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Taking an Exposure History
What Are Other Toxicants in the Home and Environment?

Course: WB 1109
CE Original Date: May 12, 2008
CE Renewal Date: May 12, 2011
CE Expiration Date: May 11, 2013
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Learning Objectives

Upon completion of this section, you will be able to

  • identify the possible sources of toxicants in the home and environment

Introduction

When eliciting information on exposures in the home and environment, the clinician should consider the following possible sources

  • common household products
  • lead products and waste
  • pesticides and lawn care products
  • recreational hazards
  • soil contamination
  • water supply

Common Household Products

The following household products are possible sources of toxicants in the home

  • aerosol sprays
  • air fresheners; stored
  • automotive products
  • cleansers
  • disinfectants
  • dry-cleaned clothing
  • fuels
  • hobby supplies
  • moth repellents
  • paint strippers and other solvents
  • paints
  • wood preservatives

Commonly used compounds that can have serious adverse health effects are listed in the table below.

Compounds Where Found

methylene chloride

  • adhesive removers
  • paint strippers
  • paint thinners

paradichlorobenzene

  • air fresheners
  • moth crystals
  • toilet bowl deodorizers

tetrachloroethylene

  • dry cleaning fluids

Further information is available in Case Studies in Environmental Medicine: Methylene Chloride Toxicity and in Case Studies in Environmental Medicine: Tetrachloroethylene Toxicity.

Levels Often Higher Indoors

Studies have found that levels of several organics average two to five times higher indoors than outdoors. During and for several hours immediately after certain activities, such as paint stripping, levels may be 1,000 times background outdoor levels (US Environmental Protection Agency and US Consumer Product Safety Commission 1995).

Pesticides and Lawn Care Products

Pesticides and lawn care products are potentially hazardous, especially to children. Pesticide exposure can occur through dermal contact, inhalation, or ingestion. At least 1,400 active ingredients can be found in more than 34,000 available preparations of insecticides, herbicides, fungicides, and other antibiologic preparations. These agents have different mechanisms of action and toxicity. There are approximately 600 active pesticide ingredients configured in more than 45,000 formulations in use today. Approximately four billion pounds of pesticides are used worldwide in agriculture and in most household gardens (US Environmental Protection Agency 1986).

Despite the ban on certain pesticides in the U.S., exposure can still occur through improper use, storage, and disposal. Some banned pesticides are used in foreign countries and may return to this country on imported foods. Proper use and storage of household pesticides and proper cleaning of food, especially raw fruits and vegetables, can help protect consumers.

Lead Products and Waste

Lead poisoning continues to be a significant health problem in the U.S. Although lead was banned from paint for home use in 1972, millions of homes, particularly those built before 1950, still contain high amounts of lead in paint that is peeling and accessible for ingestion by children.

Lead exposure also occurs through drinking water, especially in homes that have lead-soldered pipes. Significant exposures have occurred in children, particularly ages one to six years, who played in lead-contaminated soil. Acidic foods, such as juices, stored in imported pottery may leach lead from ceramic glazes. Some ceramic glazes used by hobbyists and those in imported pottery also may contain lead.

People who work in jobs where they are exposed to lead dusts or lead-containing compounds may get lead on their clothing and shoes and bring it into their cars or homes, where children and other family members may be exposed. More than a million U.S. workers are potentially exposed to lead daily in hundreds of occupations such as construction work, radiator repair, metals recycling, battery manufacturing, smelting, and pigments formulating. Good workplace and personal hygiene practices can prevent the majority of these “take-home” exposures. Children may have higher exposures since they are more likely to get lead dust on their hands and then put their fingers or other lead-contaminated objects into their mouths. Consequences of childhood lead exposure have been shown to endure into adulthood.

For further information see Case Studies in Environmental Medicine: Lead Toxicity.

Recreational Hazards

Recreational areas and products can pose a hazard to health.

Fishing and swimming in contaminated lakes and streams can expose participants to toxins contained in polluted waters.

Wooden playground structures that have not been treated with protective sealants may allow children to have dermal contact with potentially hazardous wood preservatives; these include arsenic-containing compounds, pentachlorophenol, and creosote.
Some play sands and clays have been reported to contain asbestos-like fibers. Other materials used in arts and crafts involve potentially hazardous silica, talc, solvents, and heavy metals such as lead and cadmium. Toxic materials may be encountered in making stained glass and jewelry, woodworking, model building, and oil and airbrush painting.

Persons do not need to be directly involved in these activities to become exposed; merely being in the vicinity of a work area may cause exposure. Federal legislation (the Labeling of Hazardous Art Materials Act) requires that all chronically hazardous materials be labeled as inappropriate for children's use.

For further information

Water Supply

Both public water supplies and private wells can be a source of toxic exposure, especially for industrial solvents, heavy metals, pesticides, and fertilizers. For example, an EPA groundwater survey detected trichloroethylene in approximately 10% of the wells tested. It is estimated to be in 34% of the nation's drinking water supplies. Up to 25% of the water supplies have detectable levels of tetrachloroethylene. Methylene chloride may remain in groundwater for years. Some solvents can volatilize from showers and during laundering of clothes, thereby creating a risk of toxicity via inhalation. Nitrates, a common contaminant of rural shallow wells, pose a risk of methemoglobinemia, especially to infants (US Environmental Protection Agency 1985; Agency for Toxic Substances and Disease Registry 1997).

For further information

Soil Contamination

Ingestion of contaminated soil poses a risk of toxicity, especially to children under the age of six, because of natural mouthing or pica behaviors. Lead is a common soil contaminant. Dioxin also adsorbs to soils. Certain pesticides such as chlordane can remain in the soil for years.

For further information

  • Case Studies in Environmental Medicine: Arsenic Toxicity
  • Case Studies in Environmental Medicine: Cadmium Toxicity
  • Case Studies in Environmental Medicine: Chlordane Toxicity
  • Case Studies in Environmental Medicine: Chromium Toxicity
  • Case Studies in Environmental Medicine: Dioxin Toxicity
  • Case Studies in Environmental Medicine: Lead Toxicity

Key Points

  • The clinician should consider all possible sources when eliciting information on exposure in the home and environment.
   

Progress Check

6. Of the following, which is the correct statement?

A. Lead is a common soil contaminant
B. Fishing and swimming in contaminated lakes and streams can expose participants to toxins contained in polluted waters
C. Both public water supplies and private wells can be a source of toxic exposure
D. all of the above

Answer:

To review relevant content, see Soil Contamination, Recreational Hazards, and Water Supply in this section.

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Agency for Toxic Substances and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA 30341
Contact CDC: 800-232-4636 / TTY: 888-232-6348

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