Environmental medicine

The Environmental medicine deals with the influence of environmental factors on health. In this area, the greatest focus is on anthropogenic environmental pollution. As an interdisciplinary medical field, environmental medicine deals with the environmental aspects of diseases.

What is environmental medicine?

Environmental medicine is a cross-sectional medical discipline that 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 pollution of water, air, soil or food and the physical influences of electromagnetic fields and noise pollution. Climatic and hydrological influences are also taken into account. Environmental epidemiology is also an important aspect. Clinical environmental medicine deals with the specific clinical care of affected individuals whose complaints are attributed to environmental influences. In Germany, future specialists in hygiene and environmental medicine must complete a five-year training period.

This includes four years of training in hygiene and environmental medicine in the subjects of microbiology, infection 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 necessary. Alternatively, a doctor can also be given the title of environmental doctor. This requires the recognition of a four-year further training period, with at least one and a half years being completed at a further training facility. Furthermore, participation in a course in environmental medicine lasting 200 hours is mandatory within two years.

Treatments & therapies

As already mentioned, environmental medicine deals with diseases that are caused by environmental influences. The main pollution is caused by pollutants in living and working areas. 70 to 80 percent of all environmental diseases are due to pollution.

These pollutants include solvent vapors from carpets, paints or adhesives, formaldehyde from chipboard, insecticides, herbicides and wood preservatives. Vapors from technical devices also play a major role. In addition to exposure to pollutants, hidden mold exposure also causes a large proportion of environmental diseases. In addition to mold spores, the outgassing of mold can also lead to diseases. Noise is an important source of physical pollution.

Electromagnetic fields or radiation also sometimes cause environmental diseases. The biological environmental pollution manifests itself in infections and allergies to certain biological agents. The mechanisms by which the disease develops are different. Biological and chemical agents can trigger both toxic processes and allergies in the organism. Certain chemicals act as toxins in the metabolism and disrupt it. In the case of allergies, antibodies against harmless proteins develop to a greater extent. Pollutants can damage the mucous membrane and thus promote the penetration of allergens into the body. The reactions to mold are diverse and complex. 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 unspecific complaints. A large area of ​​environmental medicine is physical exposure to heavy metals. The source of heavy metal exposure can be food, water, soil or implants in the body. Amalgam exposure to mercury is also still a major problem. The environmental factors have a very complex effect on the organism.

Everyone reacts to it individually. It is often not that easy to clearly diagnose environmentally-related diseases, especially since the course of many non-environment-related diseases is influenced by environmental factors. Clearly environmental diseases are allergies and poisoning. The relationships are also clear in the case of physical reactions to physical factors such as noise or electromagnetic and ionizing radioactive radiation. A particularly serious environmental disease is MCS. MCS means Multiple Chemical Sensitivity and represents a multiple chemical intolerance.

With this disease, even the smallest vapors of fragrances, solvents, cigarette smoke or exhaust fumes are sufficient to cause the most severe physical symptoms with tiredness, dizziness, headache, shortness of breath or other pain. However, once the trigger is removed, the symptoms will also go away. Chronic fatigue syndrome (CFS) represents another clinical picture. This syndrome appears to be a complex of various diseases in which environmental factors such as heavy metal poisoning could also play a role.

Diagnosis & examination methods

It is often not that easy to diagnose an environmental disease. The environmental influences are often invisible, inaudible and cannot be smelled. If unspecific complaints such as tiredness, exhaustion, concentration disorders, allergies, frequent infections or respiratory problems occur and cannot be assigned to a clear cause, environmental pollution should not be excluded.

This first requires a comprehensive medical history by the doctor. If no classic causes of the disease can be found, environmental studies in living and working areas should be carried out. There are many possible sources of pollution. First, material samples can be taken from carpets, carpets, wood paneling or dust and examined for insecticides, wood preservatives or other chemical pollutants. Indoor air measurements also detect solvents, formaldehyde, MVOCs or mold spores. Further material samples confirm or refute any suspicion of hidden mold infestation.

If there is exposure, the source of exposure should be removed. Symptoms often improve afterwards. Water investigations uncover possible heavy metal pollution. Of course, mercury poisoning from amalgam should also be checked. Multiple chemical intolerance can easily be diagnosed because the connection between exhalation and the severity of symptoms can be easily recognized. After removing the triggering source, the symptoms disappear immediately.