polluted. Climates are changing. The belief that the food chain is contaminated with toxic chemicals is universal and readily validated. But, what branch of the medical sciences will responsible for the diagnosis and treatment of patients who suffer environmental disease? Who is studying and documenting the new patterns of illness that emerge from our deteriorating circumstances? Where do sick people with ill-defined illness get help? Who is changing the curricula of medical schools and teaching medical students what is really going on out there?
The underlying idea of medical practice is to receive the sick and injured, patch their wounds and alleviate suffering when there is no effective treatment.Whatever the determinants of injury and disease are, the doctor and the hospital are ready to attempt rescue you. It is up to you, dear reader, to investigate the causes of disease and to change your food and environment so that you are less likely to become injured and ill. Physicians who work in occupational medicine develop expertise in the toxicology of work environments. Government agencies such as NIOSH in the USA developed standards for limiting toxic chemical exposures and provided information about work hazards. The US EPA set standards intended to reduce air and water pollution but its policies and powers have been constrained by political interference.
Not much progress has been made in bringing knowledge of the environment into community medical offices and hospitals; in this regard medical practice reveals itself to be out-of-date and often irrelevant to the real needs of many patients. Instead the environment has come to hospital in the form of destructive winds, floods and sudden unexpected changes in environments that people often assumed to be more stable and enduring. No medical specialty has assumed the responsibility of applying knowledge of environmental principles, ecology, or toxicology to all citizens. It is difficult for anyone suffering any sort of environmental problem or chemical toxicity to get even a cursory hearing from public health authorities or individual physicians. Lung disease is usually treated as an individual problem with little or no reference to the environment that people with lung disease share.
The only physicians directly involved in toxicology issues work in
occupational medicine and supervise working conditions in industries that expose workers to dust, molds, toxic chemicals and other hazards. Here the emphasis is on preventing acute exposures to toxins in concentrations that are known to be harmful. Little is known about the long term effects of chemical exposure at low doses and there is a tendency for authorities to deny illness caused by chronic exposure.
Allergists intend to deal with some of the medical problems caused by the environment, but often limit their knowledge and practice to a few selected environmental problems, such as hay fever and asthma. Even though asthma receives considerable research attention, the contribution of indoor and outdoor air pollutants and allergy to food proteins is not well understood and ignored in medical practice. By narrowing the definition of allergy to type 1 hypersensitivity, allergists leave patients without help. Some physicians perceive the shortcoming of the medical system and begin to move toward a new methodology. Many years ago, Knicker, a prominent Allergist and Immunologist, stated many years ago, in a challenge to his colleagues: "The estimated group of 40 million citizens with classical allergies is possibly the most underserved of all diseases in the U.S; medical marketing surveys suggest that many atopic individuals are not yet diagnosed or are poorly treated. In addition, there are millions of other individuals who have unrecognized adverse reactions to various antigens, foods, chemicals, and environmental or occupational triggers." (Knicker WT. Deciding the Future for the Practice of Allergy and Immunology 1985 Annals of Allergy.55;106-113 )
Selner and Staudenmayer stated: "...Allergists typically have focused exclusively on the respiratory system, the skin, and the gastrointestinal tract, to the exclusion of other body systems. They are generally not familiar with the toxologic literature which suggests that attention must be paid to symptoms other than those characteristically anticipated with IgE-mediated allergic response. Allergists must broaden their interests to include all body systems other than those traditionally associated with immunological phenomenon if they are to appropriately respond to patients needs and society's expectations."
They referred to the need for a whole systems approach - a comprehensive approach to the interactions of food, air, and water with human bodies. While Knicker and others urged allergists and immunologists to emerge from the practice of narrowly defining their specialty, into the real modern world, with all its unsolved medical problems, the American and Canadian Allergy associations moved to further limit the scope of their practice and focused on skin tests for allergy and asthma as an allergic disease related to pollen and dust allergy. The needs of sick people were neglected while professional debates and methodological arguments continue to this day.
More Biology is Needed In Medicine
A biologist sees living creatures connected to and interacting with their environment. It is normal for a biologist to think in terms of populations, food supply, seasons, weather, and social-behaviors, and to do field studies which reveal patterns of adaptation to specific environments. Anyone who has worked with animals or fish in closed environments knows how critical environmental conditions and diet are in determining both the behavior and the physical status of the residents. When a fish in an aquarium displays disturbed behavior, you do
not call a fish psychiatrist; you check the oxygen concentration, temperature, and pH of the water. You have to clean the tank and change the fish diet.
A proper biological method of medicine recognizes and solves problems in food, air, and water supplies. A steady flow of molecules from the environment enters the body of each individual through the air breathed and the food and liquids ingested. This body-input determines health and disease in whole populations over the long-term and the moment to moment functional capacity of the individual. The quality and composition of air, food, and water changes continuously. The illusion of food continuity in the supermarket conceals changes in the growth, contamination, storage, spoiling, transportation, and merchandising of food products.
Air Quality Inside Buildings
Air pollution, both indoor and outdoor, is a significant cause of health problems worldwide. Home environments contain airborne allergens, infections, irritants and toxins that can reduce the quality of life and cause disease. Indoor work and living environments concentrate air contaminants and create "sick buildings."
Every year, approximately 1,000 new chemicals are developed and added to the 70,000 chemicals, 9 million mixtures, formulations and blends of chemicals already in commercial use. Some of these chemicals are purchased for home use, others pollute work environments. Workers contaminated with industrial and agricultural chemicals bring some home on the clothing and skin. Few of these chemicals have been adequately assessed for their potential toxicity, either individually or in combination with other chemicals. Indoor air is often more polluted than outdoor air. A decrease in indoor air quality is the result of reduced ventilation and efficient construction practices, sealing homes and office buildings from the outdoor environment. Reduced ventilation contributes to the "Sick Building Syndrome" (SBS) with symptoms such a headache, fatigue, malaise, mental confusion, eye and throat irritation, coughing and wheezing.
Air inside buildings contains local aerosols that are more concentrated than outdoor air. The term "dust" refers to the larger particles in the aerosol that settle on walls and furniture. A smoker in the living room of a house produces a toxic aerosol that permeates the rest of the house. Smoke particles settle on walls and every object in a room so that a smoker leaves a trail of contamination that non-smokers smell as soon as they enter the room. Indoor air contains a living aerosol of microorganisms that infect or trigger allergic reactions. Spores of bacteria and fungi are microscopic and may persist for months or years. The abundance of microorganisms, even in a very clean house, surprises most people who have tests done to assess air quality. Insects and their excretions and body parts form part of the aerosol. Allergy to dust mites is often recognized. Other insects are common and are usually not recognized.
See Airborne Fungal Diseases
Chemicals Found in Indoor Air
Hazardous chemicals are used at home. Studies have shown that cancer risks from airborne chemicals can be higher for home environments than for hazardous waste disposal sites. The concentration of chemicals is determined by the airflow (or lack of it),heating appliances, the use of chemcials such as cleaners, perfumes, paints, adhesives, furnishings and the smoking habits of the inhabitants.
Common Indoor Airborne Chemicals
- 1,1,1-Trichloroethane Benezene
- Formaldehyde Alipthatic Hydrocarbons
- Chlordane Chloroform
- Styrene Trichloroethylene
- Toluene Xylene
- Dichloromethane Tetrachloroethylene
- Alcohols N-Hexanol
- Ethyl Acetate Acetone
- Radon 4-Phenylcyclohexene
- Carbon Monoxide Carbon Dioxide
- Polycyclic Aromatic Hydrocarbons
1,1,1-trichloroethane, p-xylene, ethylbenzene, tetrachloroethylene, o-xylene, p-dichlorobenzene, chloroform, trichloroethylene, and carbon tetrachloride.
See Learn More About Air Quality