8/23/2026
This is the 10th piece in my series about Eric Topol's book, Super Agers: An Evidence-Based Approach to Longevity.
Environmental Toxins
So far, I have mostly focused on things we can control—what we eat, how much we exercise, how well we sleep, and when we eat. This section takes a different perspective: the environment around us can also have a profound impact on our health.
1. Air pollution is a major global health threat
Particulate matter (PM)—especially fine particles such as PM2.5 and PM10—along with nitrogen dioxide and ozone, contributes substantially to premature death and disease.
Topol cites evidence that short-term exposure to fine PM is associated with about one million deaths worldwide each year. There is also no clearly established safe threshold for the long-term cardiovascular effects of PM2.5.
Chronic exposure to fine PM has been associated with roughly 20% of type 2 diabetes cases. Air pollution can affect multiple organ systems through inflammation, oxidative stress, immune dysfunction, and changes that promote blood clotting. It has been associated with cardiovascular and respiratory disease, lung cancer, cognitive decline, and even a weaker immune response to vaccination.
Outdoor air pollution is estimated to contribute to more than 8 million premature deaths each year. Climate change, wildfires, and extreme heat are making the problem even worse.
2. Indoor and residential environmental toxins also threaten health
Some important risks are much closer to home:
Secondhand smoke is associated with heart disease, stroke, type 2 diabetes, asthma, and breast cancer.
Radon, an odorless radioactive gas, increases the risk of lung cancer, particularly among nonsmokers. Yet most American homes have never been tested for radon.
Pesticides have been associated with various cancers, diabetes, Parkinson's disease, cognitive impairment, reproductive problems, and other health conditions. However, Topol notes that the evidence for some of these associations is supportive rather than definitive.
3. Noise pollution affects more than our hearing
Chronic noise pollution—particularly at night can increase stress hormones and inflammation and is associated with high blood pressure, heart disease, and type 2 diabetes.
Topol notes that about 100 million Americans are exposed to continuous daily noise levels above 70 decibels.
4. Microplastics and nanoplastics are becoming a major concern
This may be one of the most disturbing parts of the chapter.
Plastic production has increased enormously, and microplastics and nanoplastics have become widespread in our food, water, and air. They have now been detected in many parts of the human body, including arteries, blood clots, the brain, liver, lungs, intestines, placenta, and testes.
In one study of patients undergoing carotid artery surgery, microplastics were found in arterial plaques. Their presence was associated with greater arterial inflammation and a more than fourfold higher risk of heart attack, stroke, or death during three years of follow-up.
Other studies have reported associations between microplastic exposure and lower sperm counts, inflammatory bowel disease, asthma, cancer, cognitive decline, infertility, and adverse pregnancy outcomes.
The important word here is "associated." Much of this research is still emerging, and the presence of microplastics does not by itself prove that they caused these diseases.
Topol suggests some practical ways to reduce exposure: avoid storing food in plastic containers when possible, limit buying fast food, use glass or stainless-steel water bottles, and choose wooden or metal kitchen utensils.
5. PFAS: the "forever chemicals"
PFAS are synthetic chemicals with extremely strong chemical bonds that allow them to persist in the environment for a very long time.
They are widespread in drinking water and consumer products, and almost all Americans have measurable PFAS in their blood.
High exposure has been associated with kidney and testicular cancer, high blood pressure, pregnancy complications, high cholesterol, and damage to the liver, brain, thyroid, and immune system.
PFAS can be found in a surprisingly wide range of products, including nonstick cookware, fast-food packaging, clothing, carpets, dental floss, and some plastic bags.
There are tens of thousands of different PFAS compounds, while regulatory standards currently cover only a small number of them.
6. Other environmental exposures
Topol also raises concerns about unnecessary exposure to ionizing radiation, including from CT and nuclear imaging, because cumulative exposure may increase cancer risk.
He also discusses metals such as cadmium, tungsten, uranium, cobalt, copper, and zinc. Higher levels of these metals were associated with increased cardiovascular events and all-cause mortality in a large prospective study.
7. The bigger picture
Topol's larger message is that healthy aging is not determined solely by our personal lifestyle choices.
We can eat well, exercise, sleep adequately, and maintain a healthy weight, yet we are still exposed to pollutants and chemicals in the air we breathe, the water we drink, the food we eat, and the products we use every day.
These environmental exposures may add to the health risks already associated with poor diet and other lifestyle factors. Topol even raises the possibility that environmental factors may contribute to the concerning rise in certain cancers among younger adults, although that remains an area for further research.
The takeaway
We cannot eliminate every environmental toxin from our lives. But we can become more aware of them and make sensible choices to reduce unnecessary exposure.
