Identifying toxic load and environmental exposure issues in patients

There are five toxins the ODPHP is most interested in reducing within the U.S. in regard to toxic load in patients

Twenty-three percent of deaths worldwide occur as a result of “modifiable environmental factors,” according to a global assessment conducted by the World Health Organization (WHO). Among the hazards studied were toxic load hazards such as pollution (water, soil and air), chemical exposure, exposure to contaminants via certain agricultural methods, and other factors related to home, work and various outside environments.

This assessment further revealed that more than three in four diseases or injuries are significantly associated with the environment. It is linked with respiratory issues, neonatal conditions, cancer, mental disorders, neurological issues, cardiovascular diseases, asthma, and more.

To help reduce these numbers, the Office of Disease Prevention and Health Promotion (ODPHP) has instituted Healthy People 2030 which is focused, in part, on improving environmental health. There are five toxins the ODPHP is most interested in reducing within the U.S. They are arsenic, lead, mercury, bisphenol A, and perchlorate. Identifying symptoms of toxic load or overexposure to these substances can help health care professionals identify patients who may be most at risk.

Arsenic

Research indicates that arsenic negatively impacts the body by inactivating as many as 200 enzymes, particularly those involved with cellular energy and DNA synthesis and repair. It can be found in drinking water, in which it is absorbed via the small intestine, but is also a byproduct of mining and other industrial processes, which can increase skin and respiratory exposure.

The Environmental Protection Agency (EPA) limits arsenic in drinking water to 0.01 parts per million while the Occupational Safety and Health Administration limits occupational exposure to this substance to no more than 10 micrograms per cubic meter of air over 8 hours.

The WHO reports that the more immediate effects of toxic arsenic levels are vomiting, abdominal pain, diarrhea, and extremity numbness or tingling. Someone with long-term exposure — which is defined as five years or more — may notice changes in their skin coloring, skin lesions, or hardened patches on the palms of their hands and/or soles of their feet.

Toxic load and lead

One of the best-known sources of lead is paint. However, the Centers for Disease Control and Prevention (CDC) warns that this element can also be found in water pipes, some toys and jewelry, imported candies, medicines, and aviation gas. People engaged in certain hobbies might also have a greater risk of lead exposure, such as those that involve casting, soldering, shooting firearms, and the making of home-distilled liquids.

The CDC adds that symptoms of lead overexposure “can be easily overlooked” if they occur slowly over time, but also because they can be attributed to other issues. Short-term overexposure can appear as abdominal pain, constipation, fatigue, headaches, irritability, loss of appetite, tingling in the extremities, and memory loss. Long-term exposure has many of these same symptoms, along with increased feelings of depression, being easily distracted, and feeling nauseous or sick.

Mercury

The ODPHP states that it is primarily concerned with mercury levels in children. Though, the EPA explains that methylmercury exposure is also high in people who eat a lot of fish or shellfish since these animals contain this neurotoxin in their tissues.

People with toxic levels of methylmercury can experience a loss of their peripheral vision, reduced movement coordination, speech or hearing impairment, or muscle weakness. They might also notice a prickling sensation in their hands, feet, or mouth.

Mercury is also found in glass thermometers, fluorescent light bulbs, batteries, some disinfectants, dental fillings, and coal fumes. Toxic load symptoms that can appear with exposure to the mercury in these items include trouble breathing, vomiting, a bad cough, a metallic taste in the mouth, bleeding gums, numbness, shaking, and memory issues.

Bisphenol A (BPA)

Bisphenol A, which is more commonly known as BPA, can be found in a variety of plastic items, sometimes at toxic levels. For example, a 2019 study looked at 34 different plastic extracts, noting that 74% met the guidelines for being toxic in some way. This substance is also found within the water and soil, albeit at lower levels.

Research indicates that BPA negatively impacts health by disrupting the endocrine system. As such, it can change the way a person behaves, alter growth, and result in early secondary sexual maturation.

A review published in the International Journal of Medical Sciences points to several studies that connect BPA exposure with increased aggression, increases in anxiety and depression, memory impairment, and higher levels of hyperactivity.

Perchlorate

The U.S. Food and Drug Administration explains that perchlorate is made when you combine one chlorine atom with four oxygen atoms. In the U.S., it occurs naturally in the atmosphere, appearing in higher levels in arid Southwestern states. It can also be found in drinking water, some foods, and certain food containers.

Exposure to higher levels of perchlorate can disrupt thyroid function. People with increased exposure may experience eye irritation, skin rashes, coughing, nausea, vomiting, diarrhea, and weight loss according to the Environmental Pollution Centers.

If exposure is suspected

If it is suspected that a patient has been exposed to high levels of a certain contaminant, blood tests are recommended. These tests can reveal if the toxin is present, as well as in what levels. This information can then be used to determine the best course of treatment for toxic load and overexposure.