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What are a few common household environmental toxins and how can you prevent exposure?
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The environment plays a key role in the health and wellness of an individual and the community.
Certain environments can contribute to the exacerbation of illnesses or can be the cause of disease.
Some of the factors in the environment that can contribute to physiological dysfunction include toxins,
air pollutants, insects, and an infected community population. Maintaining a healthy environment is
essential for helping people live longer and for enhancing their quality of life. The conditions in and
around our homes, schools, playgrounds, and workplaces can have a major impact on our families and
communities.
The three common home environmental toxins focused on in this case study are radon, carbon
monoxide, and mold. Radon is a radioactive gas that seeps through cracks in the foundation of homes
and can cause lung cancer. Signs of radon exposure include persistent cough, difficulty breathing,
frequent respiratory infections, and bloody mucus (CDC, 2020a). Carbon monoxide is a colorless and
odorless gas produced by anything that uses gas. Prolonged inhalation of carbon monoxide causes
carbon monoxide poisoning and death. Signs of exposure to carbon monoxide include dull headaches,
dizziness, and nausea (CDC,2019). Mold is a spore that can attach to any substance with enough
moisture to allow for growth. Many people are allergic to mold and exposure to these spores can cause
stuffy nose, sore throat, cough, wheezing, itchy eyes, and rash (CDC, 2020b).
In this case study, we are focusing on the health of a single mother and her two young children.
Mrs. Jones and her 2 children, 18 months and 4 years old, recently moved into an older rental home.
Since moving in, Mrs. Jones has noticed decreased activity, increased coughing, and consistent runny
noses in both children. Her 4-year-old has also reported an upset stomach with no apparent cause. The
pediatric NP and clinic RN refer the family to the public health department for an environmental health
assessment of their home. When the home visit is conducted, several issues are discovered. These
issues include a faint sulfur scent, which can be indicative of a natural gas leak. They also have no carbon
monoxide detector in the home and Mrs. Jones reports using her car exhaust to warm the home when it
is cold. Upon further inspection, a leaky sink with visible mold growth and unsealed crack in the cement
basement floor are found. Mrs. Jones’s neighbor has also reported radon presence in their home.
Measures of primary prevention include preventing growth of mold, preventing exposure to
carbon monoxide and radon, and utilizing local resources for home inspections. Mold growth can be
prevented by controlling humidity levels, promptly fixing leak, proper cleaning up after flooding, and
properly ventilating areas prone to moisture in the home (CDC, 2017). Carbon monoxide exposure can
be prevented by maintaining household appliances and properly ventilating areas where gas appliances
are running (IDPH, 2020). Radon exposure can be prevented by having radon tests performed prior to
moving into a home. In Cincinnati, the health department offers a no cost home assessment to identify
potential health risks and current health risks (City of Cincinnati, 2022). This can act as a form of
secondary prevention if residents were already being exposed to an environmental toxin. Secondary
prevention methods also include cleaning areas that are known to contain mold and drying the areas
thoroughly (Brandt et al., 2006). Every home should also have a carbon monoxide detector to alert
residents of carbon monoxide presence in the home (Cleveland Clinic, 2020). Home radon test kits can
also be performed while living in the space and radon ventilation systems can be installed to decrease
radon exposure to acceptable levels. In Cincinnati, the Environmental and Lead Clinic connects people to
resources needed for repairs and toxin removal (Cincinnati Children’s, 2022). Finally, tertiary prevention
is determined based on the individual and will be guided by the primary care provider during follow-up
appointments after exposure (Cincinnati Children’s, 2022).
By recognizing the exposure risk of the community and creating a program aimed at educating
residents, they can be more aware of signs and symptoms and how to prevent complications. An
educational program would focus on environmental toxins common within the community, including
carbon monoxide, radon, and mold, signs and symptoms of exposure, and preventative measures
against exposure. This information would be conveyed by providing written materials distributed within
the community, organizing an education seminar for the members of the community, and identifying
local resources that can provide radon test kits, mold test kits, and carbon monoxide detectors. The
written educational materials and seminar would cover methods for preventing exposure, signs of
exposure, clinical manifestations of exposure, and when to seek emergency medical services. These
prevention methods are important in this community as we learned in our home visit that the landlord
was not compliant in fixing the leak and that certain businesses close by increase the chance of exposure
to environmental toxins. Given the environment surrounding this community and not knowing the age
of the homes, residents need to be provided with as much knowledge as possible to protect their homes
and families. In communities that are subject to an unsafe environment around them, prevention and
knowledge is the most powerful tool to give the residents the most positive outcome in keeping their
homes and families safe.
Baxi et al. (2016), analyzed how exposure to fungi effects humans and the development of
respiratory diseases as well as hypersensitivity reactions. It was found that early exposure to damp
environments and fungi is associated with the development of asthma and an increase in asthma
morbidity. While most people are relatively unaffected, outdoor exposure to high concentrations of
fungi spores can also cause asthma attacks in thunderstorms. Other diseases associated with fungus
exposure are rhinitis, allergic bronchopulmonary mycoses, allergic fungal sinusitis, and hypersensitivity
pneumonitis (Baxi et al., 2016).
The conditions in and around our homes, schools, playgrounds, and workplaces can have a
major impact on our families and communities. Exposure to lead may cause issues such as anemia,
weakness, kidney or brain damage, and sometimes death. exposure can also cause miscarriage,
stillbirths, and infertility. People with prolonged exposure to lead may also be at risk for high blood
pressure and heart disease (Centers for Disease Control and Prevention, 2021). Contaminated water can
harbor bacteria, such as those responsible for diarrhea, cholera, typhoid, hepatitis A, and polio.
According to statistics, every year, approximately 297,000 children under 5 years of age die from
diseases linked to poor sanitation, poor hygiene, or unsafe drinking water (Environmental Protection
Agency, 2021) & (National Institute of Environmental Health Sciences, 2022). Poor air quality has been
linked to health issues such as lung cancer, COPD, respiratory infections, heart disease, and stroke. Even
natural pollutants such as pollen or spores can exacerbate asthma and allergies (National Institute of
Environmental Health Sciences, 2022) & (Healthy People 2020, n.d.). Infrastructure issues can also have
a major impact on community health. Poorly maintained roads increase the risk for car accidents. Lack
of access to clean drinking water causes illness and disease. Lack of local health care infrastructure, such
as clinics capable of giving vaccinations for preventing diseases can also play a role (National Institute of
Environmental Health Sciences, 2022). More than 100 illnesses and injuries can be directly linked to
environmental health concerns. Often, these issues have the greatest impact on low-income
communities that already have significant health care vulnerabilities (World Health Organization, 2016).
According to Sircar et al. (2015), about 50,000 people each year visit the emergency room
because of carbon monoxide poisoning. Some factors that have been shown to decrease carbon
monoxide injuries include catalytic convertors in vehicles, enforcement of the 1970 Clean Air Act, and
installation of carbon monoxide detectors (Sircar et al., 2015). However, loss of power and cold weather
have been shown to increase deaths due to people using gasoline-powered generators in unventilated
areas (Sircar et al., 2015). From 1999-2012, the average annual rate of carbon monoxide mortality did
not change with the study showing that only 29 to 33% of American households reported having a
working carbon monoxide alarm (Sircar et al., 2015). Public health programs should be implemented
which emphasize the importance of installing carbon monoxide alarms (Sircar et al., 2015). A
community/public health nurse’s role includes assessing the quality of housing to help reduce the
incidence of physical and mental health problems that arise from the environment such as asthma,
cardiovascular disease, lung conditions, and cancer (Rector & Stanley, 2021, p. 255).

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