Taking A Toxic Exposure History

Designed to increase the primary care provider1s knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. The primary care clinician can play an important role in detecting, treating, and preventing disease caused by toxic exposure by taking a thorough exposure history. This issue begins with a composite case study that describes a realistic encounter with a patient. This description is followed by a pre-test (answers are provided). It ends with a post-test. Appendix issued in Sep. 1994 on Consultation, Referral and Followup lists: consultation sources; resource centers, and other sources.

Not a day goes by that humans aren’t exposed to toxins in our environment—be it at home, in the car, or workplace. But what about those toxic places and items that aren’t marked? Why are we warned about some toxic spaces' substances and not others? The essays in Inevitably Toxic consider the exposure of bodies in the United States, Canada and Japan to radiation, industrial waste, and pesticides. Research shows that appeals to uncertainty have led to social inaction even when evidence, e.g. the link between carbon emissions and global warming, stares us in the face. In some cases, influential scientists, engineers and doctors have deliberately "manufactured doubt" and uncertainty but as the essays in this collection show, there is often no deliberate deception. We tend to think that if we can’t see contamination and experts deem it safe, then we are okay. Yet, having knowledge about the uncertainty behind expert claims can awaken us from a false sense of security and alert us to decisions and practices that may in fact cause harm.

People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" "Is it safe to live near power lines?" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions. This book discusses six competency based learning objectives for all medical school students, discusses the relevance of environmental health to specific courses and clerkships, and demonstrates how to integrate environmental health into the curriculum through published case studies, some of which are included in one of the book's three appendices. Also included is a guide on where to obtain additional information for treatment, referral, and follow-up for diseases with possible environmental and/or occupational origins.

The National Human Monitoring Program (NHMP) identifies concentrations of specific chemicals in human tissues, including toxicologic testing and risk assessment determinations. This volume evaluates the current activities of the NHMP; identifies important scientific, technical, and programmatic issues; and makes recommendations regarding the design of the program and use of its products.

Mustard gas is typically associated with the horrors of World War I battlefields and trenches, where chemical weapons were responsible for tens of thousands of deaths. Few realize, however, that mustard gas had a resurgence during the Second World War, when its uses and effects were widespread and insidious. Toxic Exposures tells the shocking story of how the United States and its allies intentionally subjected thousands of their own servicemen to poison gas as part of their preparation for chemical warfare. In addition, it reveals the racialized dimension of these mustard gas experiments, as scientists tested whether the effects of toxic exposure might vary between Asian, Hispanic, black, and white Americans. Drawing from once-classified American and Canadian government records, military reports, scientists’ papers, and veterans’ testimony, historian Susan L. Smith explores not only the human cost of this research, but also the environmental degradation caused by ocean dumping of unwanted mustard gas. As she assesses the poisonous legacy of these chemical warfare experiments, Smith also considers their surprising impact on the origins of chemotherapy as cancer treatment and the development of veterans’ rights movements. Toxic Exposures thus traces the scars left when the interests of national security and scientific curiosity battled with medical ethics and human rights.