The second domain, environmental pollutants, encompasses exposures that might bring about chronic conditions or exacerbate these conditions. We include in this domain air, water, and other toxic pollutants. For example, repeated exposure to toxic waste sites may result in malignancies later in life (American Cancer Society, 2002), which in turn may lead to functional decline (Teno et al., 2001; Michael et al., 2000). Thus, exposure to water contamination or toxic wastes is likely to affect health status, particularly though cumulated effects in the lifecourse. Similarly, air pollution may make it difficult for someone with chronic obstructive pulmonary disease to climb.
