Environmental Illness

Overview

What is an environmental illness?

An environmental illness can occur when you are exposed to toxins or substances in the environment that make you sick. These health hazards may be found where you live, work, or play.

Maybe you have headaches that only occur on weekends. Or maybe you began to feel sick and got a rash after moving into a newly built home. These symptoms can be caused by exposure to toxic chemicals. For example:

• Those weekend headaches may be caused by a broken furnace leaking carbon monoxide.
• Materials in new buildings may cause nausea and rashes.

What causes it?

Exposure to some types of chemicals can cause an environmental illness. The more of the chemical you are exposed to, the more likely you are to get ill. Examples include:

Chemicals in cigarettes.

These chemicals are known to cause lung cancer.

Exposure to asbestos.

Asbestos is an insulating material found in some older buildings. It can cause tumors, lung cancer, and other diseases.

Wood-burning stoves and poorly vented gas ranges.

These can produce smoke or gases that can cause breathing problems.

Unsafe drinking water.

For example, water from a rural well polluted with pesticides or other poisons from a nearby industrial plant could cause allergies, cancer, or other problems.

Certain chemicals in the workplace.

Some may affect fertility.

Lead poisoning.

Lead can cause health problems, most commonly in children. It can also cause high blood pressure, brain damage, and stomach and kidney problems in adults.

What are the symptoms?

Symptoms of an environmental illness depend on what is causing it. The symptoms may be like those you can get with other conditions. Examples are:

• Headache.
• Fever and chills.
• Nausea.
• A cough.
• Muscle aches.
• A rash.

If you think that exposure to toxic chemicals or other health hazards could be making you sick, talk to your doctor.

How is it diagnosed?

An environmental illness can be hard to diagnose. You and your doctor may not know what is causing your symptoms. Or you may mistake your symptoms for another problem. Exposure to toxic chemicals can cause a wide range of common medical problems or make them worse.

An exposure history, which is a set of questions about your home, workplace, habits, jobs, lifestyle, and hobbies, can help you find out what is making you sick. It may point to chemicals or other hazards that you've been exposed to recently or in the past.

Keep a journal of your symptoms, and discuss it with your doctor. It may help you find patterns in your symptoms. This can help you and your doctor find out what is causing your illness.

How is an environmental illness treated?

Early treatment includes stopping or reducing your exposure to what is making you sick. These things might help:

Improve your air quality by getting rid of the source of pollution.

Don't allow smoking in your house. If smokers live in or visit your home, ask them to smoke outside.

Increase the amount of fresh air coming into your home.

Adjust gas stoves, or replace them with electric ones. Check to make sure that exhaust fans work. Installing carbon monoxide alarms in your home can also protect you and your family.

Stop the health effects of mold exposure.

Keep a dry environment indoors to reduce exposure to mold. If you do find mold, it should be removed. If the moldy area is less than 3 ft (1 m) by 3 ft (1 m), you can probably remove the mold yourself. But if the moldy area is bigger, a trained professional should remove the mold.

Further treatment will depend on your symptoms and what is causing your illness.

Indoor Air Pollutants

Common indoor pollutants that most affect health include:^{footnote 1}

• Secondhand smoke, such as smoke from the burning end of a cigarette or smoke breathed out by someone who smokes.
• Radon. This is a type of gas that can enter homes through cracks and drains.
• Formaldehyde. It's released mainly by building materials.
• Acrolein. This comes from heating cooking oil to high temperatures. It also comes from cigarette smoke.
• Tiny particles, called respirable particulates, that can get into the lungs. Common sources are tobacco smoke and diesel exhaust.

Secondhand smoke

Secondhand smoke comes from the burning end of a cigarette, cigar, or pipe and the smoke that a smoker exhales. The smoke contains nicotine and many other harmful chemicals. Breathing secondhand smoke can cause or worsen health problems including cancer, asthma, coronary artery disease, and respiratory infections. It can make your eyes and nose burn and cause a sore throat.

Secondhand smoke is especially bad for babies and young children whose lungs are still developing. Children who breathe secondhand smoke are more likely to have ear infections, pneumonia, and bronchitis in the first few years of their lives. Secondhand smoke can make asthma symptoms worse in children.

If you are pregnant, it is important that you not smoke and that you avoid secondhand smoke. You are more likely to give birth to a baby who weighs less than expected (low birth weight) if you smoke. And your baby may have a greater risk for sudden infant death syndrome (SIDS). Babies whose mothers are exposed to secondhand smoke during pregnancy have a higher risk for health problems.

Secondhand aerosol from vapes does not contain as much nicotine and other harmful chemicals as secondhand tobacco smoke does. But there is a concern about possible health risks from secondhand aerosol exposure.

Radon

Radon is a colorless, odorless radioactive gas that can enter your home through cracks in concrete walls and floors and through floor drains. The most common source of radon is uranium that normally exists in the soil or rock on which homes are built. Problems show up when the concentration of radon builds up in a home or building. Both old or new homes can have problems with radon even if they don't have a basement.

Exposure to radon gas is the second leading cause of lung cancer. (Tobacco smoke is the leading cause.) The risk of radon-associated lung cancer is much higher for people who smoke than for those who don't smoke.^{footnote 2}

You cannot smell or see radon. But it's easy to test for it with a do-it-yourself kit available in hardware stores or through the U.S. Environmental Protection Agency (EPA).

Woodstoves and gas ranges

Woodstoves that are not properly maintained and vented can give off tiny particles (particulates) and gases, including carbon monoxide, nitrogen, and hydrocarbons. Children in homes heated with woodstoves are at increased risk for respiratory problems. Gas ranges, particularly when they are not well-vented or when they are used as a source of heat, may produce nitrogen dioxide, which can cause respiratory problems.

Building materials

Exposure to building materials, products used for home improvement, and textiles can cause health problems. For example, particleboard, insulation, carpet adhesives, and other household products emit formaldehyde, which can cause nausea, respiratory problems, dry or inflamed skin, and eye irritation. Newly built homes and the confined spaces of mobile homes can be a particular problem. Using environmentally safe products—such as paint that contains a low level of or no volatile organic compounds (VOCs)—can reduce the chemical load on your body.

Sick building syndrome

Experts coined the term "sick building syndrome" to describe acute symptoms that occur only during time spent in a particular building and that cannot be explained by any specific illness or cause.

Symptoms include headache, dry cough, dry or itchy skin, dizziness, nausea, difficulty concentrating, fatigue, sensitivity to odors, and irritation of the eyes, nose, or throat. Typically the symptoms improve after you leave the building.

Poor ventilation that restricts fresh air flow inside can be a cause of sick building syndrome. Carpet, adhesives, upholstery, manufactured wood, pesticides, and cleaning fluids can give off volatile organic compounds (VOCs), including formaldehyde. High concentrations of VOCs can cause cancer. Unvented gas and kerosene space heaters, woodstoves, fireplaces, and gas stoves can produce carbon monoxide and nitrogen dioxide. These gases can harm your health.

Also, chemicals that get into a building from the outside can cause sick building syndrome. Pollutants from cars and trucks and exhaust from plumbing vents and building machinery can enter a building through vents.

Bacteria, molds, viruses, and other biological contaminants

Bacteria and molds can breed in stagnant water that builds up in humidifiers, drain pans, and ducts, or where water collects on carpet, ceiling tiles, and insulation. Humidifier fever is an illness caused by toxins from microorganisms that grow not only in large heating and cooling systems in buildings but also in home systems and humidifiers. Legionella pneumophila is an indoor bacterium that can cause Legionnaires' disease.

Some viruses can survive on household surfaces, such as counters or floors, or they can get spread through the air when an infected person sneezes or coughs.

Pet dander, pollen, dust mites, molds, and rat and mouse urine are allergens that can cause asthma attacks, allergic rhinitis, and other lung problems. Symptoms of illness caused by biological contaminants include sneezing, watery eyes, shortness of breath, lethargy, dizziness, and digestive problems.

Exposure early in life to indoor allergens such as molds may increase the risk of allergies or asthma.^{footnote 3} When modern building materials get wet, they provide an ideal place for the growth of molds. Allergies to molds can also make asthma attacks worse or cause other breathing problems.

Asbestos

Asbestos is an insulating material commonly used from the 1950s to 1970s for soundproofing and to cover floors, ceilings, water pipes, and heating ducts. When this material becomes crumbly or frayed, asbestos fibers can be released into the air. Breathing asbestos fibers may cause lung cancer, asbestosis (scarring of the lung tissue), or mesothelioma.

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Preventing Health Problems From Indoor Pollutants

Allergens in your home

You can use the following tips to help avoid health problems that are caused by allergens in your home.

• Take steps to help control viruses on household surfaces and in the air.
  • Clean household surfaces with a disinfectant.
  • Have adequate ventilation in your house.
  • Ask anyone with a viral infection, such as a cold or the flu, to cough or sneeze into the bend of the elbow or into a tissue.
• Keep your home clean and as free from dust and dust mites as possible.

  This can help reduce allergens. There are many ways to control dust and dust mites in your home, such as washing bedding in hot water to kill dust mites and eliminating furnishings, such as drapes, that collect dust.

• Try to control animal dander and other pet allergens.

  Ideas include dusting and vacuuming often and regularly cleaning areas where your pet sleeps, such as pet beds or cages.

• Use exhaust fans that vent to the outdoors.

  These fans are typically installed in kitchens and bathrooms. They can help get rid of moisture that allows microorganisms, including molds, to grow. Ventilating attic and crawl spaces and keeping humidity levels below 50% can help prevent moisture buildup in building materials.

• Try other ways to control indoor molds and bacteria.

  Ideas include preventing leaks, removing wet materials, storing fireplace wood outside the home, and using a dehumidifier during humid weather. Try to:

  • Keep humidifiers clean and refill them daily with fresh water.
  • Frequently clean evaporation trays in air conditioners, dehumidifiers, and refrigerators.
  • Replace or remove water-damaged items from your home. This includes water-damaged carpets and building materials.
• Make changes in your home to help reduce allergens.
  • Remove carpets and replace them with hardwood or tile floor.
  • Have sofas with covers that can be removed and washed.
  • Use blinds instead of drapes, because they collect less dust.
  • Have air filters in some rooms, especially in the bedrooms.

Household products

Many of the products you use to clean your home or use for hobbies and home improvement projects contain potentially hazardous chemicals. Some can be toxic and in sufficient doses can cause eye and respiratory problems, headaches, dizziness, visual problems, and memory impairment. You can use the following precautions to help prevent problems.

• Follow the instructions on the label.

  This is one of the most important ways you can protect yourself.

• Have good ventilation.

  When you use cleaning or other products, be sure to open windows or use an exhaust fan.

• Never mix household chemicals.

  For example, do not mix chlorine bleach and ammonia. Some mixtures can create toxic fumes that can be fatal.

• Use environmentally safe products.

  Vinegar, lemon juice, boric acid, or baking soda can be used instead of store-bought household cleaners. And they are less damaging to you and to the environment.

• Be especially careful with products containing methylene chloride.

  Methylene chloride is in certain products such as paint strippers, adhesive removers, and aerosol spray paints. If you use products that contain this chemical, make sure you have adequate ventilation or use them outdoors, if possible. Also, wear gloves to avoid skin contact. But whenever you can, use environmentally safe products instead.

• Avoid exposure to benzene.

  Benzene can cause cancer. Benzene is found in tobacco smoke, fuels, and paint supplies.

• Limit your exposure to newly dry-cleaned clothing or furnishings.

  Dry-cleaned goods may give off chemicals that can cause skin rashes, headaches, and dizziness. If your clothes have a strong odor when you pick them up from the cleaners, hang them outside, if possible.

Woodstoves and gas ranges

You can use the following tips to help prevent indoor air pollution from woodstoves and gas ranges.

• Make sure the woodstove doors fit tightly.
• Burn only aged or cured wood that is completely dry.
• Never burn pressure-treated wood.

  This type of wood is treated with chemicals.

• Get regular inspections.

  Have chimneys, flues, and furnaces inspected each year.

• Make sure that the flames on your gas stove are blue.

  If your gas stove has a persistent yellow flame, it may be improperly adjusted. Ask your gas company to adjust the burners so the flame tips are blue.

• If you're planning to buy a new gas range or stove, consider one that does not use a pilot light.

  Consider changing to an electric stove.

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Outdoor Air Pollutants

Polluted air comes from many sources, such as factories, cars, buses, trucks, and power plants. And there are other sources that you may not think of, such as dry cleaners, wildfires, and dust.

There are at least six major components of air pollution.

Ozone

Ozone is a gas that exists at ground level as well as miles above the earth. It's made by a chemical reaction between nitrogen oxides and volatile organic compounds (VOCs) in the presence of heat and sunlight. "Good" ozone occurs naturally about 10 to 30 miles above the earth's surface. There, in the stratosphere, it forms a layer that protects the earth's surface from the sun's harmful rays. At ground level, "bad" ozone (smog) exists. Exhaust from vehicles, industrial emissions, gasoline vapors, and chemical solvents are major sources of nitrogen oxides and VOCs. Add sunlight and hot weather to the mix, and harmful concentrations of ozone may develop.

Particulates

Particulates include dust, dirt, soot, smoke, and liquid droplets found in the air. They come from many sources, such as vehicles, factories, construction sites, unpaved roads, and burning wood. Other particulates are formed when gases from burning fuels react with water vapor and sunlight. This can result from the combustion of fuels in motor vehicles and from industrial and power plants.

Carbon monoxide

In cities with lots of traffic, most of the carbon monoxide put into the air comes from vehicle exhaust. It also comes from manufacturing processes, wood burning, and forest fires. Indoor sources include cigarettes and space heaters.

Nitrogen dioxide

When mixed with other particles in the air, nitrogen dioxide can often be seen as a reddish brown layer over many urban areas. Sources are fuels burned by vehicles, electric utilities, and industrial plants. Nitrogen dioxide is one of the nitrogen oxides, a group of highly reactive gases that contain various amounts of nitrogen and oxygen.

Sulfur dioxide

This gas is formed when fuels containing sulfur are burned. Examples are when coal and oil burn, when gasoline is extracted from oil, or when metals are extracted from ore. Sulfur dioxide is put into the air when fossil fuel is burned, such as by coal-fired power plants. Other sources are industries that create products from metallic ore, coal, and crude oil or those that burn coal or oil, such as petroleum refineries or metal processing facilities.

Lead

Leaded gasoline used to be the main source of lead in the air. But because leaded fuels have been phased out, the main sources of lead emissions are metals-processing facilities, especially lead smelters.

Effects on your health

Air pollution is a threat to your health. And it also damages crops, trees, water, and animals. The different sources of air pollution can cause different problems.

Ozone

Because of the heat factor, ground-level ozone is a summertime air pollutant that can be dangerous, especially for people with respiratory illnesses. Problems include:

• Irritation of the lungs.
• Coughing, wheezing, and pain when taking a deep breath, and breathing problems while exercising.
• Permanent lung damage from repeated exposure.
• Aggravated asthma, increased susceptibility to pneumonia and bronchitis, and reduced lung capacity.

Particulates

Very small particulates that can get into your lungs are especially harmful to your health and may increase your risk of lung cancer and heart problems. Particulates in the air you breathe can cause:

• Asthma attacks.
• Chronic bronchitis.
• Coughing and difficult or painful breathing.
• Reduced lung function.
• Eye, nose, and throat irritation.

Carbon monoxide

Carbon monoxide reduces the body's ability to deliver oxygen to tissues and organs, such as the heart and brain. It is especially dangerous for people who have heart problems. Carbon monoxide can be fatal to those exposed to extremely high levels. Every year carbon monoxide poisoning is a leading cause of deaths from toxic chemicals. People with carbon monoxide poisoning may have:

• Headaches, irritability, or loss of consciousness.
• Difficulty working, learning, or doing complex tasks.
• Aggravation of heart problems, such as angina, heart failure, and coronary artery disease.

Nitrogen dioxide

Nitrogen oxides cause many problems, including:

• Breathing problems for people with asthma and heart conditions.
• Visibility impairment. Nitrogen dioxide and nitrate particles block light transmission and reduce visibility in urban areas.

Sulfur dioxide

Sulfur dioxide causes:

• Breathing problems for people with asthma and heart conditions.

Lead

Lead may cause serious health problems, including:

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Water Pollution

Your drinking water may come from a public water system or a well, or you may use bottled water. Public water systems are regulated by the U.S. Environmental Protection Agency (EPA). But water from a well may need testing to make sure it is safe to drink. You may be able to use a water filter or a water purification system to provide safe water. It is important for you to know where your drinking water comes from, if it is treated, and if it's safe to drink.

Be aware that water can be contaminated by organisms such as bacteria or fungi, by chemicals such as pesticides, and by metals such as lead or mercury.

Here are ways you can avoid pollution in your drinking water.

• Have your private well water tested.

  If you have a private well, you are responsible for getting your well water tested to see if it is safe to drink. You may want to get your well water tested regularly to make sure it is safe. Also make sure that the well is not located too close to a septic system.

• If there is a problem with your public water, follow instructions from authorities.

  If you are on a public water system, a local agency will let you know when there is a problem with the water. Follow all instructions for purifying your water (commonly called "boil orders") or for using other water sources. Authorities will tell your community when it is safe to drink from the public water supply again.

Other Chemicals in Our Environment

Pesticides

Exposure to pesticides may come from residual agricultural pesticides in foods; from household or workplace products used to control rodents, insects, and termites; and from disinfectants and fungicides. The most likely ways you are exposed are small quantities of pesticides in the foods you eat and by direct contact with surfaces (such as plants, soils, or structures) where pesticides have been used.

If not used properly, both workplace and household pesticides can be dangerous. Exposure to high levels of some pesticides can cause headaches, dizziness, muscle twitching, nausea, weakness, and tingling sensations. Some experts believe that some pesticides may cause cancer or damage to the central nervous system.^{footnote 4} For agricultural workers, exposure to pesticides has been linked with an increased risk of non-Hodgkin lymphoma.^{footnote 5}

Pesticide exposure during pregnancy has been associated with miscarriage, fetal death, and early childhood cancers such as acute lymphoblastic leukemia (ALL). Indoor use of pesticides increases children's risk of brain tumors, ALL, and birth defects. Children can be poisoned by stored pesticides, so these should always be kept out of reach. The American Academy of Pediatrics recommends that children have as little exposure to pesticides as possible.^{footnote 6}

Mercury in fish

This is the advice from the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) for choosing fish that's low in mercury. This advice is for children ages 1 to 11 and for people who might become pregnant, are pregnant, or are breastfeeding.^{footnote 7} Eating fish and shellfish that are low in mercury can be part of a healthy diet.

The EPA divides fish into these three lists.

• Best Choices. These fish are lowest in mercury. Some examples from the Best Choices list are salmon, canned light tuna, trout, and shrimp.
• Good Choices. These fish have more mercury than fish in the Best Choices list. Some examples from the Good Choices list are halibut and canned, fresh, or frozen white albacore tuna.
• Choices to Avoid. These fish have the highest levels of mercury. Avoid eating tilefish from the Gulf of Mexico, swordfish, and shark. Also avoid king mackerel, bigeye tuna, orange roughy, and marlin.

The EPA suggests eating 2 to 3 servings of fish a week from the Best Choices list, or 1 serving a week from the Good Choices list. A serving size is 4 oz (ounces) for people age 11 or older.

Children ages 1 to 11 can have 2 servings of fish a week from the Best Choices list. Avoid serving children fish from the Good Choices or Choices to Avoid list. Those fish may have too much mercury. A serving size is 1 oz for children ages 1 to 3, 2 oz for children ages 4 to 7, and 3 oz for children ages 8 to 10.

If you're unsure about fish that has been caught locally, check local fish advisories about the safety of the fish. If no advice is available, eat only 1 serving a week. And eat no other fish that week.

Chemicals from plastics and other products

Some people are concerned about bisphenol A (BPA). This is a chemical found in some types of plastic (polycarbonate) bottles. BPA also is used to line the inside of some types of food cans and other containers. A study has shown that people who have high levels of BPA in their urine have a greater risk for heart disease.^{footnote 8} And a group of experts concluded that bisphenol A may have some effect on the behavior, brain, and prostate gland of a developing baby (fetus) or young child.^{footnote 9, footnote 10} If you are concerned about BPA, don't use bottles marked with the number 7 or the letters "PC" near the recycle symbol. You can use glass or BPA-free plastic bottles instead.

In the past, a group of substances called polychlorinated biphenyls (PCBs) were used in electrical equipment, plastics, and dyes. Although they are no longer made in the U.S., they remain in the environment. Exposure to PCBs has been linked to health problems, especially mental functions such as memory and attention in children.^{footnote 11} Exposure to PCBs also has been linked to sperm problems in men.^{footnote 12} The U.S. Environmental Protection Agency (EPA) provides information about PCBs at www.epa.gov/epawaste/hazard/tsd/pcbs/index.htm.

Chemicals called phthalates may cause problems with the reproductive organs of infants and young children, especially boys. Phthalates can be found in some plastic items (such as some medical devices) and in products such as powders, lotions, and shampoos.^{footnote 13, footnote 14}

Sand or silica dust

Silicosis is a lung disease caused by breathing in tiny pieces of sand or silica dust. Silica is a common mineral found in sand and rock. Breathing in silica may be a risk in certain jobs, such as construction, mining, rock drilling, sandblasting, and masonry. Silicosis may also be a risk for people who work with glass or ceramics.

Silicosis can cause breathing problems and damage to the lungs. Symptoms may appear many years after exposure to silica. But they can occur much sooner when there is a high level of exposure.

Silicosis can't be cured, but medicines can help manage the symptoms and treat problems such as infections.

To help prevent silicosis, you can do things to avoid dust exposure. For example, you can wear a mask or other device that prevents the fine silica dust from getting into your lungs. Employers are legally responsible for limiting exposure for workers and taking steps to protect workers.

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When to Call a Doctor

Call Poison Control now if:

• You have ingested household chemicals.
• You fear you may have a carbon monoxide leak in your home. Get outside and call.

Symptoms of an environmental illness depend on what exposure to a health hazard you may have had. The symptoms may be like those you can get with other conditions. Talk to your doctor if you think you have been exposed to something and have:

• A headache.
• Fever and chills.
• Nausea.
• A cough.
• Muscle aches.
• A rash.

You may find it helpful to create a written exposure history to take to your doctor. This may help identify the cause of your illness.