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Journal of Environmental and Public Health
Volume 2012, Article ID 356798, 15 pages
Review Article

Environmental Determinants of Chronic Disease and Medical Approaches: Recognition, Avoidance, Supportive Therapy, and Detoxification

1Children’s Hospital of Eastern Ontario Research Institute, and Senior Clinical Research Associate, Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L1
2RR 1, Box 9012, Dunrobin, ON, Canada K0A 1T0
3Faculty of Medicine, University of Alberta, Edmonton, AB, Canada T6K 4C1

Received 16 July 2011; Accepted 19 October 2011

Academic Editor: Janette Hope

Copyright © 2012 Margaret E. Sears and Stephen J. Genuis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The World Health Organization warns that chronic, noncommunicable diseases are rapidly becoming epidemic worldwide. Escalating rates of neurocognitive, metabolic, autoimmune and cardiovascular diseases cannot be ascribed only to genetics, lifestyle, and nutrition; early life and ongoing exposures, and bioaccumulated toxicants may also cause chronic disease. Contributors to ill health are summarized from multiple perspectives—biological effects of classes of toxicants, mechanisms of toxicity, and a synthesis of toxic contributors to major diseases. Healthcare practitioners have wide-ranging roles in addressing environmental factors in policy and public health and clinical practice. Public health initiatives include risk recognition and chemical assessment then exposure reduction, remediation, monitoring, and avoidance. The complex web of disease and environmental contributors is amenable to some straightforward clinical approaches addressing multiple toxicants. Widely applicable strategies include nutrition and supplements to counter toxic effects and to support metabolism; as well as exercise and sweating, and possibly medication to enhance excretion. Addressing environmental health and contributors to chronic disease has broad implications for society, with large potential benefits from improved health and productivity.