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Neurotoxicology and Teratology,Vol. 16, No. 5, pp. 525-530, 1994
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Adoption of an Adult Environmental
Neurobehavioral Test Battery
ROBERT W. AMLER,* JEFFREY A. LYBARGER,* W. KENT ANGER,1 "l BETTY L. PHIFER,*
WILLARD CHAPPELL~t AND LESLIE HUTCHINSON§
*Agency for Toxic Substances and Disease Registry, Atlanta, GA 30333
~fOregon Health Sciences University, Portland, OR 97201
:~ University of Colorado at Denver, Denver, CO 80217
§Hutchinson Consultants, PC, Atlanta, GA 30211
Received and Accepted 1 June 1994
AMLER, R. W., J. A. LYBARGER, W. K. ANGER, B. L. PHIFER, W. CHAPPELL, L. HUTCHINSON. Adop-
tion o fan adult environmentalneurobehavioraltest battery. NEUROTOXICOL TERATOL 16(5) 525-530, 1994.- Nation-
ally recognized experts participated in a 3-day workshop to discuss the complex issues associated with neurobehavioral testing
in environmental health settings, and to propose basic and focused test batteries for use in evaluating populations living
near hazardous chemical sites. The Adult Environmental Neurobehavioral Test Battery (AENTB), which evaluates major
neurobehaviorai domains and functions, was adopted by the Agency for Toxic Substances and Disease Registry (ATSDR) for
use as a basic screening panel in field studies. Pilot testing of the AENTB demonstrated an examiner training requirement of
3-6 practice sessions, a mean total testing time of 58.0 min (SD = 9.6), and, for 9 of the component tests, a sample size
requirement of fewer than 140 (or = 0.05, 95070power) to detect a 20070difference between study groups. ATSDR administered
the AENTB to 467 persons, selected randomly from 1,382 participants in field study sites in three states. Total testing time
varied noticeably by participant age and study site, suggesting an ongoing need for site-specific controls in each field study
using the AENTB. Also planned is adoption of a pediatric test battery to evaluate the domains and functions most relevant at
major stages of child development.
Neurotoxic disorders Behavioral tests Environmental toxicology
Hazardous substances Pollution Superfund ATSDR
Environmental health study
THE AGENCY for Toxic Substances and Disease Registry
(ATSDR) and the Emory University School of Public Health
convened a workshop in September 1991 to assist in develop-
ing standardized neurobehavioral test batteries for use in envi-
ronmental health field studies. The strategy was to build on
the past success of using neurobehavioral test batteries to eval-
uate persons exposed to neurotoxicants in occupational set-
tings (12). This article reviews the purpose and principal re-
sults of the workshop and summarizes steps taken by ATSDR
to adopt and implement neurobehavioral test batteries in its
health investigations of communities located near hazardous
chemical sites.
BACKGROUND
ATSDR was created by Congress to implement the health-
related portions of the Comprehensive Environmental Re-
sponse, Compensation, and Liability Act of 1980 (CERCLA),
also known as Superfund. ATSDR is mandated to conduct
environmental health studies to determine the relationships
between human exposures to hazardous substances and ad-
verse health effects. To accomplish this mission, ATSDR must
characterize many detailed events in a continuum that begins
with a pathway of environmental exposure and proceeds, if
unimpeded, to adverse organ effect, disease, or in the extreme,
death (4).
To focus Agency resources on the most serious health
problems associated with exposure to hazardous substances,
ATSDR has chosen to emphasize seven priority health condi-
tions, one of them neurotoxic disorders (1). At least 750 toxi-
cants have the potential to cause neurotoxic effects in humans
after short- or long-term exposures or latent periods (6). Of 50
chemical substances designated as high priority by ATSDR,
31 are associated with neurotoxicity (2). In addition, of the 10
=Requests for reprints should be addressed to ATSDR Division of Health Studies, Attn: Chief Medical Officer, 1600 Clifton Road (E-31),
Atlanta, GA 30333.
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