Environmental chemical exposures and disturbances of heme synthesis

William E. Daniell, Henry L. Stockbridge, Robert F. Labbe, James S. Woods, Karl Anderson, D. Montgomery Bissell, Joseph R. Bloomer, Ralph D. Ellefson, Michael R. Moore, Claus A. Pierach, William E. Schreiber, Ayalew Tefferi, Gary M. Franklin

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Porphyrias are relatively uncommon inherited or acquired disorders in which clinical manifestations are attributable to a disturbance of heme synthesis (porphyrin metabolism), usually in association with endogenous or exogenous stressors. Porphyrias are characterized by elevations of heme precursors in blood, urine, and/or stool. A number of chemicals, particularly metals and halogenated hydrocarbons, induce disturbances of heme synthesis in experimental animals. Certain chemicals have also been linked to porphyria or porphyrinuria in humans, generally involving chronic industrial exposures or environmental exposures much higher than those usually encountered. A noteworthy example is the Turkish epidemic of porphyria cutanea tarda produced by accidental ingestion of wheat treated with the fungicide hexachlorobenzene. Measurements of excreted heme precursors have the potential to serve as biological markers for harmful but preclinical effects of certain chemical exposures; this potential warrants further research and applied field studies. It has been hypothesized that several otherwise unexplained chemical-associated illnesses, such as multiple chemical sensitivity syndrome, may represent mild chronic cases of porphyria or other acquired abnormalities in heme synthesis. This review concludes that, although it is reasonable to consider such hypotheses, there is currently no convincing evidence that these illnesses are mediated by a disturbance of heme synthesis; it is premature or unfounded to base clinical management on such explanations unless laboratory data are diagnostic for porphyria. This review discusses the limitations of laboratory measures of heme synthesis, and diagnostic guidelines are provided to assist in evaluating the symptomatic individual suspected of having a porphyria.

Original languageEnglish (US)
Pages (from-to)37-53
Number of pages17
JournalEnvironmental Health Perspectives
Volume105
Issue numberSUPPL. 1
StatePublished - Feb 1997

Fingerprint

Porphyrias
Environmental Exposure
Heme
disturbance
halogenated hydrocarbon
porphyrin
hexachlorobenzene
Multiple Chemical Sensitivity
Halogenated Hydrocarbons
fungicide
abnormality
Porphyria Cutanea Tarda
Hexachlorobenzene
urine
Fungicides
Porphyrins
wheat
metabolism
blood
chemical

Keywords

  • Biological markers
  • Diagnosis
  • Environmental exposure
  • Hexachlorobenzene
  • Laboratory
  • Lead
  • Metals
  • Multiple chemical sensitivity
  • Occupational exposure
  • Porphyria
  • Porphyrins

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

Daniell, W. E., Stockbridge, H. L., Labbe, R. F., Woods, J. S., Anderson, K., Bissell, D. M., ... Franklin, G. M. (1997). Environmental chemical exposures and disturbances of heme synthesis. Environmental Health Perspectives, 105(SUPPL. 1), 37-53.

Environmental chemical exposures and disturbances of heme synthesis. / Daniell, William E.; Stockbridge, Henry L.; Labbe, Robert F.; Woods, James S.; Anderson, Karl; Bissell, D. Montgomery; Bloomer, Joseph R.; Ellefson, Ralph D.; Moore, Michael R.; Pierach, Claus A.; Schreiber, William E.; Tefferi, Ayalew; Franklin, Gary M.

In: Environmental Health Perspectives, Vol. 105, No. SUPPL. 1, 02.1997, p. 37-53.

Research output: Contribution to journalArticle

Daniell, WE, Stockbridge, HL, Labbe, RF, Woods, JS, Anderson, K, Bissell, DM, Bloomer, JR, Ellefson, RD, Moore, MR, Pierach, CA, Schreiber, WE, Tefferi, A & Franklin, GM 1997, 'Environmental chemical exposures and disturbances of heme synthesis', Environmental Health Perspectives, vol. 105, no. SUPPL. 1, pp. 37-53.
Daniell WE, Stockbridge HL, Labbe RF, Woods JS, Anderson K, Bissell DM et al. Environmental chemical exposures and disturbances of heme synthesis. Environmental Health Perspectives. 1997 Feb;105(SUPPL. 1):37-53.
Daniell, William E. ; Stockbridge, Henry L. ; Labbe, Robert F. ; Woods, James S. ; Anderson, Karl ; Bissell, D. Montgomery ; Bloomer, Joseph R. ; Ellefson, Ralph D. ; Moore, Michael R. ; Pierach, Claus A. ; Schreiber, William E. ; Tefferi, Ayalew ; Franklin, Gary M. / Environmental chemical exposures and disturbances of heme synthesis. In: Environmental Health Perspectives. 1997 ; Vol. 105, No. SUPPL. 1. pp. 37-53.
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