YET EVEN a jeepney driver who religiously keeps his vehicle in tiptop shape may not be free from falling sick from inhaling air that is heavily polluted by fumes from smoke-belching cars, trucks, motorcycles, and yes, jeeps. Neither would a well-conditioned athlete, apparently. Just recently, officials of the 2008 Olympic Summer Games that will be held in Beijing voiced their worries over what could happen to athletes who would be competing while breathing in the toxic air in the Chinese capital. One of the costs of China’s new prosperity is air pollution, brought about not only by its multiplying factories and coal-fired plants, but also by its citizens’ growing fondness for cars and more cars.

It’s a problem that is certainly not unfamiliar to Filipinos, many of whom now have respiratory ailments because of the deteriorating air quality of our cities and towns. But it’s not only the air that we have managed to poison; industrial and household waste — some of which contain chemicals that are carcinogenic — have turned our seas, rivers, and lakes into toxic soups. This raises the risks that the fish, clams, and crabs that we put on our dinner tables could well send us to the hospital.

There is no doubt that we are part of the reason why new forms of poisoning are emerging at an ever-increasing pace. That’s the bad news. The worse news is that the Philippines has been slow in producing the human and technical resources needed to address the multiplying problems of poisoning. In a country where doctors are willing to retrain as nurses just so they can work abroad, the field of toxicology is unattractive from an economic perspective even when compared to other medical specialties. Analytical laboratory systems are also poorly developed, and the few labs that exist could use regular quality-control checks. Not surprisingly, problems of toxicology are approached in a reactive, instead of a preventive, manner. Local toxicology research has also lagged behind those on other health issues.

There is weak government incentive to invest in toxicology because it is perceived to be a low priority when compared to other public-health problems in a resource-poor country. The number of local toxicology cases is supposedly small; even the pharmaceutical industry, in fact, has been reluctant to invest in service-item, yet “orphan” drugs that are used to treat many cases of poisoning. As a result, access to antidotes is low — that is, if these are available at all.

For instance, we used to have antidotes for the envenomation from cobras, which can paralyze their victims, the most common of whom include soldiers, forest rangers, agricultural workers, and golf caddies. Today we are often short of these life-saving antidotes, and that is due most probably to the drug industry’s assessment that producing these would just result in a poor return of investment. The Research Institute of Tropical Medicine (RITM) does produce some 5,000 vials of cobra antivenom a year, but it usually runs out of stock after a few months.

The statistics on toxicology cases, however, may be grossly inaccurate, given the lack of hospital resources and expertise to deal with these. Since the figures count only the cases attended to, it leaves out those that were sent elsewhere for some reason or another, or those that were misdiagnosed altogether. Excluded, too, are poison victims who failed to get medical help on time and those who opted not to seek help at all.

For sure toxicologists need to be communicators in their community and to be always on the ready to provide their services — whether or not these are appreciated. We need to explain to people the role of toxicology in our everyday lives. But we also need to emphasize that toxicology is a shared responsibility of the government, industry, and the sciences. The current lack of coordination and the seemingly neglected investment on toxicology has only placed us unnecessarily in harm’s way.

Dr. Kenneth Hartigan-Go is a medical toxicologist who is connected with the Ateneo School of Medicine and Public Health and Medical City. For more information about poisons, contact the National Poisons Center at telephone number 524-1078 or write to the Philippine Society of Clinical and Occupational Toxicology, Inc., c/o NPCMC Ward 14-A, Philippine General Hospital, Taft Ave. Manila.