Why Physician Education on Residential Air Toxics Matters
by Wayne Tuckson, MD, Natasha DeJarnett, PhD, MPH, Eviana Leggette, BS, Ann Hagan, MBA, Arnita Gadson, MA, Lauren Anderson, PhD
Zip code should not supersede genetic code as a determinant of health outcomes. Where a patient lives shapes what they breathe, what they breathe shapes their health and their health shapes their life expectancy. Health experts increasingly recognize that residential exposure to air toxins is an important contributor to illness. Yet, in routine clinical care, environmental exposures are not consistently addressed. That gap matters because the evidence is clear: indoor and residential air pollutants, including particulate matter, nitrogen dioxide and volatile organic compounds, are associated with asthma and other respiratory symptoms, cardiovascular disease, adverse birth outcomes and other harmful health effects across the life course. 5-8
Clinicians should not consider environmental exposures a peripheral issue. In fact, such awareness is directly relevant to the diagnoses, management and prevention of multiple conditions including asthma, COPD, cardiovascular disease and maternal-fetal mortality. Armed with a more complete exposure history, physicians may mitigate the
12 LOUISVILLE MEDICINE impact of heightened environmental vulnerabilities such as many home conditions, neighborhood exposures, ventilation, smoke, mold and other factors that may influence health. 1, 2, 8
Physician knowledge in this area also matters because patients trust their doctors. Research suggests that when clinicians can discuss environmental exposures and communicate practical steps for reducing them, patients are more likely to understand the risks and take protective action. 4 In this way, physician awareness can support better disease management, improved counseling and more informed patient decision-making.
Yet, this is an area where many clinicians have had little, if any, formal training at any level in their training. Environmental health remains underrepresented in medical education, despite its growing importance for patient care. 3 That makes continuing medical education especially important in filling this gap. CME courses can educate physicians about, and improve their confidence in understanding the consequences of