Environmental Medicine: Treatment, Effects & Risks

Environmental medicine deals with the influence of environmental factors on health. Within this specialty, the greatest focus is on anthropogenic environmental pollution. As an interdisciplinary medical specialty, environmental medicine addresses the environmentally related aspects of disease.

What is environmental medicine?

Environmental medicine deals with the influence of environmental factors on health. Within this field, the greatest focus is on anthropogenic environmental pollution. As a cross-sectional medical field, environmental medicine deals with the physical, chemical, and biological environmental influences on physical processes. A distinction is made between preventive and medical environmental medicine. Preventive environmental medicine examines the chemical and biological stresses of water, air, soil or food and the physical influences of electromagnetic fields and noise pollution. Climatic and hydrological influences are also included in the analysis. Environmental epidemiology is also an important aspect. Clinical environmental medicine is concerned with the concrete clinical care of affected individuals whose complaints are attributed to environmental influences. In Germany, future specialists in hygiene and environmental medicine must complete a training period of five years. This includes four years of training in hygiene and environmental medicine in the subjects of microbiology, infectious disease epidemiology, occupational medicine or alternatively pharmacology, toxicology as well as pathology or forensic medicine. Furthermore, one year of ward service in internal medicine, surgery, ENT, gynecology, neurosurgery, pediatrics, or urology is required. Alternatively, a physician may also obtain the additional designation of environmental medicine physician. This requires recognition of a four-year period of further training, with at least one and a half years completed at a further training institution. Furthermore, participation in a 200-hour course in environmental medicine is mandatory within two years.

Treatments and therapies

Environmental medicine deals, as already mentioned, with diseases which are caused by environmental influences. Pollutants in the living and working environment represent the main burden. Thus, 70 to 80 percent of all environmental diseases are caused by pollutants. These pollutants include solvent exhalations from carpets, paints or adhesives, formaldehyde from chipboard, insecticides, herbicides or wood preservatives. Evaporations from technical equipment also play a major role. In addition to exposure to pollutants, hidden mold contamination also causes a large proportion of environmental illnesses. In addition to mold spores, outgassing from molds can also cause illness. A significant physical source of exposure is noise. Electromagnetic fields or radiation also sometimes cause environmental illness. Biological environmental pollution manifests itself in infections and allergies to certain biological agents. The mechanisms of disease development are different. Biological and chemical agents can trigger both toxic processes and allergies in the organism. Certain chemicals intervene as toxins in the metabolism and disturb it. In the case of allergies, antibodies against harmless proteins are formed to an increased extent. Harmful substances can damage the mucous membrane and thus promote the penetration of allergens into the body. Reactions to molds are varied and complex. For example, many fungal spores contain toxins that cause chronic poisoning of the body. In addition, so-called volatile MVOCs (volatile organic compounds) from molds often cause nonspecific symptoms. Physical exposure to heavy metals also represents a large area of environmental medicine. The source of heavy metal exposure can be food, water, soil, or implants in the body. Mercury exposure from amalgam is also still a major problem. Environmental factors have a very complex effect on the organism. Each person reacts to them individually. It is often not so easy to clearly diagnose environmentally related diseases, especially since the course of many non-environmentally related diseases is also influenced by environmental factors. Clearly environment-related diseases are allergies and poisoning.The correlations are also clear for physical reactions to physical factors such as noise or electromagnetic as well as ionizing radioactive radiation. A particularly severe environmental disease is MCS. MCS means Multiple Chemical Sensitivity and represents a multiple chemical intolerance. In this disease, even the smallest exhalations of fragrances, solvents, cigarette smoke or exhaust fumes are enough to cause severe physical symptoms with fatigue, dizziness, headaches, shortness of breath or other pain. However, as soon as the trigger is removed, the symptoms also disappear. Chronic fatigue syndrome (CFS) represents another clinical picture. This syndrome appears to be a complex of different diseases in which environmental factors, such as heavy metal poisoning, may also play a role.

Diagnosis and examination methods

Often it is not so easy to diagnose an environmentally induced disease. The environmental factors often cannot be seen, heard, or smelled. If unspecific complaints such as fatigue, exhaustion, concentration problems, allergies, frequent infections or respiratory problems occur and cannot be assigned to a clear cause, environmental stresses, among other things, should not be ruled out. To this end, a comprehensive medical history must first be taken by the physician. If no classic causes of the illness are found, environmental investigations should be carried out in the living and working areas. There are many possible sources of pollutants. First, material samples can be taken from carpets, rugs, wood paneling, or dust and tested for insecticides, wood preservatives, or other chemical pollutants. Indoor air measurements also detect solvents, formaldehyde, MVOCs or mold spores. Additional material samples may confirm or refute a suspicion of hidden mold infestation. If exposure is present, the source of exposure should be removed. Often the symptoms improve afterwards. Water tests detect possible heavy metal contamination. Of course, mercury poisoning from amalgam should also be examined. A multiple chemical intolerance can be easily diagnosed, because here the connection between evaporation and expression of symptoms is easily recognizable. After removal of the triggering source, symptoms disappear immediately.