For each of the following patient histories, select the most likely environmental agent to cause the illness:
1. A 60-year-old woman develops a chronic cough, and a chest radiograph reveals a 5 cm right hilar mass. She is a non-smoker, and none of the persons with whom she lives are smokers. She has been healthy all her life. She is a homemaker and has raised 5 children:
2. Over a period of less than a day, a 45-year-old man develops increasing weakness and nausea with headaches, then progressive respiratory failure requiring intubation. He is a farmer. His wife says that he was out on his tractor spraying a field of melons with insecticide the day before. He has a markedly decreased serum cholinesterase level:
3. A 40-year-old man has an auto repair shop in which he does radiator repair, requiring welding. The shop is not properly ventilated. Over a period of months, he becomes more lethargic, drops his tools often, and has mental sluggishness. His dentist notes that there is a faint gray line at the gum margins. A CBC reveals a Hgb of 8.6 g/dL, and a peripheral blood smear shows basophilic stippling of the RBCs:
4. A 5-year-old girl develops headache followed by a seizure 12 hours after consumption of a bottle of a clear liquid. On examination she has decreased visual acuity:
5. Epidemiologic studies show increased prevalence of chronic bronchitis in adults residing for more than 20 years in a heavily industrialized city that generates much of its electric power from burning coal:
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