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What Are the Health Harms Associated With Petroleum-Based Fuels
and Combustion By-Products?
? Lead, used previously in gasoline, causes kidney cancer
when ingested by laboratory rodents and thus may
cause cancer in humans (20).
Respiratory Illness: Many petroleum-related air pollutants
affect respiratory tissues, producing short term
health effects like nose and throat irritation and asthma
attacks as well as long term lung damage, chronic bronchitis
and other illness.
? Hospital admissions for pneumonia, asthma and chronic
lung disease rise following days with elevated PM pollution
(1, 25-27).
? Long term exposure to traffic-related pollutants, especially
ozone, is linked to chronic respiratory illness such
as bronchitis, chronic airways obstruction, and lung
inflammation which can lead to permanent tissue damage
(28-31).
? Growth of lung function in children is hampered by living
in areas of higher air pollution; PM, acid vapor and
nitrogen dioxide have been most clearly linked to this
effect (32-34).
? Exposure to diesel exhaust, ozone, ambient PM, nitrogen
dioxide, sulfur dioxide or formaldehyde worsens the
health of adults and children with asthma (35-41).
? Children’s need for urgent or emergency care for asthma
symptoms has been associated with elevations in ozone,
PM, traffic density and NO2 (42-46). During a period
of decreased traffic in one urban area, urgent care visits
for asthma in children were fewer (47).
? In addition to aggravating pre-existing asthma, exposure
to traffic-related pollutants may cause new cases of
asthma in previously unaffected children (48-49) and
adults (50).
? Ozone levels are associated with school absenteeism for
respiratory illness (51).
? Acute exposure to ozone decreases lung function (30,
52).
? Acetaldehyde, acrolein, formaldehyde, and peroxyacetyl
nitrate are potent irritants of the respiratory tract
mucous membranes (53-54).
(For descriptions of pollutants please see fact sheet
on Toxic Pollutants)
Research on people exposed at work or via the general
environment and on animals exposed in laboratories has
shown that petroleum pollutants can cause or aggravate a
wide range of serious health problems including cancer,
birth defects, asthma, and chronic obstructive pulmonary
disease.
Early Death: Population death rates from cardiovascular
and respiratory causes rise on the days during and after
episodes of bad air pollution (1-4), the short-term concentration
of particulate matter (PM) is the most strongly
linked pollutant factor in most studies. Long-term
exposure to PM is also linked to early death, primarily
from cardiovascular and respiratory causes (5-9).
Cancer: Vaporized gasoline and engine exhaust from
gasoline and diesel engines are complex chemical mixtures
that have been recognized as cancer-causing by
state, federal and international agencies (10-12). Many
of the individual chemical components of fuels and
exhaust are also recognized carcinogens.
? Studies of workers with high exposure to diesel exhaust
report increased risk of lung cancer (13-16).
? Long term exposure to PM, ozone and sulfur dioxide
has been associated with lung cancer in the general
population (8-9).
? Benzene and 1,3-butadiene cause leukemia in humans
(17-19).
? Acetaldehyde, ethylbenzene, formaldehyde, and naphthalene
are volatile organic compounds in exhaust that
cause various cancers in laboratory animals (20-22).
? Several polyaromatic hydrocarbons cause cancer in laboratory
animals, others induce genetic mutations but
have not been tested to see if they cause cancer in animals
(23-24).
? Arsenic, beryllium, cadmium, chromium and nickel are
found at low levels in engine exhaust particulate and are
known or probable human carcinogens (20).
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What Are the Health Harms Associated With Petroleum-Based Fuels and Combustion By-Products? [ c o n t i n u e d ]
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? Longer term exposure to acetaldehyde produced nasal
and respiratory tract damage in hamsters and rats in laboratory
studies (20).
? Ac rolein causes inflammation, abnormal cellular
changes, and tissue death in the nasal passages of rats
(55).
? Decreased pulmonary function and nasal lesions have
been seen in workers with high exposures to formaldehyde
(55). Formaldehyde can cause asthma-like signs
and symptoms, especially those who have been sensitized
by previous or long-term exposure (42, 55).
? Naphthalene caused inflammation and cellular changes
in the nasal passages of mice (22, 55).
Heart and Blood Problems: Increased hospital admissions
for heart disease are associated with elevated particulate
matter pollution (3, 26, 56-58). Carbon monoxide
aggravates cardiovascular illness and is associated with
increased hospitalization for cardiovascular causes (59-
61) Carbon monoxide also reduces aerobic capacity during
exercise in healthy people (61). Lead can cause anemia
and high blood pressure (62). Of the volatile organic
compounds, few have been tested for cardiac effects in
people.
Effects on Reproduction and Fetal Development:
Many of the pollutants associated with combustion of
petroleum fuels have been linked to low birthweight or
pre-term birth, including carbon monoxide (63), PM
(64-65), 1,3-butadiene (20), benzo(a)pyrene (20), and
lead (62).
? Ozone and carbon monoxide levels during the second
month of pregnancy have been associated with fetal
heart malformations (66).
? The level of particulate matter pollution has also been
associated with infant mortality (64).
? In mice, 1, 3-butadiene damages ovaries and testes (20).
? Benzene causes sperm abnormalities in male mice.
Delayed development of fetuses has been observed in
laboratory studies of rodents and in limited studies of
humans with occupational exposure to benzene (20).
? Pregnant rodents exposed to toluene in the laboratory
had fewer live births; fetuses showed signs of growth
retardation or birth defects (20).
? Benzo(a)pyrene, a polyaromatic hydrocarbon, causes
fetal deaths, low birthweight and birth defects in mice
(20).
Nervous System Toxicity: Volatile organic compounds
like hexane, toluene, xylene and methyl ethyl ketone
found in gasoline and diesel fuels are associated with
nervous system damage (20, 68-69). Carbon monoxide
causes neurological problems in people who recover from
high exposures (61). Even at very low levels, lead poisons
the brain and nerves slowing cognitive development
in children and affecting neurobehavioral function in
children and adults (62, 67). Learning difficulties and
lower performance on tests of intelligence are associated
with a child’s blood lead level. Manganese (only present
in a few US gasolines) is associated with Parkinson’s-like
symptoms and other neurobehavioral effects (70).
Other Health Impacts: While cancer, respiratory and
developmental/reproductive effects are some of the most
notable hazards of using petroleum derived fuels, other
categories of health effects have also been associated with
specific compounds. Adverse impacts on the kidney and
the immune system are examples. Some of these effects
are only associated with compounds that are found at
relatively low levels in exhaust, and so the overall importance
to public health may not be high. But the cumulative
health effects of these toxins have not be adequately
studied and could be significant.
Bibliography:
PM acute mortality:
1. Dockery DW, Pope CA III. 1994. Acute respiratory
effects of particulate air pollution. Annu Rev Public
Health 15:107–132.
2. Katsouyanni K, Touloumi G, Spix C, et al. Short-term
effects of ambient sulphur dioxide and particulate
matter on mortality in 12 European cities: results from
Energy Independence Now
714 Bond Avenue, Santa Barbara, California, 93103 • Phone: 805.899.3399 Fax: 805.899.3388
www.einow.org • info@einow.org
What Are the Health Harms Associated With Petroleum-Based Fuels and Combustion By-Products? [ c o n t i n u e d ]
P a g e 3 o f 6
times series data from the APHEA project: Air
Pollution and Health: a European Approach. BMJ
1997;314:1658-1663
3. Samet JM, Dominici F, Curriero FC, Coursac I, Zeger
SL. 2000. Fine particulate air pollution and mortality
in 20 U.S. cities, 1987-1994. N Engl J Med
343(24):1742-9.
4. Schwartz J. 1994. Air pollution and daily mortality: a
review and meta analysis. Environ Res 64(1):36-52
Long term PM and mortality
5. D.W. Dockery, C.A. Pope, 3rd, X. Xu et al., An association
between air pollution and mortality in six US
cities. N Engl J Med 329 (1993), pp. 1753–1759.
6. C.A. Pope, 3rd, M.J. Thun, M.M. Namboodiri et al.,
Particulate air pollution as a predictor of mortality in
a prospective study of US adults. Am J Respir Crit
Care Med 151 (1995), pp. 669–674.
7. Krewski D, Burnett R, Goldberg MS, et al. Reanalysis
of the Harvard six cities study and the American
Cancer Society study of particulate air pollution and
m o rtality: Health Effects Institute special re p o rt .
Boston: Health Effects Institute, 2000.
8. D.E. Abbey, N. Nishino, W.F. McDonnell et al.,
Long-term inhalable particles and other air pollutants
related to mortality in nonsmokers. Am J Respir Crit
Care Med 159 (1999), pp. 373–382
9. C.A. Pope, 3rd, R.T. Burnett, M.J. Thun et al., Lung
c a n c e r, card i o p u l m o n a ry mort a l i t y, and long-term
exposure to fine particulate air pollution. JAMA 287
(2002), pp. 1132–1141
Agencies listing gasoline and diesel exhaust as carcinogens:
10. The list of “chemicals known to the State of
California to cause cancer” can be found at:
h t t p : / / w w w. o e h h a . c a . g ov / p ro p 6 5 / p ro p 6 5 l i s t / New l i s
t.html
11.The list of agents evaluated for carcinogenicity and
resulting classifications by the National Toxicology
Program can found at:
http://ehp.niehs.nih.gov/roc/toc10.html
12.Agents, mixtures and exposures evaluated for carcinogenicity
by the International Agency for Research on
Cancer can be found at:
http://monographs.iarc.fr/monoeval/grlist.html
Diesel Exhaust causes cancer:
13. Garshick E, Schenker MB, Munoz A et al. 1987. A
case-control study of lung cancer and diesel exhasut
exposure in railroad workers. Am Rev Respir Dis
135:1242-1248.
14. Garshick E, Shenker MB Munoz A et al. 1988. A retrospective
cohort study of lung cancer and diesel
exhaust exposure in railroad workers. Am Rev Respir
Dis 137: 820-825.
15. California EPA 1998. Proposed identification of
diesel exhaust as a toxic air contaminant. Part B:
health risk assessment for diesel exhaust. California
En v i ronmental Protection Agency, Office of
En v i ronmental Health Ha z a rd Assessment, Air
Toxicology and Epidemiology Section, May 1998.
16. Bhatia R, Lopipero P, Smith AH. 1998. Diesel
exhaust exposure and lung cancer. Epidemiology 9(1):
84-91
Benzene causes leukemia:
17. Rinsky, RA; Smith, AB; Horning, R; et al. (1987)
Benzene and leukemia: an epidemiologic risk assessment.
N Engl J Med 316:1044-1050.
18. Yin SN, Hayes RB, Linet MS, et al. 1996. An
expanded cohort study of cancer among benzeneexposed
workers in China. Environ Health Perspect
104 Suppl 6:1339-41
Butadiene and leukemia:
19. Delzell E; Sathiakumar N; Hovinga M. 1996. A follow-
up study of synthetic rubber workers. Toxicology
113:182-189.
Other VOCs that cause cancer:
20. Brief summaries of scientific data on many of the
compounds in fuels and exhaust have been prepared
by USEPA and are available on-line from the
Integrated Risk Information System (IRIS):
h t t p : / / w w w. e p a . g ov/iris/index.html. Fu rther re f e rences
to the original studies are available on the IRIS
Energy Independence Now
714 Bond Avenue, Santa Barbara, California, 93103 • Phone: 805.899.3399 Fax: 805.899.3388
www.einow.org • info@einow.org
What Are the Health Harms Associated With Petroleum-Based Fuels and Combustion By-Products? [ c o n t i n u e d ]
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web pages for specific chemicals.
21. Toxicology and carcinogenesis studies of ethylbenzene
(CAS No. 100-41-4) in F344/N Rats and B6C3F1
Mice (Inhalation Studies). National Tox i c o l o g y
Program report number TR-466. Available online at:
http://ehp.niehs.nih.gov/ntp/docs/ntp.html
22. Toxicology and carcinogenesis studies of naphthalene
(CAS No. 91-20-3) in B6C3F1 Mice (Inhalation
Studies). National Toxicology Program report number
TR-410. http://ehp. n i e h s . n i h . g ov / n t p / m e mbers/
tr410/TR-410.pdf
23. Toxicological profile for polycyclic aromatic hydrocarbons.
U.S. department of health and human services;
Public Health Service; Agency for Toxic Substances
and Disease Registry. August 1995.
24. ARC monographs on the evaluation of the carcinogenic
risk of chemicals to humans. Volume 32:
Polynuclear Aromatic Compounds, Part 1: Chemical,
En v i ronmental and Experimental Data. 1983.
International Agency for Research on Cancer, Lyon.
Hospitalization for respiratory causes:
25. U.S. Environmental Protection Agency. 1996. Air
Quality Criteria for Particulate Matter, Vol. 3. U.S.
Environmental Protection Agency, Research Triangle
Park, NC. 134-183. Publication No. PB96-168257
EPA/600/P-95/001CF. Chapter 12 contains extensive
review of the epidemiology for PM; chapter 11 is toxicology.
26. Zanobetti A, Schwartz J, Do c k e ry DW. 2000.
Airborne particles are a risk factor for hospital admissions
for heart and lung disease. Environ Health
Perspect ??08(11):1071-1077.
27. Buckeridge DL, Glazier R, Harvey BJ, Escobar M,
Amrhein C, Frank J. 2002. Effect of motor vehicle
emissions on respiratory health in an urban area.
Environ Health Perspect 110(3):293-300.
Chronic Respiratory illness
28. Schwartz J. 1993. Particulate air pollution and chronic
respiratory disease. Environ Res 62(1):7-13.
29. Abbey DE, Ostro BE, Petersen F, Burchette RJ. 1995.
Chronic respiratory symptoms associated with estimated
long-term ambient concentrations of fine particulates
less than 2.5 microns in aerodynamic diameter
(PM2.5) and other air pollutants. J Expo Anal
Environ Epidemiol5(2):137-159.
30. U.S. Environmental Protection Agency. Air Quality
Criteria for Ozone and Related Ph o t o c h e m i c a l
Oxidants, EPA / 6 0 0 / P – 9 3 / 0 0 4 c F. Re s e a rch Tr i a n g l e
Park, NC; 1996.
31. Detels R, Tashkin DP, Sayre JW, Rokaw SN, Massey
FJ Jr, Coulson AH, Wegman DH. The UCLA population
studies of CORD: X. A cohort study of changes
in respiratory function associated with chronic exposure
to SOx, NOx, and hydrocarbons. Am J Public
Health 81:350-359 (1991).
Pulmonary growth in children:
32. Gauderman WJ, Gilliland GF, Vora H, Avol E, Stram
D, McConnell R, Thomas D, Lurmann F, Margolis
HG, Rappaport EB, Berhane K, Peters JM.
Association between air pollution and lung function
growth in southern California children: results from a
second cohort. Am J Respir Crit Care Med. 2002 Jul
1;166(1):76-84.
33. Gauderman WJ, McConnell R, Gilliland F, London S,
Thomas D, Avol E, Vora H, Berhane K, Rappaport
EB, Lurmann F, Margolis HG, Peters J. 2000.
Association between air pollution and lung function
growth in southern California children. Am J Respir
Crit Care Med. 162(4 Pt 1):1383-90.
34. Horak F Jr, Studnicka M, Gartner C, Spengler JD,
Tauber E, Urbanek R, Veiter A, Frischer T. 2002.
Particulate matter and lung function growth in children:
a 3-yr follow-up study in Austrian schoolchildren.
Eur Respir J 19(5):838-45.
Asthma:
35. Koenig JQ. 1999. Air pollution and asthma. J Allergy
Clin Immunol 104(4 Pt 1):717-22.
36. Pandya RJ, Solomon G, Kinner A, Balmes JR. 2002.
Diesel exhaust and asthma: hypotheses and molecular
mechanisms of action. Environ Health Perspect 110
Suppl 1:103-12.
37. McConnell R, Berhane K, Gilliland F, London SJ,
Vora H, Avol E, Gauderman WJ, Margolis HG,
Lurmann F, Thomas DC, et al. Air pollution and
Energy Independence Now
714 Bond Avenue, Santa Barbara, California, 93103 • Phone: 805.899.3399 Fax: 805.899.3388
www.einow.org • info@einow.org
What Are the Health Harms Associated With Petroleum-Based Fuels and Combustion By-Products? [ c o n t i n u e d ]
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bronchitic symptoms in southern California children
with asthma. Environ Health Perspect 107:757-760
(1999).
38. Thurston GD, Lippmann M, Scott MB, Fine JM.
1997. Summertime haze air pollution and children
with asthma. Am J Respir Crit Care Med 155:654-
660.
39. Holgate ST. 2002. Health Effects of Acute Exposure
to Air Pollution. Pa rt I: Healthy and Asthmatic
Subjects Exposed to Diesel Exhaust. Res rep Health
Eff Inst 112.
40. Just J, Segala C, Sahraoui F, Priol G, Grimfeld A,
Neukirch F. 2002. Short-term health effects of particulate
and photochemical air pollution in asthmatic
children. Eur Respir J;20(4):899-906.
41. Schlesinger RB. Toxicology of sulfur oxides. In: Air
Pollution and Health, Holgate ST, Samet JM, Koren
HS, Maynard RL eds. Academic Press. 1999.
42. Delfino RJ. 2002. Epidemiologic evidence for asthma
and exposure to air toxics: linkages between occupational,
indoor, and community air pollution
research. Environ Health Perspect 110 Suppl 4:573-
89.
43. Tolbert PE, Mulholland JA, MacIntosh DL, Xu F,
Daniels D, Devine OJ, Carlin BP, Klein M, Dorley J,
Butler AJ, et al. Air quality and pediatric emergency
room visits for asthma in Atlanta, Georgia, USA. Am
J Epidemiol 151:798-810 (2000).
44. White MC, Et zel RA, Wi l c ox WD, Lloyd C.
Exacerbations of childhood asthma and ozone pollution
in Atlanta. Environ Res. 1994;65:56-68.
45. Yu O, Sheppard L, Lumley T, Koenig JQ, Shapiro
GG. 2000. Effects of ambient air pollution on symptoms
of asthma in Seattle-area children enrolled in the
CAMP study. Environ Health Perspect 108(12):1209-
14.
46. Norris G, YoungPong SN, Koenig JQ, Larson TV,
Sheppard L, Stout JW. 1999. An association between
fine particles and asthma emergency department visits
for children in Seattle. Environ Health Perspect
107(6):489-93.
47. Friedman MS, Powell KE, Hutwagner L, Graham
LM, Teague WG. 2001. Impact of changes in transportation
and commuting behaviors during the 1996
Summer Olympic Games in Atlanta on air quality and
childhood asthma. JAMA285(7):897-905.
48. McConnell R, Berhane K, et al. 2002. Asthma in
exercising children exposed to ozone: a cohort study.
Lancet 359(9304):386-91.
49. Brauer M, Hoek G, Van Vliet P, Meliefste K, Fischer
PH, Wijga A, Koopman LP, Neijens HJ, Gerritsen J,
Kerkhof M, Heinrich J, Bellander T, Brunekreef B.
2002. Air pollution from traffic and the development
of respiratory infections and asthmatic and allergic
symptoms in children. Am J Respir Crit Care Med
166(8):1092-8.
50. McDonnell WF, Abbey DE, Nishino N, Lebowitz
MD. 1999. Long-term ambient ozone concentration
and the incidence of asthma in nonsmoking adults:
the AHSMOG Study. Environ Res 80(2 Pt 1):110-
21.
Other ozone effects:
51. Gilliland FD, Berhane K, Rappaport EB, Thomas
DC, Avol E, Gauderman WJ, London SJ, Margolis
HG, McConnell R, Islam KT, Peters JM. The effects
of ambient air pollution on school absenteeism due to
re s p i r a t o ry illnesses. Ep i d e m i o l o g y. 2001
Jan;12(1):43-54. Absences were related to ozone levels,
but not to PM10 or NO2.
52. Balmes JR, Aris RM, Chen LL, Scannell C, Tager IB,
Finkbeiner W, Christian D, Kelly T, Hearne PQ,
Ferrando R, et al. 1997. Effects of ozone on normal
and potentially sensitive human subjects. Pa rt I:
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normal and asthmatic subjects. Res Rep Health Eff
Inst 78:1–37.
Summary documents for respiratory effects of
acrolein, acetaldehyde, formaldehyde and naphthalene:
53. OEHHA. Acute Reference Exposure Levels (March
2000 update). Summary documents for the acute
effects of acrolein and formaldehyde are available at:
h t t p : / / w w w. o e h h a . c a . g ov / a i r / a c u t e re l s / a l l Ac R E L s . h t
ml. For acetaldehyde, see reference #20 above.
54. Vyskocil A, Viau C, Lamy S. 1998. Peroxyacetyl
nitrate: re v i ew of tox i c i t y. Hum Exp Tox i c o l
17(4):212-20.
55. OEHHA. Chronic Reference Exposure Levels
(September 2000 update). Summary documents for
Energy Independence Now
714 Bond Avenue, Santa Barbara, California, 93103 • Phone: 805.899.3399 Fax: 805.899.3388
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What Are the Health Harms Associated With Petroleum-Based Fuels and Combustion By-Products? [ c o n t i n u e d ]
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chronic effects of acrolein, formaldehyde and naphthalene
are available at: http://www.oehha.ca.gov/air/chronic_
rels/AllChrels.html For naphthalene, also see #22,
above.
Cardiovascular effects of air pollution:
56. Dockery DW. 2001. Epidemiologic evidence of card
i ovascular effects of particulate air pollution.
Environ Health Perspect. 109 Suppl 4:483-486.
57. Schwartz J. 1999. Air pollution and hospital admissions
for heart disease in eight U.S. counties.
Epidemiology 10(1):17-22.
58. Burnett RT, Smith-Doiron M, Stieb D, Cakmak S,
Brook JR. 1999. Effects of particulate and gaseous air
pollution on cardiorespiratory hospitalizations. Arch
Environ Health 54:130-139.
59. Mann JK, Tager IB, Lurmann F et al. 2002. Air pollution
and hospital admissions for ischemic heart disease
in persons with congestive heart failure or
arrhythmia. Environ Health Perspect 110(12):1247-
52.
60. Linn WS, Szlachcic Y, Gong H Jr, Kinney PL,
Berhane KT. 2000. Air pollution and daily hospital
admissions in metropolitan Los Angeles.En v i ro n
Health Perspect 108(5):427-434.
61. USEPA, 2000. Air quality criteria for carbon monoxide.
EPA 600/P-99/001F. Jun 2000. U.S.
Environmental Protection Agency, Office of Research
and De velopment, National Center for
Environmental Assessment, Washington, DC.
62. Toxicological Profile for Lead (Update). 1999. United
States Public Health Se rvice, Agency for Tox i c
Substances and Disease Registry. Atlanta, GA.
Low birth weight, birth defects, and infant
mortality:
63. Ritz B, Yu F. The effect of ambient carbon monoxide
on low birth weight among children born in southern
California between 1989 and 1993. Environ Health
Perspect 1999;107:17–25.
64. Woodruff TJ, Grillo J, Schoendorf KC. 1997. The
relationship between selected causes of postneonatal
infant mortality and particulate air pollution in the
United States. Environ Health Perspect 105:608-612.
65. Ritz B, Yu F, Chapa G, Fruin S. 2000. Effect of air
pollution on preterm birth among children born in
Southern California between 1989 and 1993.
Epidemiology 11(5):502-511.
66. Ritz B, Yu F, Fruin S, Chapa G, Shaw GM, Harris JA.
2002. Ambient air pollution and risk of birth defects
in Southern California. Am J Epidemiol 155(1):17-25
Neurotoxicity of gasoline, air pollution or specific
compounds:
67. Ostro B. 2000. Lead: evaluation of current California
air quality standards with respect to protection of child
ren. Re p o rt pre p a red for the California Air
Re s o u rces Board and California Office of
Environmental Health Hazard Assessment. Available
on-line at: http://www.oehha.ca.gov/air/criteria_pollutants/
AQAC2.html
68. Burbacher TM. 1993. Neurotoxic effects of gasoline
and gasoline constituents. En v i ron He a l t h
Perspect101 Suppl 6:133-41.
69. Ritchie GD et al. 2001. J Toxicol Environ Health B
Crit Rev 4(3):223-312 A review of the neurotoxicity
risk of selected hydrocarbon fuels.
Toxicological Profile for Manganese (Update). 2000.
United States Public Health Service, Agency for Toxic
Substances and Disease
Energy Independence Now
714 Bond Avenue, Santa Barbara, California, 93103 • Phone: 805.899.3399 Fax: 805.899.3388
www.einow.org • info@einow.org

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