High risk groups

The tolerance of the newborn infant to environmental toxicants is not well understood, therefore it is prudent to assume that that the very young are more susceptible to toxic chemicals than adults. Indeed, exposure of the immature organs to pesticide residues can permanently alter the structure or function of an organ system (NRC, 1993) and therefore it is important to protect infants from the potential harm of pesticide residues in their food. 

Equally important is the fact that infants are dependent on a very narrow range of foods to provide their complete nutrition. The diversity of food intake in adults tends to protect against imbalances this protective diversity is not 

In a survey of 25 domestic and imported infant formulae (IF) products (20 milk based, five soy based) and 30 weaning foods commercially available in New Zealand (Vannoort and Cressey personal communication data presented at New Zealand Institute of Food Science and Technology meeting, July 1997), some pesticide residues were detected, but all extremely low and well below regulatory limits and health safety standards. Residues of pp-DDE were found in seven out of 20 (35%) milk-based infant formulae at concentrations ranging from 0.00003 to 0.00048 mg.kg 1, on a ready-to-feed basis. The parent compound, pp-DDT was found in one milk-based IF at 0.00065 mg. kg, and dieldrin residues detected in four out of five (80%) soy-based IF at concentrations ranging from 0.00005 to 0.00008 mg.kg-1. 

Mean intakes for fully formula-fed infants less than one month of age (the age at which the energy requirements per kilogramme bodyweight are the greatest) were estimated to be less than 0.1 % of the ADI for total DDT, while for dieldrin mean intake was 9.5% of the ADI. 

Two OPs were detected in the survey azinphos-methyl in one soy-based formula at 0.022 mg.kg-1 on RTF basis, and pirimphos-methyl in two cereal-based weaning foods at 0.005 and 0.014 mg.kg-1. All were well below MRLs. No other pesticides of the 140 screened for were detected. 

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Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for all children age 2-23 months. It is also recommended for certain children age 24-59 months. Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain high-risk groups. See MMWR. 2000 49(RR-9) 1-35. 

Hepatitis A vaccine. Hepatitis A vaccine is recommended for use in selected states and regions, and for certain high-risk groups consult your local public health authority. See MMWR. l999 48(RR-l2) l-37. 

CalabreseE. 1978. Pollutants and high risk groups The biological basis of increased human susceptibility to environmental and occupational pollutants. New York, NY John Wiley and Sons. 

People who can transmit flu to others at high risk for complications. Any person in close contact with someone in a high-risk group should get vaccinated. This includes all health care workers, household contacts, and out-of-home caregivers of children 0 to 23 months of age and adults 65 years of age and older. 

Post SG (1999). Future scenarios for the prevention and delay of Alzheimer Disease onset in high-risk groups An ethical perspective. American Journal of Preventative Medicine, 16, 105-110. 

Pseudomembranous colitis (PMC) results from toxins produced by Clostridium difficile. It occurs most often in epidemic fashion and affects high-risk groups such as the elderly, debilitated patients, cancer patients, surgical patients, any patient receiving antibiotics, patients with nasogastric tubes, or those who frequently use laxatives. 

Vaccines are recommended for high-risk groups. Live oral attenuated vaccine Ty21a and parenteral polysaccharide vaccine have been shown to confer 42% to 77% efficacy for a duration of 3 to 5 years. 

Administer MPSV4 to children aged 2-10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high risk groups. See/WMW 2005 54(No. RR-7) 1-21. 

Employees of residential care facilities for high-risk patients / Household members of persons in high-risk groups Immunization of children aged 6 to 59 months is recommended. Influenza vaccine should be offered to anyone wishing to avoid influenza infection. Individuals who should not be vaccinated are those with anaphylactic hypersensitivity to eggs or other components of the vaccine or adults with febrile illness (until the fever abates). 

The worldwide nature of HIV infection makes it a very important health problem. No continent s or country s populations are safe from infection, and the virus can spread rapidly and undetected once it enters a high-risk group. Public health officials predict that, if current rates of spread continue, there will be 45-110 million cases of HIV infection worldwide by the year 2000. The majority of the cases are likely to be in Asia. 

Alpert HR (2008) Manipulation of free nicotine and its dosing to target high risk groups. Paper presented at the cigarette industry s entry into the smokeless tobacco market. Harvard School of Public Health, Boston, MA, July 10, 2008... 

Calabrese, E.J. and L.A. Baldwin. 2002. Hormesis and high-risk groups. Regul. Toxicol. Pharmacol. 35 414- 28. 

Many dietary and environmental factors have been implicated as possible etiologic factors in the development of pancreatic cancer, but no definite causal relationships have been established. The strongest evidence points to cigarette smoking as a risk factor associated with pancreatic cancer (20-24). Occupational exposure to certain chemicals has also been linked to pancreatic carcinoma (25). Others in the high-risk group include stone miners, cement workers, gardeners, textile workers, and leather tanners (17,26). 

Moore GS, Calabrese EJ. 1980a. G6PD a potential high-risk group to copper and chlorite ingestion. J Environ Pathol Toxicol 4 271-279. 

Most patients with medical disorders who commit suicide, even those with terminal disorders, have concurrent treatable major depression. In addition, the type of medical condition may increase risk. Thus, patients with respiratory diseases are three times more likely to commit suicide than patients with other medical conditions. Those on hemodialysis or who suffer from cancer also constitute high-risk groups, in comparison with the general population. 

Sackmann-Muriel F, Felice MS, Zubizarreta PA et al. Treatment results in childhood acute lymphoblastic leukemia with a modified ALL-BFM 90 protocol lack of improvement in high-risk group. Leak Res 1999 23 331-340. 

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