CHAPTER 4: THE HEADACHE ENVIRONMENT
Chapter 4: The headache environment
The air bites shrewdly.
Julius Caesar, William Shakespeare
Just as the foods we eat can set the stage for headaches, toxic substances or allergens in the air we breathe can also bring head pain. Also, other environmental factors such as the weather, noises and light might trigger a headache attack.
The question arises (as it has in Chapter 3): are these headache triggers direct causes of chronic headache, or do they switch on other mechanisms that are laying in wait? With certain headache types, like eyestrain headache or sinus headache, there is an organic cause of headache. But, for chronic tension-type, migraine and cluster headaches, the mechanisms are under dispute. The same theories uphold for environmental toxicity as they do for dietary toxicity (see Chapter 3, Food Sensitivity, Intolerance and Allergy, page [TK]. Briefly, reactions to substances in the environment may result from:
• Intolerance -- due to a functional, anatomical problem in breaking the substance down or eliminating it
• Allergy -- an immunologic problem whereby the body mounts an immune response against an offending substance
• Chemical sensitivity -- a non-immunologic syndrome, probably a combination of central nervous system damage and enzyme deficiencies, which may be caused by chronic exposure to toxins, or genetics, or both.
Removing the sensitivity-causing substance might relieve the headache for the time being. But, in its unbalanced state, the body remains poised for reactions to other substances. So, while identifying and eliminating toxic causes of headache is obviously important, it's also important to explore whether other, deeper factors are at play.
The air we breathe indoors
By now, most of us know that air pollution is bad for the health -- but it may be surprising for many of you to learn that indoor pollution can incur health consequences that are as grave, or even more serious, than those caused by outdoor pollution. Thernon Rudolph, MD, an environmental physician and author of An Alternative Approach to Allergies (Harper Perennial) was one of the first to recognize indoor pollution as a potential health risk. Here are some startling facts:
The National Academy of Sciences estimates that indoor pollution contributes up to $100 billion annually in healthcare costs. The Occupational Safety and Health Administration (OSHA) estimated that more than 20 milion Americans work with chemicals known to cause nervous system damage, even when used in small amounts. And, according to the National Research Council, complete toxicity information is available for only 2% of the 70,000 chemicals in daily use.
Poor ventilation
The energy crisis in the 1970s can be blamed for many ills, not the least of which is setting the stage for environmental illness. To conserve energy, the government encouraged weatherization and energy-efficient construction. The upside was savings on energy bills; the downside was poor ventilation in new buildings. As a result, all of the new materials and products that contain petrochemicals, formaldehyde and other toxins (and they are ubiquitous) become trapped in our super-insulated environments.
Offices or homes built in the fall or winter in colder regions are particularly prone to causing indoor environmental problems. These new building materials are often treated with substances which, without the chance to escape through ventilation, will off-gas and "percolate" in an enclosed space. Environmental toxins that normally would have a chance to escape by opening a window in spring or summer are, in the winter, trapped and accumulate -- resulting in higher-than-normal levels of toxins, and a higher potential for causing toxic reactions.
Hidden headache hazards
Some of the biggest headache-causing suspects on the home front are humidity, dust mites, molds, yeast and algae. But other factors to consider include chemicals that emit from cleaning solutions, personal care products, dry cleaning, wood preserving, and other sources to be discussed below.
Humidity
I know of one headache sufferer who can predict humid weather more accurately than any weather man. But she is not alone. Many headache sufferers know when it's going to rain and can presage drops in barometric pressure. These individuals seem to be more prone to headache during air travel, or while climbing to high elevations.
There are a few possible explanations for her talent; perhaps her body is reacting to a change in the weather, or maybe it's reacting to factors that thrive under humid conditions, such as dust mites, molds, yeast and algae.
Dust mites are microscopic insects that flourish under conditions that are common in today's American household. It should be noted that the dust mite itself is not the offender, but its droppings. The more dust mites you have, the more droppings, etc. Yeast, algae and molds coexist and proliferate under similar conditions as the dust mite.
The kitchen
We've already discussed how foods that you cook on your stove can trigger headache, but what about the stove itself? Gas stoves can be particularly hazardous due to the emission of nitrogen dioxide , benzene and carbon monoxide . Cleaning solutions might also contain ingredients that trigger headaches. Moist areas, for example under the sink, can be breeding grounds for dust mites, yeast, algae, molds and fungi. Cookware made of aluminum, or dishes made of plastic, might be the source of allergens.
The bathroom
As mentioned above, moist areas are perfect for the growth of common household allergens. The shower stall creates an ideal habitat for the proliferation of molds. Again, cleaning solutions should be suspected as possible headache-producing sources.
The volatile molecules in these and other highly-scented personal products (such as shaving lotions, soaps,moisturizers, shampoos, etc.) can quickly assault the nervous system, and bring on a headache.
House-wide considerations
Dry cleaning, treated woods and insulation materials often emit formaldehyde. Polyurethane, a clear, plastic sealant often used in finishing woods and other materials, can be toxic for several months after its application. Other products used in during the process of pressure-treating woods may incite headache attacks, as well. Carbon monoxide from home heating systems is a potentially dangerous source of headache, an early symptom of possible poisoning.
The rapid changes temperature in heating/cooling ventilation systems are good breeding grounds for molds and fungi, which then become distributed throughout the building.
Insecticides often contain vasoactive agents that could trigger a headache. Consider also your water supply , which can harbor chemicals leached from nearby factories or farms. In one study, headaches plaguing a Western Illinois community were traced to water pollution with trichloroethylene (TCE). Even if water testing fails to uncover toxic levels of chemicals, many headache sufferers are highly sensitive to even low levels of toxins -- levels that may be considered safe for the general population.
Hidden ingredients that can cause headache
According to the Environmental Protection Agency, the following ingredients -- found in common personal care and cleansing products -- have been found to cause headaches.
| |Benzyl | Ethyl acetate |a-Terpineol |Methelyne |
| |alcohol | | |chloride |
|Aftershave | |• |• | |
|Air freshener |• | |• | |
|Cologne |• |• |• |• |
|Deodorants |• | |• | |
|Dishwashing | |• | | |
|liquid | | | | |
|Fabric | |• |• | |
|softener | | | | |
|Hairspray | | |• | |
|Laundry |• | |• | |
|bleach | | | | |
|Laundry | | |• | |
|detergent | | | | |
|Nail polish |• |• | | |
|remover | | | | |
|Nail polish | |• | | |
|Paint | | | |• |
|Perfume |• |• |• | |
|Shampoo |• |• | |• |
|Soap |• | |• | |
|Varnish | | | |• |
|remover | | | | |
|Vaseline |• | |• | |
|lotion | | | | |
Headache in the office
Office politics aside, lurking within the carpeting and walls of your office building could be toxic substances that bring on chronic headaches. Factory workers may be exposed to noxious inhalants or chemicals absorbed through the skin which may cause headaches (see Chemicals, below). Consider these environmental factors in your place of work:
Chemicals
What types of chemicals are commonly used? If you work in a dynamite factory, for example, suspect nitroglycerine . A potent vasodilator, nitroglycerine is a common headache-triggering factor. In fact, any chemical factory work should raise a red flag . People who work with welding, mining, metalizing, metal grinding or finishing, paint (that contains lead) or any sort of combustion might be exposed to headache-causing inhalants. Farmers and farm workers should consider pesticide exposure. People who work in printing or art might not be aware that the fixatives and markers they use daily are noxious, especially for the sensitive headache sufferer. Individuals who work in building and construction might want to explore whether they're exposed chemicals were used for treating woods -- both in the woods themselves (formaldehyde and others) and in their sealing (polyurethane and others). Also, many offices have regular pest control schedules; consider whether your headaches coincide with fumigation .
Fumes and noxious odors
People with chronic headaches might also be highly sensitive to odors, such as fumes from the above-mentioned sources, perfumes, automobile exhaust and cigarette smoke.
Lighting and computers
As mentioned, those of you who suffer from migraine with aura can be especially sensitive to changes in light. Bright or flashing lights can precipitate a migraine attack. Infrared lights (from welding and other operations) can also precipitate headaches. Fluorescent lights, which tend to flicker -- sometimes almost imperceptibly -- can also bring on headaches, migraine and others. Reading, poor lighting or astigmatism are common causes of eyestrain headache.
Job activities
Sudden exertion can bring on a headache, as may bad postural habits. See Chapter 7 for more information.
Travel
Many factors that occur during travel can, either alone or in combination, bring on a headache attack. For example, when hiking to altitudes above 10,000 feet, people who are not susceptible to headaches may experience them. Changing time zones can throw off your internal biological clock, resulting in stress and hormonal changes that may set the stage for headache. Travel-related factors that may cause headaches include:
• Atmospheric changes (see below)
• Changes in time zones
• Constant motion
• Altitude
• Enclosed environment (particularly during air travel, see Poor ventilation above)
• Skipping meals (see Chapter 3)
Is your office making you sick?
Complete the following questionnaire. If you answer "yes" to any of the questions, investigate the sources as possible headache triggers.
Yes No
/ / / / I am exposed to chemicals in my workplace.
If yes, please list (eg, glues and fixatives, aerosol sprays, sealants, pesticides)
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
/ / / / The windows in my office building cannot be opened.
/ / / / The heating system uses gas or oil for fuel.
/ / / / I use a computer much of the day.
/ / / / My job requires a lot of air travel.
/ / / / The lighting source is fluorescent lights.
/ / / / My work requires physical exertion.
/ / / / My job environment is noisy.
/ / / / My coworkers smoke.
/ / / / I am exposed to perfumes, sprays or other fumes on the job.
Weather changes
It's hay fever season, and while everyone else is sneezing and wheezing, you're getting headaches. Is there a connection? Some headache experts might attribute it to allergies, while others point to changes in the weather. Many headache sufferers seem to be exquisitely sensitive to barometric and/or humidity changes. As we discussed above, humidity is a common headache trigger, possibly due to the proliferation of allergens. Other researchers attribute this weather reaction to ionic changes -- positive and negative charges in the air -- during changes in atmospheric pressure.
We'll explore ways of detecting and reducing environmental headache hazards in Chapter 6.
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