Final Blog

I have really enjoyed this environmental health course. It has taught me A LOT about environmental health that I did not know before this semester. I liked the mix of readings, lectures (both guest lectures and Dr. Sattler's lectures), and videos used for teaching. 

I thought blogging was worthwhile and really helped me stay on top of the course material each week. I especially liked that many of the blog posts prompted me to do research into my own life like looking into the safety of my personal care products and cleaning products or looking into where my water comes from and the quality of my tap water. Additionally, now I have different databases I can continue to use and refer to like the EWG Skin Deep Cosmetics Database which will definitely be useful in the future. My only complaint about blogging was the number of technical issues my group had with blogger. A few times in the semester the commenting was not working properly which took so much time to resolve and caused a lot of frustration.

Climate Change

1. What do you personally find most troubling about climate change?

Climate change is and will continue to negatively affect all life on earth as CO2 emissions increase. Air pollution, extreme weather events, food insecurity, and rising sea levels, among other effects of climate change are all extremely troubling and frightening. Climate change is an extremely complex issue that will require commitments and efforts from all countries and governments across the globe. Actions need to be taken swiftly. What I truly find most troubling is this quick orchestration of countries and governments. Our own current Administration is clearly not interested or committed to tackling climate change given the rollbacks of Obama-era climate policies and the U.S. withdrawal from the Paris Agreement. If this will take a worldwide effort, how do we get everyone on the same page? That is a daunting task. 

2. As a public health professional, what do you think needs the greatest attention right now?

I think tackling climate change will require both proactive and reactive efforts. Some attention should be paid towards mitigating the effects of climate change. This might include building levies, dams, and using other technologies to protect coastal areas from rising sea levels or better preparing for extreme weather like hurricanes and flooding by educating the public about emergency preparedness and planning or setting up emergency shelter and cooling centers for extreme heat. Just as much or maybe more attention needs to be paid towards reducing CO2 emissions. This will include pushing for better policies and legislation, abandoning fossil fuels and adopting clean energy at greater rates, supporting local, organic farming rather than conventional farming, among other things. 

3. If you were visiting with a long-lost relative who had never heard about climate change, how would you describe it and its attendant human health and ecological threats?

I would explain that human activities, especially burning fossil fuels for energy, are resulting in greenhouse gas emissions that are creating a "blanket" around the earth. As the sun warms the earth, heat is trapped in by the "blanket" of greenhouse gases. Thus the planet is warming up and causing a host of problems which include melting ice and rising sea levels, an increase in extreme weather events with droughts and flooding, warmer summers with an increase in days of extreme heat, among other things. This will impact human health both directly and indirectly. Direct effects will include air pollution and/or heat-related disease and the exacerbation of chronic illnesses. Indirect effects will include food and water insecurity. 

A Zero Waste Life

After watching Lauren Singer's "Why I live a zero waste life" Ted Talk, I am truly amazed. Though she is just one person committing to such lifestyle she is making a difference considering how much waste one person produces each year. I, alone, produce a lot of waste from food packaging to canned and bottled drinks to food waste to personal care product packaging. I was intrigued how Lauren could actually live a zero waste life because nearly everything we purchase or consume is packaged some way or another. I do not think at this point in my life I could commit to a ZERO waste life. I could probably be more conscious of the waste I produce and decrease the amount of waste I create. I could purchase and eat a diet that consists of more fresh fruits and vegetables rather than processed foods that are canned and packaged. I could also commit to exclusively using my reusable water bottle rather than purchasing water bottles when it is more convenient. I could also learn to compost. I could look into the personal care products that I use and eliminate one's that are unnecessary for personal hygiene. There are many things I can do to reduce the amount of waste I produce. I think after watching the Ted Talk and the other videos as well as reading the article on plastic waste in our oceans, I feel more inclined to put more effort and consciousness into what I purchase and how I dispose of things.

Exposures and controls in my workplace

I work at SFO Medical Clinic. I think for the most part, biological exposures are the greatest concern as I am sure it is in most healthcare settings. We have an x-ray machine in the clinic, so radiological exposures might be another concern. Additionally, the clinic is in an airport and we can sometimes smell the fumes from the airplanes in the clinic. I think this could be considered a chemical exposure.

The nurses are well-trained to triage and assess the symptoms of a person who presents in the clinic. If there is a chance that the patient might be contagious, he/she is put into an exam room immediately so that they are not sitting in the waiting room with other patients. We also have a negative pressure exam room that can be used to isolate the contagious individual. We regularly (especially after a possibly contagious person presents in the clinic) use Super Sani-Cloth to wipe down the check-in and check-out desks, clipboards, and pens that the patients use. As far as radiation exposure, the x-ray technicians are well-trained to protect themselves. There is also a light outside of the x-ray room that is lit when an image is being shot so that someone outside in the hallway does not enter. The smell of airplane fumes in the clinic occurs once in a while, but the airport does not do anything to prevent it nor do we do anything in response to the fumes.

From the lecture, we learned about the hygiene hierarchy of controls. Obviously the best and most effective control is to eliminate the hazard completely. In the case of biological exposures or even radiological exposures (x-ray in this case), it is impossible to remove these exposures in a healthcare setting. Clinics and hospitals exist to treat people who are sick. We use x-rays as a tool to treat people. We cannot eliminate these exposures here. The most obvious controls we must exercise in this setting are administrative controls and personal protective equipment, which is what I believe is currently being done in my workplace.

Asbestos and Mesothelioma

Asbestos is a natural mineral that is heat and chemical resistant which has made it useful in many products. Insulation is one product where asbestos has been used. Asbestos becomes a problem when disturbed or damaged as asbestos fibers are released into the air and people inhale or ingest them.

Since the 1920s, asbestos has been linked to serious health effects, one of which is mesothelioma. There are 3,000 new cases of mesothelioma diagnosed each year. Symptoms include chest pain, shortness of breath, fatigue, and persistent cough, among other things. These symptoms do not show up until 10-50 years after exposure. Despite the growing knowledge of the harm of asbestos exposure, the use of asbestos boomed between the 1930s to 1970s. High risk occupations for asbestos exposure include: construction workers, manufacturing and industrial workers, automotive manufactures and mechanics, and shipyard workers.

Asbestos is not currently banned in the United States. The organizations that oversee and enforce asbestos regulations are the Environmental Protection Agency, the Occupational Safety and Health Administration and the Mine Safety and Health Administration. Attempts made to ban asbestos in the past were unsuccessful. The Clean Air Act was amended to include asbestos as an air pollutant in 1970. In the same decade, the Toxic Substances Control Act gave the EPA the authority to regulate toxins, asbestos included. In 1980, the Comprehensive Environmental Response, Compensation and Liability Act began Superfund sites. In 1989, the EPA rolled out the Asbestos Ban and Phase-Out Rule, which was overturned by the Fifth Circuit Court of Appeals in 1991. In most recent attempts, under the Frank R. Lautenberg Chemical Safety for the 21st Century Act of 2016, the EPA selected asbestos as one of ten chemicals for risk assessment increasing hopes for a ban. Under the Trump Administration this past summer, however, the EPA proposed the Significant Use Rule, which would allow the use of asbestos with approval from the EPA.

While no ban currently exists to protect against asbestos and its harmful health effects, there are federal and state laws that dictate how asbestos must be removed and disposed of. Certified asbestos professionals are trained and licensed to follow the strict guidelines for asbestos removal and disposal. In my opinion, this does not truly protect people from the exposure to asbestos.

All information came from the Mesothelioma + Asbestos Awareness Center. For more information, visit https://www.maacenter.org

WHO and the occupational health of health workers

WHO writes "protecting the occupational health of health workers is critical to having an adequate workforce of trained and health health personnel." I really like this quote. The health of health workers is so important because they take care of people who are sick. In the healthcare setting, workers are exposed to biological hazards like TB, Hepatitis, HIV/AIDS, and others. WHO reported that 37% of hepatitis B among health workers resulted from workplace exposure and that only 20% of health workers in some places in the world are vaccinated. The WHO Global Plan of Action encourages members to create national programs for occupational health among health workers and for WHO to create national hepatitis B immunization campaigns.

I work at an urgent care clinic at San Francisco International Airport. Though I do not do direct patient care, I can be exposed to biological hazards and psychological hazards in this setting. Before I was hired to work at the clinic, I had to undergo a pre-employment physical where I had to provide my vaccination history and have titers drawn to confirm my vaccinations. Apparently, this may not be routine in all parts of the world given the statistic of hepatitis B vaccination rate being only 20% in some places. I am glad we have an international organization, WHO, to help advocate for and protect the health of health workers.

http://www.who.int/occupational_health/topics/hcworkers/en/

MSDS and ToxNet

I work in the front office at an urgent care clinic, so my exposure to chemicals is not very high. One thing we use often in the front office is the Super Sani-Cloth Germicidal Wipe to disinfect desk tops, keyboards, telephones, clipboards, and pens. The wipes contain a mixture of chemicals that include: Isopropyl Alcohol, n-Alkyl (60% C14, 32% C16, 5% C12, 5% C18) dimethyl benzyl ammonium chlorides, and n-Alkyl (68% C12, 32% C14) dimethyl ethylbenzyl ammonium chlorides. Using the MSDS I answered the following questions:

• What are the health risk associated with this chemical?
• The product is flammable and can cause serious eye irritation.
• Is the chemical a carcinogen?
• The product is not considered carcinogenic.
• What personal protective equipment or special precautions should be taken when working with this chemical?
• PPE include eye protection as appropriate, disposable protective gloves as appropriate, and suitable respiratory equipment if insufficient ventilation.
• When using the product, one should not eat, drink, or smoke. One should wash his or her hands after using product.
• If this is a chemical found in your workplace, what training/education were you given about any risks associated with this chemical?
• I do not believe I was given any training/education for the use of these wipes. I remember being told that there is a 2 minute dry time and maybe I was told to use gloves but I honestly can't remember. I read the bottle the wipes come in, use gloves when using the product, and wash my hands immediately after use. I think there needs to be training or reminders for safely using this product. I've observed coworkers use this product with their bare hands and I've also watched a coworker use the product to clean ink off of one of the desk tops where soap and water probably would have been sufficient. 

I noticed on the MSDS under Toxicological Information that "not available" or "not applicable" was listed next to the specifics for skin corrosion/irritation (ex: exposure minutes) and for respiratory or skin sensitization. Using TOXNET, I looked up isopropyl alcohol which is the major chemical component in the wipes. Though the major risks of the wipes listed on the MSDS were its flammability and serious eye irritation, there were many other adverse health effects listed on TOXNET. These included central nervous depression, liver, kidney, cardiovascular depression, brain damage, drowsiness, coma and respiratory depression, irritation of mucous membranes and eyes, among other things. It was surprising to me that the MSDS made the product seem safer than it might actually be.