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48 Integrative Medicine • Vol. 8, No. 6 • Dec 2009/Jan 2010 Kreisberg—Green Medicine Tips
Lowering the Risk
Lowering risks of indoor exposures involves 3 measures:
source control, proper ventilation, and air cleaners. Checking
buildings for each indoor contaminant can easily be done and is
worth encouraging every patient to do. Proper ventilation is nec-
essary for maintaining a healthy indoor environment. Air clean-
ers or filters, while not required, are recommended for sensitive
patients or for buildings that need remediation or are located in
neighborhoods that have high exposure to air pollution.
In the United States, data suggest that 30 to 70 million
workers exhibit symptoms of sick-building syndrome.5
Symptoms of upper-respiratory distress, such as chest tightness
as well as lethargy, nasal congestion, dry throat, and headaches
can all be caused by indoor pollutants. Completing an environ-
mental exposure history with every patient is an essential task of
any medical clinician. The Agency of Toxic Substances and
Disease Registry (www.atsdr.cdc.gov/csem/exphistory/ehin-
door_pollution.html) has an easy-to-use series of case studies
that provide busy health professionals with the invaluable skills
of recognizing indoor air pollutions and exposure components,
as well as a guide to completing a work history or an environ-
mental history. The usefulness of these skills become clear as you
broaden your understanding of environmental impacts on
patients and family alike. Learn these skills well. It seems that
Americans will only continue to spend more time indoors.
References
1. US Department of Health and Human Services, Centers for Disease Control and
Prevention, Coordinating Center for Health Promotion, National Center for Chronic
Disease Prevention and Health Promotion, Office on Smoking and Health. The
Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon
General. Rockville, MD: US Department of Health and Human Services; 2006.
2. US Environmental Protection Agency, Office of Radiation and Indoor Air. The Inside
Story: A Guide to Indoor Air Quality. Available at: http://www.epa.gov/iaq/pubs/
insidest.html#Look7. Accessed October 15, 2009.
3. US Environmental Protection Agency, Office of Radiation and Indoor Air. EPA
Assessment of Risks from Radon in Homes. June 2003. Available at: http://www.epa.
gov/radon/pdfs/402-r-03-003.pdf. Accessed October 15, 2009.
4. Oliver LC, Shackleton BW. The Indoor Air We Breathe: A Public Health Problem of the
90’s. Public Health Records, Sep-Oct 1998. US Department of Health and Human
Services. Available at: http://www.anapsid.org/cnd/files/airwebreathe.pdf.
Accessed October 15, 2009.
Kreisberg—Green Medicine Tips Integrative Medicine • Vol. 8, No. 6 • Dec 2009/Jan 2010 49