that patterns of pesticide exposure among farmers have geographical and temporal significance. Specific use of and exposure to organophosphate and carbamate chemicals decrease enzyme activity within the body, resulting in greater health anomalies among farmers, especially during agricultural seasons. The use of xenobiotic (foreign chemical compounds) substances like pesticides and fertilizers in agriculture are increasing. Thus, those working with and around these toxicants must have protection. Considering that agricultural workers often experience pesticide exposure at higher rates due to occupation, long-term research must identify potential health concerns surrounding common pesticides. The study author, Dana Barr, Ph.D., states, “The majority of farmers in this study reported that they had at least one health symptom associated with pesticide intoxication. This investigation can be used to promote safer use of pesticides among farmers and mitigate exposure among residents living near a rice field. The findings will be critical for establishing and launching several preventive programs in the future.” Researchers evaluated the health effects of pesticide exposure among a cohort of farmers in Thailand during inactive and active rice farming periods. Using geographic information system (GIS) mapping, researchers compared […]

(Beyond Pesticides, February 9, 2022) Insecticide use during pregnancy significantly increases the occurrence of Otitis Media (OM) in infants, according to research published in Scientific Reports from a team of Japanese researchers late last month. Otitis Media, an infection of the space behind the ear drum, is a common disease among children. While most infections go away on their own, some children experience pain, fever, and in some cases complications that result in hearing loss. This research underscores the myriad of dangers and diseases that pesticide use can precipitate, which are not considered under risk assessments conducted by the U.S. Environmental Protection Agency (EPA). Scientists collected their initial data from the ongoing Japan Environment and Children’s Study, a national birth cohort study that evaluates environmental factors affecting children’s health in Japan. Data recorded include factors such as maternal age, birth weight, and gestation weeks, and mothers provided answers to a range of questionnaires, including one relating to exposure to insecticides during pregnancy. Study authors utilized a range of other covariates to control for further risk factors, such as family history of OM, living with other siblings, nursery attendance, parental smoking habits, and others. The study determined that OM during an […]

(Beyond Pesticides, February 3, 2022) A study published in the journal Thorax finds lifetime occupational (work-related) exposure to pesticides increases incidents of chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Although research often attributes COPD risk to genetics or cigarette smoking, the increasing rate of COPD incidents indicates an external cause of disease development. Although an exact etiology (cause) of the increase in respiratory disease cases remains unknown, the connection between chronic respiratory diseases and exposure to pesticides continues to strengthen. Several circumstances, including smoking patterns, poverty, occupation, and diet, can influence disease prognosis. However, studies show that relative exposure to chemicals like pesticides can occur within each circumstance, making chemical exposure ubiquitous. Additionally, pesticide drift is an omnipresent issue impacting communities surrounding farming operations, and dust may harm humans, plants, and aquatic systems. Therefore, this review highlights the significance of evaluating the association between pesticide exposure and disease development, especially for diseases generally attributed to genetics or vices. Researchers in the study note, “[W]e found that cumulative exposure to pesticides is associated with an increased risk of COPD, with positive exposure-response trends. The unique large sample and the confirmation of our results in sensitivity analyses, in particular in never-smokers, support the validity […]

(Beyond Pesticides, February 1, 2022) A study published in Environmental Science and Technology finds that concentrations of quaternary ammonium compounds (QUATs or QACs) in the human body have increased during the COVID-19 pandemic, raising health and safety concerns. QACs include a variety of chemicals in personal care, pharmaceutical, and medical products used as disinfectants, sanitizers, antimicrobials. However, over the past 70 years, large-scale production and use of these compounds led to accumulation in the environment, including surface water, sediment, and soil. Previously, researchers thought most QACs lack the potential to bioaccumulate,  as the chemicals are highly water-soluble, while dermal and oral absorption rates are low. However, emerging evidence demonstrates that specific QACs bioaccumulate in blood and other body tissues and can cause a range of toxic effects. Therefore, studies like this highlight the significance of monitoring chemical exposure for adverse health effects. The researchers note, “Further efforts are needed to explore the relationship between the use of QAC-containing products and the levels of QACs in human blood or of their metabolites in urine. Considering the increased use of some QACs as a result of the Covid-19 pandemic, our findings warrant further exposure and epidemiological research focused on QACs.” Amidst the outbreak […]

(Beyond Pesticides, January 24, 2022) The advisory board of health experts who counseled President Biden during his transition have now called for an entirely new domestic pandemic strategy geared to the “new normal” of living with the virus indefinitely. While this new strategy addresses important issues like “reimagining public health” and disparities in vulnerability to COVID, it misses out on an important one—reducing vulnerability to disease by eliminating exposure to toxic chemicals, especially those that threaten the immune, nervous, and respiratory systems. Tell the President, EPA, and Congress to address the ongoing threat of Covid-19 by eliminating toxic pesticide use that elevates overall, and disproportionately for people of color, the public’s vulnerability to the virus. The strategic initiative is organized by Ezekiel J. Emanuel, MD, PhD, an oncologist, medical ethicist, and University of Pennsylvania professor who advised former President Barack Obama. The group published a collection of opinion articles in the Journal of the American Medical Association (JAMA). In those articles, the group advises President Biden to give up on an eradication goal, accept that COVID-19 is here to stay—that is, that it is becoming endemic—and adopt a goal of living with it. These articles explore what that means. The […]

(Beyond Pesticides, January 12, 2022) Well water in agricultural regions of Sri Lanka is contaminated with highly hazardous insecticides and associated with a decline in kidney function, according to research published in npj Clean Water this month. This finding is the latest piece in an ongoing ‘puzzle’ regarding the epidemic of chronic kidney disease of unknown origins in Sri Lanka and other developing countries in agricultural regions. Although the exact etiology of the disease has not been confirmed, a number of scientific studies have pointed the finger at industrial agriculture, increasingly finding evidence of chronic pesticide exposure in affected populations.   To better understand the connection between agrichemical exposure and kidney health, researchers enrolled 293 individuals from Wilgamuwa, Sri Lanka into a prospective study. Baseline data was retrieved on occupational and environmental exposure factors, focusing in on the water source individuals used at their homes. Samples of each participant’s household wells were taken and analyzed for the presence of pesticides. Of the wells sampled, 68% were found to contain pesticides. Further, every well where pesticides were detected had at least one pesticide recorded above global drinking water guidelines. The chemicals found were also some of the most toxic pesticides to […]

(Beyond Pesticides, January 5, 2022) Household pesticide use is associated with harmful impacts to infant motor development, according to a study published late last year in the journal Paediatric and Perinatal Epidemiology. The research focused on primarily low-income Hispanic women located in Los Angeles, California, enrolled in an ongoing study referred to as Maternal and Developmental Risks from Environmental and Social Stressors (MADRES). As with other pollutants in society, low-income, people of color communities are disproportionately in contact with toxic pesticides, resulting in exposures that can start early, and affect health over the course of one’s lifetime. Women enrolled in the MADRES cohort are over the age of 18, and speak English or Spanish fluently. For the present study, roughly 300 MADRES participants met the criteria for enrollment, and completed household pesticide use questionnaires at a 3-month post-natal visit. The questionnaire generally inquired whether pesticides had been used in one’s home since their child was born. After another 3 months, researchers also tested infants’ motor development using an Ages and Stages-3 protocol screening tool, which evaluates a child’s ability to execute muscle movements. Overall, roughly 22% of mothers reported pesticide use in their home during the first months of their […]

(Beyond Pesticides, December 21, 2021)  A research team undertaking a review of industry-conducted glyphosate safety studies submitted to EU (European Union) regulators shows that most of the research fails to meet current international standards for scientific validity. The researchers find that of the 11 reviewed studies, which were submitted to regulators by Bayer AG (now owner of the Monsanto “Roundup” brand of glyphosate herbicide) and several other chemical companies, only two are scientifically “reliable”; six others are deemed “partly reliable,” and the remaining three, “not reliable.” These results go, in part, to the age of some of the studies (see below); but they also underscore the point Beyond Pesticides has made for years. Regulators, whether in the UK, the U.S., or anywhere else, ought not be relying solely and without adequate auditing on industry-generated and -funded safety research in making safety determinations that underlie regulations impacting the well-being of millions of people (and other organisms), never mind the environment writ large. The report, from a team working out of the Institute of Cancer Research (ICR) at the Medical University of Vienna, is timely: the European Food Safety Authority (EFSA) and European Chemicals Agency (ECHA) are currently considering whether or not […]

(Beyond Pesticides, December 16, 2021) A study by Shanghai Jiao Tong University, China, finds Parkinson’s Disease (PD) risk increases with elevated levels of organochlorine (OCP) and organophosphate (OP) pesticides in blood. Among patients with PD, specific organochlorine compounds have greater associations with cognitive impairments, including depression and brain function. Research finds exposure to chemical toxicants, like pesticides, can cause neurotoxic effects or exacerbate preexisting chemical damage to the nervous system. Although the mechanism by which pesticides induce disease development remains unclear, researchers suggest changes in protein enzyme composition and cellular dysfunction from pesticide exposure interrupt normal brain function. Parkinson’s disease is the second most common neurodegenerative disease, with at least one million Americans living with PD and about 50,000 new diagnoses each year. The disease affects 50% more men than women, and individuals with PD have a variety of symptoms, including loss of muscle control and trembling, anxiety and depression, constipation and urinary difficulties, dementia, and sleep disturbances. Over time, symptoms intensify, but there is no current cure for this fatal disease. While only 10 to 15 percent of PD incidences are genetic, PD is quickly becoming the world’s fastest-growing brain disease. Therefore, research like this highlights the need to examine alternate […]

(Beyond Pesticides, December 9, 2021) The cost to maintain crops using conventional pesticides outweighs the economic benefits from crop production and yield, according to a report, Pesticides ‘cost double the amount they yield,’ by the French-based organization Bureau for the Appraisal of Social Impacts for Citizen Information (BASIC). Moreover, the annual cost of increasing organic farms three-fold by 2030 is less than the cost of pesticides to society (i.e., adverse health and ecological effects from pesticide use and contamination). However, the price to pay from pesticide use encompasses much more than the products themselves. Researchers point to the need for government and health officials to consider the billion-dollar costs associated with adverse health effects from pesticide use, especially as studies confirm that pesticides cause cancer, Parkinson’s, and other diseases that are increasing. Thus, this report adds to the growing body of research demonstrating the unsustainability of conventional, chemical-intensive agricultural practices. The National Academy of Sciences identifies four goals of sustainable agriculture—productivity, economics, environment, and social well-being for future generations. However, current chemical pesticide use threatens sustainable agriculture. Although the primary concerns about pesticide usage centers on health and ecological concerns, including food security, this report provides an economic assessment that offers an […]

(Beyond Pesticides, December 2, 2021) A study published in Cellular Physiology and Biochemistry finds atrazine (ATR) exposure worsens lung disease outcomes in individuals with idiopathic (spontaneous) pulmonary fibrosis (IPF), a group of incurable lung diseases involving damaged/scarred lung tissue. Furthermore, chemotherapeutic products used to treat lymphoma (immune system cell cancer) like bleomycin can induce pulmonary fibrosis complications exacerbated by pesticide exposure. However, pesticide-related pulmonary fibrosis can have implications for neurological health, such as motor function. Scientific literature already finds an association between pesticide exposure and respiratory illnesses such as asthma, lung cancer, and chronic obstructive pulmonary disease (chronic bronchitis). Although IPF impacts over 5 million people a year globally, the disease is difficult to predict, which is concerning as the death rate is 50 to 56 percent within the first few years. Therefore, studies like this highlight the significance of evaluating how pesticide exposure impacts respiratory function, especially when exposure to respiratory toxicants increases vulnerability to existing respiratory-fixated illnesses like Covid-19. Advocate have urged the U.S. Environmental Protection (EPA) to incorporate scientific findings that these—where chemical exposures exacerbate an existing medical condition—into its pesticide registration review program. Researchers note, “[O]ur data represent an addition to the complex information on ATR-induced pulmonary toxicity. In particular, in this […]

(Beyond Pesticides, December 2, 2021) Thousands of residents in Houston, Texas are suing Union Pacific Railroad Company for contaminating their properties with highly hazardous creosote wood preservatives. One of these lawsuits comes from Latonya Payne, legal guardian of Corinthian Giles, a 13-year-old boy who died of leukemia after a five year battle with the disease. A recent report found that the community is in the midst of a childhood leukemia cancer cluster, with disease rates five times the national average. Late last month, U.S. Environmental Protection Agency (EPA) Administrator Michael Regan toured the area as part of his Journey to Justice tour. However, while Administrator Regan vows federal assistance with the cleanup of these long-lived chemicals, EPA is currently in the process of reauthorizing creosote use for another 15 years with the knowledge that it is virtually impossible to produce and use without causing contamination and poisoning. Some environmental advocates are suggesting that Administrator Regan take a tour of EPA’s pesticide registration program and stop the unnecessary poisoning that disproportionately affects people of color and those with vulnerabilities or preexisting medical conditions that increase their vulnerability to toxic chemical exposure. While advocates say that cleaning up EPA’s mess in communities […]

(Beyond Pesticides, December 1, 2021) Women exposed to metabolites of the banned insecticide chlordane are over three times more likely to develop endometriosis, finds research published in the journal Environment International. The study is the latest to find links between persistent organic pollutants (POPs), still lingering in our environment and in our bodies, and chronic disease. According to an economic analysis conducted in 2016, exposure to endocrine (hormone) disrupting chemicals, often implicated in considerable damage to the body’s reproductive system, results in billions of dollars of health care costs from female reproductive disorders. Researchers set out to integrate two methodologies into their evaluation, combining analysis of POP biomarkers in blood with an analysis of biomarkers in that body that correspond with cell functioning, inflammation, and stress. A total of 87 women were enrolled in the study, half of whom had deep endometriosis, a quarter of whom also had the disease and sought surgical intervention, and a remaining quarter without reproductive concerns acted as a control. Twenty polychlorinated biphenyls (PCBs) and 30 organochlorine pesticide compounds were analyzed, as were various biomarkers and inflammatory cytokines. The analysis revealed two compounds to be positively associated with endometriosis – trans-nonachlor, a breakdown product of […]

(Beyond Pesticides, November 30, 2021) The chronicle of developments in the glyphosate saga has just grown longer: the California Supreme Court has rejected a request by Bayer AG for review of the August 2021 First District Court of Appeal (San Francisco) ruling, for the plaintiffs, that Monsanto knowingly marketed a product — Roundup — whose active ingredient (glyphosate) could be dangerous. The $87 million in damages awarded to the plaintiffs in the litigation, Alberta and Alva Pilliod, has thus survived Bayer’s challenge. This highest state court decision racks up another loss for Bayer (which now owns the Monsanto “Roundup” brand) — despite its dogged insistence, throughout multiple lawsuits (with many more still in the pipeline), that glyphosate is safe. Beyond Pesticides has covered the glyphosate saga extensively; see its litigation archives for multiple articles on glyphosate lawsuits. Glyphosate has been the subject of a great deal of public, advocacy, and regulatory attention, as well as the target of thousands of lawsuits — particularly since the 2015 declaration by the IARC (International Agency for Research on Cancer) that the compound is a likely human carcinogen. In June 2020, facing approximately 125,000 suits for Roundup’s role in cancer outcomes, Bayer announced a $10 billion […]

(Beyond Pesticides, November 18, 2021) A study published by King George’s Medical University, India, finds exposure to xenobiotic substances like pesticides during pregnancy increases risks associated with preterm birth, including a rise in cesarean section (C-section) deliveries and a decrease in fetal body weight. Preterm births occur when a fetus is born early or before 37 weeks of complete gestation. Premature births can result in chronic (long-term) illnesses among infants from lack of proper organ development and even death. Birth and reproductive complications are increasingly common among individuals exposed to environmental toxicants, like pesticides. The Center for Disease Control (CDC) reports the preterm birth rate is increasing annually. Therefore, studies like this can help government and health officials safeguard human health by assessing adverse effects following prevalent chemical exposure. The study notes, “To the best of our knowledge, this was a pioneering study, and it may help to increase our knowledge with regard to xenobiotic exposure in biological systems and the need for stringent guidelines for agricultural use of pesticides.” The study examines the association between the transfer of xenobiotics (foreign synthetic substances like pesticides) from mother to fetus. Transferal of these toxic substances can result in biological and chemical changes (i.e., genotoxicity […]

(Beyond Pesticide, November 4, 2021) A scientific literature analysis by the Federal University of Goias, Brazil, finds occupational (work-related) exposure to agricultural pesticides increases the risk for 45 different types of cancer. This analysis assesses studies from the last decade—2011 to 2020—to identify cancer risk associated with occupational exposure by country, pesticide type, and methods used to diagnose disease. Many pesticides are “known or probable” carcinogens (cancer-causing agents), and widespread uses only amplify chemical hazards, adversely affecting human health. However, research on cancer and pesticides lacks comprehensive information regarding human health effects associated with long-term chemical use. This study highlights the significant role that long-term research plays in identifying potential health concerns surrounding registered pesticides. The use of these xenobiotics (foreign chemical compounds) substances in agriculture are increasing. Thus, it is important those working with and around these toxicants have protection. The analysis notes, “Overall, then, the results of the present study emphasize the need to evaluate overuse of pesticides and the concomitant increase in the number of cancer cases. Future research should thus include active intervention in the correct use of pesticides by farmworkers and encourage adequate training and the use of PPEs [personal protective equipment], as well as routine periodic medical […]

(Beyond Pesticides, November 3, 2021) With a significant and increasing share of the U.S. population reporting sensitivities to certain chemicals, a team of researchers at University of California (Irvine), University of Texas (San Antonio), and the Massachusetts Institute of Technology is working to better understand how these symptoms develop. Although referred to by several names over the years, including Multiple Chemical Sensitivity (MCS) and Idiopathic Environmental Illness, medical professionals are now referring to the disease as Chemical Intolerance, or Toxicant Induced Loss of Tolerance (TILT), to better represent the disease process and range of nervous system symptoms that individuals develop to low level chemical exposures. “We established evidence of this previously understudied disease process,” said Shahir Masri, Sc.D, at University of California, Irvine. “Our insights will help public health scientists, physicians and policymakers better understand how to minimize harmful exposures and prevent future disease.” TILT is characterized by a two-step process. First, there is an “initiation exposure event,” whereby an individual is either repeatedly exposed to low levels of certain chemicals, or experiences a major exposure incident. In the second stage, affected individuals are “triggered” even by minute exposures, not only to the chemical that affected them in the first […]