Toxicological Profile for Chlorine

Title: Toxicological Profile for Chlorine

Subject of planned Report: The ATSDR toxicological profile succinctly characterizes the toxicologic and adverse health effects for the substance being described.

Purpose of Planned Report: The purpose of the toxicological profile is to provide a source of toxicological and epidemiological data on hazardous substances most commonly found at hazardous waste sites and in support of public health assessments at these sites.

Type of Dissemination: ISI

Timing of Review (including deferrals): April 2010

Type of Review (panel, individual or alternative procedure): Individual

Opportunities for the Public to Comment (how and when): A draft of this profile was made available for a 90-day public comment period on October 23, 2007.

Peer Reviewers Provided with Public Comments before the Review: No

Anticipated Number of Reviewers: 3 or fewer

Primary Disciplines or Expertise: toxicology, environmental health, chemistry

Reviewers Selected by (agency or designated outside organization): CDC/ATSDR

Public Nominations Requested for Reviewers: No

Charge to Peer Reviewers: DTEM Charge to Peer Reviewerspdf icon [PDF – 124 KB]

Peer Reviewers:

1. John Balmes
1. Balmes, John
Academic and Professional Credentials B.A., University of Illinois, Urbana
M.D., Mt. Sinai School of Medicine, City University of NY
Residency in internal medicine, Mt. Sinai Hospital, New York City
Board certification in internal medicine and pulmonary medicine
Current Position Title Professor of Medicine in Residence, University of California, San Francisco (UCSF), Department of Medicine
Professor in Residence, School of Public Health, University of California, Berkeley
Director, Northern California Center for Occupational and Environmental Health (COEH)
Chief, Division of Occupational and Environmental Medicine, San Francisco General Hospital
Director, Occupational Medicine Residency Program, UCSF
Director, Human Exposure Laboratory, Lung Biology Center, UCSF
Organizational Affiliation(s) Current member: American Thoracic Society, American College of Occupational and Environmental Medicine, American College of Chest Physicians
Areas of Expertise, Discipline, Relevant Experiences Dr. Balmes’ laboratory, the Human Exposure Laboratory (HEL), has been studying the respiratory health effects of various air pollutants for the past 18 years, recently focusing on the airway inflammatory effects of ozone and fine particles. The HEL was the first group to demonstrate a) histological evidence of ozone-induced airway injury and inflammation in human subjects, b) that asthmatic subjects have greater inflammatory responses to ozone than normal subjects, c) that ozone-induced inflammatory responses in normal subjects attenuate with short-term exposures on consecutive days in the lung, and d) that asthmatic subjects recruit macrophages to the airways with consecutive day exposures. The lab is currently studying the impact of a genetic polymorphism of the antioxidant enzyme, glutathione-S-transferase M1, on the susceptibility of asthmatic subjects to ozone. We are also studying patterns of gene expression in our human model of ozone-induced acute airway inflammation. For the past 5 years, Dr. Balmes has been conducting outpatient clinical evaluations of current and former workers at Lawrence Livermore National Laboratory with beryllium sensitization for the presence of chronic beryllium disease, and has participated in a U.S. Department of Energy funded effort to develop a national beryllium research repository. Dr. Balmes is also collaborating on several epidemiological projects, including comparison of ozone exposure impacts on lung function of lifetime residents of the Los Angeles Basin and the San Francisco Bay area; the “Fresno Asthmatic Children’s Environment Study”; and a longitudinal study of the effects of biomass smoke exposure on chronic respiratory health of ~500 young children in rural Guatemala. A fourth project involves school-based asthma surveillance in children using a short survey. He is on the editorial board of the International Journal of Occupational and Environmental Health, and consultant editor of the Archives of Environmental Health. Dr. Balmes is also an ad hoc referee for numerous other journals and has authored and coauthored over 110 scientific journal articles, peer-reviewed over 30 government documents, and authored and coauthored 45 book chapters in scientific reference works and textbooks.
Recommended by Scientific/Professional Society or General Public No
2. Meryl Karol
2. Karol, Meryl
Academic and Professional Credentials B.S., Microbiology, Cornell University
Ph.D., Immunochemistry, Columbia University
Current Position Title Professor Emerita, University of Pittsburgh
Organizational Affiliation(s) American Public Health Association, Pennsylvania Public Health Association, International Union of Toxicology, Secretary-General (elected) 1998-2004, International Union of Toxicology, Director (elected) 1995-1998, Society of Toxicology (1994 elected President of the Society), American Thoracic Society, American Association for the Advancement of Science, Sigma Xi
Areas of Expertise, Discipline, Relevant Experiences Dr. Karol is an internationally recognized expert in inhalation toxicology and immunotoxicology. She has served on EPA’s Science Advisory Board since 2003 and was the Chair of the National Research Council’s Committee on Toxicologic and Radiologic Effects from Depleted Uranium. She has authored and coauthored over 100 scientific papers in peer reviewed professional journals, and over 20 book chapters in scientific books, including Immunologic responses of the lung to inhaled toxicants, in: Concepts in Inhalation Toxicology; and Immunology of the respiratory tract (with RW Lange), in Pulmonary Immunotoxicology. In addition, Dr. Karol has presented at over 70 professional society meetings and symposia. She is also currently on the editorial boards of the journals Biomedical and Environmental Sciences and Inhalation Toxicology.
Recommended by Scientific/Professional Society or General Public No
3. Dennis Shusterman
3. Shusterman, Dennis
Academic and Professional Credentials B.A., Human Development, Pacific Oaks College, Pasadena
M.D., University of California, Davis
M.P.H., Environmental Health Sciences, University of California, Berkeley
Current Position Title Professor of Medicine, Division of General Internal Medicine, University of Washington
Professor of Environmental & Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington
Director, Occupational and Environmental Medicine Residency/Fellowship
Organizational Affiliation(s) Current member: American Thoracic Society (ATS), European Rhinologic Society (ERS), European Chemoreception Sciences (AChemS), American Academy of Allergy Asthma and Immunology (AAAAI)
Areas of Expertise, Discipline, Relevant Experiences Dr. Shusterman is an expert in pulmonary function and inhalation pathologies. He has authored and coauthored 40 medical and scientific papers and case reports on diseases of the lung, nose and throat, including 13 papers and presentations specifically relating to chlorine exposure and its effects on the human respiratory system. He is also a prolific peer reviewer, having reviewed articles for numerous professional journals, including: American Journal of Industrial Medicine, American Journal of Respiratory and Critical Care Medicine, Annals of Allergy Asthma & Immunology, Archives of Environmental Health, Behavioural Brain Research, Behavioral Neuroscience, Chemical Senses, Clinical and Experimental Allergy, Environmental Health Perspectives, European Respiratory Journal, International Journal of Occupational and Environmental Health, JAMA, Journal of Applied Physiology, Journal of Environmental Medicine, Journal of Occupational and Environmental Hygiene, Journal of Occupational and Environmental Medicine, Journal of Toxicology: Clinical Toxicology, Neuroscience, Neuroscience Letters, Psychosomatic Medicine, Toxicological Sciences, Western Journal of Medicine.
Recommended by Scientific/Professional Society or General Public No

Peer Reviewers’ Comments: Chlorine Summary Reportpdf icon [PDF – 1.62 MB]

CDC/ATSDR’s Response to Reviewers’ Comments: Chlorine Formal Dispositionpdf icon [PDF – 31 KB]

The ISI/HISA Dissemination Itself

Page last reviewed: August 18, 2015