Chemically intolerant patients have for years moved from cities and other pollution sources, e.g., locations that burn wood to heat homes in winter, like parts of the Pacific Northwest, because of air pollution.

Where is the nation’s worst particulate pollution? In 2011, the American Lung Association published a list: 1. Bakersfield-Delano, Calif. 2. Fresno-Madera, Calif. 3. Pittsburgh-New Castle, Pa. 4. Los Angeles-Long Beach-Riverside, Calif. 5. Salt Lake City-Ogden-Clearfield, Utah 6. Provo-Orem, Utah 7. Visalia-Porterville, Calif. 8. Birmingham-Hoover-Cullman, Ala. 9. (tie) Hanford-Corcoran, Calif.; Logan, Utah; Sacramento-Yuba City, Calif.

Smog cloaks Salt Lake City’s skyline in 2011. (Photo: U.S. Environmental Protection Agency)

But this is new: Now couples are being advised to avoid air pollution when they try to conceive a baby. See the Salt Lake Tribune story “Docs: Wait - or get out of Utah’s bad air - to conceive.”

Cities in Utah endure days and even weeks of concentrated air pollution created by temporary atmospheric inversions. Common in winter, inversions trap air pollution close to the ground and push it to unhealthy levels. Utah is not alone. Los Angeles and Pittsburgh live with an even higher risk according to the American Lung Association.

If concentrated pollution can endanger a fetus, think about its overall threat to public health.

Exposures like those in Utah have the potential to initiate TILT, or Toxicant-induced Loss of Tolerance — the two-step disease process that is affecting growing numbers of people in the United States and abroad. Unfortunately, these people may not recognize their illness because of “masking.” Masking? Think of a frog placed in boiling water. Legend has it that the frog immediately jumps out, but if the water is slowly heated, the frog remains and boils to death. He adapts but to his detriment, even demise.

Masking is why we need doctors to screen patients with the QEESI, or Quick Environmental Exposure and Sensitivity Inventory, a medical questionnaire to detect loss of tolerance. And the rise in TILT shows the need for EMUs, or environmental medical units, to isolate the masking elements in patients. Then we can begin to “see” what these exposures are doing to us. The QEESI and EMU are important modern-day tools much like the microscope and physician Robert Koch’s 19th-century postulates, which helped “prove” the germ theory a century ago.

Salt Lake City is rightfully concerned about a new study in the journal Environmental Health Perspectives. It showed the risk of having a baby of low birth weight jumps 10 percent in areas with higher concentrations of particulate matter, including PM2.5. That’s the pollution that spikes in winter inversions and leads to Utah’s pollution. Ultrafine particles easily enter human airways and can travel through the nose to the brain’s limbic system, which regulates mood, behavior, short-term memory and a host cognitive functions.

There are no good choices to avoid the inversion threat, but inaction is the worst of them.

Are we going to become like China, where wealthier individuals equip their cars and homes with sophisticated air filtration devices? Where children wear masks in cities to filter air? What about the vast majority of families who cannot afford this?

Sunday, September 12, 2010

Newswise — Swimming in indoor chlorinated pools may induce genotoxicity (DNA damage that may lead to cancer) as well as respiratory effects, but the positive health effects of swimming can be maintained by reducing pool levels of the chemicals behind these potential health risks, according to a new study published in a set of three articles online September 12 ahead of print in the peer-reviewed journal Environmental Health Perspectives (EHP). This study is the first to provide a comprehensive characterization of disinfection by-products (DBPs) in an indoor pool environment and the first to study the genotoxicity of exposure to these chemicals among swimmers in an indoor chlorinated pool.

DBPs form in pool water from reactions between disinfectants such as chlorine and organic matter that is either present naturally or is introduced by swimmers, such as sweat, skin cells, and urine. Previous epidemiologic studies have found an association between exposure to DBPs in drinking water and risk of bladder cancer, and one such study has found this association for dermal/inhalational exposure such as occurs during showering, bathing, or swimming.

Chemicals in Indoor Swimming Pools May Increase Cancer Risk

Share your story of chemical exposure and loss of tolerance by responding to this post. If we feel your story may be helpful to others learning about TILT, Dr. Miller will re-post your story with her comments. Be aware that you are posting your story in a public forum. Do not include identifying information unless you are comfortable with it being available to anyone on the web, and please do not post your story if you are pursing any legal action regarding your exposure or TILT-related illness. We also ask that you do not name any third parties including doctors, coworkers or family members. We will remove any postings that are not appropriate to this forum and the topics we address.

Following is a format you may wish to follow in describing your experiences. Specific information is most helpful.

Initiating exposure(s): What was it? Which year did it occur?

How many others were exposed and did they develop TILT?

Fill out the QEESI – what are your scores on the 5 scales, both now and when you were at your worst?

After the initial exposure, how soon did your intolerances begin? Which did you notice first? Which caused the most severe symptoms?

Please indicate if you have experienced the following types of intolerance, and describe your principal reactions/symptoms.
Chemical intolerances:
Food intolerances:
Caffeine intolerance:
Alcoholic beverage intolerance:
Adverse drug reactions or drug intolerance:

What medical diagnoses have you or other affected family members received since developing TILT?

How many doctors did you see before you figured out what had happened to you?