In medical training, we are taught how to take a social history. Who do you live with? What do you do for work? Do you smoke? Do you drink? Do you use drugs?
These questions are meant to tell us about a person’s risks. But no one taught me to ask a question that now seems embarrassingly obvious, given that we spend about 90 percent of our time indoors: What kind of environment are you living in?
We are trained to think of health as something that happens largely inside the body. Organs malfunction, hormones shift, and cells mutate. We search for pathology in blood and on scans. Sometimes that is exactly where the answer is, but not always.
What enters the lungs matters—hence the typical “Do you smoke?” question. But many of us spend almost all of our time breathing the air of homes, offices, schools, hospitals, barracks, dormitories, and apartment buildings. We assume these spaces are neutral backdrops to our lives, when in fact they are active participants.
