Every day, we're exposed to a chemical soup.
If you sat too close to the TV as you watched the weather report this morning, you likely inhaled flame-retardant chemicals emitted when electronic components heat up. On your drive to work, your car's interior was probably off-gassing harmful chemicals. At the office, you could have inhaled ozone if your desk is close to the Xerox, and your workspace is probably cleaned every night with products containing potentially toxic chemicals.
For most of us, this kind of exposure seems to have little effect. But for some, the chemicals in their environment can trigger serious health issues, including respiratory problems such as asthma and chronic bronchitis. It may affect neurological health, too. A 2007 study from the State University of New York found a strong correlation in some children between attention deficit hyperactivity disorder and exposure to lead contaminants, cigarette smoke and other environmental hazards.
In the last few decades, a stream of medicine has emerged to diagnose and treat people suffering from conditions triggered by environmental factors. The field relies on a growing body of scientific literature exploring the effects of ingested chemicals on human health.
Edmonton's Pediatric Environmental Health Specialty Unit (PEHSU) is Canada's first and only health unit dedicated to children's environmental health. The special unit, located at the Misericordia Community Hospital, studies potential links between children's illnesses and exposure to chemicals, both synthetic and natural.
"Children are very vulnerable, and that's what our clinic is all about," says Dr. Irena Buka, clinical professor of pediatrics and director of the unit. Children are particularly susceptible to environmental pollutants because of their developing bodies and brains, Buka explains. Because children breathe in more air, drink more water and eat more calories pound for pound than adults do, more contaminants enter their bodies. Being closer to the ground, they also more easily inhale pollutant dusts and car exhaust.
At the Edmonton clinic, patient ailments tend to be related to respiratory and neurodevelopment problems. To determine proper treatment, parents are asked to fill out a detailed questionnaire designed to determine whether a child is being exposed to toxins in the air, water and food.
"In every human, there's a genetic influence, as well as an environmental influence," explains Lorie Grundy, a registered nurse with PEHSU. "The gene will reign supreme, but we never know who among us will be adversely affected by environmental factors [or] whether we'll have something inside to protect us, or not."
Environmental doctors are sometimes called "the doctors of last hope" because patients often seek them out after seeing many other physicians without success, says Dr. Jennifer Armstrong, who heads the Ottawa Environmental Health Clinic. Armstrong, who has practised environmental medicine for 13 years, is also president of the Canadian Society for Environmental Medicine and former president of the American Academy of Environmental Medicine.
It's estimated that about 1.2 per cent of the population is incapacitated because of environmental factors, Armstrong says, adding that many more people have been adversely affected in long-term ways. For example, much research has found sperm counts in men have steadily declined in the last 20 years because of exposure to synthetic chemicals in everyday use, and some scientists believe the toxins are also linked to the shrinking number of males born over the last half-century.
Another example comes from a study last year from the University of California, which found evidence suggesting the upswing in autism diagnoses may be caused by exposure to pollutants (because the brain is more sensitive to environmental factors than other organs) - thus an increase of 600 to 700 per cent in autism cases in California in just 11 years. (However, the vast majority of researchers and medical professionals believe the increasing number of cases is due to improved diagnosis.)
Chronic exposure to mould, as another example, seriously weakens a person's immune system and could make them more vulnerable to health problems later on, says Armstrong. "You don't want to surround yourself with a world full of pollution," she says.
It's impossible to live a completely clean life, but there are ways to minimize your exposure. Armstrong recommends eating organic produce and being attentive to indoor air quality, since we spend so much time indoors.
Dr. Harold Hoffman, an Edmonton physician who specializes in occupational health and has an interest in environmental health, suggests people be aware of any hobbies that involve chemicals - like building models, for instance - and be careful to ensure proper ventilation. Regularly replace the filter on your furnace and be wary of any small black dots on the walls, which can signal a serious mould issue in a home or office.
Buka considers second-hand smoke to be one of the biggest environmental health risks for Edmontonians - particularly children. Children in the city can still be exposed to second-hand smoke in cars, though other jurisdictions in Alberta and Canada have moved to restrict smoking in vehicles when children are present.
Pesticides are another major health risk. Many contain neurotoxins that could be linked to ADHD, asthma and cancer, says Buka. However, she says, determining a correlation between chemicals and illnesses is difficult, because of insufficient background information about levels of chemicals in Canadian children.
While the American Academy of Environmental Medicine has existed for about 40 years, the field is relatively new to Canada. Doctors here cannot formally specialize in environmental medicine, though they can claim it as a professional interest. Buka says the discipline has probably been slow to emerge here because of a lack of training for doctors and nurses.
Hoffman thinks the field also may be slow to emerge because of a scarcity of scientific literature. "It's a broad area and we don't have all of the answers, and exposures are very low. So, it's hard to get some of the effects clarified."
It may seem overwhelming in a world filled with synthetic chemicals, but reducing exposures is well worth it, Hoffman says. "My perspective is if you cut it down significantly, your body is better able to handle the rest of the junk that's thrown at you, and you'll be fine."
Buka thinks doctors won't wholeheartedly embrace environmental medicine until there are tools and practices for busy physicians to incorporate into their work. After all, they are practical professionals who often don't have time to comb through the literature. The expansion of the field will also depend on student training. Currently, environmental medicine isn't taught in any medical schools. "What's taught in medical schools is what society demands," says Buka. She notes that societal pressures led to medical schools training doctors to deal with things like heart attacks and cancer. Perhaps, soon, the list will also include environmental health.
In this sometimes-toxic world, environmental medicine looks at what pollutants can make susceptible people sick. Thankfully, an Edmonton clinic is helping legitimize this emerging field of medicine in Canada.
Links:
[1] http://www.avenueedmonton.com/issue/january-2010
[2] http://www.avenueedmonton.com/print/1212?page=2