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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:
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:
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:
If you think that exposure to toxic chemicals or other health hazards could be making you
sick, talk to your doctor.
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.
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.
Early treatment includes
stopping or reducing your exposure to what is making you sick. These things
Further treatment will depend on your symptoms and what is
causing your illness.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about environmental illness:
Indoor air pollution can
affect you at home, work, or even places you visit. It can increase your risk of a respiratory disease, such as
asthma, allergies, and lung cancer. Indoor air pollution can be worse in
winter, when windows are shut tight and less fresh air can circulate. A study found that three pollutants commonly found in houses have the greatest effect on health:1
tips for reducing indoor air pollution.
One of the most common and toxic indoor air pollutants is
cigarette smoke. Experts believe about 90% of lung cancers
are caused by cigarette smoke.2 Smoking, or even
secondhand smoke, increases your risk of
heart attack and
Tobacco smoke contains many chemicals, some of which can cause cancer. If you are a
nonsmoker and household members or coworkers will not stop smoking around you,
ask that they smoke only in well-ventilated or isolated areas. Never smoke
around children or allow them to be exposed to cigarette smoke, especially if
they have asthma or allergies.
Exposure to cigarette
smoke causes wheezing, coughing, and extra mucus (phlegm) in many children.
Secondhand smoke also can cause fluid to build up in the inner ear, which can
ear infections. Lower respiratory infections, such as
bronchitis, are also risks. Sometimes these types of
infections become serious enough to require a hospital stay, especially when
they develop in babies and young children.3
Babies who are exposed to secondhand smoke are at increased risk for
sudden infant death syndrome (SIDS).4
Cigarette smoke may cause asthma in children.4 Also, children with
asthma who are exposed to cigarette smoke have more attacks and more severe
symptoms than other children with asthma.4
See information on the
increased impact of environmental illnesses on children. For example, in recent years, the number of children with
asthma has more than doubled, and environmental causes are suspected.
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. Consider changing to an electric
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.
If you use a woodstove, make sure
the stove doors fit tightly. Burn only aged or cured wood that is completely dry.
Never burn pressure-treated wood because it is treated with chemicals.
Have chimneys, flues, and furnaces inspected each year.
more information, see the topic
Carbon Monoxide Poisoning.
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.
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
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 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
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
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. You can help control viruses by:
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.5 Allergies to molds can also make asthma attacks worse
or cause other breathing problems.
Keep your home clean and as free from dust as possible to
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. Also, there are many steps you can take
animal dander and other pet allergens.
Exhaust fans that vent to the outdoors and are installed in kitchens and
bathrooms can help get rid of moisture that allows microorganisms, including
molds, to grow. When modern building materials get wet, they provide an ideal
place for the growth of molds, which can make asthma attacks worse and
may cause other respiratory symptoms. Ventilating attic and crawl spaces and
keeping humidity levels below 50% can help prevent moisture buildup in building
materials. There are other ways to
control indoor molds, such as preventing leaks,
removing wet materials, storing fireplace wood outside the home, and using a
dehumidifier during humid weather.
Keep humidifiers clean and
refill them daily with fresh water. Frequently clean evaporation trays in air
conditioners, dehumidifiers, and refrigerators. Water-damaged carpets and
building materials can also have molds and bacteria in them. It is difficult to
get rid of bacteria or molds. So, if possible, replace or remove water-damaged
items from your home.
You can also:
For more information, see:
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. One of the most important ways you can protect yourself is by
following the instructions on the label. When you use cleaning or other products,
be sure to open windows or use an exhaust fan to provide good ventilation.
Never mix household chemicals, such as chlorine bleach and ammonia. Some mixtures can
create toxic fumes that can be fatal.
It's better to 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,
including 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
Avoid exposure to benzene, which can cause cancer.
Benzene is found in tobacco smoke, fuels, and paint supplies. Also, try to limit your exposure to newly dry-cleaned
clothing or furnishings. Dry-cleaned goods may emit perchloroethylene (also known
as tetrachloroethylene) and trichloroethylene. These chemicals may cause skin
rashes, headaches, and dizziness.6 If your clothes emit a strong odor when you pick them up from
the cleaners, they may not have been dried properly and can release more of
this chemical. After removing the protective plastic from the clothes, hang
them outside, if possible. Consider finding a dry cleaner that uses less toxic
Asbestos is an insulating material commonly used from the
1950s to 1970s for soundproofing and to cover floors and ceilings, water pipes,
and heating ducts. When it 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
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 smokers than nonsmokers.7
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). For more information,
see the topic
How you react to indoor air pollutants
depends on your age, health, and how sensitive you are to certain chemicals or
biological pollutants, such as bacteria or molds. Treatment can be as simple as removing
and limiting your exposure to
toxic chemicals in your home. In some cases, serious
illnesses—such as cancer, heart disease, and respiratory disease—can develop
after long-term and repeated exposures. With such long-term exposures,
treatment may be extensive, depending on the type of illness.
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. Dirty air is a threat to your health. And it also damages crops,
trees, water, and animals.
There are at least six major components of air
For more information, see the topics
Carbon Monoxide Poisoning and
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.
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.
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.10 For agricultural workers, exposure to pesticides has been
linked with an increased risk of
Pesticide exposure during
pregnancy has been associated with
miscarriage, fetal death, and early childhood cancers
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.12
tips for reducing pesticide exposure in your home, such as reducing your use
of lawn and garden pesticides and limiting your exposure to moth
For most people, the level of
mercury absorbed by eating fish and shellfish is not a health concern. But in a
fetus or young child, this can damage the brain and
nerves (nervous system). Because of the mercury found in fish,
the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency
(EPA) advise women who may become pregnant, pregnant women, nursing mothers,
and young children to avoid eating fish high in mercury and to eat limited
amounts of fish and shellfish that are lower in mercury.13 For more information, see the topic
Avoiding Mercury in Fish.
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.14 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.15, 16 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
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.17 Exposure to PCBs also has been linked to sperm problems in men.18 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.19, 20
If you believe you have an
environmental illness, first consider your symptoms.
If your symptoms are severe (for example, you are having trouble breathing),
you have ingested household chemicals, or you fear you may have a
carbon monoxide leak in your home, call your Poison
Control Center immediately. Otherwise, contact:
You may find it helpful to create a written
exposure history to take to your doctor, to help
identify the cause of your illness.
Logue JM, et al. (2012). A method to estimate the chronic health impact of air pollutants in U.S. residences. Environmental Health Perspectives, 120(2): 216–222.
Ettinger DS (2008). Lung cancer and other pulmonary
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U.S. Environmental Protection Agency
(2011). Smoke-free homes. Available online: http://www.epa.gov/smokefree/index.html.
U.S. Environmental Protection Agency
(2010). Health effects of exposure to secondhand smoke.
Available online: http://www.epa.gov/smokefree/healtheffects.html.
Iossifova YY, et al. (2009). Mold exposure
during infancy as a predictor of potential asthma development. Annals of Allergy, Asthma, and Immunology, 102(2):
Agency for Toxic Substances and Disease Registry
(2011). Toxic substances portal—Trichloroethylene (TCE): Public Health Statement for
U.S. Environmental Protection Agency (2012).
A Citizen's Guide to Radon: The Guide to Protecting Yourself and Your Family From Radon. Available online:http://www.epa.gov/radon/pubs/citguide.html.
Raaschou-Nielsen O, et al. (2013). Air pollution and lung cancer incidence in 17 European cohorts: Prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncology, 14(9): 813–822.
Shah ASV, et al. (2013). Global association of air pollution and heart failure: A systematic review and meta-analysis. Lancet, 382(9897): 1039–1048.
Baldi I, et al. (2011). Neurobehavioral effects of long-term exposure to
pesticides: Results from the 4-year follow-up of the
PHYTONER Study. Occupational and Environmental Medicine, 68(2): 108–115.
Fritschi L, et al. (2005). Occupational exposure to pesticides and risk of non-Hodgkin’s lymphoma. American Journal of Epidemiology, 162(9): 849–857.
Council on Environmental Health (2012). Pesticide exposure in children. Pediatrics, 130(6): e1757–e1763. Available online: http://pediatrics.aappublications.org/content/130/6/e1757.full. [Erratum in Pediatrics, 131(5): 1013. Also available online: http://pediatrics.aappublications.org/content/131/5/1013.3.full.]
U.S. Food and Drug Administration (2004). What you
need to know about mercury in fish and shellfish: 2004 EPA and FDA advice for
women who might become pregnant, women who are pregnant, nursing mothers, young
children. Available online:
Melzer D, et al. (2010). Association of urinary bisphenol A concentration with heart disease: Evidence from NHANES 2003/06. Public Library of Science ONE, 5(1): e8673. Also available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800195/?tool=pubmed.
National Toxicology Program, Center for the
Evaluation of Risks to Human Reproduction (2008). NPT-CERHR Monograph on the Potential Human Reproductive and Developmental Effects of Bisphenol A (NIH Publication No. 08-5994). Available online:
Braun JM, et al. (2011). Impact of early-life bisphenol A exposure on behavior and executive function in children. Pediatrics, 128(5): 873–882.
Chen A, et al. (2011). Developmental neurotoxicants in e-waste: An emerging health concern. Environmental Health Perspectives, 119(4): 431–438.
McAuliffe ME, et al. (2012). Environmental exposure to polychlorinated biphenyls and p,p'-DDE and sperm sex-chromosome disomy. Environmental Health Perspectives, 120(4): 535–540.
National Toxicology Program, Center for the
Evaluation of Risks to Human Reproduction (2006). NPT-CERHR Monograph on the Potential Human Reproductive and Developmental Effects of Di(2-Ethylhexyl) Phthalate (DEHP) (NIH Publication No. 06-4476).
Sathyanarayana S, et al. (2008). Baby care
products: Possible sources of infant phthalate exposure. Pediatrics, 121(2):
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Current as of:
October 8, 2013
Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine
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