Evaluating Risks of Acquired Clinical Vulnerability Among Subjects Exposed to E-Waste

Abstract

Long-term exposures to some environmental toxicants are known to induce chronic diseases. Certain diseases, such as lung cancer, may result from chronic exposures that are lower than those caused by certain “classical” carcinogens (e.g., tobacco smoke) (Vineis et al. 2004). Diseases result from antecedent events (Rothman and Greenland 1998). Such events either complete an incomplete causal chain that allow disease onset (Vineis and Kriebel 2006) or precipitate a chain of events, which creates a clinical state of vulnerability. Clinical vulnerability may render exposed subjects more susceptible to morbidity(s) following low dose long-term exposure to some environmental toxicants. When increased vulnerability occurs, it may either be acquired or be of genetic origin. The concept of acquired clinical vulnerability (ACV) results from insults that produce consequential pathophysiological changes that predispose exposed subjects to disease. ACV comprises a complex biological process that is manifested by exposure to toxicants, generally over the course of many years, and results from subtle changes that occur at the cellular and molecular level.