Blog #4: How Do We Gather Information Regarding Environmental Exposure?

With my increased knowledge of toxicology from this section, there are numerous questions that I would include in the histories of certain patients that I had not previously considered. The location of a patient’s home can be very telling in many ways. If the home is located next to certain areas of high exposure, such as a freeway or fracking site, there may be clues to the causes of particular symptoms. A patient presenting with asthma symptoms could have numerous different exposures in the environment that need to be explored. Being adjacent to a dry-cleaning facility could indicate that the patient receives chronic exposure to perchlorethylene, especially if they live in an apartment located above the facility. The location of a home will also offer clues to the age of the home if the patient is unsure of when it was built. Older homes are significantly more likely to contain some amount of lead paint, especially those built before 1940. These homes may also contain some level of lead in the pipes or lead solder used in plumbing. This could be crucial information to collect when a patient presents with a condition like anemia. Educating patients about these risks and encouraging them to be proactive by testing their homes for lead, especially before performing any sort of renovation, could significantly reduce dangerous levels of exposure. Patients that live in more rural areas may receive their water via a well. It would be important to gather this information and determine whether the patient may receive increased exposure to radon. Have they ever had their home tested for radon?

I would also like to collect information regarding the patient’s occupation and explore what types of toxic chemicals and substances to which they could be at risk for exposure. Do they use materials that contain latex, fragrances, or pesticides? Does their job require them to use cleaning agents or paint? Do they use the proper personal protective equipment (PPE) when using these substances? I previously worked at an old military hospital that still had asbestos in the insulation. During renovations, there were several signs placed and very strict precautions and barriers set up to protect workers. Also, in what types of hobbies does the patient participate? Some hobbies involve materials and chemicals that could be potentially dangerous without the proper protective equipment. I would explore if there are any hobbies that involve glues, paints, fragrances, or lead-based substances, such as soldering. I had never before flour as an asthma trigger, but it is now clear how dangerous it can be as an airborne powder. Those working in the food/baking industry likely have no idea of the risks of exposure.