environmental exposures

our bodies are in constant contact with the environment. environmental hazards present in the air we breathe, the food and water we drink, or the products we place on our skin can cause adverse health effects. cehchv has provided concise guidance on a few of the more common adverse environmental exposures that we commonly counsel on at our local center in the hudson valley.

Environmental Tobacco Smoke

Exposure to secondhand smoke is extremely dangerous to health. Secondhand smoke gets into the air when tobacco products are burned in cigarettes, cigars, and pipes. Secondhand smoke, also known as environmental tobacco smoke (ETS), contains thousands of toxic chemicals, many of which are known to be cancer causing. A 2006 Surgeon General report stated that exposing nonsmokers to secondhand smoke at home or work significantly increases the risk of developing heart disease and lung cancer. Secondhand smoke also has adverse effects on children and can lead to respiratory problems, ear infections, and asthma attacks.

Research shows that exposure to even small levels of secondhand tobacco smoke is associated with the development of many serious health problems, including heart disease, cancer, chronic respiratory infections, and asthma. Exposure to secondhand smoke during pregnancy can harm a baby's healthy growth and development for years to come. Exposure to tobacco smoke during pregnancy is associated with abnormal lung function in infancy that can persist through adolescence. Smaller birth weights, premature delivery, Sudden Infant Death Syndrome (SIDS), and miscarriage are also dangers associated with prenatal exposure to secondhand smoke.

There are many things to do to minimize exposure to secondhand smoke:

• Do not smoke. And don't allow anyone else to smoke in your home or car where smoke gets contained and remains in carpets, clothing, and furniture.

• If you, another household member, or guest must smoke, do it outdoors and away from children. 

• Ask friends and relatives to avoid smoking near your children. 

• Avoid smoky restaurants and parties. Choosing the non-smoking section is not adequate protection. 

• Choose your caregivers carefully. Make sure they do not smoke or, if they do, ask them not to smoke around your child. 

• Encourage family members and close friends who smoke to quit. 

Carbon Monoxide

Carbon monoxide is a colorless, odorless and tasteless gas. But the danger it poses is real. Carbon monoxide replaces oxygen in your blood and the consequences can be fatal. In the U.S., more people die each year of exposure to carbon monoxide than of any other type of poison. 

Carbon monoxide is produced by appliances and other devices that burn gas, petroleum products, wood and other fuels. Sometimes carbon monoxide can accumulate to dangerous levels in your car, home or other poorly ventilated areas. 

The signs of carbon monoxide poisoning can be subtle, but simple precautions can save your life. 

Symptoms of carbon monoxide poisoning:

• Dull headache, the most common early symptom

• Dizziness

• Nausea

• Vomiting

• Chest pain

• Confusion

• Irritability

• Impaired judgment

• Loss of consciousness 

Carbon monoxide poisoning can be especially dangerous for people who are sleeping or intoxicated. The fumes may be fatal before they realize there's a problem.

Causes of carbon monoxide poisoning: 

Carbon monoxide poisoning is caused by inhaling carbon monoxide fumes. When there's too much carbon monoxide in the air, your body replaces the oxygen in the hemoglobin of your red blood cells with carbon monoxide. This keeps life-sustaining oxygen from reaching your tissues and organs. 

Various appliances fueled by wood or gas produce carbon monoxide, including:

• Fuel-burning space heaters

• Furnaces

• Charcoal grills

• Cooking ranges

• Water heaters

• Fireplaces

• Portable generators, including those often used on houseboats

• Wood-burning stoves

• Car and truck engines 

Normally the amount of carbon monoxide produced by these sources isn't cause for concern. But, if appliances aren't kept in good working order or if they're used in a closed or partially closed space, such as using a charcoal grill indoors or running your car in a closed garage, the carbon monoxide can build to dangerous levels. Even swimming behind a motorboat or riding in the back of an enclosed pickup truck can be dangerous. 

Smoke inhalation during a fire also can cause carbon monoxide poisoning. 

Carbon monoxide fumes are dangerous for anyone. 

Some people are more susceptible to the effects of carbon monoxide, including: 

• Unborn babies

• Infants

• Older adults

• People who smoke

• People who have chronic heart disease, anemia or respiratory problems 

If you suspect you've been exposed to carbon monoxide:

• Get into fresh air immediately

• Seek emergency medical care

Tests and diagnosis for carbon monoxide poisoning:

• Your doctor will ask about your medical history

• Blood sample to measure the amount of carbon monoxide in your blood.

Complications of carbon monoxide poisoning:

• Permanent brain damage

• Damage to your heart, possibly leading to life-threatening cardiac complications years after the poisoning

• Death 

Treatments and drugs: 

The goal of treatment is to replace the carbon monoxide in your blood with oxygen. In the hospital, you may breathe pure oxygen through a mask placed over your nose and mouth. This helps oxygen reach your organs and tissues. If you can't breathe on your own, a machine (ventilator) may do the breathing for you. 

In some cases, hyperbaric oxygen therapy is recommended. With this therapy, you're placed in a full-body pressurized chamber. Inside the chamber, air pressure is more than twice as high as normal atmospheric pressure. This speeds the removal of carbon monoxide from your blood. 

Preventing carbon monoxide poisoning: 

• Invest in carbon monoxide detectors. Install a carbon monoxide detector on every floor or level of your home. Install additional detectors outside individual bedrooms. Check the batteries every time you check your smoke detector batteries — at least twice a year. If the alarm sounds, leave the house and call the fire department or local utility company from a nearby phone. 

• Open the garage door before starting your car. Never run your car in a closed garage. If you have an attached garage, keep the garage door open and the door to the house firmly closed while the car is running. Remove snow or other debris from the tailpipe before using the car. 

• Use gas appliances as recommended. Never use a gas stove or oven to heat your home. Use portable gas camp stoves only outdoors. Use fuel-burning space heaters only when someone is awake to monitor them and doors or windows are open to provide fresh air. Don't run a generator in an enclosed space, such as the basement or garage. 

• Keep your gas appliances and fireplace in good repair. Make sure your appliances are properly vented. Clean your fireplace chimney and flue every year. Ask your utility company about yearly checkups for any gas appliances.

mold

Exposure to molds can be harmful to your health, especially in children whose defense systems are only partially formed, making them more susceptible to environmental pollutants. 

Our bodies come in contact with mold in 3 ways: 
1. By breathing mold spores that become airborne
2. By eating mold in food
3. By touching mold on surfaces. 

Over 200 different types of indoor molds have been identified. They grow best in moist, wet environments, and tend to spread rapidly on almost any surface; food, tile, paint, dust, sheetrock, plaster, wood, and fabric such as clothing or furniture upholstery. Molds destroy the surfaces on which they grow. Now scientific research is showing links between mold exposure and increased risk of sveral health conditions, including asthma, skin reactions, and chronic fatigue syndrome. It is important to control mold growth, so that your family and your home remains healthy. 

Recent research is showing that mold exposure at a young age increases children's likelihood of developing asthma. Mold can also trigger attacks in asthmatics, provoke allergic reactions, and irritate skin. 

The most effective way to reduce mold levels in homes is a combination of these 3 steps: 

• discarding non-cleanable items, such as wet carpet and drywall

• cleaning surfaces with safe fungicides 

• employing cross ventilation drying methods

Moisture control is essential to minimizing mold growth.

There are many ways to control moisture, and subsequent mold growth in your home:

• If any part of your home becomes damaged with water, dry the area within 24 to 48 hours to prevent mold growth. 

• If you suspect that mold is a problem in your home, fix leaky plumbing or other sources of water leakage. 

• Mold can be washed off hard surfaces with detergent and water. Remember to dry these areas completely.

• Replace moldy areas that are harder to clean, such as ceiling tiles, carpets, and furniture upholstery. 

• Make sure your home has a source of fresh air to keep unnecessary moisture and hazardous mold out. 

• Remember to turn off moisture-producing appliances, such as humidifiers, if you notice moisture on windows and other surfaces.

Air pollutants

Air Pollutants

Pollutants in air we breathe can be bad for our health. Babies in the womb and children are especially vulnerable as their bodies are growing and developing. Urban air in particular is more polluted than in surrounding regions as street traffic is denser in cities; industry, bus depots, and sewage treatment plants are sited nearby residential areas; and typical urban living in apartment buildings spreads secondhand smoke easily to many non-smoking homes. Even fumes from heating fuels, cooking, and burning candles can build up indoors and be bad to breathe if apartments are not well ventilated. Asthma affects greater numbers of city dwellers than residents in non-urban areas. It is important to know how to protect yourself and your family from air pollution. Fortunately, there is a lot you can do to reduce harmful exposures at home. There are also clean air campaigns you can join to help lower air pollution levels in your community. 

A lot of urban air pollution comes from heavy traffic. Trucks and buses are the worst polluters as they use diesel fuel, not gasoline. Diesel is a big polluter. Trucks and buses without new emission controls can put 50 times more pollution into the air than vehicles using gasoline. When diesel fuel burns, black carbon particles get into the air. The nose, throat, and lungs (upper respiratory system) can't filter out black carbon particles because they are so small. These particles get deep into the lungs and can make breathing difficult. They can also contribute to increased allergies and asthma. 

Pollution comes from inside our homes too. The pollution measuring machines used in our studies also measure tiny particles of pollution that come from indoor sources. We found more tiny particles of pollution indoors than outdoors called PAHs (polycyclic aromatic hydrocarbons). They can be very dangerous to children's health, increasing risk of asthma and cancer. PAHs get into the air when fuel is burned. Indoor sources of PAHs add to the pollution coming in from outside. Common indoor sources are home heating fuels, tobacco smoke, cooking blackened foods, and burning candles and incense. 

Some PAHs are known to cause cancer. Babies exposed to higher levels of PAHs in the womb are born with damage to cells that could increase their risk of cancer.

Reduce PAHs at home: 

• Don't smoke. And keep cigarette smoke away from children. Ask friends and relatives not to smoke near your child(ren) or in your home. 

• Don't burn, char, or blacken food. Use a kitchen fan while cooking. Limit the use of candles and incense in your homes. 

Lower your own and your children's cancer risk: 

• Eat 5 or more fruits and vegetables every day. 

• Exercise regularly.

• Don't smoke. And keep cigarette smoke away from children. Ask friends and relatives not to smoke near your child(ren) or in your home. 

• Avoid excessive weight gain. 

• Don't eat burned, charred, or blackened foods. 

Join community efforts towards cleaner air: 
Get involved with people in your neighborhood who are working to clean up the air. Community organizations coordinate effective clean air campaigns that are producing results. 
They are working to: 

• Reduce air pollution from trucks and buses. 

• Allow fewer trucks and buses in residential neighborhoods. 

• Require trucks and buses to be equipped with new emission controls. 

• Prevent trucks and buses from keeping their engines idling when they stop to make deliveries. 

• Reduce air pollution from waste transfer stations and power plants. 

• Monitor pollution sources closely, ascertaining that the most current pollution control devices are being used and that operations comply with code. 

• Campaign to keep non-operational stations and plants closed. 

• Work to keep new stations and plants from opening in and near residential areas. 

• Increase residents' environmental health awareness. 

• Educate local residents about what is bad for their health and the Environment. 

• Train local residents to advocate for themselves and their neighborhoods. 

• Share knowledge of pollution sources and other relevant information with environmental and community groups citywide. 

• Collaborate with researchers at nearby university to help learn about the health effects of pollution.

• Build more walking paths and local gardens.

pesticides

Pesticides are chemicals that prevent or destroy unwanted pests such as insects, rodents, and fungi. Since pesticides are designed to hurt or kill living things, it is not surprising that they can harm humans too. Babies and children are more vulnerable to pesticides than adults because their bodies are in the process of developing. Their defenses against toxicants are immature and do not yet provide adequate protection. Prenatal and early-life exposure to chemical-based pesticides can permanently change the way biological systems function. Children's nervous systems and cognitive development can be adversely affected and some research studies have shown a link to increased cancer risk. 

Pesticides can enter our bodies when we breathe air following the use of spray pesticides or when we eat fruits and vegetables treated with pesticides. Pregnant women pass their contact with pesticides on to their unborn babies. The Center's research has shown that pesticides can easily cross the placenta during pregnancy, reaching the developing infant. Young children have greater exposure to pesticides than adults as they spend more time on the floor and grass where pesticides are commonly applied, they put objects and hands in their mouths, and they may eat more foods contaminated with pesticides. 

Exposure to pesticides during pregnancy harms the healthy growth and development of babies in the womb and adversely affects development in early childhood. 

Residential IPM:
Integrated Pest Management (IPM) is a safer, low-toxicity approach to keeping homes free of pests and toxic pesticides. When used during pregnancy, IPM reduces pests in your home and the level of harmful pesticides reaching you and your unborn baby. Using IPM after pregnancy keeps children safer from pesticides that may harm early development. 

Residential IPM uses 4 main tools to minimize exposure to pesticides: 

1. Cleaning — Keep kitchen free of food spills and crumbs so pests do not come looking for food. Take out kitchen garbage every day. 

2. Low-Toxicity Pest Control Products — Avoid using residential pesticides in the forms of sprays, bombs, and fogs. Lower-toxicity pesticides, in the form of sticky traps, bait stations, and gels, are safe to use, last longer, and are more effective. Throw away old pest control products. Avoid products that have chlorpyrifos and diazinon. Examples include Tres Pasitos, Tempo, or Tiza China (Chinese Chalk). These rat and roach poisons are dangerous for children. 

3. Building Repairs — Repair leaky pipes and close large holes, cracks, and crevices in your apartment to block pest entry points and eliminate breeding sites. Plug small cracks with caulk; for bigger holes, use steel wool or copper mesh and spackling compound. 

4. Family Teamwork — Talk to household members about the importance of everyone pitching in to help remove garbage from the home each day, eat meals and snacks in the kitchen only, and clean up dishes and food spills as quickly as possible. Inform household members about which pest control products are best to use at home and get everyone to agree not to use pesticide sprays or let exterminators into the apartment.

LEAD

Lead poisoning remains the most common environmental hazard threatening children throughout the United States, affecting approximately 240,000 children ages six years and younger. 

Lead is a metal found in the environment that can be neurotoxic and carcinogenic to human health. Lead is inhaled or ingested and carried throughout the body in the bloodstream. All organ systems are susceptible to damage. Pregnant women, babies, and children under six years of age are especially vulnerable to lead. 

Conducting routine test for lead levels in blood. 

During pregnancy, lead poisoning can lead to spontaneous abortions, stillbirth, and low birth weight. Lead stored long term in bones and teeth can also get released back into the bloodstream and compromise babies' brain development in the womb. Lead poisoning disrupts normal brain development in infancy and early childhood when major bodily systems are newly forming and developing. Even low levels of lead poisoning can lead to lower IQ, learning disabilities, behavioral problems (e.g. hyperactivity, aggressive behavior), speech delay, and hearing loss. High levels of lead poisoning can lead to irreversible brain damage and even death. 

Lead poisoning is entirely preventable. Yet thousands of new cases occur every year, indicating that parents and others caring for young children need to become more aware of lead sources in order to help reduce children's exposure and prevent lead poisoning. 

There is no safe level of lead. Children can be harmed by very small amounts of lead. Lead gets into the body most commonly when children ingest lead that is in paint chips, dust, drinking water, and dirt containing lead paint chips or dust. The Centers for Disease Control sets the level of concern at 10 g/dL, or 10 micrograms per deciliter. (A microgram is approximately 1/1000 of a grain of sugar and a deciliter equals a half cup.) However, studies show that even levels of exposure below 10 g/dL can interfere with healthy brain development and can lead to lower IQ. Symptoms of lead poisoning in children are generally missed until lead levels become dangerously high. By this time, brain damage is permanent. The only way to know your child's lead level is to have your pediatrician do a blood test. Blood tests for lead poisoning by your child's pediatrician should begin at 6 months and be repeated every year from age one to six years. 

The only way to know your child's lead level is to get a blood test done by your pediatrician. If a problem is found early, there is a lot that can be done to reduce lead exposure and prevent serious health problems. 

Test your child for lead. 

• Make sure your pediatrician tests your child's blood for lead at 6 months and repeats this test at every annual check-up from one to six years of age. 

• Call your pediatrician for the test results. Ask what your child's blood lead level is. And ask if the test result is normal. If the test result is not normal, ask your pediatrician what to do to lower your child's lead level. Also ask when your child should get another blood test. 

• Tell your pediatrician about any peeling paint at home or other possible lead hazards. 

Follow these recommendations for minimizing your child's exposure to lead:

Reduce and eliminate lead paint and dust.
Lead paint was used inside homes in the United States until 1978. This paint may still be present beneath layers of new paint. If it remains encased by new paint, there is no hazard. However, lead is released into the environment when old paint chips, flakes, peels, or is ground into sweet-tasting dust by doors and windows opening and closing. Home renovations often release a lot of lead paint into the environment. To be safe: 

• Wash your child's hands often, especially after playing, and before eating and sleeping.

• Clean your home often and thoroughly.

• Clean your child's toys often and thoroughly.

• Get your home inspected for lead and have your drinking water tested for lead. 

Improve your drinking water.
Lead used in old water pipes can leach into water, as can leaded solder which was legal to use on residential drinking water pipes through the 1980's. Lead solder is still legal today for commercial use. And all faucets and plumbing fittings are still allowed to contain up to 8 percent lead. Lead cannot be boiled out of water. To be safe: 

• Run water for 30 seconds until cool water becomes cold. This flushes out water sitting in pipes that could be collecting lead.

• Always use cold water for drinking, cooking, and making baby formula. Hot water draws out more lead from pipes than cold water.

• Use a water filtration system.

• Get your drinking water tested for lead. Call EPA's Safe Drinking Water Hotline, 1-800-426-4791.

• Replace old water pipes that are lined with lead. 

Feed your child healthy foods.
Good nutrition helps children's bodies resist lead. 

• Feed your child foods that are high in Iron, Calcium and Vitamin C to strengthen his or her body's resistance to adverse health effects of any lead exposure.

• Add a food or drink containing Vitamin C to every meal.

• Cook food in iron pots and pans to add iron to your child's diet.

• Limit your child's intake of foods high in fats and oils which make it easier for the body to absorb lead. Remove meat fat and chicken skin before serving.

• Feed your child 5-6 small meals daily instead of 3 larger meals. A child with an empty stomach will absorb more lead into his or her body. 

• Do not cook, serve or store food in imported pottery and do not store food in containers made of ceramic, leaded crystal, or china. 

Be careful with costume jewelry.
Costume jewelry often contains lead. Avoid buying costume jewelry for your child, especially jewelry that is made in China, has white fake pearls, plastic cords, or dull metallic parts. Keep costume jewelry away from children who put toys in their mouth or suck their thumb. If you do buy your child costume jewelry, avoid dollar stores and other discount stores. And stay aware of product recalls as large companies and more upscale stores also sell costume jewelry containing lead.

MERCURY

Mercury is a metal that is found in air, water, and soil. Mercury does not break down in the environment and is toxic to humans, building up in our bodies over long periods of time. Mercury exists naturally in several forms. The most common organic mercury compound is known technically as methylmercury. Methylmercury is of particular concern because it can build to very high levels in certain types of fish that people commonly eat. Mercury is also in certain cosmetics, household products, and is used in some religious practices. 

Mercury is a compound that can harm children's health even before birth. The developing fetus is extremely vulnerable to environmental pollutants as systems for clearing the body of toxins are in the process of being formed. Exposure to mercury can harm the healthy development of the brain and nervous system. Pregnant women exposed to mercury pass this toxicant on to their developing infants. If levels are high enough, mercury can cause nervous system damage to babies. Mercury also gets transferred to babies through breast milk, although the benefits of breastfeeding are still thought to outweigh the negatives. 

You can't see, smell, or taste mercury. So it is important to know the main sources of mercury in order to avoid unnecessary exposure. 

Mercury gets into our body mostly when we: 

• Breathe mercury vapors in the air 

• Eat certain fish with high mercury levels 

• Use skin products containing mercury 

• Touch mercury used in religious rituals 

• Touch mercury when household items containing mercury break (e.g. fever thermometer)

4 steps you can take to avoid mercury exposure are:
1. Don't eat fish high in mercury 

Fish that are low in mercury and safe to eat include catfish, pollock, wild or canned salmon, shrimp, and canned light tuna. Don't eat fish from local waters that contain too much mercury. Before buying fish ask where it came from. 

Best fish to eat, Contain the least mercury

• Anchovies

• Butterfish Catfish

• Clam Crab (Domestic)

• Crawfish / Crayfish

• Croaker (Atlantic)

• Flounder

• Haddock (Atlantic)

• Hake

• Herring

• Mackerel (N. Atlantic, Chub)

• Mullet

• Oyster

• Perch (Ocean)

• Plaice

• Pollock

• Salmon (Canned)

• Salmon (Fresh)

• Sardine

• Scallop

• Shad (American)

• Shrimp

• Sole (Pacific)

• Squid (Calamari)

• Tilapia

• Trout (Freshwater)

• Whitefish

• Whiting 

2. Don't use cosmetics high in mercury.
Check the ingredients on labels and avoid products with the words “mercury” or “mercurio.” 
Cosmetics to avoid are: 

• Recetas de la Farmacia Normal

• Miss Key Crema Blanqueadora

• Santa Cream

• Dermaline Skin Cream

• Jabón Germicida 

3. Don't use azogue.
Another name for mercury is “azogue”. Azogue is used in religious practice to ward off evil spirits and bring protection and good luck. Azogue is mercury and is very harmful to your health. Instead of azogue, many santeros and espiritistas use natural herbs and oils from original Caribbean traditions.
Here are some safe alternatives to azogue: 

• rompe zaraguey - for spiritual cleansing

• pasote , agua de florida, or bomba santera - to remove evil influences from the home

• agua de florida - to calm nerves / improve digestion 

4. Don't touch spilled mercury
Even small mercury spills may need to be cleaned by trained professions. If you spill more than 2 tablespoons of mercury, call a health professional service or your local poison control center. 
To clean up a small (less than 2 tbsp) mercury spill (such as from a broken thermometer), follow these 10 steps: 

1. Open a window and run a fan to get vapors out of your home.

2. Keep children away from the spill area. 

3. Remove any metal jewelry that you are wearing before cleaning up a spill. Mercury is a metal and may stick to your jewelry. 

4. Wear rubber gloves when cleaning up the spill. 

5. Carefully pick up any broken glass (from thermometers or light bulbs). Use sticky tape to help pick up small pieces. Put glass in a plastic bag and tie up tight. 

6. Scoop up mercury drops with a stiff piece of paper. Sticky tape also helps to pick up small droplets. Put mercury in a plastic bag and tie up tight. 

7. Shine a flashlight around the spill area to find smaller drops. Use a cloth rag to clean up. 

8. Throw away rags, paper, and tape used to clean up the mercury. Put all in a plastic bag and tie up tight.

9. Use a heavy plastic trash bag to double bag all bags of broken glass, mercury, and cleaning items. Tie the bag tightly. 

10. After cleaning, wash hands, and stay out of the room where mercury spilled for as long as possible. Keep the window open or a fan running.