Common chronic conditions include cardiovascular and cerebrovascular disease, cancer, diabetes, metabolic syndrome, and obesity, neurocognitive disorders, and immune dysfunction such as autoimmune disease. These are leading causes of morbidity and mortality in developed countries, and are increasingly prevalent in developing nations [1
While average life spans lengthened through recent history, rising rates of noncommunicable chronic diseases in younger people mean that escalating numbers are spending an increasing proportion of their life coping with sickness, rather than enjoying health [4
]. Indeed, chronic diseases associated with obesity may even turn the tide of improvements in average lifespans [5
], previously gained from diverse advancements in public health and medicine such as in maternal and neonatal care and improvements in management of infectious diseases, trauma, and cardiovascular events.
Chronic disease is crippling some economies as countries struggle to develop [3
] in the face of rising healthcare costs, pervasive individual suffering, beleaguered families caring for afflicted loved ones, and truncated opportunities as workers fall ill during what should be their most productive years.
It was recently conservatively estimated that costs in the United States of environmental disease in children alone amounted to a staggering $76.6 billion in 2008, just from “lead poisoning, prenatal methylmercury exposure, childhood cancer, asthma, intellectual disability, autism, and attention deficit hyperactivity disorder” [6
]. The wide-spread implications are vividly illustrated by considering neurocognitive disorders, with a small IQ decrement across society. As abilities and intellect are reduced among the best and brightest, we lose potential leaders and innovators, while simultaneously costs mount for continuing care needed by larger numbers at the bottom end of the IQ and abilities spectrum [7
Searching for reasons for increased chronic diseases in the young, their ailments cannot be ascribed to reduced mortality from infectious disease. Similarly, genetics may predispose individuals to chronic disease, but this cannot account for rapidly increasing prevalence within a generation or two. This leaves us with pervasive environmental factors [1
]. While research centers and international health organizations devote considerable time and attention to the issue of toxicant exposure and bioaccumulation of xenobiotics within the human body [8
], direct connections to prevalent chronic disease are rarely made, and initiatives to tackle chronic disease may not even mention environmental or occupational exposures to toxicants, as was the case for a 2010 report prepared for the World Health Organization, “Tackling Chronic Disease in Europe” [9
Other prominent authorities such as the U.S. President's Cancer Panel decry that chemical assessment, regulation, and enforcement are woefully inadequate to protect public health and that environmental and occupational exposures are rarely suspected or queried in the differential diagnosis of disease [10
In this paper we provide a brief overview of toxicants and associated mechanisms that may be contributing to chronic disease, discuss how links between toxic exposures and adverse outcomes are explored and regulated, and outline measures that may be adopted by health care practitioners and individuals to improve health. These measures include reducing exposures, counteracting effects, and enhancing metabolism and excretion of toxicants.