TOXDetect Profile

Introducing Our Latest Innovation in Environmental Toxicant Exposure Testing


Our daily lives expose us to hundreds of toxic chemicals from food, water, household products, personal care products, plastics, and air pollution. Exposure to these environmental toxicants wreak havoc on normal metabolic processes that lead to immune dysfunction, neurological disorders, endocrine disruption, certain types of cancer, and beyond.

The TOXDetect Profile is designed to pinpoint your environmental toxicant exposure. This profile measures 19 metabolites utilizing state-of-the-art LC-MS/MS technology, guaranteeing unmatched accuracy and reliability – all from a single urine sample.

Our high-complexity laboratory is committed to delivering accurate and reliable results in coordination with these top licensure programs:
Urine
Turnaround Time: 1-2 weeks

Turnaround times are estimates. Detailed order tracking is available in the MosaicDX Portal.

* Available in English, Spanish, German, Portuguese, Japanese, French, Polish, Hungarian

Become a TOXDetective

In our new blog series, we dive deep into becoming a TOXDetective, offering fresh perspectives and actionable insights to the TOXDetect Profile. This series will cover in-depth reviews of toxicant detoxification and health implications, followed by avoidance strategies and tools for tackling exposures.

Additional posts will continue to be released, so stay tuned. Whether you’re just beginning to navigate the complexities of environmental toxicants or looking for actionable steps for your patients, our series offers guidance every step of the way.

Become a TOXDetective >>

What Patients Might Benefit From the TOXDetect Profile

Continuous and increasing exposure to environmental toxicants is posing serious health threats including:

  • ADHD
  • Alzheimer’s Disease
  • Asthma
  • Autism Spectrum
  • Behavioral Abnormalities
  • Birth Defects
  • Cardiovascular Disease
  • Cognitive Dysfunction
  • COPD
  • Diabetes
  • Endocrine Disruption
  • Endometriosis
  • Fatigue
  • Headache
  • Immune Dysfunction
  • Fertility
  • Memory Disturbance
  • Mood Changes
  • Nausea and Vomiting
  • Neurological Symptoms
  • Obesity
  • Parkinson's Disease
  • Respiratory Problems
  • Various Cancers

Details

What are Environmental Toxicants?

Environmental toxicants are substances present in the environment that threaten the health of all living organisms. Whether natural or human-made, these substances infiltrate through industrial activities, pollution, agriculture, and waste disposal.

Exposure to environmental toxicants, whether absorbed, inhaled, or ingested, has been associated with various health issues. Despite the staggering 2000% increase in plastic production from 15 million to 311 million tons between 1964 and 2014, and the annual disease cost burden of $340 billion from endocrine disrupting chemicals, the majority of chemicals remain unassessed for human impact. With over 80,000 chemicals registered in the U.S. under the Toxic Substances Control Act and thousands more introduced annually, it’s essential to identify exposures and mitigate their health impacts through testing.

Why Test?

Identifying and removing environmental toxicant exposure is fundamental to achieving comprehensive and lasting health outcomes for patients. The TOXDetect Profile is specifically designed to assess for exposure to various toxicants that can cause or contribute to chronic diseases. It equips healthcare practitioners with the ability to identify the underlying causes of toxicity and develop informed and personalized treatment plan for detoxification and healing.

Learn More About the TOXDetect Profile: Explore FAQs

Analytes

Review and download an overview of the analytes we measure with our Toxicant Testing Comparison Chart.
The TOXDetect Profile measures 19 metabolites across the below parent compounds:

  • Enhanced insight into phthalate exposure is provided by measuring five phthalate metabolites. Phthalates are a family of widely used chemicals found in most products that have contact with plastics during production, packaging, or delivery. These plasticizers which make plastic more flexible, and durable are associated with a number of health problems including reproductive, neurological, respiratory, and increased risk of certain types of cancer. Most significantly they are known as endocrine disruptors. Phthalates are referred to as “the everywhere chemical” due to the fact they are used in hundreds of products, including toys, food packaging, shampoo, vinyl flooring, and more. Detection of Monoethylphthalate (MEP),Monobutyl phthalate (MBP), Mono-2ethylhexyl phthalate (MEHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and Monoisobutyl phthalate (MiBP) in urine is an indicator of exposure.
  • Xylene is widely used in industry and medical laboratories. Xylene is released primarily from industrial sources. One can also come in contact with xylene through automobile exhaust and a variety of consumer products such as cigarette smoke, paints, varnish, rust preventives, and shellac. Literature suggests that xylene exposure causes toxic effects on various systems of the body. Longer term effects can damage the liver and kidneys. Detection of 2-3-4 Methylhippuric Acid (2,-3-,4-MHA) in urine is an indicator of exposure.
  • Styrene is widely used to make plastics and rubber, which are used to manufacture a variety of products, such as insulation, pipes, automobile parts, printing cartridges, food containers, and carpet backing. Exposure may occur through ingestion via transfer to foods, especially fatty foods heated in styrene containers, through breathing indoor air that has styrene vapors from building materials, photocopiers, tobacco smoke, and other products. Styrene and styrene oxide have been implicated as reproductive toxicants, neurotoxicants, and linked to an increased risk of leukemia and lymphoma. Detection of Phenylglyoxylic Acid (PGO) in urine is an indicator of exposure.
  • Benzene has been used extensively in the past as an industrial solvent; however, due to its toxicity and potential health hazards, its use has been reduced. Exposure can occur occupationally, in the general environment and in the home as a result of the ubiquitous use of benzene-containing petroleum products, including motor fuels and solvents. Benzene exposure has been linked to respiratory, hepatic, cardiovascular, immune, nervous, and endocrine system dysfunction. Detection of N-Acetyl Phenyl Cysteine (NAP) in urine is an indicator of exposure.
  • Acrylonitrile exposure occurs through the use of products containing acrylonitrile, such as acrylic fiber clothing or carpeting, acrylonitrile-based plastics, leaching into foods from plastic food containers, and cigarette smoke. Humans exposed to high levels via inhalation experienced respiratory tract irritation, labored breathing, dizziness, cyanosis, limb weakness and convulsions. It is considered a probable human carcinogen, with evidence suggesting an association with lung cancer. Detection of N-Acetyl (2-Cyanoethyl) Cysteine (NACE) in urine is an indicator of exposure.
  • 1-bromopropane is an organic solvent used for metal cleaning, foam gluing, and dry cleaning. Studies have shown that 1-BP is a neurotoxin as well as a reproductive toxin. Research indicates that exposure to 1-BP can cause sensory and motor deficits. Chronic exposure can lead to decreased cognitive function and impairment of the central nervous system. Acute exposure can lead to headaches. Detection of N-Acetyl (Propyl) Cysteine
    (NAPR) in urine is an indicator of exposure.
  • 1,3 butadiene is a petrochemical used to produce synthetic rubber used for car and truck tires and is also an environmental toxicant found in car exhaust, combustion of fuels for warmth or energy production and cigarette smoke. It is associated with adverse health impacts, including cancer, and cardiovascular disease. The International Agency for Research on Cancer (IARC) concluded that 1,3 butadiene is a human carcinogen. Detection of N-Acetyl (3,4-Dihydroxybutyl) Cysteine (NADB) in urine is an indicator of exposure.
  • Ethylene oxide is a man made substance widely used in the production of various chemicals such as plastics, textiles and antifreeze (ethylene glycol). Additionally, ethylene oxide is commonly used as a sterilizing agent for medical equipment. Inhalation is the most common route of exposure in occupational settings and via tobacco smoke. There is some evidence that exposure to ethylene oxide can cause a pregnant woman to lose a pregnancy. The International Agency for Research on Cancer (IARC) concluded that ethylene oxide is a known human carcinogen, exposure is linked to increased risk of leukemia and non-Hodgkin’s lymphoma. Vinyl chloride is colorless gas used primarily to manufacture polyvinyl chloride (PVC) and widely used in numerous products such as pipes, wire and cable insulation, packaging materials, various construction materials and disposable medical products. Inhalation is the most common route of exposure primarily in occupational settings, also via smoke from cigars or cigarettes. Acute high-level exposure can produce headaches, dizziness, drowsiness, and loss of consciousness. Long term exposure can result in hepatocellular changes and increased incidence of liver cancer. The International Agency for Research on Cancer (IARC) concluded that vinyl chloride is carcinogenic to humans. Detection of 2-Hydroxyethyl Mercapturic Acid (HEMA) in urine is an indicator of exposure.
  • 2,4-Dichlorophenoxyacetic Acid (2,4-D) is one of the most widely used herbicides in the world. It is commonly used in agriculture and landscaping. Chronic exposure to lower levels of 2,4-D has been associated with potential health effects, including endocrine disruption, reproductive effects, developmental effects, and increased risk of non-Hodgkin lymphoma. Detection of 2,4-Dichlorophenoxyacetic Acid (2,4-D) in urine is an indicator of exposure.
  • Pyrethroids are widely used in agriculture, household insect control, and veterinary medicine. Pyrethroids work by targeting the nervous system of insects, causing hyperexcitation and paralysis. The most common potential impacts to health include neurobehavioral, neurodevelopmental, and endocrine disruption. Exposure has also been associated with an increased risk of all-cause and cardiovascular disease mortality. Detection of 3-Phenoxybenzoic Acid (3-PBA) in urine is an indicator of exposure.
  • Organophosphate pesticides are widely used in agriculture to control pests, as well as in residential settings to manage insects and rodents. The organophosphate pesticides work by inhibiting the activity of acetylcholinesterase, an enzyme essential for proper nerve function. Exposure to organophosphates has been associated with neurological deficits, neurodegenerative diseases, peripheral nerve effects, and neurodevelopmental issues. Additionally, long-term exposure has been linked to oxidative stress, psychological effects, and liver function abnormalities. Detection of Diethylphosphate (DEP) in urine is an indicator of exposure.
  • Triphenyl phosphate is commonly used as a flame retardant in consumer products such as furniture, electronics, and textiles. It is also present in personal care products, such as nail polish and cosmetics, and contact with these products can lead to dermal absorption. Triphenyl phosphate can also be ingested from food and beverages due to migration from packaging materials or contamination during food processing. Exposure to triphenyl phosphate can alter endocrine function and impact reproduction. Altered thyroid function and decreased semen quality has been observed in humans. Detection of Diphenyl Phosphate (DPP) in urine is an indicator of exposure.
  • Acrylamide is formed when starchy foods, such as potatoes, grains, and coffee beans, are cooked at high temperatures. Other potential sources of acrylamide exposure include cigarette smoke, as acrylamide is formed during the combustion of tobacco, and certain cosmetic products that may contain acrylamide as a contaminant. Acrylamide has been linked to an increased risk of cancer, particularly in organs such as the kidneys, ovaries, and uterus. Other potential health effects include neurotoxicity, genotoxicity, reproductive toxicity, hepatotoxicity, immunotoxicity, and increased cardiovascular risk. Detection of N-Acetyl (Carbomethyl) Cysteine (NAE) in urine is an indicator of exposure.
  • Perchlorate is a chemical used in fireworks, road flares, explosives, and rocket fuel. Perchlorates are considered environmental contaminants due to their widespread use and persistence in the environment. Perchlorate can also enter the food supply through contaminated water used for irrigation or through food processing. Milk is also a source of perchlorate, the content in milk is related to the presence of perchlorate in feed. Perchlorate inhibits the thyroid’s uptake of iodine. This interference can disrupt thyroid function and lead to health problems such as hypothyroidism (underactive thyroid) or other thyroid disorders. Pregnant women, infants, and children are particularly vulnerable to the effects of perchlorate exposure on thyroid function. Detection of Perchlorate (PERC) in urine is an indicator of exposure.
  • Bisphenols are synthetic compounds used in the production of plastics and resins, commonly found in various consumer products, including food and drink containers, water bottles, thermal receipt papers, dental sealants, toys, cosmetics, and the lining of canned goods. Along with being a known endocrine disruptor, BPA has raised concerns due to potential health impacts related to reproductive and developmental effects, increased risk of obesity, diabetes, cardiovascular disease, and certain cancers. In response to these concerns many companies now produce “BPA-Free” products; however, some BPA alternatives like BPS have also raised concerns about potential similar effects. Detection of Bispehnol S (BPS) in urine is an indicator of exposure.

Sample Reports

The TOXDetect profile is design to help identify exposure to environmental toxicants and guide a targeted prevention and treatment plan. Our enhanced test report provides results in an easily comprehensible format, empowering practitioners with the essential insights and actionable clinical utility for informed decision making.

Key Enhancements on the Report Include:

  1. Summary of Elevated Results: Highlights elevated environmental toxicants at the beginning of the report for quick reference.
  2. Improved Readability: Results are categorized by environmental toxicant class for convenient referencing, enhanced by visually intuitive graphic results.
  3. Comprehensive Test Results: Presents results for all toxicants measured categorized into chemical classes including phthalates, VOCs, pesticides, and other important toxicants, for thorough analysis.
  4. Detailed Interpretations: Revised interpretations from literature review provide a succinct overview of the toxicant, potential exposure routes, health effects, and insights into its metabolic processes, facilitating comprehensive treatment planning.

Curious to delve deeper in the TOXDetect profile test report? Watch our quick 3-minute explainer video and download the sample report below:

Test Prep and Instructions

MosaicDX offers patient-friendly sample collection kits that make testing simple. Each kit includes:

  • Visual, step-by-step instructions for test preparation and sample collection.
  • Personalized shipping cards.
  • Pediatric collection bags if needed.

With just one easy urine sample collection, patients can confidently and accurately collect their samples.

Patient Resources

Explore our assets designed to help practitioners educate and support patients about environmental toxicants and the MosaicDX TOXDetect Profile. These resources enhance patient understanding, decision-making, and overall health journey:

  • Patient Brochure: A comprehensive guide that explains the importance of environmental toxicant testing and how the TOXDetect Profile can benefit patients.
  • Sample Collection Factsheet: A summarized version of the detailed collection instructions, highlighting the most important aspects to ensure accurate sample collection and reliable test results.

How TOXDetect Profile can remove barriers to healing, insights from Joseph Pizzorno, ND

“Assessing people for toxic exposure should be part of primary care. We shouldn’t wait for people to not respond to conventional therapies before starting to think about toxins.”  – Joseph Pizzorno, ND

Frequently Asked Questions

Patients with high toxic levels are at greater risk of concomitant exposure from all toxins. For patients with specific exposure history, practitioners can order individual panels or combine profiles to identify or more rapidly reduce or remove multiple sources of toxin exposure:

These test can all be done from one urine sample:

Several substances measured by the TOXDetect Profile may come from various sources of exposure. The panel cannot determine the specific origin of the toxicant, but it can provide information on the most common sources. By collaborating with your healthcare provider, you can investigate and eliminate potential sources of exposure. 

Glyphosate is a standalone test or an optional add-on to other urine tests such as the TOXDetect ProfileMycoTOX, and Organic Acids Test.

VOCs are chemicals that easily evaporate into the air and can originate from various sources both indoors like household and beauty products, building materials, and cigarette smoke, as well as outdoors like vehicle emissions, industrial processes, construction activities, agriculture from pesticides, gasoline vapors, and from VOC containing paints, coatings, and sealants. Their impact on human health may include respiratory irritation, headaches, and dizziness, with some VOCs being carcinogenic and harmful to the nervous system. Certain VOCs have been linked to reproductive and developmental issues.

Phthalates are a series of widely used chemicals found in most products that have contact with plastics during production, packaging, or delivery.  These plasticizers which make plastic more flexible, and durable are associated with a number of health problems including reproductive, neurological, respiratory, and increased risk of certain types of cancer.(16,17,18)  Most significantly they are known as endocrine disruptors.(15)   Phthalates are referred to as “the everywhere chemical” due to the fact they are used in hundreds of products, including toys, food packaging, shampoo, vinyl flooring, and more.

If you or a patient has had a TOXDetect Profile and/or a Glyphosate Test run and found moderate-high levels of any compounds, there are things you can do to help your body eliminate the toxins and to prevent future exposures. The first steps to reducing the amount of toxins presently in the body are to switch to eating only organic food and drinking water that has common toxins, including pesticides filtered out. Most conventional food crops are exposed to larger and larger doses of pesticides and herbicides, and by switching to organic you will prevent exposure to hundreds of these toxicants. Many of these chemicals have also contaminated our water supplies. Installing a high-quality water filtration system in the home that eliminates them is important to do and there are several options available.  

The next step to avoiding future exposures is to change the products you use on a daily basis – from food and beverage containers to beauty and cleaning products. Instead of using plastic water bottles and food containers, switch to glass or metal. Never microwave food in plastic or Styrofoam containers and do not drink hot beverages from plastic or Styrofoam cups. Make sure your shampoo, soaps, lotions, and other beauty products are free of phthalates. Use cleaning products made from natural ingredients or make your own at home.  

To eliminate toxins from the body, we highly recommend exercise and the use of saunas, especially infrared sauna therapy to rid many chemicals through sweat. Infrared sauna is superior to conventional sauna because it reaches deeper into the body, increasing the circulation in the blood vessels, and causing the body to start to releasing many of the chemicals stored in body fat.  

There are two supplements that are particularly useful in helping the body detoxify. The first is glutathione, or its precursor N-acetyl cysteine. Glutathione is one of the most common molecules used by the body to eliminate toxic chemicals. If you are constantly exposed to toxicants your stores of glutathione could be depleted. The second supplement is vitamin B3 (niacin). Some may not enjoy the flushing that can happen when taking niacin, however, this flushing is from the blood vessels dilating, which is useful in the detoxification process.  If sensitive to the flushing, start with the lowest recommended dose and work up from there.

Please refer to your test’s specific Test Preparation and Instructions for more information regarding the potential effects of medications, foods, and supplements on this test. 

You make also consult your healthcare provider prior to making any changes to your medications.

Mosaic Diagnostics offers written interpretations within test reports and complimentary consultations with our clinical educators for qualified practitioners. To schedule a consultation, simply sign in to your MosaicDX account and book a consultation online. 

We encourage all patients to discuss results with your practitioner.

Our Resources tab also contains educational materials that you may find useful, we also offer MosaicEDGE workshops for qualified practitioners to better understand the fundamentals of lab testing.

Patients with high toxic levels are at greater risk of concomitant exposure from all toxins. For patients with specific exposure history, practitioners can order individual panels or combine profiles to identify or more rapidly reduce or remove multiple sources of toxin exposure:

These test can all be done from one urine sample:

Yes, it is possible to conduct multiple urine tests using a single urine sample, provided that the volume requirement for each test is met. The urine collection container typically holds around 50 mL of urine. However, for timed and 24-hour urine tests, a specialized collection jug or bag is necessary. 

Have a question? We've got answers.

Our team of experts can help you find exactly what you need. Contact us now and let's get started.

Clinical References

Lin CY, Lee HL, Jung WT, Sung FC, Su TC. The association between urinary levels of 1,3-butadiene metabolites, cardiovascular risk factors, microparticles, and oxidative stress products in adolescents and young adults. Journal of Hazardous Materials. 2020 Sep;396:122745.

Penn A, Snyder CA. 1,3-Butadiene and Cardiovascular Disease. In: Comprehensive Toxicology [Internet]. Elsevier; 2018 [cited 2024 Feb 8]. p. 538–44.

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR). ToxGuide™ for 1,3-Butadiene. [cited 2024 Feb 7].

Perry J, Cotton J, Rahman MA, Brumby S. Organophosphate exposure and the chronic effects on farmers: a narrative review. Rural and Remote Health. 2020 Jan 6;

Fghihi-Zarandi A, Dabaghzadeh F, Vaziri A, Karami-Mohajeri S, Ghorbaninejad B, Zamani A, et al. Occupational risk assessment of organophosphates with an emphasis on psychological and oxidative stress factors. Toxicology and Industrial Health. 2022 May 5;38(6):342–50.

Beach JR, Spurgeon A, Stephens R, Heafield T, Calvert IA, Levy LS, et al. Abnormalities on neurological examination among sheep farmers exposed to organophosphorous pesticides. Occupational and Environmental Medicine. 1996 Aug 1;53(8):520–5.

Kupfermann N, Schmoldt A, Steinhart H. Rapid and Sensitive Quantitative Analysis of Alkyl Phosphates in Urine after Organophosphate Poisoning. Journal of Analytical Toxicology. 2004 May 1;28(4):242–8

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR).  ATSDR: toxicological profile information sheet. Benzene. Choice Reviews Online. 2003 Feb 1;40(06):40-3428-40–3428.

Bi Y, Li Y, Kong M, Xiao X, Zhao Z, He X, et al. Gene Expression in Benzene-exposed Workers by Microarray Analysis of Peripheral Mononuclear Blood Cells: Induction and Silencing of CYP4F3A and Regulation of DNA-dependent Protein Kinase Catalytic Subunit in DNA Double Strand Break Repair. Chemico-Biological Interactions. 2010 Mar;184(1–2):207–11.

Niu Z, Wen X, Wang M, Tian L, Mu L. Personal Exposure to Benzene, Toluene, Ethylbenzene, and Xylenes (BTEXs) Mixture and Telomere Length: A Cross-sectional Study of the General US Adult population. Environmental Research. 2022 Jun;209:112810.

Li W, Ruan W, Cui X, Lu Z, Wang D. Blood Volatile Organic Aromatic Compounds Concentrations Across Adulthood in Relation to Total and Cause Specific Mortality: A Prospective Cohort Study. Chemosphere. 2022 Jan;286:131590.

Chapter 8 Benzene, toluene, xylene (BTX). In: Industrial Catalysis [Internet]. De Gruyter; 2021 [cited 2023 Nov 13]. p. 29–32.

Teras LR, Diver WR, Deubler EL, Krewski D, Flowers CR, Switchenko JM, et al. Residential Ambient Benzene Exposure in the United States and Subsequent Risk of Hematologic Malignancies. International Journal of Cancer. 2019 Feb 27;145(10):2647–60.

Al-Harbi M, Alhajri I, AlAwadhi A, Whalen JK. Health Symptoms Associated With Occupational Exposure of Gasoline Station Workers to BTEX Compounds. Atmospheric Environment. 2020 Nov;241:117847.

1999 CDC and ATSDR Symposium on Statistical Methods. JAMA. 1998 Jun 10;279(22):1776.

Bahadar H, Mostafalou S, Abdollahi M. Current Understandings and Perspectives on Non-cancer Health Effects of Benzene: A Global Concern. Toxicology and Applied Pharmacology. 2014 Apr;276(2):83–94.

Snyder R, Sammett D, Witmer C, Kocsis JJ. An Overview of the Problem of Benzene Toxicity and Some Recent Data on the Relationship of Benzene Metabolism to Benzene Toxicity. In: Genotoxic Effects of Airborne Agents. Springer US; 1982:225-240. Accessed December 4, 2023. http://dx.doi.org/10.1007/978-1-4613-3455-2_18

Rappaport SM, Kim S, Lan Q, et al. Human benzene metabolism following occupational and environmental exposures. Chemico-Biological Interactions. 2010;184(1-2):189-195. doi:10.1016/j.cbi.2009.12.017 doi:10.1021/tx00036a017

Ichihara G. Neuro-reproductive Toxicities of 1-bromopropane and 2-bromopropane. International Archives of Occupational and Environmental Health. 2004 Dec 10;78(2):79–96.

Toraason M, Lynch DW, DeBord DG, Singh N, Krieg E, Butler MA, et al. DNA Damage in Leukocytes of Workers Occupationally Exposed to 1-bromopropane. Mutation Research/Genetic Toxicology and Environmental Mutagenesis. 2006 Jan;603(1):1–14.

Kawai T, Takeuchi A, Miyama Y, Sakamto K, Zhang ZW, Higashikawa K, et al. Biological Monitoring of Occupational Exposure to 1-bromopropane by Means of Urinalysis for 1-bromopropane and Bromide ion. Biomarkers. 2001 Jan;6(5):303–12.

Frasch HF, Dotson GS, Barbero AM. In vitro Human Epidermal Penetration of 1-Bromopropane. Journal of Toxicology and Environmental Health, Part A. 2011 Oct;74(19):1249–60.

Styrene [Internet]. National Institute of Environmental Health Sciences. [cited 2023 Nov 10].

Härkönen H, Holmberg PC. Obstetric Histories of Women Occupationally Exposed to Styrene. Scandinavian Journal of Work, Environment & Health. 1982 Mar;8(1):74–7.

Birks L, Casas M, Garcia AM, Alexander J, Barros H, Bergström A, et al. S07-2 Occupational Exposure to Endocrine-disrupting Chemicals and Birth Weight and Length of Gestation: A European Meta-analysis. In: Symposium 7 – Reproductive Health and Endocrine Disruption at the Workplace [Internet]. BMJ Publishing Group Ltd; 2016 [cited 2023 Nov 13].

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Styrene.

Huff J, Infante PF. Styrene Exposure and Risk of Cancer. Mutagenesis. 2011 Jul 1;26(5):583–4.

Styrene Factsheet. CDC. Published September 2, 2021. Accessed December 4, 2023. https://www.cdc.gov/biomonitoring/Styrene_FactSheet.html

Mendrala AL, Langvardt PW, Nitschke KD, Quast JF, Nolan RJ. In vitro kinetics of styrene and styrene oxide metabolism in rat, mouse, and human. Archives of Toxicology. 1993;67(1):18-27. doi:10.1007/bf02072030

Watabe T, Hiratsuka A. Metabolism and Genotoxicity of the Plastic Monomer Styrene. Eisei Kagaku / Journal of Hygienic Chemistry1983;29(5):247-263. doi:10.1248/jhs1956.29.5_247

Sumner SJ, Fennell TR. Review of the Metabolic Fate of Styrene. Critical Reviews in Toxicology. 1994;24(sup1):S11-S33. doi:10.3109/10408449409020138

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR). ToxGuideTM for Acrylonitrile.[cited 2024 Oct]

Kawai T, Takeuchi A, Miyama Y, et al. Biological monitoring of occupational exposure to 1-bromopropane by means of urinalysis for 1-bromopropane and bromide ion. Biomarkers. 2001;6(5):303-312. doi:10.1080/13547500110034817

Marsh GM, Gula MJ, Youk AO, Schall LC. Mortality among chemical plant workers exposed to acrylonitrile and other substances.v American Journal of Industrial Medicine. 1999;36(4):423-436. doi:10.1002/(sici)1097-0274(199910)36:4<423::aid-ajim3>3.0.co;2-m

Sakurai H. Carcinogenicity and Other Health Effects of Acrylonitrile with Reference to Occupational Exposure Limit. INDUSTRIAL HEALTH. 2000;38(2):165-180. doi:10.2486/indhealth.38.165

Kaneko Y, Omae K. Effect of Chronic Exposure to Acrylonitrile on Subjective Symptoms. The Keio Journal of Medicine. 1992;41(1):25-32. doi:10.2302/kjm.41.25

Dubois JL, Kaliaguine S. 2 Alternative routes to more sustainable acrylonitrile: biosourced acrylonitrile.v In: Industrial Green Chemistry. De Gruyter; 2020:31-62. Accessed December 4, 2023. http://dx.doi.org/10.1515/9783110646856-002

Kedderis GL, Batra R, Koop DR. Epoxidation of acrylonitrile by rat and human cytochromes P450. Chemical Research in Toxicology. 1993;6(6):866-871.

Forde MS, Robertson L, Laouan Sidi EA, Côté S, Gaudreau E, Drescher O, et al. Evaluation of Exposure to Organophosphate, Carbamate, Phenoxy Acid, and Chlorophenol Pesticides in Pregnant Women From 10 Caribbean Countries. Environmental Science: Processes &amp; Impacts. 2015;17(9):1661–71.

Wilson NK, Strauss WJ, Iroz-Elardo N, Chuang JC. Exposures of Preschool Children to Chlorpyrifos, Diazinon, Pentachlorophenol, and 2,4-dichlorophenoxyacetic Acid Over 3 years From 2003 to 2005: A Longitudinal Model. Journal of Exposure Science &amp; Environmental Epidemiology. 2009 Sep 2;20(6):546–58.

de Azevedo Mello F, Magalhaes Silva BB, Barreiro EBV, Franco IB, Nogueira IM, Nahas Chagas PH, et al. Evaluation of Genotoxicity After Acute and Chronic Exposure to 2,4-dichlorophenoxyacetic Acid Herbicide (2,4-D) in Rodents Using Machine Learning Algorithms. The Journal of Toxicological Sciences. 2020;45(12):737–50.

Van Ravenzwaay B, Hardwick TD, Needham D, Pethen S, Lappin GJ. Comparative metabolism of 2,4-dichlorophenoxyacetic acid (2,4-D) in rat and dog. Xenobiotica. 2003;33(8):805-821. doi:10.1080/0049825031000135405

Koureas M, Tsakalof A, Tsatsakis A, Hadjichristodoulou C. Systematic Review of Biomonitoring Studies to Determine the Association Between Exposure to Organophosphorus and Pyrethroid Insecticides and Human Health Outcomes. Toxicology Letters. 2012 Apr;210(2):155–68.

Bao W, Liu B, Simonsen DW, Lehmler HJ. Association Between Exposure to Pyrethroid Insecticides and Risk of All-Cause and Cause-Specific Mortality in the General US Adult Population. JAMA Internal Medicine. 2020 Mar 1;180(3):367.

Zago AM, Faria NMX, Fávero JL, Meucci RD, Woskie S, Fassa AG. Pesticide Exposure and Risk of Cardiovascular Disease: A Systematic Review. Global Public Health. 2020 Aug 20;17(12):3944–66.

Pitzer EM, Williams MT, Vorhees CV. Effects of Pyrethroids on Brain Development and Behavior: Deltamethrin. Neurotoxicology and Teratology. 2021 Sep;87:106983.

Yan D, Zhang Y, Liu L, Yan H. Pesticide exposure and risk of Alzheimer’s disease: a systematic review and meta-analysis. Scientific Reports. 2016;6(1). doi:10.1038/srep32222

Godin SJ, Crow JA, Scollon EJ, Hughes MF, DeVito MJ, Ross MK. Identification of Rat and Human Cytochrome P450 Isoforms and a Rat Serum Esterase That Metabolize the Pyrethroid Insecticides Deltamethrin and Esfenvalerate. Drug Metabolism and Disposition. 2007;35(9):1664-1671. doi:10.1124/dmd.107.015388

Benjamin S, Masai E, Kamimura N, Takahashi K, Anderson RC, Faisal PA. Phthalates Impact Human health: Epidemiological Evidences and Plausible Mechanism of Action. Journal of Hazardous Materials. 2017 Oct;340:360–83. 

Liu G, Cai W, Liu H, Jiang H, Bi Y, Wang H. The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis. International Journal of Environmental Research and Public Health. 2021 Mar 1;18(5):2375. 

Segovia‐Mendoza M, Nava‐Castro KE, Palacios‐Arreola MI, Garay‐Canales C, Morales‐Montor J. How Microplastic Components Influence the Immune System and Impact on Children health: Focus on Cancer. Birth Defects Research. 2020 Aug 6;112(17):1341–61. 

Wang Y, Qian H. Phthalates and Their Impacts on Human Health. Healthcare. 2021 May 18;9(5):603. 

Frederiksen H, Skakkebaek NE, Andersson A. Metabolism of phthalates in humans. Molecular Nutrition &amp; Food Research. 2007;51(7):899-911. doi:10.1002/mnfr.200600243 

Genuis SJ, Beesoon S, Lobo RA, Birkholz D. Human Elimination of Phthalate Compounds: Blood, Urine, and Sweat (BUS) Study. The Scientific World Journal. 2012;2012:1-10. doi:10.1100/2012/615068 

Technical Overview of Volatile Organic Compounds [Internet]. US EPA. 2014 [cited 2023 Nov 8].

Association AL. Improve Indoor Air Quality [Internet]. American Lung Association. [cited 2023 Nov 8].

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR).  Volatile organic compounds [cited 2023 Nov 8].

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR) ToxGuideTM for Xylenes. [cited 2024 Feb 7].

Langman JM. Xylene: its toxicity, measurement of exposure levels, absorption, metabolism and clearance. Pathology. 1994;26(3):301-309. doi:10.1080/00313029400169711

Martínez Steele E, Buckley JP, Monteiro CA. Ultra-processed Food Consumption and Exposure to Acrylamide in a Nationally Representative Sample of the US Population Aged 6 Years and Older. Preventive Medicine. 2023 Sep;174:107598.

Konings EJM, Baars AJ, van Klaveren JD, Spanjer MC, Rensen PM, Hiemstra M, et al. Acrylamide Exposure From Foods of the Dutch Population and an Assessment of the Consequent Risks. Food and Chemical Toxicology. 2003 Nov;41(11):1569–79.

Wang B, Wang X, Yu L, Liu W, Song J, Fan L, et al. Acrylamide Exposure Increases Cardiovascular Risk of General Adult Population Probably by Inducing Oxidative Stress, Inflammation, and TGF-β1: A Prospective Cohort Study. Environment International. 2022 Jun;164:107261.

Mucci LA. Dietary Exposure to Acrylamide and Cancer Risk: The Role of Epidemiology. Epidemiology. 2006;17(Suppl):S78. doi:10.1097/00001648-200611001-00179

Capuano E, Fogliano V. Acrylamide and 5-hydroxymethylfurfural (HMF): A review on metabolism, toxicity, occurrence in food and mitigation strategies. LWT – Food Science and Technology. 2011;44(4):793-810. doi:10.1016/j.lwt.2010.11.002

Liu J, Wattar N, Field CJ, Dinu I, Dewey D, Martin JW. Exposure and Dietary Sources of Bisphenol A (BPA) and BPA-alternatives Among Mothers in the APrON Cohort Study. Environment International. 2018 Oct;119:319–26.

Wu LH, Zhang XM, Wang F, Gao CJ, Chen D, Palumbo JR, et al. Occurrence of Bisphenol S in the Environment and Implications for Human Exposure: A Short Review. Science of The Total Environment. 2018 Feb;615:87–98.

Pang Q, Li Y, Meng L, Li G, Luo Z, Fan R. Neurotoxicity of BPA, BPS, and BPB for the Hippocampal Cell Line (HT-22): An Implication for the Replacement of BPA in Plastics. Chemosphere. 2019 Jul;226:545–52.

Ma Y, Liu H, Wu J, Yuan L, Wang Y, Du X, et al. The Adverse Health Effects of Bisphenol A and Related Toxicity Mechanisms. Environmental Research. 2019 Sep;176:108575.

Oh J, Choi JW, Ahn YA, Kim S. Pharmacokinetics of bisphenol S in humans after single oral administration. Environment International. 2018;112:127-133. doi:10.1016/j.envint.2017.11.020

Landrigan PJ, Meinhardt TJ, Gordon J, Lipscomb JA, Burg JR, Mazzuckelli LF, et al. Ethylene oxide: An overview of toxicologic and epidemiologic research. American Journal of Industrial Medicine. 1984 Jan;6(2):103–15.

Centers for Disease Control and Prevention (CDC) Toxic Substances Portal – Ethylene Oxide [cited 2024 Feb 7].

Li Q, Csanády GA, Kessler W, Klein D, Pankratz H, Pütz C, et al. Kinetics of Ethylene and Ethylene Oxide in Subcellular Fractions of Lungs and Livers of Male B6C3F1 Mice and Male Fischer 344 Rats and of Human Livers. Toxicological Sciences. 2011 Jul 23;123(2):384–98.

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR). ToxGuide™ for Vinyl Chloride. [cited 2024 Feb 7].

Centers for Disease Control and Prevention (CDC) Perchlorate Factsheet [Internet]. 2021 [cited 2024 Feb 8].

U.S. Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry (ATSDR). ToxGuide™ for Perchlorates. [cited 2024 Feb 7].

Wang C, Chen H, Li H, Yu J, Wang X, Liu Y. Review of Emerging Contaminant Tris(1,3-dichloro-2-propyl)phosphate: Environmental Occurrence, Exposure, and Risks to Organisms and Human Health.v Environment International. 2020 Oct;143:105946.

Meeker JD, Cooper EM, Stapleton HM, Hauser R. Exploratory analysis of urinary metabolites of phosphorus-containing flame retardants in relation to markers of male reproductive health. Endocrine Disruptors. 2013;1(1):e26306. doi:10.4161/endo.26306

Meeker JD, Stapleton HM. House Dust Concentrations of Organophosphate Flame Retardants in Relation to Hormone Levels and Semen Quality Parameters. Environmental Health Perspectives. 2010;118(3):318-323. doi:10.1289/ehp.0901332

Belcher SM, Cookman CJ, Patisaul HB, Stapleton HM. In vitro assessment of human nuclear hormone receptor activity and cytotoxicity of the flame retardant mixture FM 550 and its triarylphosphate and brominated components. Toxicology Letters. 2014;228(2):93-102. doi:10.1016/j.toxlet.2014.04.017

Pillai HK, Fang M, Beglov D, et al. Ligand Binding and Activation of PPARγ by Firemaster®  550: Effects on Adipogenesis and Osteogenesis in Vitro. Environmental Health Perspectives. 2014;122(11):1225-1232. doi:10.1289/ehp.1408111

Wang X, Li F, Liu J, Ji C, Wu H. Transcriptomic, proteomic and metabolomic profiling unravel the mechanisms of hepatotoxicity pathway induced by triphenyl phosphate (TPP). Ecotoxicology and Environmental Safety. 2020;205:111126. doi:10.1016/j.ecoenv.2020.111126

Zhang Q, Lihong C, et al. Metabolic Mechanism of Aryl Phosphorus Flame Retardants by Cytochromes P450: A Combined Experimental and Computational Study on Triphenyl Phosphate. Environ. Sci. Technol. 2018, 52, 24, 14411–14421. doi:10.1021/acs.est.8b03965.s001