California Wildfires, Toxic Smoke, and Chemical Intolerance

california wildfires TILT chemical intolerance

By Dr. Claudia Miller, allergist/immunologist, professor emeritus, and leader of the TILT Program at UT Health San Antonio

Do you live in Los Angeles?

Our hearts go out to you, to the first responders, and to the residents who are suffering from the fires and smoke.

As health care providers who know about Mast cell activation syndrome (MCAS), your knowledge of mast cells and the long-term effects of acute or repeated exposures to toxic smoke on mast cells will be pivotal in the coming days. Indeed, you are best-equipped to teach others about mast cells. As we know, most doctors and affected individuals do not yet understand the multi-system symptoms, especially the neurological symptoms, people are going to experience. Not everything will be attributable to PTSD or depression or exhaustion.

In my decades of serving as an environmental consultant, researching and writing about Toxicant-induced Loss of Tolerance (TILT), I have learned that a wide range of toxic exposures can disrupt mast cell function. Structurally diverse substances, ranging from pesticides and VOCs, to implants, synthetic drugs, toxic molds, and chemically complex combustion products are increasingly common initiators and triggers of chemical intolerance, TILT, and MCAS.

Our population-based surveys using the QEESI have shown that chemical, food and drug intolerances now affect approximately 30% of US adults. The prevalence in polluted countries (India, Russia) approaches 50%.

What these seemingly unrelated, toxic exposures share in common is that they are all fossil fuel related—even mold indoors and toxic algal blooms have increased due to weather extremes (floods, hurricanes, droughts) attributable to fossil fuel combustion. Our exposures to these toxicants have increased exponentially in the past 300 years—since the Industrial Revolution but especially in the past few generations since World War II when fossil fuel derivatives (primarily petrochemicals) entered the marketplace and our lives, including plastics, many drugs, pesticides, etc. These chemicals are foreign to mast cells which evolved more than 500 million years ago to protect our internal milieu from the external chemical environment. A single major exposure event or repeated lower level exposures to the combustion products of coal, oil, or natural gas, or their chemical derivatives can damage mast cells which we now suspect may be due to epigenetic alteration of mast cell DNA. Epigenetic alterations are not mutations. Rather, they act more like switches that turn on or turn off genes. Nevertheless they are heritable. They can be transmitted to children and are appearing in the form of autism and ADHD in the offspring of adults with TILT.

What we found is that parents whose chemical intolerance scores on the internationally validated QEESI were in the top 10% of US adults, versus the bottom 10%, had 5.7 times the risk of having a child professionally diagnosed with autism and 2.1 times the risk of having one with ADHD.

Smoke from the fires in LA is composed of ultrafine, highly respirable particles which can remain airborne for days, and are chemically complex unlike the relatively “simple” smoke our ancestors inhaled before WW2.

Among individuals who already suffer from MCAS—perhaps secondary to a failed breast implant (recalling that these horrific fires are occurring in LA), these individuals are apt to be more susceptible to an exacerbation of their MCAS resulting from exposure to the smoke, or whenever chemicals are used to disperse or clean up or cover the odor of smoke (fragrances!) that has been entrained in their clothing, bedding, furnishings, or if they try to reenter their contaminated homes that still smell of smoke. Insurors know this and do not wish to cover these losses or chronic medical conditions.

If you, your colleagues or patients wish to know more about TILT, please steer them to the Quick Environmental Exposure and Sensitivity Inventory (QEESI), our TILT Tutorial on Autism/ADHD and TILT Tutorial for Exposed Communities and Individuals, history-taking forms, and peer-reviewed publications all of which are available and downloadable free of charge on our UT website: TILTresearch.org.

I often say that wish I didn’t know what I know about the health consequences of chemical exposures, including complex chemical combustion products. I learned by serving as medical consultant to the VA on veterans’ exposures to oil well fires and burn pits, to New York City’s World Trade Center Registry, and currently to those exposed to smoke from the train derailment and tank car fire in East Palestine, Ohio.

The most vulnerable (“TILTed”) individuals should leave the area. Proper personal protection for first responders and others is imperative although extremely difficult to do. Mental health problems, autism, ADHD, bullying, road rage, suicides, homicides, and other behaviors can be triggered by formerly tolerated chemicals (such as fragrances, cleaning agents, engine exhaust), by foods (altered mast cells in the GI tract lose tolerance for foods, food additives, etc.) Addictions to foods, caffeine, alcohol, nicotine increase. Many of these responses are due to alteration of mast cells that protect the olfactory-limbic (nose to brain) pathway, our airways, and digestive tracts.

Only by understanding mast cells and TILT can many of these adverse outcomes be prevented and treated.

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