Environmental Illness

Indoor air pollution

Indoor air pollution can affect you at home, work, or even places you visit. It is a common source of respiratory diseases, including Reference asthma Opens New Window, allergies, and lung cancer. It can be worse in winter, when windows are shut tight and less fresh air can circulate.

See Reference tips for reducing indoor air pollution, such as not allowing anyone to smoke in your home.

Cigarette smoke

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.^{Reference 1} Smoking, or even inhaling Reference secondhand smoke Opens New Window, increases your risk of Reference heart attack Opens New Window and Reference stroke Opens New Window.

Tobacco smoke contains many chemicals, some of which are known to 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 cause Reference ear infections Opens New Window. Lower respiratory infections, such as Reference pneumonia Opens New Window and Reference bronchitis Opens New Window, 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.^{Reference 2}

Babies who are exposed to secondhand smoke are at increased risk for Reference sudden infant death syndrome (SIDS) Opens New Window.^{Reference 3}

Cigarette smoke may cause asthma in children.^{Reference 3} Also, children with asthma who are exposed to cigarette smoke have more attacks and more severe symptoms than other children with asthma.^{Reference 3}

See information on the Reference 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 and gas ranges

Woodstoves that are not properly maintained and vented can give off tiny particles (particulates) and gases, including Reference carbon monoxide Opens New Window, 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 stove.

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.

For more information, see the topic Reference Carbon Monoxide Poisoning.

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 Reference volatile organic compounds (VOCs) Opens New Window—can reduce the chemical load on your body.

Sick building syndrome and building-related asthma

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 Reference volatile organic compounds (VOCs) Opens New Window, 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.

Outdoor sources of chemicals can also cause sick building syndrome. Pollutants from cars and trucks and exhaust from plumbing vents and building machinery can enter a building through vents.

Building-related asthma is the term used when symptoms of a diagnosed illness can be linked directly to airborne contaminants within a building. Symptoms include cough, chest tightness, and wheezing. Leaving the building may not immediately improve the symptoms.

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 Reference toxins Opens New Window 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 Reference Legionnaires' disease Opens New Window.

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:

• Cleaning household surfaces with a disinfectant.
• Having adequate ventilation in your house.
• Having anyone with a viral infection, such as a cold or the flu, cough or sneeze into the bend of the elbow or into a tissue.

Reference Pet dander Opens New Window, pollen, Reference dust mites Opens New Window, molds, and rat and mouse urine are allergens that can cause asthma, Reference allergic rhinitis Opens New Window, 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.^{Reference 4} Reference 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 Reference 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 to control Reference 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 Reference control indoor molds, such as preventing leakage, 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:

• 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 bedroom.

For more information, see:

Reference Reference Allergies: Avoiding Indoor Triggers.

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. 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 Reference 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 instead.

Avoid exposure to benzene, which can cause cancer. Benzene is found in tobacco smoke, stored fuels, paint supplies, and vehicle exhaust. 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^{Reference 5}. 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 chemicals.

Asbestos

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 Reference lung cancer, asbestosis (scarring of the lung tissue), or Reference mesothelioma Opens New Window.

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 Reference radon-associated lung cancer is much higher for smokers than nonsmokers.^{Reference 6}

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 Reference Radon.

Treatment for indoor air pollution

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.

Outdoor air pollution

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 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 Reference volatile organic compounds (VOCs) Opens New Window 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. 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 that causes inflammation much like a sunburn.
  • Coughing, wheezing, and pain when taking a deep breath, and breathing problems while exercising.
  • Permanent lung damage from repeated exposure.
  • Aggravated Reference asthma Opens New Window, increased susceptibility to Reference pneumonia Opens New Window and Reference bronchitis Opens New Window, and reduced lung capacity.
• 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. Particulates in the air you breathe can cause:
  • Aggravated asthma.
  • Chronic bronchitis.
  • Coughing and difficult or painful breathing.
  • Reduced lung function.
  • Eye, nose, and throat irritation.
• 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. Reference Carbon monoxide Opens New Window 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 Reference carbon monoxide poisoning Opens New Window 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 Reference angina Opens New Window, Reference heart failure Opens New Window, and Reference coronary artery disease Opens New Window.
• 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. Nitrogen oxides cause many problems, including:
  • Respiratory problems associated with ground-level ozone.
  • Acid rain, which is made when nitrogen oxides and sulfur dioxide react with other substances in the air and form acids. The acids then fall to earth as rain, snow, dry particles, or fog.
  • Toxic chemicals. Nitrogen oxides mix with common organic chemicals and even ozone to create toxic chemicals that can cause biological mutations.
  • Visibility impairment. Nitrogen dioxide and nitrate particles block light transmission and reduce visibility in urban areas.
• Sulfur dioxide. These gases are 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. Sulfur dioxide causes:
  • Health problems for people with asthma and heart conditions.
  • Acid rain.
  • Damage to forests and crops.
  • Damage to fish in streams and lakes.
• 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. Lead may cause serious health problems, including:
  • Damage to kidneys, liver, brain, nerves, and other organs. Lead may also cause Reference osteoporosis Opens New Window and reproductive problems. Excessive exposure can cause seizures, Reference intellectual disability Opens New Window, behavioral disorders, memory problems, and mood changes. Low levels of lead cause brain and nerve damage in young children and fetuses, which can lead to learning problems and low IQ.
  • Reference High blood pressure Opens New Window and increases in heart disease.
  • Reference Anemia Opens New Window.

For more information, see the topics Reference Carbon Monoxide Poisoning and Reference Lead Poisoning.

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 liver and central nervous system.^{Reference 7, Reference 8} Pesticide exposure during pregnancy has been associated with Reference miscarriage Opens New Window, fetal death, and early childhood cancers such as Reference acute lymphoblastic leukemia (ALL) Opens New Window. 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. For agricultural workers, exposure to pesticides has been linked with an increased risk of Reference non-Hodgkin's lymphoma Opens New Window.^{Reference 9}

See Reference tips for reducing pesticide exposure in your home, such as reducing your use of lawn and garden pesticides and limiting your exposure to moth repellents.

Mercury in fish

For most people, the level of mercury absorbed by eating fish and shellfish is not a health concern. But in a Reference fetus Opens New Window or young child, this can damage the brain and nerves (Reference nervous system Opens New Window). 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.^{Reference 10} For more information, see the topic Reference Avoiding Mercury in Fish.

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. A study has shown that people with high levels of BPA in their urine have a greater risk for heart disease.^{Reference 11} And a group of experts concluded that bisphenol A may have some effect on the behavior, brain, and prostate gland of a developing baby (Reference fetus Opens New Window) or young child.^{Reference 12, Reference 13} 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.^{Reference 14} The U.S. Environmental Protection Agency (EPA) provides information about PCBs at http://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.^{Reference 15, Reference 16}

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