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CMAJ • June 11, 2002; 166 (12)
© 2002 Canadian Medical Association or its licensors

Review
Synthèse

Identifying and managing adverse environmental health effects: 5. Persistent organic pollutants

Alan Abelsohn*, Brian L. Gibson{dagger}, Margaret D. Sanborn{ddagger} and Erica Weir§

From the Departments of *Family and Community Medicine and {dagger}Public Health Sciences, University of Toronto, Toronto, Ont.; and {ddagger}the Department of Family Medicine and §the Community Medicine Residency Program, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.

Correspondence to: Dr. Alan Abelsohn, Department of Family and Community Medicine, University of Toronto, 1–1735 Bathurst St., Toronto ON M5P 2K4; fax 416 483-8182; alan.abelsohn@utoronto.ca

Abstract

CONCERN AND AWARENESS IS GROWING about the health effects of exposures to environmental contaminants, including those found in food. Most primary care physicians lack knowledge and training in the clinical recognition and management of the health effects of environmental exposures. We have found that the use of a simple history-taking tool — the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) — can help physicians identify patients at risk of such health effects. We present an illustrative case of a mother who is concerned about eating fish and wild game because her 7-year-old son has been found to have learning difficulties and she is planning another pregnancy. Potential exposures to persistent organic pollutants (POPs) and mercury are considered. The neurodevelopmental effects of POPs on the fetus are reviewed. We provide advice to limit a patient's exposure to these contaminants and discuss the relevance of these exposures to the learning difficulties of the 7-year-old child and to the planning of future pregnancies.




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