Make The Connection:
Health & Environment

20 Provocative Questions and Thier Answers
Andrea DesJardins
© 2001, All rights reserved. This article may be printed for personal use. All other uses must retain this copyright notice, a link to our website (/index.html), and must not be reprinted for sale.

If you suffer from chronic headaches, migraines, asthma, allergies, chronic sinus stuffiness, joint pain, chronic fatigue, or any of a number of other vague symptoms and your doctor can not find a medical cause, your environment may be the culprit. Homes, schools, workplaces, and shopping centers -- virtually any indoor environment -- can harbor chemical and biological pollutants that can lead to chronic health complaints. Understanding your environment and the factors that can lead to symptoms can be your first step toward living a healthier life.

The purpose of this Question and Answer document is not to alarm, but to provoke reflection about the impact our personal choices can have on our own health and well being, as well as the health and well being of our families, friends and neighbors. In other words, to help you make the connection between your health and your environment.

Reducing the toxins in our environment requires a shift in the way we view our environment and our choices. Hopefully this document will help you to begin to think differently about the products you use and how you use them. For many people, completely removing toxins from your environment may be unrealistic, but any reduction, even a small one, is an improvement. In time you may find that reducing the use of environmentally unfriendly products is easier than you thought.

  1. Can you explain what you mean by "environment'?
  2. What symptoms are related to environmental exposures?
  3. Who is adversely affected by environmental exposures?
  4. What products are considered harmful?
  5. Where would I find these substances?
  6. Of the products listed, which are of greatest concern?
  7. When am I exposed?
  8. How am I exposed to harmful substances?
  9. How much of a product must I be exposed to before it is harmful to me?
  10. How can I find out what is in the products I use?
  11. Why should I care if an occasional product I use has toxic ingredients?
  12. Don't I have a right to choose whether or not I use these products?
  13. If I use a product that has a carcinogenic chemical in it, does this mean I will get cancer?
  14. If I use a product that is toxic but not carcinogenic, will the effect last beyond the time that I'm actually using the product?
  15. Are the ingredients in personal care products harmful to me?
  16. How do I find out if household and personal care products cause my symptoms?
  17. If these products are really harmful to health, why are manufacturers allowed to sell them?
  18. I really like wearing fragrances, why should I give it up?
  19. Why do I need to use unscented products?
  20. How can I prove that I can't work around fragrances?

Q: Can you explain what you mean by "environment'?

The term 'environment' is generally understood to refer to the world around us. Common usage of the term has come to mean the soil, water, flora, fauna and air that makes up our planet, but the true definition actually includes our personal spaces as well. When we think of environmental pollution we usually think of water or air pollution outside of our homes, but it also includes the air inside our homes and other indoor locations as well.


Q: What symptoms are related to environmental exposures?

There are many symptoms that may be related to environmental pollution created by the frequent use of certain types of consumer products. These symptoms are rarely life threatening, but many are annoying and may in time lead to a decreased level of functioning and decreased quality of life. Some evidence even suggests that long-term exposures to certain pollutants may actually lead to permanent health consequences and even disability.

Examples of symptoms that can be caused by use of consumer products include headache, asthma or other breathing difficulties, fatigue, dizziness, numbness and tingling, inability to concentrate, allergies, pain, sinus problems, and frequent infections, to name a few. The variety of symptoms can be so diverse that virtually any symptom that can not be attributed to organic disease may have its root in an environmental factor of some sort. There is no definitive list, nor standard array of symptoms, and diagnosis is often a matter of trial and error.

The problem is that the longer these symptoms are ignored, the more likely they will escalate to a level where the symptoms are persistent, even in the absence of obvious exposures.


Q: Who is adversely affected by environmental exposures?

Given a great enough exposure to a substance, anybody is at risk for developing symptoms. The young are particularly vulnerable because their central nervous systems, liver, kidneys and other organs are still developing, making them more susceptible to the toxic effects of chemicals found in many consumer products. People with compromised immune systems, sensitive nervous systems, allergies and other disorders are also more susceptible, but nobody is completely immune.


Q: What products are considered harmful?

There are many products around the home that may contain ingredients that have the potential to cause harm. These include:

Not every product in every category has potentially harmful ingredients, but many do.


Q: Where would I find these substances?

All of these products can be purchased for use in and around the home, but many are also used around workplaces and other public places so they are virtually ubiquitous. Away from the home, exposures to cleaning products and pesticides are the most common.


Q: Of the products listed, which are of greatest concern?

Of all the products listed, pesticides and cleaning products containing glycol ethers are of greatest concern, but all of the listed products are of concern. Pesticides are of greatest concern because they have been documented in many cases to cause neurological and organ damage, and many people may be exposed to them without knowing it. This is especially troubling now that odor masking agents are being added to pesticides so the tell-tale odor of recent pesticide applications is not longer a reliable warning. Products containing glycol ethers are of concern because they are common to many cleaning products and glycol ethers have been shown to be far more damaging to the central nervous system than previously believed.


Q: When am I exposed?

Virtually every indoor environment can lead to an exposure. All public places are cleaned with surface cleaning agents, and often fragrances are used to deodorize or scent the air. Many public places are also frequently treated with pesticides.

In our homes there are many consumer products that we use everyday that contain chemicals that may potentially be harmful to our health. These products include household cleaners, household furnishings (i.e. fabric finishes, formaldehyde in particle board, etc.), pesticides, deodorizers, arts and crafts supplies, home maintenance supplies (paints, stains, etc.), and even our personal care products such as shampoo, hair spray and perfume. Some of these products we already know the dangers of, but some products we presume are safe when in reality they may not be.


Q: How am I exposed to harmful substances?

When these products are used they can enter the body by several different means: by inhalation, by absorption through skin, eyes and mucous membranes, and through ingestion. Many of the products we use evaporate into the air we breathe, and in some cases small droplets of the product may settle on surfaces throughout the home. Those droplets may either evaporate into the air or come in contact with skin when the surface is touched, so exposure may occur even after the product is no longer being used.

The lack of knowledge about the products that we use is further complicated by the complacency we feel toward warning labels. In this litigation-happy age we have begun to view warning labels as a manufacturer's way of covering their backsides against lawsuits rather than as legitimate warnings against adverse health effects of the products we use. Further, warning labels may not adequately cover all potential health effects, so they may not adequately convey the actual risk associated with the frequent use of a product.


Q: How much of a product must I be exposed to before it is harmful to me?

This is a question for which there is no concrete answer. There are several issues that must be addressed at this point: 1) the cumulative effect of exposures to multiple products; and 2) the threshold at which any given individual will experience adverse health effects.

First, we use so many different products in our homes and have so many different sources of exposures that looking at any one source will not give an accurate picture. It is one thing if we were only exposed to one product, but that is never the case. When a manufacturer claims that their product is safe when used as directed they are not taking into account the fact that the consumer might be using other similar products at the same time. It is possible that when a consumer uses multiple products with similar ingredients that the cumulative exposure may exceed safety limits. And that is assuming that all products are used as intended by the manufacturer.

Further, products used inside the home enter the air in the home, and unless there is a great deal of outside air entering the building, the chemicals can remain in the air long after the product is no longer being used. Additionally, porous surfaces such as carpeting, draperies, bedding, upholstery, and even walls can absorb chemicals and slowly release them back into the air over time. If the product is used often the concentrations of the chemicals in the indoor air can increase and the people living in the home will be continually exposed. When multiple products are used in the home then the concentrations of indoor air pollutants can rapidly accumulate, and the people living in the home may not even be aware how high the concentration has become.

As an example of how persistent household chemicals can be, one study found high levels of the pesticide chlorpyrifos in carpeting and other furnishings, including children's toys, more than 10 years after the last time the product was used in the home!

One factor that makes it difficult to predict the effect of environmental exposures is the fact that people all react differently to chemical exposures. Some people are capable of being exposed to seemingly high levels of a pollutant and not have any obvious ill effects, while others may immediately begin to exhibit symptoms of exposure. More often people might have a strong reaction to one pollutant, but little or no reaction to others.

Another complication is that previously healthy people may experience a single sensitizing event that changes the way they respond to environmental exposures. Or they may have several different exposures at the same time that in combination cause an adverse response that would not have otherwise occurred. The most common example of this is a concurrent exposure to a pesticide and another irritating product. Pesticides have a tendency to alter how the liver, the primary organ for decontaminating the body, processes chemicals in the bloodstream. When this decontamination process is altered then environmental chemicals that have made their way into the bloodstream may not be removed quickly enough to avoid some sort of toxic effect.

One reason may differ in their ability to process environmental pollutants lies in genetics. People vary in their body's ability to detoxify chemicals in their environment. Once a chemical enters the body, some people can rapidly metabolize and excrete the chemical, minimizing the potential harm that can be wrought. On the other hand, some people might not be able to metabolize the chemicals as quickly, so the chemical may either begin to accumulate in their body, or at the very least remain in the blood long enough to be able to exert its toxic effect. Other people may have underlying health conditions that make them more susceptible to the toxic effects of chemicals. In other words, there is a great variation in the population regarding the ability to withstand chemical exposures, but this variation is generally not taken into consideration when the potential health effects of a product are being weighed.

Therefore, with these considerations in mind, it is impossible to say how much of a product is safe to use in any given situation. Unfortunately, these variables are not worked into the equation when a company creates a product formulation that contains even a small amount of a toxic chemical.


Q: How can I find out what is in the products I use?

Finding out what is in a product depends upon what the product is. All personal care products are required by law to list their ingredients on the label, so it is relatively easy to read the labels and select products that are more healthful. Unfortunately, the labeling laws do not cover any other consumer product, so finding out what is in your favorite cleaner may be, at best, difficult.

The first step in trying to identify the ingredients in a product involves calling the manufacturer and requesting a Material Safety Data Sheet (MSDS). This is a document that has been prepared in the event that there is a fire or spill involving a large quantity of this product. It contains information vital for firefighters and rescue personnel, and is supposed to include the chemical names of any ingredient for which there are regulatory standards of exposure. Unfortunately, there is a loophole in the law that allows manufacturers to claim ingredients as proprietary so long as the health and safety data is correct, so there is no guarantee that an MSDS will actually list any or all of the ingredients.

The second problem is that not every chemical used in household products has a regulatory standard associated with it. In fact, less than 1,000 of the more than 80,000 chemicals used by industry actually have regulatory standards, and little is often known about the actual toxicity of the remaining chemicals.

If an MSDS does not list the ingredients then there is little a consumer can do to become informed about the products they use. There are no laws requiring manufacturers to divulge their ingredients to consumers, and even physicians treating cases of poisoning might have some difficulty in obtaining the information.


Q: If I don't use a particular product very often and I take care to air my house out afterwards, why should I care if an occasional product I use has toxic ingredients?

Scientists are just beginning to understand the potential health effects associated with low-dose exposures to common household chemicals. It is still unclear whether such exposures can actually cause an otherwise healthy person to develop symptoms of chemical toxicity, or whether the exposures aggravate an undiagnosed underlying susceptibility to the effects of chemicals. People with allergies, asthma, migraine headaches, depression and associated disorders, and autoimmune disorders may be particularly sensitive to the toxic effects of chemicals because of the alterations in body chemistry caused by these disorders.

Currently accepted science holds that short-term exposures to known toxins are not harmful, period. However, there is ample evidence to indicate that caution may be warranted because current research methods rely on certain assumptions that may not be valid. Since for many years toxicology studies focussed only on whether or not a chemical caused cancer, science simply has not unraveled all of the mysteries surrounding the human body and chemical exposures. Furthermore, many symptoms do not have biomarkers--or objective evidence of their presence through blood or other analysis--so it is impossible to know if the animals subjected to the toxicology tests actually suffered symptoms such as headache or other neurological symptoms that we tend to associate with low-dose exposures.

It is also unknown whether repeated exposures to low doses of chemicals can cause permanent changes to the body. We do know that alcoholics can develop both acute symptoms of alcohol consumption, as well as long-term changes to the liver and digestive systems. We also know that repeated high-dose exposures (i.e. occupational) to neurotoxins can cause permanent changes to nerve tissue. Without lifetime studies of the effect of common chemicals on the body it is hard to argue that repeated low-dose exposures to toxic chemicals . even when the exposures are punctuated by periods of no exposure . can not have some health effect, even if it is just a subtle one. In the absence of hard data the only prudent action is one of avoidance whenever possible.


Q: But don't I have a right to choose whether or not I use these products? It's not like I'm forcing them on anyone else!

Even if you are not convinced that your personal use of a product is harmful for your health, the collective consumer demand for chemicals can have an impact on the lives of many people.

Many of the chemicals we use in common consumer products are known to be toxic, if not in the home setting then most definitely in the occupational setting. When consumers purchase products containing toxic ingredients they create a demand for the manufacture of toxic chemicals. While one product may only contain a small amount of a toxic chemical, thousands of pounds of that chemical must be made so that it can be used by the manufacturer in the formulation of that consumer product. This means that hundreds, if not thousands of workers are exposed to concentrated levels of these toxic chemicals, and thus their risk for health effects is increased.

In the home, whenever a product containing a toxic chemical is used, the product contributes to air pollution. This can be a particular problem indoors where the concentration of air pollutants may be as much as 10 times higher than outdoor air. Further, if a person uses several products containing toxic chemicals then their exposure, as well as the likelihood for toxic effects, is increased.

Finally, for products that are used and then rinsed down the sewer system, the cumulative effects of the contribution from all households can be quite pronounced. One person using scented shampoo that enters the sewage system might not have much of an impact, but thousands of people using scented shampoo can result in measurable concentrations of chemicals, particularly fragrance chemicals, in the sewage system. This cumulative contribution puts more of a demand on municipal wastewater treatment plants, and increases the likelihood that pollutants may escape into local aquifers and waterways.

If nothing else, we have to remember that when it comes to consumer products, the choices we make can have consequences extending far beyond ourselves.


Q: If I use a product that has a carcinogenic chemical in it, does this mean I will get cancer?

It is extremely rare that a single, or even multiple exposures to a carcinogenic chemical will by itself result in cancer. While cancer is a scary and life threatening disease, it is not a simple one to acquire. Years of toxicological research have underscored that the primary cause of cancer involves cumulative lifetime exposure to multiple carcinogenic compounds, plus age and heredity. This is even true in the case of childhood cancers, where genetics and in-utero exposures are believed to play a significant role. While it can be frightening to realize that you might have been unknowingly exposed to a carcinogenic chemical, it isn't worth panicking over. The best course of action is to simply remove the source of the exposure.

Q: If I use a product that is toxic but not carcinogenic, will the effect last beyond the time that I'm actually using the product?

At the current level of knowledge, it is virtually impossible to say whether or not symptoms elicited during short-term exposures will result in long-term damage. Symptoms of overexposure are the body's way of attempting to prevent overt poisoning by causing a person to stop an exposure before too much damage can occur. Unfortunately, repeated exposures to toxic chemicals may cause this protective mechanism to malfunction, thus putting the individual at greater risk for harm.

An example of this mechanism, and how it can be overwhelmed, is the sense of smell. Smell was originally developed as an early warning system, where foul smelling odors caused the body to be repelled, thus removing the body from the hazardous situation. However, upon repeated exposures to the same toxin, the sense of smell can be overwhelmed, and eventually lost, while the toxic effects remain unchanged. So for example, if a person moves to an area where water has a high sulfur content, they might notice a strong sulfur odor in their water at first, but they will soon find that they don't smell it at all. Meanwhile, a visitor to the area might smell the sulfur and not overcome their repulsion to it during the length of their stay. The same goes with fragrances& the longer a person uses the same fragrance, the greater the likelihood that they won't be able to smell it on themselves at all, which leads to an increase in the use of a favorite fragrance over time that is often noticeable to others.

Since symptoms like headache, nausea, mental "fogginess," fatigue etc. can all be indicators of toxic exposures, it is hard to ignore the possibility that the repeated eliciting of such symptoms by the use of household chemicals may indeed lead to long-term adverse health consequences. Since there are so many diseases for which we do not understand the cause, we can't say for certain that these diseases don't have past chemical exposures as a contributing factor. In the absence of indisputable evidence to the contrary it may be best to work under the assumption that there may indeed be long-term health effects.

Further, Some products don't cause cancer, but can cause changes in genetic material or affect a developing fetus. Not every adverse effect will have a physical symptom associated with it.


Q: Are the ingredients in personal care products harmful to me, and if not, why should I read labels or even care what is in the products I use?

Chemicals are studied for their health effects independently of other ingredients with which they might be mixed, so any information on health effects will not account for synergistic, or combined, effects. Product formulations are generally not required to be studied for their health effects, so having a long list of 'safe' ingredients on the label does not necessarily represent the relative safety of the product itself. Therefore, the greater the number of ingredients in a product, the greater the likelihood for synergistic effects, even if none of the ingredients are particularly harmful on their own. When one is presented with many options, it is almost always best to select the product with the fewest ingredients to minimize the potential for synergistic effects.

Further, it is virtually impossible for the average consumer to be able to remember the names and health effects of various chemical ingredients, so the fewer the ingredients the less likely that a harmful ingredient will be missed.

Finally, some products still contain ingredients that are known to be harmful because nobody has banned these ingredients from use in personal care products. For example, research has shown that chemicals with the letters DEA (i.e. cocamide DEA, Lauramide DEA, etc.) or the word . diethanolamine. as part of the name are carcinogens. However, in the time since that information was made public in March 1998, few companies have removed it from their formulations, and no regulatory action has been taken to prevent its use in consumer products.


Q: How do I find out if household and personal care products cause my symptoms?

First you want to make sure that your symptoms are not being caused by carbon monoxide build-up in your home. Second, you want to also evaluate other sources of pollutants such as auto exhaust, industrial pollutants, wood smoke, etc. Finally you need to eliminate the possibility that mold and other household allergens are the cause.

Once you have eliminated other possibilities, the only way you can find out if your nasal stuffiness, headaches, lethargy or any number of other vague symptoms are caused by household and personal care products is to completely remove them from your environment. This includes ALL personal care products that are scented or contain alcohol, as well as all surface cleaning products (glass cleaner, all purpose cleaners, etc.), all scented laundry products, and all air, fabric or carpet fresheners, disinfectants and deodorizers. It may still take several months to notice a difference as it can take a long time for fragrances to wear off, be washed out of your clothing, and for your body to rid itself of the excess chemicals that have accumulated over your lifetime. It will take a while for your nose to regain the ability to smell low levels of scent, but when it does you will smell things you may have never smelled before. Eventually, if these products are indeed causing your symptoms, you will come to notice two things: 1) you feel better when you are in your home and not surrounded by products containing irritants and fragrances; and 2) you will notice a marked difference in how you feel when you are exposed to products containing irritants and fragrances.

Depending on what sacrifices you are willing to make you can do things to further detoxify your environment (i.e. reduce your dependence on commercial products even more), or you can stick to using unscented and environmentally responsible products and be happy that you are feeling better.


Q: If these products are really harmful to health, why are manufacturers allowed to sell them?

One of the biggest myths of the consumer world is that anything that can be purchased over the counter must be safe for consumers to use. This couldn't be further from the truth. Take one look at the products available and you will see that many of them carry warning labels that indicate there might be health or safety risks associated with that product. Many other products do not carry any warnings at all if they are not considered primary irritants, flammable, explosive, corrosive or overt poisons. Further, many consumers ignore these warnings or do not even read them at all.

While manufacturers don't intend for their products to be harmful, there are very few regulations that cover the ingredients used in common consumer products. In many cases, when a chemical ingredient is found to be hazardous, or even carcinogenic, it may take years before manufacturers are required to even begin phasing out that ingredient. In the meantime, an unwary public continues to be exposed to a potentially hazardous substance.

While the FDA is the regulatory authority over cosmetic products (which covers products such as shampoos, lotions, soaps and cosmetics), there is very little oversight of cosmetics manufacturers, and no requirement for manufacturers to prove that their products are safe. In fact, the FDA won't even investigate consumer complaints about cosmetic products unless they receive in a short period of time a large number of complaints that can be documented by medical evidence.

Consumers really have to be their own watchdogs when it comes to the safety of the products we bring into our homes. When a product has a safer alternative that is just as effective, we have a social responsibility to use the least toxic product available.


Q: I really like wearing fragrances, why should I give it up?

The main reason people wear a fragrance is to be attractive to others. While some of the effect of fragrances has been achieved through shrewd marketing campaigns, there is real science behind scents. The human nose is an extremely complex and sensitive organ that is capable of "imprinting" scents as memories. Babies quickly learn not only what their mother smells like, but if they are breastfeeding, they also learn to 'sniff out' their mother's breast, even in their sleep.

Even though the nose can detect minute levels of pheromones, the body's natural attractants, we have learned over time that fragrances can enhance the physiological reaction we have when we smell our mates. Different scents have been shown to cause a variety of physiological changes, including such things as mood enhancement and relaxation. In fact, when the physiological changes are taking place it is evidence that fragrances are having a pharmacological effect. In a word, fragrances can act as drugs.

And, as with regulated pharmaceuticals, as well as illicit drugs, fragrances can have unintentioned side effects.

While it is likely that the occasional use of fragrances are not harmful, the biggest reason to reduce or eliminate the use of synthetic fragrances (as opposed to essential oils, which discussed below) is that there is absolutely no way to know to what you are being exposed in any given fragrance formulation. There are over 5,000 different chemicals used in making fragrances, and any given fragrance may have as many as 600 different chemical ingredients. Yet only a fraction of those chemicals have been tested for their health effects. Further, there is ample evidence that fragrances are responsible for a variety of health effects, from allergic reactions to the triggering of asthma attacks and migraine headaches. Whether synthetic fragrances actually cause illness is still being debated, but the absence of hard data does not necessarily vindicate them.

Going fragrance free in your consumer products doesn't mean that you have to live a totally unscented life. A reasonably safe alternative is to use essential oils to scent your body and the products that you use. For example, if you want your clothes to smell . fresh. you can purchase a fragrance free laundry detergent then add a few drops of an essential oil to the detergent when you do laundry. You can do the same with your unscented body lotion, shampoo and other products, but be aware that essential oils can have pharmaceutical effects as well (In fact, it is the pharmaceutical effect of essential oils that is the basis for the alternative medicine modality of aromatherapy).

The difference between essential oils and 'fragrances' is that essential oils are naturally derived from plant materials, while 'fragrances' are created in a laboratory. It is unclear why there are such significant differences in health effects between the two, but it is clear that the laboratory created 'essence' is not equal to its natural counterpart. For greater insight into the world of essential oils (and for information on creating your own special fragrance blends) consult a good book on aromatherapy.


Q: I can't smell any scent in most of the products I use, and they don't seem to bother me anyway, so why do I need to use unscented products?

You may not be able to smell much scent in the products you use because the regular use of a scented product will desensitize your nose to that particular fragrance. Since so many products we use are fragranced, the nose can be overwhelmed, thus reducing your ability to notice just how scented our society has become.

There is a difference between using fragrances in your own home versus wearing them in public places, particularly those places where you might be in close proximity to others. While you may not feel that you are affected by the fragrances in the products you are using, millions of migraine and asthma sufferers are. A person does not have to use a product to have an adverse reaction to it. In some cases, asthma and migraine sufferers are so sensitive to fragrances that scents used by other people can be enough to trigger a migraine headache or asthma attack. Asthma can be immediately life threatening, and while migraines themselves don't kill, they can lead to situations that put migraine sufferers in physical danger, such as car crashes.

As a courtesy to the people around you, it is wise to carefully consider how your fragrance choice might impact others. Just because you can't smell a fragrance doesn't mean it can't cause symptoms in others. If someone asks you to refrain from wearing fragrances around them, understand that medical evidence is on their side and respect their request.


Q: I have asked my boss to make my workplace fragrance free, but I'm getting a lot of resistance. How can I prove that I can't work around fragrances?

The resistance that many people get when they try to enact a fragrance-free workplace policy has much to do with people feeling like their freedoms are being trampled on. People generally feel that they have a right to choose whether they wear fragrances or not (most people enjoy fragrances), and when they don't feel they have any health effects from their choice they feel that their right is being violated.

Probably the best way to handle such situations is to respond positively instead of negatively. Start by obtaining a letter from your physician stating that you must avoid fragrances for reasons of health, then approach management about instituting a fragrance-free policy. If management feels that a fragrance-free policy wold be too cumbersome to enact, offer a compromise and ask management to help mediate an agreement between you and the people with whom you have the most contact. In the event that you are unable to work this out on your own, you can contact your state's Office of Civil Rights. In many states this office will help mediate between you and your employer.

As a peace offering you might want to consider hosting a "make your own fragrance" party where you invite your co-workers to create their own special fragrance blend using a selection of essential oils that you have determined are not problematic for you. This would reassure your co-workers that you are not trying to dictate their hygiene practices, but are instead genuinely affected by their fragrances. By acknowledging their desire to wear a fragrance you will help heal the inevitable conflict that will arise upon your request for a fragrance-free workplace.



This document is (C) 2001-2004 Earth Angels Association, All rights Reserved.  Permission is granted to print a copy of this document for personal use. Permission to reprint either electronically or in hard copy can be obtained from the author.