 Environmental Exposure Last month, scientists at the Alzheimer’s Association International Conference shared the finding that long-term exposure to wildfire smoke increases the risk of being diagnosed with dementia. Surprisingly, this risk was found to be higher than that of other types of air pollution, such as vehicle emissions. Fortunately, this risk does not apply to all of us, but it does allude to the important conversation about environmental exposure and the associated risks of cognitive decline and neurodegeneration. Unlike our resolutions around exercise and diet, where the research is robust, this topic is more controversial. Why is that? What we know about the impact of toxins and toxicants on the human condition is largely drawn from people with occupational exposure in agriculture or manufacturing and hobbies, such as pottery or painting. Historically, these individuals became canaries in a coal mine due to their higher-than-normal exposures. And, unlike diet and exercise where you can intentionally expose some study participants and not others to the study variable, it would be unethical to intentionally expose any study participants to a toxin or toxicant. Thus, our studies are largely based upon epidemiology (rates of diseases in populations) and animal research or models. Today’s Special Edition Mini Resolution Today we will be addressing the toxins and toxicants that have demonstrated an association with neurodegeneration and declining cognitive function. These include the “cides” (pesticides, herbicides, etc.), heavy metals (like mercury and lead), and BPA and its alternatives. Keep in mind not everyone has equal exposure to nor equal genetic susceptibility with the substances discussed. Our goal is to generate awareness, not fear. PRO TIP: We have packed a lot of information into today’s Motivated Monday’s special edition. Bookmark this blog so you can refer back to it when needed! Toxins occur in nature and are all around us. Examples include heavy metals or mold. Toxicants are manufactured substances, such as plastics and pesticides. Both can make their way into the air we breathe, the water we drink, the food we eat and can even be absorbed by the skin. 
How do these substances impact our neurology?
Some substances, like forever chemicals and heavy metals, persist in the environment and our bodies. They are lipophilic (fat loving), meaning long-term chronic exposure can cause bioaccumulation in fat, both in humans and in our food chain. Certain substances (like BPA) may be rapidly metabolized into a reduced toxic form and then excreted, but not before impacting the body. Thus, reducing our exposure can be very impactful as a long-term strategy to chronic exposure. How can we do that? Let’s focus on what we can control, like the exposure to toxins and toxicants in our homes. EXPOSURE IN OUR AIR Since toxins and toxicants can enter the home via your central heating and air conditioning, the use of a MERV 8-13 filter on your HVAC system is suggested. In addition, some toxins or toxicants can be generated within the home (e.g., mold or chipping lead paint). In such cases, an indoor air purifier can help, both mechanically and via activated carbon filters. Ideally, you’ll want to select one that removes particulate matter as small as PM 2.5. You may even decide to have your air quality tested by an industrial hygienist. EXPOSURE IN OUR WATER Whether naturally occurring in the environment or a product of human activities, toxins and toxicants can enter the water supply by runoff into our aquafers. This also includes bottled water, which often originates from a tap, not a spring. Keep in mind, even though our water supply is routinely tested, guidelines regarding allowable limits may not meet the muster for your family. Your local water company is tasked with monitoring your water safety, so your first stop is to contact them for a water report. Testing the water from your own tap is probably a good extra step because a lot can happen between the reservoir and your home. Here is the EPA’s guide to certified labs for water testing. If you are on well water, the EPA recommends annual testing. You may alternatively decide to abandon the extra step of testing and just install a water filter—a market with many options. Point of entry (POE) filtration systems can be installed where your home connects to the water supply. If you live in an apartment and are unable to install a POE, filters can be added to your showers and faucets. For filtration, the EPA provides a comprehensive document on which types of water filters are best for contaminants. An industrial hygienist can also help you assess your water quality and implement solutions as indicated. EXPOSURE IN OUR FOOD
Diet is the main source of exposure to toxins and toxicants. Let’s break down a few concerns: Pesticides+ Herbicides While the “cides” serve a valuable purpose in public health (eliminating disease causing vectors such as rodents and mosquitos), they also create concerns for human exposure. Click here to view our Motivated Mondays 2023 email on “cides” in our food. Heavy metals Beyond “cides” and BPE exposure (below), there is the concern for heavy metals in food. In fish, one of the biggest concerns is mercury. This wallet card can be helpful when dining out or at the fish market. In rice, where arsenic is a concern, you can rinse the rice thoroughly and also cook it in a rice to water ratio more akin to pasta than rice, 1:6. Did you ever read a headline about heavy metals found in processed food, such as baby food or protein powder, and think to yourself, “What the heck?” Well, the potential contamination may come from one of two sources. One, manufacturing equipment itself may generate shavings of metal which end up in the product on the shelf. Or, two, since heavy metals naturally occur in the Earth’s crust, they may contaminate raw materials purchased by manufacturers from countries where regulations are more relaxed. Thus, It is also important to read labels for the country of origin, which is required of certain foods under certain conditions. In some cases, sourcing your ingredients from countries which tightly regulate their food production (such as Australia and New Zealand) is a better option. BPA Can you go a day, even an hour, without coming into contact with plastic? It’s virtually impossible! Plastic is simply in, on and around everything—it is ubiquitous in our lives. While BPA in plastic has garnered the most attention as a threat to our health, the “alternatives,” BPS and BPF, possess the same if not worse adverse effects on health. Thus, purchasing “BPA free” plastic is not always an effective strategy. Further support for plastic avoidance was evident in a pre-printed published (not yet peer-reviewed) study in which nano- and micro-plastics (NMPs) made of polyethylene (BPA- free), were found in human post-mortem livers, kidneys and brains in increasing numbers from 2016-2024 (50% more!). The highest concentration of NMPs was found in the brain, likely due to the fact that plastic is lipophilic, and the brain is 60% fat. With regard to heart disease, NMPs have previously been identified as drivers of inflammation, potentially precipitating cardiovascular events. For neurological health, it is currently unclear how or if the NMPs exert a deleterious effect. When plastic cannot be avoided, you can manage your exposure by keeping in mind that the nature of the food itself impacts the absorption of BPA to our foods, as does the temperature. Acidic, salty, fatty foods are more likely to absorb BPA, and certainly microwaved food is more likely to absorb BPA. For this reason, we strongly urge you to never microwave your food in plastic containers. Below are common food exposures to plastic:
OTHER CONSIDERATIONS IN THE HOME Pesticide-use in the home Human exposure can occur inadvertently by in-home use of “cides.” Routes of administration can include inhalation, dermal contact and ingestion via food and water. Acute exposure can lead to poisoning, but because the “cides” are lipophilic, long-term chronic exposure can cause bioaccumulation in body fat, both in humans and in our food chain. The decision to use the “cides” in and around the home is a personal one. The benefit of the “cide” must be weighed with the risk of use, especially if children or pets are in the home—while you are unlikely to lick the baseboards after a spray, they are likely to do so. The University of California has an excellent overview for use of pesticides in and around the home. If you garden, here is an article to learn more about general non-chemical pest controls, the specifics of what you need will vary by what you grow and the type of pests you encounter. Paint Lead in paint was banned in 1978, so homes built before then may contain lead. Importantly, intact paint (i.e., not chipping or flaking) is considered safe as long as it remains that way, but paint that is compromised can be of concern. Here is the EPA information on lead paint. As mentioned last week, an industrial hygienist can assess your home for all environmental concerns and recommend solutions or ways to minimize risk. Personal care products If you are interested in learning what heavy metals the government allows in, and how much, you may review this document from the FDA. If you seek safer personal care products, the Environmental Working Group provides lists of products they have verified that are free of concerning chemicals. Smoking We all know cigarettes contain harmful ingredients like nicotine, carbon monoxide and tar, but did you know they also contain heavy metals like arsenic, cadmium, chromium, nickel and lead? For this reason, and countless others, you may want to think twice about buying that next pack. If you need help quitting smoking, contact your concierge physician. Hobbies Certain hobbies such as jewelry making, painting, pottery and stained glass making have the potential to expose the artist to heavy metals. You may wish to source materials from this verified list by the Art and Materials Creative Institute. Dental The first recorded use of dental amalgams dates back to the Tang Dynasty in 659 CE. The decision to remove dental amalgams is a personal one, as the removal process itself creates the risk of mucosal absorption, ingestion and inhalation of mercury. If you decide to engage in a conversation with your dentist about the removal of dental amalgams, be sure to ask about the precautions they take, which should include use of dental dams (used to isolate the operative site to prevent mucosal absorption or ingestion). To avoid inhalation and high-volume suction, HEPA room air filters and an oxygen mask are recommended. Whew! We’ve left you with a lot of information this week. Feel free to reach Motivated Mondays Coach Michele at [email protected] with any questions. We’ll see you next week to kick off our NEW mini resolution for September!
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MICHELE MCCAMBRIDGE, MPH, MSMichele is the Senior VP of Membership Development at Concierge Choice Physicians. She is also a professional in the areas of nutrition, fitness and wellness. Archives
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