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The recent number of articles in the popular press concerning loss of intellect among children exposed to chlorpyrifos is important in the use of this pesticide. Although in-home use of chlorpyrifos was restricted in the U. S in 2000, it is widely used in agriculture, and is a serious risk to health and intellect for people working and living in proximity to fields. Detectable levels of chlorpyrifos detected in New York City children, raises the question of exposure via food.

Across the U. S. we learn that students are doing poorly in school, often blaming the teachers and their unions. Are teachers no longer competent to teach or have children been "dumbed-down" by exposure to this neurotoxin?

The State of California is considering restriction on use, but is prepared for strong opposition from the pesticide and big agricultural industries.

Back in the "Dark Ages" - a mere 50 years ago - when I was a medical student and intern at Wayne State University, I rotated through Children's Hospital in Detroit. It was staffed by some of the most thoughtful and kind physician/professors I have ever met. I attended a clinic named "FLK" otherwise known as Funny Looking Kid clinic. There we saw children who had abnormal looking faces, abnormal body parts, and, often impaired intelligence. Many of the children required complicated medical care, but I don't recall much discussion as to why they had these abnormalities that had dramatically cut short their futures and altered the lives of their families.

Realizing you have given birth to a child with birth defects is devastating - not only for the child, but for the family, and for society in general. If the child survives infancy, it means being "different" and having to cope with disability, and with having to learn alternative ways to function. For many families, it means 24/7 care of a child who can never live independently. For society the costs can be enormous - surgery (often multiple), medications, social services, special education, special equipment, then alternative living arrangements, if and when family cannot care for their child, now grown to a non-functional adult.

Although the neurotoxicity of pesticides has been known for decades, recently, several national magazines, have named the pesticide, chlorpyrifos (Dursban/ Lorsban), as an agent causing loss of intelligence, as well as birth defects and structural brain damage.

Dr. James Hamblin's article in March 2014 issue of The Atlantic, titled "The Toxins that Threaten Our Brains." listed 12 commonly used chemicals, including chlorpyrifos, which is marketed as Dursban and Lorsban. The exposures described in the Atlantic articles were urban, so we do not know exactly how widespread is this epidemic is, especially if we do not include agricultural areas such as in California, Hawaii and the mid-West..

That same month, The Nation published articles by Susan Freinkel "Poisoned Politics" and Lee Fang "Warning Signs" who reported adverse effects from exposure to Dursban and Lorsban.

Dr. Hamblin's article generously cites Drs. Philip Landrigan of Mt. Sinai in New York City and Philippe Grandjean of Harvard that a "'silent pandemic' of toxins has been damaging the brains of unborn children."

Dr. Landrigan chaired a 1998 meeting of the Collegium Ramazzini International Scientific Conference, held in Carpi, Italy. In attendance was Dr. Grandjean, whose research found "Methylmercury as a hazard to brain development." Dr. Richard Jackson, from the U. S. CDC was also in attendance, as well as U.S. governmental and university members.

At that Collegium Ramazzini International Scientific Conference, on October 25, 1998, I presented definitive data in my paper: "Chlorpyrifos (Dursban) exposure and birth defects: report of 15 incidents, evaluation of 8 cases, theory of action, and medical and social aspects." This presentation followed my earlier publications beginning in 1994 wherein I reported damage to the unborn from the same pesticide.

The Ramazzini organization sent my paper to the European Journal of Oncology for publication. Since my paper reported birth defects, not cancer, the paper has received little notice, but the attendees, including the EPA, have known of the findings for 16 years.

Currently a new battle is occurring in Hawaii over the use of pesticides, especially by Dow AgroSciences, DuPont Pioneer, BASF Plant Science, and Syngenta on the island of Kauai where giant seed companies develop Genetically Modified Organisms (GMOs) and other specialized seeds. The pesticides used there include alachlor, atrazine, chlorpyrifos, methomyl, metalochlor, permethrin and paraquat. The author, Paul Koberstein from Cascadia Times estimates that annually, more than 2000 pounds of chlorpyrifos are used per acre per year on Kauai, compared to less than 0.025 averages for the U. S. Mainland.

In addition to Hawaii, areas in California include workers and families from the Imperial Valley and other intensive agricultural areas where pesticide use is extensive. Using the Koberstein data, annual use of chlorpyrifos in California is approximately 1500 pounds/ acre.

Neurological Damage: Before and After Birth

Birth defects arise as a result of two mechanisms - damage to a gene, prior to fertilization, or damage to the growing cells of the fetus after life in the womb has begun. Differing from genetic damage, such as occurs in Down syndrome or Trisomy-21, the latter damage results from exposure of the developing fetus to agents called teratogens. For many years Mongolism was the name applied to children with growth delays, similar facial and hand features and intellectual deficits.

Chlorpyrifos is a unique pesticide. It is a combination of an organophosphate and a trichlorinatedpyridinol (TCP.) TCP is not only the feedstock used in the manufacture of chlorpyrifos, but also a contaminant in the product, and a metabolic breakdown product that is known to cause central nervous system abnormalities (hydrocephaly and dilated brain ventricles), and other abnormalities (cleft palate, skull and vertebral abnormalities) in fetuses as reported by Dow Chemical Co.

In March 1995, I was asked to fly to Arkansas to see a child whose mother had been exposed to the pesticide Dursban (chlorpyrifos) early in the pregnancy of her daughter.

Mrs. S had been working in a bank when in mid-March, 1991, she noticed a man spraying the baseboards behind the station where she worked as a teller. She said she asked the man if was okay to be in the area since she was pregnant, and she said the man told her it was "perfectly safe. She said the spraying had occurred around 4 PM, and that she worked at the bank until 6:30 PM, and when she went home that evening she had nausea and a" bit of headache." She said she retuned to work the next day, felt nausea, but worked most of the day. An electrical fire at the drive-in window followed the pesticide event, and a technician used of a "fogger" that sprayed a "citrus-like" chemical that was intended to deodorize the smoke odor. Mrs. S. said she worked at the bank until about April of that year, and then worked at a credit union until her daughter was born in September.

When Mrs. S. was about five months pregnant she had an ultrasound, which showed that her baby had enlarged ventricles in her brain. Further examination revealed absence of the septum pellucidum, a central portion of her brain. Mrs. S. had additional follow up at a university center as well as with her own physician that showed normal amniocentesis and normal chromosomes.

Both Mr. & Mrs. S. said that caring for the daughter A. has been a severe financial and emotional drain, sometimes requiring them to be up 72 hours to try to soothe A's crying.

A. had surgery to repair her cleft lip when she was six months old, and repair of her cleft palate and left eyelid when she was a year old.

Both cleft lip and palate can now be repaired (in areas with skilled surgeon, and insurance or other funds) but until they are, the child has difficulty feeding and risks poor nutrition, upper respiratory and lung problems as a result of aspiration of food.

Additional diagnostic procedures indicated that A has a cleft left eye (failure of her eye to fuse during development), and she cannot blink her eye or move the left side of her face. A. was unable to sit up on her own by the time she was a year old, had to have food pureed until she was two, then her parents realized that when A neared her 4th birthday, she could not hear, when they began a program of sign language with the aid of a speech therapist.

A's brother B. was born two years later, and is well, sleeping thought the night when he was two weeks of age.

I was given a tour of the bank where Ms. S worked by its' Senior Vice-President, and to minimize stress to A, I examined her in the presence of her pediatrician. I also accompanied her parents to their home where I could observe A. at her home environment. A. was a small-boned child who walked with a wide-based, unsteady gait and who made audible sounds, but no language content. Her head was enlarged with hydrocephaly and a small bruise due to a recent, commonly occurring fall.

Her abnormalities included to following, and were characteristic of findings in other children: low-set, tapering ears, wide-spaced nipples, and frequent infections. This litany is not to horrify readers, but to bring to attention to the burdens imposed upon this child, her parents, and society as a whole. I evaluated seven more children, two families each having two children with similar, but more severe medical conditions.

With the exception of child #1, the seven children were profoundly retarded, were diapered, could not speak, and required feeding.

I first met C & D in 1996, along with their parents and handsome, healthy older brother, at their attractive home on the West Coast. Both D (a girl) and C (a boy) were lying flat, diapered, mouths open, fists clenched, staring into space, and being fed by bottle. Even today, looking at the photograps reminds me what a enormous burden was dealt to that family.

Ultimately I evaluated eight children, and identified seven more, reported by Dow Chemical Co., the manufacturer, to EPA on November 2, 1994, with reporting delays of as long as seven years from when the corporation first learned of them. I obtained the reports via a Freedom of Information request (FOI) from EPA. The reports were labeled with the revealing name: "DERBI" - or - "Dow Elanco Research Business Index."

When I saw seven more children, all of who looked like siblings, (much as Trisomy-21 or Down Syndrome children do) it became clear to me, that the cause was linked to Dursban, the pre-natal exposure common to each.

Among the Dursban-exposed children, all 8 had both brain and palate abnormalities, seven had widespread nipples and growth retardation, six had low vision or blindness and six had genital abnormalities, five had brain atrophy and external ear abnormalities, four children had absence of the corpus collosum that is the critical connection between the two hemispheres of the brain. Chromosomal studies were normal in all 8 families. All families reported stress and enormous financial burden to care for their children.

In addition to the children with birth defects, I also evaluated a number of families and a group of adults who had been exposed at their work site. Of the workers, all 12 complained of headache, and three of dizziness. Eight had findings of central nervous system damage, and six had peripheral nervous system damage. The patients reported upper respiratory and chest symptoms, as well as nausea, vomiting, diarrhea, and four had incontinence. The families also reported abnormalities and deaths in their household pets.

In February 1996, my deposition in the first case was taken by three groups of attorneys representing the defendants, two principally defending Dow Elanco. I was questioned for three 8-hour days. Ultimately a list of 565 exhibits was accumulated that included over 10,000 pages of materials that I supplied and relied upon for my opinion. These materials included Dow documents and correspondence, EPA documents, legal depositions, basic embryology, biochemistry and toxicology of chlorpyrifos, medical records of other exposed children, patents, books, articles, etc, etc.

Chlorpyrifos was designed to be neurotoxic in action. It is an interesting pesticide, in that it has not only an organophosphate portion, but also it has three chlorine atoms attached to a pyridinol ring. This ring is trichloropyridinol (TCP), a significant hazard, because it is fat-soluble, and persistent, up to 18 years as claimed by Dow Chemical Co. TCP also forms the body of trichlophenoxyacetic acid, part of Agent Orange, also linked to birth defects and cancer. In a war that ended in 1975, Agent Orange continues as a risk to the Vietnamese, and to military troops that were stationed there.

According to multiple Dow documents, TCP is the feedstock for production of chlopryrifos, a contaminant in the product, and a metabolic breakdown product. TCP has been demonstrated to cause central nervous system anomalies (hydrocephaly and dilated brain ventricles) as well as cleft palate, skull and vertebral abnormalities in the fetus at doses nontoxic to the mother, similar to the defects seen in affected children.

That TCP caused birth defects was known by Dow in 1987, but not reported to EPA until five years later in 1992. TCP is used to manufacture chlorpyrifos, and as such, comes under regulation of Section 8(e) of the Toxic Substances Control Act (TSCA), rather than the Federal Insecticide, Fungicide and Rodenticide Control Act (FIFRA.) Though there was regulatory difference, TSCA states very clearly "any person who manufactures, processes or distributed in commerce a chemical substance or mixture, or who obtains information which reasonable supports the conclusion that such substance or mixture presents a substantial risk of injure to heath or the environment, shall immediately inform the Administrator of such information. [Emphasis added.] From 1976 to 1982, I was a member of a 16 person Advisory Committee to the EPA for TSCA, Chairman of the Risk-Benefit Assessment Group from 1977 to 1979, and a member of the Carcinogen Policy Sub-group from 1977 to 1981. It was clear that risks and benefits do no accrue to the same party. In the case of chlorpyrifos, the risks are to the unaware public, and the benefits to the corporation.

The Legal System is Not the Same as the Justice System

Bernard P. Whetstone was a well-established attorney who handled the initial birth defects case in Little Rock, Arkansas, and was aware of another case in that state. Mr. Whetstone was a "Southern Gentleman" with a soft drawl who had earned both a bachelor and doctorate of jurisprudence, and started practice in 1934. In 1995, he worked with Davidson and Associates until he retired in 1999 at age 86. Mr. Whetstone died in 2001.

I was required to appear in court in Little Rock, where Judge Eisley ruled that I was not qualified. Hard to believe that 10,000 pages of documents is not adequate, but that opinion was softened because he ruled that all the plaintiff's experts were not qualified. Another physician/ toxicology expert and I evaluated additional patients (adults) who developed multiple adverse effects, including central nervous system damage, so Dow, employing the Eisley decision, argued successfully in other court jurisdictions that we were not qualified to give an opinion.

The main Dow law firm was Barnes and Thornburg from Indianapolis, where DowElanco, the co-manufacturer, Eli Lilly is located. Eli Lilly is a manufacturer of both pharmaceuticals and pesticides. Barnes & Thornburg has over 500 attorneys in 12 cities and appeared to be very well staffed and funded.

A recent news release noted that William W. Wales, who spent more than 30 years in the legal department of The Dow Chemical Company and Dow AgroSciences LLC, had joined Barnes & Thornburg LLP's Indianapolis office as a partner in the firm's litigation and corporate departments. "Bill's depth and breadth of experience in a variety of matters will be a tremendous asset to many of our clients who are dealing with similar issues," said Joseph G. Eaton, Vice Chair of the firm's Litigation Department and Co-Chair of the Toxic Tort Practice Group. Joseph Eaton is one of the attorneys who took my extensive deposition. They were the most aggressive law firm I had ever encountered, and I have testified in more than 700 depositions and/or court appearances

In defense of their product, the Dow attorneys argued that there were no reports of levels of pesticides used or actual, existing levels - a questionable tactic, since the corporation has never suggested or requested that such records be obtained.

Although the EPA stopped home use of Dursban in 2000, Lorsban is widely used in agriculture, on ornamentals, and places where women, the unborn and children are exposed. For many, this exposure is without their knowledge or consent. How is this allowed to happen?

Is the continuing use of Dursban/ Lorsban due to successful advertising, and recommendations from country and state agricultural agents, or is it an inept or politically adept EPA?

We must recall, September 2001, when the then administrator of the U.S. Environmental Protection Agency and former governor of New Jersey Christie Whitman said on September 13, 2001, "EPA is greatly relieved to have learned that there appears to be no significant levels of asbestos dust in the air in New York City." A week later, Whitman said: "Given the scope of the tragedy from last week, I am glad to reassure the people of New York and Washington, DC that their air is safe to breathe and their water is safe to drink."

In 2008, the U. S. EPA named Dow as an Energy Star Partner of the Year for excellence in energy management and reductions in greenhouse gas emissions.

Dow's fleet of skilled lawyers have managed to save Dow from liability, such as when they achieved a reversal of a $925 million judgment for the contamination of the area around Rocky Flats, the Colorado facility that produced plutonium triggers for hydrogen bombs. And, a lawsuit filed by Vietnamese, damaged by Agent Orange against Dow and Monsanto was dismissed.

Dow is a multinational corporation and the third largest chemical manufacturer in the world, with earnings more than $57B in 2013. (That's a B as in billion.) In addition to the manufacture of insecticides, herbicides, fungicides, and genetically modified seeds, Dow also manufactures multiple plastics, polystyrene, polyurethane, synthetic rubber, biphenyl-A as well as many other chemicals.

What are the chances that the use of Lorsban will be curtailed in the agricultural areas of Hawaii, California and elsewhere? Given what we know of the financial strength of the Dow Corporation, the weakness of the EPA, and our paid-for Congress, the outlook does not look promising.

The Burden of Brain Damage

If the top corporate officials were required to care for one of these severely brain-damaged children for a week, would it change their minds about the ethics of manufacturing chlorpyrifos and corporate profits?

There is not a teacher who can teach brain-damaged children to read and do math, which raises the larger question being proposed: are children's lack of learning due to poor teachers, or to subtle brain damage? If children are being damaged to various degrees, profoundly in the situation of the 15 children sited in my research, to "mild" learning and/or behavioral problems, ranging from decreased IQ, Asperbergers, hyperactivity, autism, etc., how much is attributable to exposure to pesticides such as Dursban/ Lorsban? If we blame poor teaching, and teachers' unions, but don't stop the use of brain-damaging pesticides, where does that leave our U. S, society as a source of creativity and intellect in this world?

Janette D. Sherman, M. D. is the author of Life's Delicate Balance: Causes and Prevention of Breast Cancer and Chemical Exposure and Disease, and is a specialist in internal medicine and toxicology. She edited the book Chernobyl: Consequences of the Catastrophe for People and Nature, written by A. V. Yablokov, V. B., Nesterenko and A. V. Nesterenko, published by the New York Academy of Sciences in 2009. Her primary interest is the prevention of illness through public education. She can be reached at: toxdoc.js@verizon.netand www.janettesherman.com