people do not figure out what is happening to them. It is what happens to most people who are injured by environmental exposures. Simply, you lose the ability to evaluate your surroundings.
Think of times you have been sick but still had to go to work etc. You push yourself to do what you need to do. Your body compensates for fatigue and ill feelings by pushing harder. Over time, the person is losing their ability to analyze their environment as their energy is focused on just getting done what you need to do. In other words, putting 2 and 2 together becomes harder and harder. I will bet you that this couple had trouble taking care of their day to day responsibilities such as paying bills on time, meeting social obligations, organizing etc. They will reach a point where they can no longer compensate - lifelong disability with organ damage including brain.
It is slow motion poisoning and most people don't realize it is happening to them. And it doesn't take a tar sand - it could be a sick house, chemicals in the workplace, accidental spills. Most are treated the same as these people by the medical community, state & federal agencies, and employers.