User:Blancer707/Sandbox2: Difference between revisions

=== Response to Reversions ===

Dear Editor,

We are in complete agreement that this article should be balanced and accurate and I am happy to work with you to advance the quality of this page. However, I disagree with your characterization of my edits, which were in response to the edits that you and other editors had made previously. I am not the original architect of this article and have been working within the framework of what had already been created.

Moreover, while you repeatedly state that you are just “trimming the fat,” the reality is that you are selectively deleting well supported and highly relevant facts to support a single point of view. This form of editing is not only self serving and disruptive, but is also a disservice to the reader.

I further disagree that both my version and your version were accurate. Indeed, there were numerous false statements in earlier iterations of this article, which I took the time to research and correct only to find that you had globally reversed nearly all of them (and on more than one occasion). This type of editing is extremely disruptive. Similarly, there were many instances where highly relevant facts were left out--perhaps in the spirit of streamlining content – nonetheless, it’s misleading. For example, you state up front that in humans, lindane affects the liver, kidneys and nervous system. This statement is patently false. The liver and kidney effects you refer to relate to the findings from animal toxicology studies where rodents were fed high doses of lindane or technical-grade HCH (which as you know contain the more toxic alpha and beta isomers) over prolonged periods of time. Indeed, the primary reason for conducting animal toxicity studies is to establish safe levels for human use/exposure. In humans, the CNS is the primary system affected by exposure to toxic amounts of lindane. This is a well established and undisputed fact.

In response to your comments regarding specific edits, I note the following:

*To reiterate, your edit regarding liver and kidney toxicity in “humans” is patently false. The ATSDR toxicology report notes specifically that the primary organ system affected in humans following exposure to toxic amounts of lindane is the nervous system, not the liver and kidneys: “In humans, the most commonly reported effects associated with oral exposure to γ-HCH are neurological. Most of the information is from case reports of acute γ-HCH poisoning.” This fact is well established and the literature replete with support, well beyond the citations included here. You further neglect to note that the liver and kidney effects you refer to (and as detailed in the body of the ATSDR Toxicology report on pages 35, 79-87 and 110) relate to findings from select animal toxicology studies, many of which did not involve lindane but rather the more toxic technical-grade HCH and beta and alpha isomers. As you likely know, animal tox studies are conducted to establish safe exposure levels for humans (e.g., national water criterion, agricultural tolerances, etc). It is unreasonable to expect the lay public to appreciate this fact and understand the implications to human health without further explanation. The statement was therefore corrected.

*Your edit regarding how lindane works is misleading and does not “simplify” the communication in a meaningful way but rather creates ambiguity. It was therefore revised. Lindane was developed specifically to destroy parasitic insects and the section is about the chemical’s mechanism of action, not its human safety profile as implied. I refer to the wording used in other Wikipedia articles for other like chemicals-- permethrin and malathion--which also work by way of their neurotoxic insecticidal properties to kill parasitic insects—neither is referred to as a “neurotoxin”:

**“Permethrin is a common synthetic chemical, widely used as an insecticide, acaricide, and insect repellent. It belongs to the family of synthetic chemicals called pyrethroids and functions as a neurotoxin, affecting neuron membranes by prolonging sodium channel activation.”

**“Malathion is an organophosphate parasympathomimetic which binds irreversibly to cholinesterase.”

*Your criticism of the statement "Limited data suggest that lindane may be an endocrine disruptor but additional research is needed to determine the relevance to public health" as being too round about was nearly a verbatim taken from page 139 of the ATSDR report that you cited. Specifically the report states “The amount of evidence is limited and further investigation is necessary to ascertain the relevance and impact to public health.” In my opinion, your statement over simplifies the subject; however, I have no problem expanding in the body of the article in the spirit of compromise.

*With regard to carcinogenicity, please note that the edits were not based solely on the ATSDR report but rather a number of authoritative reviews and studies on this subject matter. Further, the chronology is relevant as the science has advanced over time and the more recent reviews taken on by the EPA and the WHO have accounted for these insights whereas those by the IARC and NCI have not. The statement was revised to address your concerns while preserving the integrity of the science.

*Relative to the Stockholm Convention, I disagree that it is intuitive to the lay reader that this applies only to countries that have ratified the treaty, particularly given the language that the ban is global. I think this is misleading and implies that the chemical is banned worldwide, which is false. Again, I appreciate your attempt to simplify and agree that it could be shortened.

Lastly, as you continue to contribute to this page, please respect that Wikipedia is for consensus building and not for global deletions to the work of others. The edits made today are to increase the accuracy of the article, provide additional details that are relevant to this topic, and to enhance its readability. I have provided detailed support and rationales for each edit, and have respected your attempt to reorganize the information while making compromises where appropriate.

== Updates to Clarify and Correct Inaccurate and Biased Information ==

=== Legal Status ===

As of January 12, 2010, there were 152 signatory countries listed on the Stockholm Convention website. Information was corrected.

=== Introductory Section: ===

'''Regarding mechanism of action''': This section relates to the chemical's mechanism of action (MOA), not human safety as implied here. The statement that "lindane is a neurotoxin" was revised to avoid ambiguity, and is in line with the language used in other Wikipedia articles for other like chemicals with similar MOAs. For example, “Permethrin is a common synthetic chemical, widely used as an insecticide, acaricide, and insect repellent. It belongs to the family of synthetic chemicals called pyrethroids and functions as a neurotoxin, affecting neuron membranes by prolonging sodium channel activation.” Same goes for Malathion: “Malathion is an organophosphate parasympathomimetic which binds irreversibly to cholinesterase.”

'''Regarding toxicity''': The statement as previously written (affects the ... liver and kidneys) was false and was therefore corrected for a second time. In humans, the primary body system affected by excess exposure to lindane is the nervous system, not the liver or kidneys. The section on Human Health Effects in this article notes the same. This fact is well established and the evidence undisputed. Indeed, liver and kidney effects, as detailed in the body of the ATSDR tox report (see pages 35, 79-87 and 110) related to findings from select animal toxicology studies involving chronic high-dose exposures, not human exposures. Moreover, many of these studies did not involve lindane but rather more toxic technical-grade HCH and the beta and alpha isomers. Indeed, animal toxicology studies are conducted to establish safe levels of a chemical for human exposure. Detailing results without this understanding is highly misleading and does not serve the lay reader well.

'''Regarding carcinogenic potential''': The most current authoritative reviews on this subject by the EPA and the WHO have concluded that lindane is not likely to be a major human carcinogen. Older reviews by the IARC and the NCI did not take into account newer scientific insights. As a compromise, the statement was revised to include mutatenicity and to more objectively state the facts, which are detailed in the body of this article.

'''Regarding pharmaceutical use''': Wording was awkward. Modified for clarity.

=== History and Use ===

Changes to this section reflect grammatical refinements and addition of relevant information that was previously deleted.

'''Regarding agricultural vs pharmaceutical formulations''': Information on lindane concentrations in various formulations was reinserted as it is highly relevant to the specific applications and exposure risks associated with lindane.

'''Regarding major uses''': The fact that more than 99% of lindane uses have historically been for agricultural purposes is an important and relevant historical detail reported by many sources, including the Commission for Environmental Cooperation, that helps to set context for the global uses of this chemical. It has been reinserted.

'''Regarding agicultural bans''': As worded, the statement was false and therefore corrected. Lindane is not banned internationally and is legal in many countries including the US and Canada. Rather, countries who have ratified the treaty have agreed to phase out agricultural uses of lindane, with a specific exemption for healthcare uses. This is not an intuitive point and needs to be spelled out for the lay reader. As noted by the Convention, the ban applies to “countries that have ratified the Convention” Source: http://www.pops.int/documents/guidance/beg_guide.pdf

Additional edits were to simplify and clarify the wording and information for the reader, including the statement regarding toxicity of the alpha and beta isomers.

'''Regarding FDA position''': A statement regarding the FDA's position on lindane medications was added for accuracy and completeness of discussion on US history and uses.

'''Regarding resistance''': Resistance is a major concern with scabies and lice treatments, which is why governments are advocating for the development of treatment alternatives. I am not clear why this information was deleted previously, but it has been restored here as it is a highly relevant public health issue and an important reason why second-line treatments are sometimes required.

'''Regarding FDA warning letter''': I am not clear why this information is even included in this article—it occurred in 2007, has been resolved and relevant safety information provided in another section of this article. Perhaps someone can provide a fresh point of view on this. However, in the spirit of compromise, the paragraph was simplified and the information regarding the outcome ( which was deleted by a previous editor for unknown reasons) restored along with the link to the statements that the company was required to clarify. This information is relevant to the public and to purposefully exclude it is misleading at best.

'''Regarding pending legislation''': This paragraph was expanded for accuracy. The previous version implies to the lay reader that lindane is banned in Michigan, which is false.

'''Regarding the California analysis''': Important details of this report were reinserted as they are highly relevant to the extent that conclusions can be drawn, particularly for such a narrow study. It is improper to report the authors’ opinions as facts without also describing key limitations of the analysis. This is basic research reporting 101.

As well, the study did not report a “marked” decrease. The editorialized remark was thus deleted. As an aside, the levels of lindane entering CA reclamation plants, as reported in this paper, never exceeded levels considered safe by current national water safety standards for lindane. Similarly, the statement that the decline in lindane water levels was "Dramatic" is an opinion of the Wikipedia editor, and not an objective finding of the study. Statement revised.

The opposing viewpoint expressed by the EPA is highly relevant to include here for balance. Why this was removed previously is unclear but biases the communication and does not serve the reader well.

=== Human Health Effects ===

Information briefly expanded here from introductory statement above. Language is nearly verbatim from the CDC’s ATSDR toxicology report cited.

'''Regarding prenatal exposure to beta-HCH''': The statement was deleted because this article as well as this section relates to the health effects of lindane, not other HCH isomers. To also clarify, the previous statement was inaccurate. Beta-HCH is not an isomer of lindane but rather an isomer of HCH. This was one of many corrections made previously that was reverted.

'''Regarding cancer risk''': This section was reworked to more accurately reflect the available data and expert positions on this subject. The information regarding the EPAs cancer classification of lindane was also in error and was corrected. Similarly, the IARC 2B classification was not for lindane specifically but the broader class of hexachlorocyclohexanes. All of the information provided here comes from the referenced reports. The intent was to correct inaccurate information and to also provide more context for the data and positions that have been published over the years. Review dates were included because some of the experimental data that was relied upon in earlier reviews were later deemed scientifically flawed and less relevant by more current scientific standards. Please note that the lead statement regarding animal studies does not reflect the science on this subject and was removed.

'''Regarding adverse reactions''': Section revised for accuracy and clarity. Previous version implied that seizures are common events vs the rare events that they are -- this is true for agricultural, occupational, and pharmaceutical chemical exposures. Also, it is standard practice to report common events first, followed by less common and rare systemic effects.