A recent study determined that there are more than 350,000 chemicals and chemical mixtures registered for production and use, a number three times as high as previously estimated. Up to 70,000 of these chemicals are described ambiguously and more than 50,000 are classified as “confidential,” leading to an enormous gap in knowledge. Given the woeful lack of data and study, it isn’t possible to fully understand how chemicals in the environment may be making us more susceptible to COVID-19. We do know enough, though, to take some prudent steps. Here’s some of what’s known at this point:
1. The numbers of COVID-19 cases, hospitalizations, and deaths are all linked to levels of fine particulate matter in the air.
Particulate matter is an airborne mixture of solid and liquid particles. The smaller or finer the particles, the more problematic they are for human health, because they can more easily evade defenses. Several recent studies examined the relationship of particulate air pollution to COVID-19. A study by the World Bank Group found that the level of fine particulate matter was a highly significant predictor of how many confirmed cases and hospital admissions there would be in a geographical area. They report that a pollution increase of 20 percent may increase COVID-19 cases by nearly 100 percent. The researchers controlled for health-related preconditions and demographic factors and note that patterns suggest the number of cases is not simply related to population density.
Particulate pollution is also associated with COVID-19 morbidity. The Guardian reports on a US study finding that “even a tiny, single-unit increase in particle pollution levels in the years before the pandemic is associated with a 15% increase in the death rate.” It further notes that long-term exposure to particle pollution was already known to increase the risk of death from all causes, but that in the case of COVID-19 deaths, the increase was 20 times higher. The correlation held when poverty levels, smoking, obesity, and availability of COVID-19 tests and hospital beds were factored in. It also held when New York City (with many cases) and counties with few cases were removed from the data pool.
2. Indoor air is generally more polluted than outdoor air.
The Environmental Protection Agency (EPA) states that the air inside homes and other buildings tends to be more polluted than outdoor air even in the most populated and industrialized cities. It’s easy to feel helpless about our exposure to outdoor air pollution, but to a large degree, we can control our indoor environments.
Particulate pollution inside a home or other building can come in many forms. Combustion (burning candles or incense, using a fireplace, etc.) is a significant contributor. Household dust is also a source, and can lodge in carpets, sofas, chairs, curtains, and bedding and easily become airborne when, for example, carpets are walked on or people sit on sofas or chairs. For multiple reasons (some of which I’ll discuss later), it’s wise to address as many sources of toxicity inside a building as possible. Different types of contamination interact. As one website explains, “Particles in air are either directly emitted, for instance when fuel is burnt and when dust is carried by wind, or indirectly formed, when gaseous pollutants previously emitted to air turn into particulate matter.”
3. There are known risk factors for COVID-19 complications, and known chemical connections to them.
The Centers for Disease Control (CDC) notes that people at high risk for severe illness from COVID-19 include those with lung disease or asthma, obesity, diabetes, kidney or liver disease, and heart conditions. The list of chemicals that can contribute to these conditions is long.
Researchers tested 50 types of consumer products for 66 chemicals related to asthma or hormone disruption (associated with diabetes and obesity) and found 55 of them. Implicated chemicals include those found in fragrances, cleaners, cosmetics, plastic, hair care products, detergents, and more. Some of the highest concentrations of problematic chemicals were found in fragranced products, such as dryer sheets, air fresheners and perfumes. Vinyl was also a significant source of exposure.
Because the kidney and liver are involved in detoxifying chemicals, all exposures can stress and affect them. The National Kidney Foundation notes that kidney disease may be associated with herbicides, pesticides, air pollution, and heavy metal exposure. There are at least 123 chemicals associated with fatty liver, according to a study in Toxicologic Pathology. A significant number are found in pesticides (including herbicides and fungicides). Solvents, plasticizers, fragrances, paints, polishes, and dyes are also sources. Heart disease is likewise associated with a long list of chemical exposures, including (according to an article in Interdisciplinary Toxicology) those found in pesticides, cleaning products, plastic, adhesives, paints, and many other products.
4. It’s wise to choose disinfectants carefully.
In a warning posted soon before COVID-19 became big news, Consumer Reports noted that many people may not know that products labeled “disinfecting” contain EPA-registered pesticides. The report notes that people who use disinfectants and cleaners regularly in their work (janitors and healthcare workers, for example) have higher rates of asthma. According to Newsweek, nurses who cleaned surfaces with disinfectants at least once a week had a 24 to 32 percent higher risk of developing COPD than nurses who used the products less often.
An article entitled Safer Disinfecting at Home in the Times of Coronavirus states that quats (quaternary ammonium chlorides, commonly found in disinfectants) are associated with a list of problems, including breathing difficulty, skin irritation, reproductive harm (including possible fertility and birth defect issues) and antimicrobial resistance. Chlorine bleach can also be problematic. The author recommends using disinfectants containing hydrogen peroxide, alcohol, lactic acid, citric acid, or thymol.
5. Ventilation is our friend.
Information from the 1918 influenza pandemic indicates that fresh air and sunlight seem to have prevented deaths among those infected. An article on the subject reports that “in the 1960s, Ministry of Defence scientists proved that fresh air is a natural disinfectant. Something in it, which they called the Open Air Factor, is far more harmful to airborne bacteria — and the influenza virus — than indoor air. . . . Their research also revealed that the Open Air Factor’s disinfecting powers can be preserved in enclosures — if ventilation rates are kept high enough.”
Adequate ventilation is known to limit the spread of airborne pathogens in healthcare environments. The author of an article entitled Could the Indoor Air Quality of Our Buildings Become Part of the COVID-19 Playbook? asks whether addressing ventilation in other buildings might likewise be part of an anti-viral strategy (which also includes reducing indoor contaminants). The article notes that in their publication Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19), the CDC recommends increasing ventilation rates and the percentage of outdoor air.
6. Every exposure matters
There’s been a lot of talk lately about “viral load.” The viral load, however, is only a small part of a person’s overall toxic load, or toxic body burden. There are natural and man-made toxins inside every human being (even newborns). Some chemicals are metabolized relatively quickly and others stick around for decades or even a lifetime. Some chemicals have been shown to directly affect the immune system, but every substance added to the body requires resources to manage and takes a person one step closer to the tipping point at which staying healthy is no longer possible.
It can be helpful to know what chemicals are likely to cause what symptoms or diseases, or to know whether you have a genetic weakness that might make you more susceptible to the effects of a certain class of compounds. It isn’t necessary to know that, though, in order to begin to protect yourself.
A guide to addressing indoor air pollution during lockdown and beyond suggests the following:
Minimize use of air fresheners, pesticides, harsh cleaning products, aerosol sprays, and adhesives.
Reduce indoor burning.
Use an exhaust fan or open windows or doors.
To those, I would add the following suggestions:
Keep things clean (using simple, non-toxic products) and reduce the number of surfaces that hold dust. It’s not a quick, easy fix, but removing carpet can make a big difference.
Go fragrance free. A single fragrance can contain several hundred chemicals. (Also, fragrances in the products you use affect others around you as well.)
Determine how toxic your personal care products are and make changes if necessary. The Skin Deep database is a good source of information.
Reduce plastic use, especially in the kitchen.
Eat organic food.
Much needs to be done on a societal level to help us stay healthy, but there’s also much that each of us can do personally. Now is a good time to do it.