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Environmental Illness

AWARENESS SESSION

Denis St-JeanNational Health and Safety OfficerPublic Service Alliance of Canada

Union of Taxation EmployeesHealth and Safety Conference

November 6, 2015

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Environmental Illness

DID YOU KNOW

Today we spend more than 80% of our time indoors.

Our indoor air is 5 times more polluted than the outdoors.

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Environmental Illness

Factors Affecting Indoor Air Quality

• Ventilation• Humidity/dryness• Cleaners, deodorizers, fragrances• Furniture, building materials• Biological agents (i.e. moulds)

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Environmental IllnessSick Building Syndrome• Nausea• headache• fatigue• burning eyes• aching, flu-like• respiratory difficulties• sensitive to chemicals

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Environmental Illness

DID YOU KNOW

The lung is the major entry organ for chemicals.

Airborne chemicals are the major source of chemical exposure today.

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Environmental Illness

DID YOU KNOW

More than 4,000 chemicals are used in fragrances.

Of these, 95% are made from petroleum.

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Environmental Illness

An emerging issue in environmental

health is the phenomenon of

Environmental Illness (EI) or

Multiple Chemical Sensitivity (MCS).

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Environmental Illness

Also known as:• Environmental Sensitivities• Chemical Intolerance • Environmental Hypersensitivity • Chemical Hypersensitivity Syndrome• Gulf War Syndrome

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What is it ?

• Chemicals do injure people to varying degree of severity

• Different human physiological systems are suspected

• individual characteristics

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What is it ?

the brain• the most sensitive organ for injury

from chemicals

• Evidence abounds that chemical brain injury is common and generally misdiagnosed.

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What is it ?

the immune system• Characterized by multi-organ

symptoms • In response to low level chemical

exposures that are considered safe for the general population

• “Sub toxic" concentrations

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How are EI acquired ?

Through exposure to chemicals:• Solvents• Pesticides• Biological contaminants (i.e. moulds)• Drugs

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How are EI acquired ?

It can be the result of long term

exposure to low levels of hazardous

substances such as daily exposure to

poor indoor air quality.

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How are EI acquired ?

It can also be due to chronic, low level

exposure, such as a move into a brand

new office with significant emissions

of volatile organic compounds from

the building materials, furniture and

carpets.

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How are EI acquired ?

Finally it can result from a single

overwhelming exposure such as a

chemical spill.

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Is this new ?

• Scientists have known since the early 1900s that occupational exposure to certain chemicals can induce severe immune effects

• Recent chemical disasters of national and international prominence have renewed interest in the subject

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Is this new ?

It is generally agreed that human health

is influenced by the environment and

that many diseases are caused or

enhanced by environmental factors, but

effects on the immune system have

been difficult to delineate.

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Is this new ?

Some researchers contend that certain

chemicals can affect immunity,

significantly increasing an individual's

susceptibility to disease, in some cases

causing hypersensitivity reactions or

immunosuppression.

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Immune System

When parts of the immune system are

damaged, the body cannot fight its

adversaries and conditions and

diseases ranging from allergies to

cancer.

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Do Chemicals Injure Immunity?

Studies have shown that chemical

exposures can affect immunity in

two major ways:

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Do Chemicals Injure Immunity?

1) by causing hypersensitivity reactions, including allergy, or

2) by causing immunosuppression, a reduction in the responses and activities of the immune system.

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EI: Who’s at risk ?

A recent review of several studies

revealed a highly consistent ratio of

women to men of approximately 4:1,

with an average age of onset in the

fourth decade.

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EI: Who’s at risk ?

“Age, genetics, pre-existing disease, lifestyle, diet, drugs, or stress may compound the effects of chemical exposures to further compromise immune function and increase the chance of disease”.

Michael Luster, head of the Environmental Immunology and Neurobiology Section of the U.S. National Institutes of Health.

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EI: Who’s at risk ?

“ From a family doctor who says "it's all in your head" to medical research that has historically focused on men, bias in the medical profession can influence the quality of your health care.”

Lila A. Wallis, M.D., clinical professor of medicine at Cornell University Medical College in New York City and director of the American Medical Women's Association's advanced curriculum on women's health .

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Exposure Limits

80 % 10 % 10 %

Number of affected individuals

Concentration of exposure

How an exposure limits is established

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Exposure Limits

The canary was once the only safeguard miners had against dangerous gas build-up. If the canary fell off its perch and died, it was a signal to evacuate the mine ... fast.

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Exposure Limits

Could those who

suffer from

environmental illness

be the canaries in our

workplaces ?

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Reported SymptomsNonspecificHeadache, fatigue, insomnia, weakness, weight change, memory loss, dark circles under eyes

NeuromuscularNumbness, poor coordination, dizziness, lack of concentration, tremor, visual disturbance, syncope, muscle spasms, aching

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Reported SymptomsCutaneousRash, facial swelling, burning, eczema

CardiovascularChest pain, hypertension, edema

RespiratoryCough, hoarseness, recurrent otitis, rhinitis, recurrent respiratory infection, asthma

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Reported Symptoms

GastrointestinalOesophageal spasm, hepatitis, jaundice, change in appetite, constipation, nausea, vomiting, abdominal pain, anorexia

PsychologicDepression, anger, fright, panic, confusion, anxiety, agitation, hyperventilation, claustrophobia

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Reported Symptoms

MucosalSore throat, eye irritation, photophobia

Genito-urinaryImpotence

Source: Journal of Occupational Medicine, Volume 31 No. 3, March 1989

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Recognition of EI

When a person carries an MCS

diagnosis, the competing interests of

insurance companies, employers, and

government programs often erect

seemingly insurmountable barriers.

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Recognition of EI

Not only is MCS a misunderstood

disease, but it is caused by

substances upon which our

Industrialized economies depend.

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Recognition of EI• Subject of medical research worldwide • Biomarkers and tests increasingly

available to establish a diagnosis • Canadian government published a report

urging reform of the pesticide legislation (which has been done), and recommending that MCS be officially recognized and its treatment covered by our public healthcare (not yet done).

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Recognition of EI• The international consensus statement

on MCS syndromes was published in June 1999 (Archives of Environmental Health vol. 54/3).

• Canadian Medical Association Journal published series of research papers (April-June 2002) on health effects of the environment

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Accommodation of EI

• Under the Canadian Human Rights Act, individuals suffering from a disability must be accommodated up to undue hardship.

• Environmental sensitivity is considered a disability.

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Accommodation of EI

Some examples of accommodations:• high efficiency filters• removal of carpets or other trigger

elements (other office equipment that tends to off-gas)

• revisit cleaning schedule with minimally toxic cleaning products

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Accommodation of EI

Some examples of accommodations:• modification of job duties• modification of hours of work• retraining and/or transfer to another

position• telework until work area can be made

safe

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Accommodation of EI

The situation may arise and create the

need for a scent-free policy.

As with most workplace policies, be sure

to consider the following:

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Scent-Free Policy• Conduct an assessment or survey of

workers (extent of the problem).• Involve the health and safety committee• Educate the employees• Reinforce that policy is being

implemented as a result of medical concerns - not just a dislike for a certain smells.

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Scent-Free Policy• Make it clear that policy applies to

everyone (visitors, patients, etc) • Policy statement notice on all

appointment cards, stationery, room booking notices, employment postings, etc.

• Decide on wording for 'Scent Free' signs and where the signs will be posted.

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Scent-Free Policy• Let everyone know that the policy will

be reviewed and can be changed because of experience or new knowledge

• Post a list of "approved" unscented products

• Provide information on EI/MCS to all

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Accommodation of EI

The situation may arise and create the

need for a scent-free policy.

In January 2006, the PSAC National Board

of Directors endorsed a new

Policy on Scent-Free Environments.

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Environmental Illness

Above all:• Listen to their story• Be supportive and understanding• Learn more about this illness• Collaborate with the implementation of

the accommodation• Limit your use of scented products• Respect Fragrance-Free Zones