Hydrogen Sulphide (Sewer Gas) And CVD
When one thinks of what leads to and/or amplifies heart problems, what often comes to mind is obesity, salty and processed foods, and too little exercise, among other problems. However, in these cases, there is a common thread in which the individual is assumed to have personal control and therefore contributed to their own downfall, making their health problem not only a cause of their own moral failing but ultimately their fault. However, not all aspects of health are caused by this. Invisible dangers often caused by one's environment, such as plumbing problems and hydrogen sulphide poisoning, present symptoms that are reminiscent of late-stage heart disease, so oftentimes those with heart disease who are exposed to this due to poor housing can be left to the fumes that they did not cause and are forced to unjustly take the blame for their own heart condition.
But let’s investigate this further.
There is a reason that this substance is often simply known as “sewer gas.” According to the article, Sewer Gas Poisoning Causing Transient And Focal ST-segment Elevation In The ECG: Case Report by Kumar et al., it “is a mixture of gases formed by the decomposition of wastes dumped in sewers from both households and industries” (Kumar et al., 2022). This is why such exposure is more common than people realise, as it is a byproduct of modern plumbing systems.
Sewer gas “mainly consists of hydrogen sulphide, methane, carbon monoxide, sulphur dioxide, and various nitrogenous gases. Because of the closed nature of the underground sewer pipelines, these gases build up to very high concentrations and produce levels that are highly toxic to the human body” (Kumar et al., 2022). So, this is not only toxic to people with heart conditions but to the vast majority of the population.
It is so dangerous because a main component of this invisible danger “is hydrogen sulphide, a colourless gas with the odour of rotten eggs. H2S is directly toxic and causes cellular hypoxia by inhibiting mitochondrial cytochrome oxidase, which may rapidly lead to multi-organ dysfunction and death. It can cause unconsciousness within seconds and hence [is] also known as knockdown gas” (Kumar et al., 2022). Now, the severity of this impact is dictated by the concentration. “At low exposure levels (0.05 ppm), early signs and symptoms include a rotten-egg smell, fatigue, headaches, nausea or vomiting, dizziness or lightheadedness, and poor memory and concentration. High levels of sewer gas exposure which occasionally occurs during manual scavenging leads to loss of smell, throat and eye irritation and congestion in eyes, mental depression (>500 ppm), seizures, coma, and even death immediately (>1000 ppm)” (Kumar et al., 2022). So, even people with normally functioning cardiovascular systems are affected. What does this mean if you have CVD?
If one has CVD, the potential for one to become impacted by this danger is amplified. The article, Cardiotoxicity of Gaseous Poisons written by Curcic, Miljaković and Antonijević points out that, “cardiotoxicity resulting from gaseous pollutants can present diverse symptoms, contingent upon the gas kind, concentration, and exposure length. The issue is a major concern in medicine, especially in nations where air quality fails to meet legal standards and levels of gaseous pollutants exceed permissible limits,” (Curcic, Miljaković and Antonijević, 2025). Therefore, the heart can be affected by such gases, and their prevalence depends on where one lives and the environmental standards of that place.
Now, in terms of cardiovascular-specific impacts, the article continues, noting how, “common symptoms of cardiotoxicity due to gaseous poisons include chest pain, a sensation of pressure or tightness in the chest, palpitations, shortness of breath potentially accompanied by a feeling of suffocation, dizziness or lightheadedness resulting from diminished oxygen delivery to the brain, syncope, fatigue or weakness often attributable to reduced oxygen supply and cardiac function, nausea or vomiting, cyanosis, hypotension, and arrhythmias. Some well-known gaseous substances that are cardiotoxic include carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), chlorine (Cl), cyanide gas (HCN) etc. Interference with the oxygen transport could affect almost all tissues, while the other four mechanisms, direct myocardial damage, electrophysiological alterations, inflammatory responses, and autonomic nervous system disruption, could be hazardous, as well, and cause severe cardiotoxicity,” (Curcic, Miljaković and Antonijević, 2025). This is potentially very dangerous for people with heart conditions.
But why does this matter? Surely if one has a sewage problem, they could easily just move out and get away from this potential danger to their health. Well… it’s complicated.
Unstable housing is a continuing problem for people with CVD, especially since CVD often intersects with poverty, gender, and racial disparities. The article, Importance of Housing and Cardiovascular Health and Well-Being: A Scientific Statement From the American Heart Association, by Sims et al. dives into this deeply. For example, it addresses how, “several structural factors, including residential segregation, gentrification, and the recent foreclosure crisis, affect cardiovascular health by limiting access to affordable, high-quality housing. Racial residential segregation, or the systematic separation of racial and ethnic groups, may also influence CVD risk and serve as a root cause of health disparities in CVD. The occurrence of a higher proportion of one racial/ethnic group within neighborhoods is not inherently problematic; studies have shown that predominantly minority urban neighborhoods are more likely to have more social support and cohesion, as well as access to some culturally specific resources and services. However, this may be offset by limited economic resources and access to jobs and high-quality schools, poorer access to health-enriching resources, and exposure to toxic stressors,” (Sims et al., 2020). Furthermore, “Housing quality factors have been shown to affect a number of health outcomes among both children and adults. However, little is known about the impact of housing quality and safety on cardiovascular health. Extensive literature has shown that air pollutants, specifically particulate matter and elemental carbon, are associated with CVD and mortality. These pollutants can be found in indoor residential environments as a result of using biomass, wood, and kerosene stoves, and having tighter building construction and poor air ventilation systems. In addition, secondhand smoke exposure is highly prevalent among residents in multiunit housing and public housing, and secondhand tobacco smoke can migrate through shared ventilation systems, unsealed cracks, and door spaces, leading to adverse health outcomes. Although many low-income families turn to “doubling up” and overcrowding as a cost-saving coping strategy, this too may contribute to adverse health outcomes among both children and adults” (Sims et al., 2020). As one can see, being exposed to hydrogen sulphide is dangerous to one’s cardiovascular health and it is not necessarily easy to escape from if one has CVD. The article, Relationship Between Cardiovascular Disease and Low Income Countries by Vibhuti Puthiyaveetil states that, “low income households had a significant increase of cardiovascular deaths compared to wealthier households” (Vibhuti Puthiyaveetil, 2025). That being said, given the significant impact hydrogen sulphide can have on the general population, especially on those with CVD, it is important that these impacts be known, considering how many people who experience CVD live in substandard housing.
Specifically, one danger I believe needs addressing more deeply is the potential connection between hydrogen sulphide and INR results. This is particularly important for people who need to take blood thinners, especially those with mechanical heart valves. The article, Toxic Effects Of Hydrogen Sulfide Donor NaHS Induced Liver Apoptosis Is Regulated By Complex IV Subunits And Reactive Oxygen Species Generation In Rats by Feng et al. is a study that “aimed to explore the effect of commonly used concentration of NaHS on the liver and its potential damage mechanism” (Feng et al., 2020). The results of this study concluded that, “H2S concentration increased, mitochondrial complex IV activity inhibited, the COX I and IV subunits and mitochondrial apoptosis pathway-related proteins expression increased in a time- and dose-dependent manner. We confirmed that 1 mg/kg NaHS had no injury effect on the liver, 3 and 5 mg/kg NaHS inhibit the activity of mitochondrial complex IV by promoting COX I and IV subunits expression, leading to the increase in ROS and ultimately inducing apoptosis and liver injury” (Feng et al., 2020). This liver injury is significant because it can affect the efficiency with which the body metabolizes warfarin and the potency of its effect.
Another article, Oral Anticoagulation in Patients With Liver Disease by Qamar et al., specifically points to this dynamic and danger of people taking blood thinners and those who have damaged liver function. One factor it addresses is how, “patients with liver disease may already have an elevated INR at baseline. Thus, the dose of warfarin and the target INR are not well defined in this population. Suboptimal dosing in response to an elevated INR at baseline may result in an increased risk of thrombotic events, and titrating to a supratherapeutic INR could result in bleeding complications. Patients with liver disease have a lower mean time in therapeutic range, which has been associated with a 2-fold increase in the incidence of bleeding when compared with patients without liver disease. This risk that may be significantly influenced by other factors such as serum albumin and renal function in patients with liver disease” (Qamar et al., 2018). This means that having a damaged liver, which can be caused by hydrogen sulphide exposure, may lead to an increase in INR levels, just as one of the many negative impacts of inhaling the toxic gas.
This is not merely theoretical for me because, personally, I just left the hospital today after having my INR skyrocket; my liver results were elevated, and I experienced, and I experienced confusion, lightheadedness, and subtle difficulty breathing. Over the years living in my apartment, I’ve had arrhythmias, headaches, confusion, lack of concentration, and so many other symptoms, which are all traceable to hydrogen sulphide poisoning.
I have since tried the following method at home as a preventive measure and recommend it to anyone experiencing similar symptoms. However, be sure to clear it with your doctor first, while you discuss your symptoms and medical history.
What I did was clean all the drains at once with natron/baking soda and white vinegar. Then I left it to fizzle and erode the biofilm for 30 minutes. After that, I washed the drains out with warm water for 1 minute or more. Finally, on top of everything, I put baby oil on top to seal it so absolutely no gas could leak through.
If you experience hydrogen sulfide toxicity, this is a simple, cost-effective way to protect your health by creating an impermeable barrier to the invading gases. However, before you test it out, I say again to please check with your doctor to make certain this method is right for your health and will not compromise you in any way.
It is important to acknowledge that being diagnosed with CVD is not a matter of moral failure, nor is it a result of poor decision-making. Rather, the symptoms of CVD can also come from and be exacerbated by exposure to factors, even invisible ones, that others cannot see. Personally, it took me four years before people (family and friends) took me seriously about the hydrogen sulphide, and even now, many still don’t. It’s difficult for them to trust the judgment of the ‘sick one’ and give up the savior/victim narrative where they got used to seeing me as deteriorating because of my illness, rather than a person whose illness is being amplified by their negligence. In my opinion, too many people still don't understand that CVD is not a choice nor a moral failing, but instead, simply a fact of life that needs to be addressed, understood, and respected.
What do you think? Did you find this helpful? Have you ever experienced this?
Comment below.
Tune in next Monday and Friday for more! I will be writing more now that I’m finally feeling better, so I’m getting a new, more frequent schedule.
Keep ticking, everybody!
P.S. Are there any aspects of CVD health or pacemakers you’d like to know more about?
Feel free to email me at:
blairmueller28@gmail.com
Reference List
Curcic, M., Miljaković, E.A. and Antonijević, B. (2025). Cardiotoxicity of Gaseous Poisons. Advances in Biochemistry in Health and Disease, pp.401–414. doi:https://doi.org/10.1007/978-3-031-90598-8_21.
Feng, X., Zhang, H., Shi, M., Chen, Y., Yang, T. and Fan, H. (2020). Toxic Effects Of Hydrogen Sulfide Donor NaHS Induced Liver Apoptosis Is Regulated By Complex IV Subunits And Reactive Oxygen Species Generation In Rats. Environmental toxicology, [online] 35(3), pp.322–332. doi:https://doi.org/10.1002/tox.22868.
Kumar, L., Mawari, G., Kumar, N., Sarkar, S. and Daga, M.K. (2022). Sewer Gas Poisoning Causing Transient And Focal ST-segment Elevation In The ECG: Case Report. Journal of Family Medicine and Primary Care, 11(10), pp.6533–6536. doi:https://doi.org/10.4103/jfmpc.jfmpc_552_22.
Qamar, A., Vaduganathan, M., Greenberger, N.J. and Giugliano, R.P. (2018). Oral Anticoagulation in Patients With Liver Disease. Journal of the American College of Cardiology, [online] 71(19), pp.2162–2175. doi:https://doi.org/10.1016/j.jacc.2018.03.023.
Sims, M., Kershaw, K.N., Breathett, K., Jackson, E.A., Lewis, L.M., Mujahid, M.S. and Suglia, S.F. (2020). Importance of Housing and Cardiovascular Health and Well-Being: A Scientific Statement From the American Heart Association. Circulation: Cardiovascular Quality and Outcomes, 13(8). doi:https://doi.org/10.1161/hcq.0000000000000089.
Vibhuti Puthiyaveetil (2025). Relationship Between Cardiovascular Disease and Low Income Countries. Rising Researchers, [online] (Summer 2025). Available at: https://risingresearchers.com/journal/relationship-between-cardiovascular-disease-and-low-income-countries/ [Accessed 16 Nov. 2025].
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