Environmental therapy, also known as environmental medicine and formerly called clinical ecology, is the diagnosis and treatment of conditions caused by environmental factors.
The founder of environmental medicine was Theron G. Randolph, M.D., who was a trained specialist in internal medicine, immunology, and allergies. Several decades ago, Randolph became concerned with chronically ill patients who had symptoms of allergies and immune system disorders, but didn't respond to conventional medical care. Randolph believed that patients were getting sick from environmental substances and pollutants that allergy specialists could not determine or did not recognize as causing illness. Conventional allergy specialists in Randolph's time believed that allergies could only be detected by measuring the response of immunoglobulin E (IgE). IgE is a particular antibody produced by the immune system when an antigen (foreign substance) triggers a reaction. Randolph believed that testing for allergies using only this technique limited the determination of immune system problems. Using other tests and techniques, he found that many substances that didn't necessarily cause increased amounts of IgE could create allergic symptoms and complications in the body. Research has since shown that food allergies cause increases in immunoglobulin G (IgG) and not in IgE. Scientists
Randolph also found that allergic and toxic substances often produce subtle reactions in the body that may accumulate into major illnesses and problems. Many of these substances were not previously thought of as allergenic or toxic, including numerous common foods and chemicals (particularly petrochemicals and by-products of industry). Randolph determined that environmental agents could cause mental and behavioral disturbances as well as physical symptoms. Randolph and other doctors developed and used new diagnostic techniques, including intradermal (between skin layers) and sublingual (under the tongue) allergy tests, to determine exactly which environmental factors were influencing illnesses. Environmental doctors were able to heal many patients, simply by removing certain foods and chemicals from their environments.
Randolph went on to dedicate his work to studying the interaction between patients and their environments. He and his colleagues called this new field of medicine clinical ecology, which was later changed to environmental medicine. The field's basic ideas are that doctors must consider both the patient and the patient's environment in treatment, and that there are cause and effect relationships between environmental factors and illness. Environmental factors include food, air, water, living arrangements, and workplace environments. For illnesses that are caused by exposure to negative environmental factors, healing can be induced not by drugs, but by testing for and removing the environmental causes of illness and by strengthening the patient's resistance.
Environmental therapists have isolated many substances that cause illness and adverse reactions in people, including chemicals, car exhaust, tobacco smoke, pesticides, drugs, food additives, and common allergens like dust, mold, animal dander, and pollen. Many people may also have allergic and negative reactions to common foods such as dairy products, corn syrup, sugar, wheat, certain fruits and vegetables, nuts, and meat. Exposure to toxic and allergenic substances may exert a cumulative effect on the body, weakening and taxing the immune system over time so that the body becomes hypersensitive (more susceptible) to substances that were once tolerated.
In 2002, a Harvard University study demonstrated that global warming was adding to the presence of airborne allergens like ragweed pollen. Atmospheric carbon dioxide concentration is up 29 percent since industrial times began and is expected to double again in the next 50 to 100 years. The heavy carbon dioxide concentration helps plants grow faster and larger, producing more allergens.
Environmental medicine has become increasingly popular in the last few decades as the public has become more aware of environmental pollution. Every year, more than 700,000 different chemicals are released into the environment, and the figure has been growing by 10% or more per year. Toxic or allergenic chemicals can be found in everything from common household materials like carpet and furniture to basic items like food and water. Environmental therapists believe that new medical problems have arisen due to the immune system's inability to handle all of the new pollutants and synthetic chemicals to which it is exposed. Environmental illness is the cumulative effect of lengthy or constant exposure to these toxins. Those with environmental illness become hypersensitive to even minute quantities of common materials. Environmental hypersensitivity can cause severe disability in many people.
Environmental medicine recognizes that some new and baffling illnesses have appeared that conventional medicine either does not recognize or is unable to treat, sometimes called "twentieth century diseases." These conditions include environmental illness/multiple chemical sensitivity (EI/MCS), chronic fatigue syndrome, fibromyalgia, Gulf War syndrome, and sick building syndrome. Furthermore, diseases for which environmental causes are believed to be major factors are also increasing (like cancer and asthma), making environmental medicine increasingly important.
Environmental medicine is helpful for those patients suffering from chronic allergies, asthma, chronic fatigue syndrome, EI/MCS, fibromyalgia, Gulf War syndrome, and sick building syndrome. It is helpful for those with conditions that are influenced by environmental factors, such as cancer, as well as for those who have been exposed to high levels of toxic materials due to accident or occupation. Environmental medicine is also used for people suffering allergic or immune system problems that conventional medicine is unable to diagnose or treat. Symptoms for those suffering environmental illness include unexplained fatigue, increased allergies, hypersensitivity to common materials, intolerance to certain foods and indigestion, aches and pains, low-grade fever, headaches, insomnia, depression, sore throats, sudden weight loss or gain, lowered resistance to infection, general malaise, and disability.
Environmental therapy treats patients by first identifying the environmental causes of illness. The next step is removing environmental causes and reducing exposures
The cost of treatment by a practitioner of environmental medicine can vary depending on the education of the practitioner. Costs are generally comparable to visits to trained medical specialists. Practitioners may be conventionally trained medical doctors, researchers with graduate degrees in environmental medicine, or alternative medicine practitioners such as homeopaths, Ayurvedic medicine practitioners, traditional Chinese medicine practitioners, and naturopaths. Treatment costs vary, depending on the type and number of tests required to identify problems and the subsequent healing therapies required. Many insurance policies cover costs of environmental therapy, particularly when the practitioner is a certified medical doctor. Consumers should be aware of their insurance company's policies on coverage.
Diagnosing environmental illness
Environmental therapists use extensive testing to determine the environmental factors that may be causing illness. These factors include infection, allergy, addictions, and toxic chemicals. Infections that often plague those with environmental illness can be caused by parasites, bacteria, viruses, and yeast. Blood, urine, stool, and hair analyses are used to measure a variety of bodily functions that may indicate problems. Environmental therapists have access to laboratories that specialize in sophisticated blood, urine, and other diagnostic tests.
In testing for environmental illness, liver function is studied closely because the liver is the principle organ in the body responsible for removing toxic compounds. Another useful blood test is a test for zinc deficiency, which may indicate heavy metal poisoning. Heavy metal poisoning can be caused by lead, mercury, arsenic, cadmium, and aluminum, all of which are present in the environment. Hair analysis is also used to test for heavy metal toxicity. Blood and urine tests can also be completed that screen for toxic chemicals such as PCBs (environmental poisons), formaldehyde (a common preservative), pesticides, and heavy metals. Immune system tests, which show levels of particular antibodies, can also indicate specific environmental factors. Hormone levels also may indicate environmental illness. Certain blood and urine tests may suggest nutritional deficiencies and proper recovery diets can be designed for patients.
Environmental therapists also perform extensive allergy and hypersensitivity tests. Intradermal and sublingual allergy tests are used to determine a patient's sensitivity to a variety of common substances, including formaldehyde, auto exhaust, perfume, tobacco, chlorine, jet fuel, and other chemicals.
Food allergies require additional tests because these allergies often have reactions that are delayed for several days after eating the food. The RAST (radioallergosorbent test) is a blood test that determines the level of immunoglobulins in the blood after specific foods are eaten. The cytotoxic test is a blood test that determines whether certain substances affect blood cells, including foods and chemicals. The ELISA-ACT (enzyme-linked immunoserological assay activated cell test) is considered one of the most accurate tests for allergies and hypersensitivity to foods, chemicals, and other agents. Other tests for food allergies are the elimination and rotation diets, where foods are systematically evaluated to isolate those that are causing problems.
Therapies used in environmental medicine
After environmental causes of illness are identified, the next step is to reduce or eliminate the patient's exposure to them to reduce the burden on the immune system. Patients are advised to immediately remove toxic and allergic agents from the home and workplace, to make lifestyle and dietary changes to reduce exposure, and to improve general physical and mental health.
Detoxification methods are used by alternative practitioners in treating environmental illnesses. These methods try to rid the body of accumulated toxic substances and to restore efficient functioning. Detoxification methods include dietary therapies, fasting, exercise, sweating, laxatives, enemas, and other techniques that stimulate and support the body's natural detoxification mechanisms. Nutritional and herbal supplements are used in the detoxification and strengthening process. These supplements include antioxidants and vitamins, numerous herbs that detoxify the body and stimulate the immune system, and enzymes to improve digestion. Natural and holistic treatments are used to rebuild and strengthen the patient's overall health and resistance. Traditional healing systems such as traditional Chinese medicine, naturopathy, ayurveda, and homeopathy may be used as therapeutic programs for environmental illness.
Patients can assist diagnosis and treatment by keeping detailed diaries of their activities, symptoms, and contact with environmental factors that may be affecting their health.
If detoxification treatments are used, patients may experience side effects of fatigue, malaise, aches and
Research & general acceptance
Environmental medicine is gaining more respect in the medical community and is now a field in conventional medicine. Many leading medical schools and universities offer programs or specialties in environmental medicine. Research in environmental medicine is being widely funded and conducted by mainstream organizations such as the National Institutes of Health, the Environmental Protection Agency, as well as alternative medical schools. The National Academy of Science recognizes that many illnesses are caused or influenced by environmental factors, including cancer and multiple chemical sensitivity. The U.S. Centers for Disease Control have estimated that up to 82% of diseases may be due to environmental and lifestyle factors.
Training & certification
The American College of Occupational and Environmental Medicine is the world's largest organization for environmental medicine. Its members include certified and practicing doctors. The American Academy of Environmental Medicine certifies environmental medicine practitioners. The National Institute of Environmental Health Sciences is affiliated with the National Institutes of Health. It conducts research in environmental medicine and supports several academic programs of study in environmental medicine, including those at Harvard, Oregon State University, Vanderbilt, University of California, and MIT.
Goldberg, Burton. Chronic Fatigue, Fibromyalgia and Environmental Illness. Tiburon, CA: Future Medicine, 1998.
Lawson, Lynn. Staying Well in a Toxic World. Chicago: Noble 1993.
Randolph, Theron G., M.D. Environmental Medicine: Beginnings and Bibliographies of Clinical Ecology. Fort Collins, CO: Clinical Ecology Publications, 1987.
Steinman, David, and Samuel Epstein. The Safe Shopper's Bible. New York: IDG, 1993.
"Global Warming May Significantly Increase Airborne Allergies." Immunotherapy Weekly (April 10, 2002):4.
Health Connections Quarterly 7510 Northforest Dr., North Charleston, SC 29420. (843) 572-1600. http://www.coem.com.
Journal of Occupational and Environmental Medicine 1114 N. Arlington Heights Rd., Arlington Heights, IL 60004. (847) 818-1800.
American Academy of Environmental Medicine. 23121 Verdugo Dr., Suite 204, Laguna Hills, CA 92653. (714) 583-7666.
Center for Occupational and Environmental Medicine. 7510 Northforest Dr., North Charleston, SC 29420. (843) 572-1600. http://www.coem.com.
Northwest Center for Environmental Medicine. 177 NE 102nd St., Portland, OR 97220. (503) 561-0966.
Teresa G. Odle