Adding money to a poorly functioning system is irresponsible. It’s better to examine why we have so many patients and whether they are actually receiving the best care, or what has been left undone. Where is the root cause? I can’t claim to have any new ideas when the field has been addressed in several reports and development plans, but these have not been implemented or even acknowledged. Therefore, I can only point out that in Estonia, people are not protected from products made of toxic chemicals, such as various petrochemical preparations that contain carcinogenic, neurotoxic, endocrine-disrupting chemicals, etc., which are the actual causes of the diseases that have proliferated here.

The consequences are now evident, but the causes are still not recognized because many necessary actions, which have been outlined in Estonia’s Human Development Reports and in current health development plans such as the “Population Health Development Plan 2020–2030” and the “Cancer Prevention Action Plan 2021–2030,” have not been implemented. However, these have been omitted from the “Health Insurance Fund Development Plan 2022–2025,” meaning that these activities are not being funded and are not taking place.

The following needs to be done:

1. Establish limits for indoor air pollutants.
2. Measure indoor air quality along with identifying pollution sources.
3. Supervise product safety.
4. Conduct biomonitoring.
5. Adapt medical care to take all of the above into account

INDOOR AIR POLLUTANT LIMITS – In 2015, the Center for Environmental Health Studies funded and published a study titled “Indoor Air Pollutant Limits in Various European Countries.” The study lists the main indoor air pollutants and their health effects. Chapter 5 also provides recommendations for Estonia. I understand that these have not yet been implemented, and there are still no regulatory limits for pollutants in Estonia. The standards for workspaces are surprisingly lenient and differ significantly from WHO recommendations.

INDOOR AIR QUALITY MEASUREMENT – People’s homes have become very harmful environments for health. The current state of the country is reviewed in the “Estonian Human Development Report 2023” Chapter 5: Physical Environment and Mental Well-Being, 5.2 Disruption Due to Air and Noise Pollution, page 313:

Environmental pollution causes people distress and mental health deterioration. Air pollution is the most significant environmental risk to our health. In Estonia, outdoor air quality is generally good. Problems arise in cities where there are many pollution sources and people who come into contact with them. The report on the impact of outdoor air on the health of Estonians focuses on particulate matter, especially fine particles, which most affect mental health in air pollution (Orru et al., 2022). Although the number of fine particles in the air in Estonia has decreased over the last decade, there is no reason for complacency.

Today, the impact of indoor air quality on mental health is unknown because it has not been studied from the standpoint of pollution sources. Numerous case studies from abroad suggest that this connection exists, although this topic has not been sufficiently studied internationally to draw conclusive conclusions.

Environmental pollution affects mental well-being and health. Assessing the health effects of nitrates and glyphosates is currently a complex problem. There are few studies linking the effects of pesticides on mental health, and this field is not addressed in Estonia. Since the impact on the human microbiome is known and, in turn, affects mental health, scientific debate should be closely monitored.

As humans, we depend on the environment in which we live. The cleaner, more natural, and more environmentally friendly the living environment, the stronger the society’s mental resilience.
In other words, the health damages caused by air pollution are known, but not that the elephant is actually indoors, and indoor air quality is not being sufficiently addressed in Estonia. Although it is possible to order an expensive air quality measurement, it does not identify the pollution sources so that they can be removed from the room, as even the best ventilation system cannot ventilate them out if the supply is constant. In fact, the field has been studied, but it seems that the report’s author has not sought answers.

PRODUCT SAFETY SUPERVISION – Product safety supervision is clearly regulated and divided between various agencies by the “Product Conformity Act.” In this area, the Director-General of the Health Board should currently investigate why product safety supervision is not functioning as it should and make the necessary reorganizations. We hope that in the future, product safety supervision will proceed according to existing laws. If we lack the relevant laboratory, it needs to be established. If we know what toxins people are exposed to, we can also look for the same substances in the patient’s body to remove them most effectively.

BIOMONITORING – Already in the “Estonian Human Development Report 2009” Chapter 2.6 Environmental Factors and Public Health, it was mentioned that Estonia should join the biomonitoring network launched in the European Union on 1.12.2009. WHO’s “Health for the 21st Century” strategy aimed for all people in the European region to live in a safer environment by 2015. However, things went differently for us, and the results are now here.

The HBM4EU (Human Biomonitoring for Europe) project took place from 2017 to 2021. It was a five-year initiative focused on assessing Europeans’ exposure to chemicals and their health effects, as well as developing methods for human biomonitoring. Why didn’t Estonia participate? It cannot be said that there was no money—the project was funded with 74 million euros from the Horizon 2020 program through the European Commission.

Its follow-up project, “The Partnership for the Assessment of Risks from Chemicals (PARC),” continues the work of HBM4EU, strengthening the scientific basis for chemical risk assessment and facilitating the EU’s transition to next-generation evidence-based risk assessment. Is it possible for Estonia to join this phase?

CHANGES IN MEDICAL CARE –  Since toxins in consumer products are not considered as disease-causing agents alongside alcohol and tobacco, doctors are unable to adequately diagnose diseases caused by them. In most cases, doctors do not know why a person has become ill and don’t even ask this question but instead focus on symptoms. Toxins do not initially disrupt blood test results, only after damage has reached the endocrine system, such as the thyroid, or diabetes has developed. As a result, many people feel unwell, suffer from pain, but the doctor says there is nothing wrong with them because the tests are normal—no diagnosis or treatment is provided. These patients have gathered in social media public health groups, where they seek help from others’ experiences because the doctor does not know, cannot help, or the proposed treatment does not work or is even intolerable.
At the same time, while the European Union has initiated the process of banning so-called eternal toxins, a doctor in Estonia says that poison is not toxic to humans because it has not been proven. Practice shows that doctors are unaware of what biomonitoring means, how asthma, allergies, autoimmune diseases, and cancer develop. The common belief is that diseases are normal, especially for older people. For a young doctor, even a 45-year-old is considered elderly. A rheumatologist thinks that crooked fingers are a completely normal part of aging and that the immune system attacks the body because it is bored. A gastroenterologist does not have the term microbiome in their vocabulary and is convinced that volatile organic compounds do not harm human health. For a psychiatrist, no other diseases exist—people make them up, and they prescribe antidepressants because there are so many problems in the world, without conducting any tests. Unfortunately, this is not a humor column, but a few excerpts from actual conversations in a doctor’s office.

The medical system and doctors are satisfied with themselves and are asking for more money. Criticizing them is frowned upon and even dangerous. When something is so self-satisfied, there is no hope for progress. As we can see, the current crisis has specific causes, which are not due to a lack of money but unfinished work. Feeding this system with 150 million euros next year is neither sensible nor necessary and will double the deficit for the following year. Something needs to be done differently. By eliminating toxins from the living environment, a large number of illnesses will be prevented, and the symptoms of chronic poisoning will disappear immediately, and if the damage is not yet irreversible, it is possible to recover from a previously incurable chronic disease. After successful cancer treatment, there is only hope that the disease will not return if carcinogenic toxins have been removed from the patient’s living environment. This mindset is self-evident regarding alcohol but is unknown when it comes to environmental toxin damage. Alcohol is just one toxic product, but a similar hangover can be obtained by morning from a polyurethane foam mattress and pillow. Several such examples have already made it into the media.

Medicine must become entirely functional. Treatment must begin with identifying the cause of the disease, eliminating it, and, if necessary, supporting the body successfully with natural remedies, which do not have side effects similar to medications. Functional medicine is purely evidence-based, and it is already available in Estonia, but the Health Insurance Fund does not support it. Why? Why has it been decided for us that only drug-based medicine is legal? Why don’t we have a choice? Medications have already become a separate stream of pollution flowing into the sewage system. Statistics and studies have shown that in the US, medications are the number one cause of death. Do we have the same goal in mind, or do we still want to become the healthiest nation in the world?