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.

Heavy Metals

Perhaps the most surprising and interesting to me was the link Needleman pointed out between lead exposure and behavior. One case-control study found that arrested and convicted youths were at higher risk of delinquency associated with bone lead concentrations (OR = 4). Another study found a fourfold increase in homicide rates in U.S. counties with the highest air lead levels. It sort of makes me wonder if we should convict people and assign punishment the same way knowing this information. What was also very persuasive was the cost-benefit analysis for removing lead hazards in homes that were built before lead-based paints were banned in 1971. It would cost $33.7 billion over 30 years, which is a lot of money, but the benefit would equate to $61.7 billion, nearly double the expense. That seems well worth the investment.

In the short article on the outbreak of childhood lead poisoning in Nigeria, I was glad to read that there was local involvement at every step of the intervention because that is so important for success. Another key feature of the intervention was the implementation of safer mining practices which helps to ensure safety and health in the future.

Green Chemistry

While phasing out and getting rid of toxins and pollutants in our environment is very important, research and formulation of safe alternatives is also necessary. This is where green chemistry comes in. I actually first heard about green chemistry when I was looking for a topic to write about for my literature review. I came across an article on mussels, specifically their byssal threads which they use to attach themselves to rocks and other mussels, and their implications for green chemistry and synthesizing polymers and adhesives. 

I think the 12 principles of green chemistry are great because they focus on using renewable sources to synthesize chemicals that are not toxic to humans or the environment, do not accumulate in the environment, and minimizes waste. It basically is everything current industry is not. Reading the 12 principles, I am reminded of the precautionary principle. This is how we ought to do research and create chemicals, with safety and health of both humans and the environment as a forethought not afterthought. After watching the video on the Great Pacific Garbage Patch, I was amazed. I was mostly amazed that it is known that plastics persist and do not degrade and thus accumulate, this had to have been known when plastic was first created. Where did scientists and industry think all the plastics would end up? Was that ever discussed as a pitfall?

Six Chemical Classes

I really enjoyed watching Green Chemical Policy Institute's video series on the six chemical classes approach. It was very informative and well done. I chose to further look into phthalates. Using Biomonitoring California's Phthalates Fact Sheet, I learned that phthalates are found in a variety of products that most people use daily. These include: school lunchboxes, backpacks, food packaging and containers, gloves, fragrances (perfume, lotion, deodorants, etc.), nail polish, and medications among other things. Phthalates can disrupt hormones, fetal, infant, and child development, and decrease fertility. The CDC found 13 phthalate metabolites in the urine of participants in 2003-2004 NHANES. They found that phthalates exposure is widespread in the U.S., which is not surprising considering all the items that phthalates are present in, some of which are listed above. To add, adult women have higher levels of phthalate metabolites in their urine than men. According to Green Chemical Policy Institute, to limit exposure to harmful phthalates, one can use glass food containers, avoid plastics with recycle codes 3 to 7, eat less canned and packaged foods, wash hands before eating and drinking, and opt for fragrance-free personal care products.

An Ideal Chemical Policy

I really like the six reforms under the Louisville Charter for Safer Chemicals, which are:

1. require safer substitutes and solutions
2. phase out persistent, bioaccumulative, or highly toxic chemicals
3. give the public and workers the full right-to-know and participate
4. act on early warnings
5. require comprehensive safety data for all chemicals
6. take immediate action to protect communities and workers

In my opinion, these reforms would all be included in an ideal chemical policy. I especially like the consideration of the precautionary principle, or preventing harm before it happens. When dealing with chemicals for which health effects may only be seen many years after exposure, it is important to take the precautionary approach. If a policy that proposes the aforementioned reforms is ever passed in the United States, I fear that it won't be enough to protect U.S. consumers considering many products and food items are imported from other countries. So, a truly ideal chemical policy would be one that includes these reforms at an international level, like the Stockholm Convention. This would ensure better health and safety for all people. In watching the short video, The Pesticide Trap, I was stunned as I watched a man spray harmful pesticides on his cotton crops with no protective gear and his clothing drenched in the pesticide. I became even more upset when I learned that the man could not read the pesticide container nor did he understand the symbols on the container and thus did not know the adverse health effects of exposure. This scenario could be avoided if an international chemical policy existed that would, for instance, give workers the right-to-know (Reform No. 3) and protect workers (Reform No. 6). 

Chemical Policy Reform

The Louisville Charter for Safer Chemicals outlines six necessities for a revamped chemical policy for better regulation of harmful chemicals in the United States. I really liked all six principles, but chose to read more on "Require Safer Substitutes and Solutions." This principle simply stands by "No Data, No Market." It is rather incredible that this is not already in place, it is common sense and really the way it ought to be. This principle would require manufacturers to submit the health and safety information for their chemical product before it is allowed to stay on the market or enter the market. This would apply to all chemicals, including the 69,000 chemicals that were put on the market prior to 1979, that were "grandfathered" under the Toxic Substance Control Act enacted in 1976. Before reading the background paper for this reform, I thought one potential pushback by manufacturers would be high costs. The background paper, however, reported that costs would be minimal for industries. In fact, the estimated cost for compliance with Europe's REACH (Registration, Evaluation and Authorization of Chemicals) program was less than 0.15% of the chemical industry's sales revenue over an 11 year period. That is a lot lower than I would expect. That is very little money spent upfront for better health outcomes and money saved in the long run.

Guth, J. H., Denison, R. A., & Sass, J. (2005). Background paper for reform no. 5 of the Louisville Charter for Safer Chemicals. The Louisville Charter. Retrieved from https://smartpolicyreform.org/the-charter/background-papers-for-the-louisville-charter/background-paper-5

Pesticides: What's on my Food

Using whatsonmyfood.org, I looked up the pesticides that could have been present in one of my meals yesterday. I ate at Gen Korean BBQ for lunch and had rice, beef, green onion, bell peppers, corn, and zucchini. The food items with the most number of potential pesticide residues were sweet bell pepper (53), green onion (31), and rice (15). Just seeing the number of pesticides that I could have been exposed to in just one meal makes me feel nauseated. Among the pesticide residues, every toxin was present...carcinogens, hormone disruptors, neurotoxins, developmental or reproductive toxins, and bee toxins. This information is disgusting and overwhelming. After this, I may consider eating out less and cooking at home more. I can limit my exposure to these harmful toxins by buying organic and ensuring proper food preparation. In terms of public health, we absolutely need policy to regulate what is being used on our food. Just like with the safety of personal care products available to consumers where I assumed ingredients were tested and deemed safe before they were allowed on the market, I assumed the same of food. So, as we work towards and until we have good policy, the public health community can raise awareness of the absent policy and guidelines around the use of pesticides on food and teach people to make healthier choices like buying organic or choosing conventional foods that have lower pesticide residues.

My Topic of Interest: Climate Change and Homelessness

I decided to pursue an MPH because I am passionate about and interested in working with people experiencing homelessness. So, for my literature review, I am looking into the effect of climate change on the homeless population. We know that with climate change we will see an increase in extreme weather events. It is important to understand the challenges associated with extreme heat and cold that affect the health of the homeless population. 

Some of the agencies that are concerned with homelessness include: U.S. Department of Health & Human Services (federal), U.S. Department of Housing and Urban Development (federal), Health Care for the Homeless (national) and at the local levels there are many smaller organizations. In the Bay Area, a few organizations include: Catholic Charities of San Francisco, Catholic Charities of the East Bay, Bay Area Rescue Mission, Dorothy Day House, Glide Memorial Church, Winter Nights Shelter, among others.

The National Institutes of Health's Role

The National Institutes of Health, whose role is to conduct research, is comprised of 27 Institutes and Centers. One is the National Institute of Environmental Health Sciences (NIEHS), established in 1966. Their mission is "to discover how the environment affects people in order to promote healthier lives." Their research incorporates epidemiological studies, toxicological studies, and intervention and prevention studies. They study a wide range of environmental exposures including air pollution, climate change, lead exposure, asbestos exposure, carcinogens, among many others. All research studies and findings are available to the general public.

For more information, click here:

National Institute of Environmental Health Sciences

My Local Environmental Services

Looking at the Alameda County Public Health Department's list of programs and services, I have identified several environmental services. As I was going through the list, the obvious environmental programs and services were Asthma Start Program, Lead Poison Prevention, Tobacco Control Program, and Wildfire Smoke. Before taking this class and learning about the breadth of environmental health, I would not have identified any additional environmental programs. However, knowing what I know now, I would also include the following in that list: Emergency Preparedness - Public Health Emergency Preparedness (PHEP); Equity, Social & Health; and MRSA - Methicillin-resistant Staphylococcus Aureus. I chose to include Emergency Preparedness because with climate change we will see an increase in extreme weather events prompting weather-related emergencies across the country. We have already begun seeing this. I chose to include Equity, Social & Health because I learned that hazardous environmental exposures disproportionately affect poor and minority neighborhoods. And lastly, I included MRSA as an environmental program in light of what I learned last week about the use of antibiotics in livestock and its contribution to antibiotic resistance.

Alameda County also has an Environmental Health Department. Looking at their list of programs on their website, I found the most interesting to be the Healthy Nail Salon Recognition. I get my nails done every 4-6 weeks, so this program jumped out at me right away. This program recognizes salons that use safer products and practices. They also have a nail technician certification project. Looking at the salons on the list, my usual nail salon is not listed. This may prompt me to choose a different salon in the future, one that is on the list.

Obesogens

Using Seasonal Food Guide, I was amazed to find a large variety of food available in California this time of year. The list of produce available in California in early October includes: apples, avocados, cabbage, carrots, cauliflower, corn, cucumbers, eggplant, garlic, grapes, green beans, lettuce, melons, and the list goes on. I am not sure if the variety is this large in other states, but think of all the meal possibilities with this many produce options. Though it would take more planning to create meals using what is in season, I think it is a great way to eat healthier and support a healthy environment. I recently joined a CSA and am pleased with the quality of the produce I received in my first box and look forward to creating delicious seasonal meals.

Before reading Obesogens: An Environmental Link to Obesity, I had never heard of obesogens. The study of obesogens is new and interesting and has implications for understanding obesity and preventing it. A few obesogens mentioned in the article include: atrazine, DDE, soy phytoestrogen genistein, monosodium glutamate, and bisphenol A (BPA) among others. I was interested in looking into BPA because I see and hear BPA-free a lot, especially regarding reusable water bottles and containers. Using TOXNET, I found a cross-sectional study that looked at the association between BPA exposure and BMI in children. Wang et al. found that the average BPA concentrations in urine and daily intake estimates increased with BMI (2012). The study being cross-sectional, however, cannot presume causation. The same study highlighted that six billion pounds of BPA are produced annually around the world and that BPA is found in household appliances, food packaging, and plastic bottles (Wang et al., 2012). Knowing this and the effect BPA exposure has on BMI raises concern and calls for more research.

Wang, H., Zhou, Y., Tang, C., Wu, J., Chen, Y., & Jiang, Q. (2012). Association between bisphenol A exposure and body mass index in Chinese school children: a cross-sectional study. Environmental Health, 11. Retrieved from http://www.ehjournal.net/content/11/1/79

Use of Antibiotics

Antibiotic resistance is a serious and urgent issue. It is clear that the best way to combat the issue is to stop nontherapeutic uses of antibiotics. As far as I can tell, the Preservation of Antibiotics for Medical Treatment Act (PAMTA) has been introduced in the House in March 2017 and the Prevention of Antibiotic Resistance Act (PARA) was introduced in the Senate in March 2017. Antibiotic resistance is increasing quickly. Antibiotic Resistance 101 highlights a study that found an eight- to sixteen-fold increase of one type of antibiotic resistant bacteria after just 3 years of using a certain type of antibiotic in poultry. Thus, it is paramount to take actions swiftly.

Nearby Livestock May Raise 'Superbug' Risk highlighted the risk of contracting livestock-associated MRSA. It is so scary and concerning that just living near livestock increases your risk of contracting this disease. Speaking to the slow action taken to combat antibiotic resistance I mentioned previously, we should really look at this scenario as a lesson. Without controlling antibiotic resistance, how many more "superbugs" will be born?

It was very surprising to read that there is no difference in the effectiveness of antibiotic vs. non-antibiotic soaps among healthy individuals AND that the use of antibiotic soap among sick individuals, in fact, makes them sicker. I am a total hand washer. I also use Wet Ones or hand sanitizer when soap and water is not available. Reading Scientists Discover That Antimicrobial Wipes and Soaps May Be Making You (and Society) Sick has me rethinking my hand washing behavior and the products I use. 

After reading Antimicrobials in Hospital Furnishings: Do They Help Reduce Healthcare-Associated Infections?, I learned that the use of antimicrobials in furniture has implications for increased antibiotic resistance. At the same time, it seems that there is little to no evidence to support the effectiveness of antimicrobials in furnishings in reducing HAIs. So, I really don't think they should be used.

Industrial Farming

Vanishing of Bees was very enlightening. Before watching the documentary, I did not know about colony collapse disorder nor did I fully appreciate the critical role bees play in the environment. The first thoughts I usually have when thinking about bees are honey and bee stings, pollination does not cross my mind. I learned how important bees are and why colony collapse disorder is so alarming. It is clear that the bees' exposure to systemic pesticides is the cause. Not only does pesticides directly affect us, this is one way it indirectly affects us. With a decline in bees, will eventually come the decline in agricultural yield and thus less food available to feed the population. This is a public health issue.

Dirt! The Movie was very interesting. Before watching this movie, I did not think about the effect pesticides have on the dirt, itself. I more so thought of how pesticides affect the actual plant or crop.  The movie discussed the adverse effects of single-species farming. This type of industrial farming has increased the number of pests and thus the use of pesticides to control these pests. The pesticides, in turn, decreases the quality of the soil. Nitrogen-rich fertilizer is then added to the soil. The nitrogen is only partially absorbed by the plant and the rest eventually gets into rivers and the ocean affecting ocean life. To add, the excess nitrogen results in the production of nitrous oxide, which contributes to climate change. The movie explained this well and has helped me understand the grand effect pesticides have on our environment. The movie also briefly discussed composting. I do not currently compost, I have never composted, and I do not know anyone that composts. I would definitely consider composting in the future now that I understand that it increases sustainability. My apartment building has bins for composting, so I have no reason not to try it.

Using Factory Farm Map, I found that there are no factory farms in Alameda County, CA. Prior to looking this up, I did not know whether or not there were factory farms near me.

My Sewage Facility

As far as I can tell, there is only one sewage treatment plant that serves the area I live. It is East Bay Municipal Utility District's wastewater treatment plant located at 2020 Wake Avenue in Oakland, CA. This treatment plant treats 63 million gallons of wastewater daily serving 685,000 people on the East Bay shoreline. The sewage that is treated there becomes green energy, nutrient-rich soil conditioner, and recycled water that gets released into the San Francisco Bay.

Campaign for Tap Water

If I had to create a nationwide campaign to encourage drinking tap water instead of bottled water, my slogan would be "Tick-tock TAP!" The campaign would emphasize that the time is now to make the change from drinking bottled water to drinking tap water. The campaign will highlight the cost, quality, and environmental impact of bottled water compared with that of tap water and urge people to make the switch.

Consumer Confidence Reports (CCR) and Water Quality

My water is provided through the East Bay Municipal Utility District. Most of the East Bay's water comes from the Mokelumne River watershed in the Sierra Nevada. My water comes from the Pardee, Briones, and San Pablo reservoirs. The Orinda (year-round) and San Pablo (as needed) water treatment plants serve my area. From what I can tell, there were no chemicals detected outside of state and federal limits/goals, which I am pleased with. The chemicals that peaked my interest were the unregulated ones where a typical source is "release of industrial chemicals." These chemicals were Chromium, Molybdenum, Strontium, and Vanadium. Using Haz-Map, I found that the adverse effects related to Chromium include: skin sensitizer, asthma, hepatotoxin, nephrotoxin, reproductive toxin, and human carcinogen. Haz-Map did not have Molybdenum, Strontium, and Vanadium, alone. They only had other chemical compounds with these in them, so I could not find the adverse effects for those three. 

I use a BRITA filter for my tap water at home before drinking it. Just yesterday, I went to purchase a filter replacement and learned that they filter out heavy metals like Copper, Mercury, and Cadmium. BRITA also filters out Chlorine and Zinc. I do, also, drink bottled water when I am not at home and did not bring my reusable water bottle with me. After watching the Story of Bottled Water, I am definitely more inclined not to purchase bottled water. I did not realize the extent of the adverse environmental impact, especially with recycled water bottles. There really is no excuse for me to buy bottled water when I have a reusable water bottle and places to fill it at home, school, and work. 

Public Health Importance of Safe Drinking-Water

The safety of water is so important because it is the basic necessity of life. Simply put, we need water to survive. We use water for drinking, in agriculture to grow and raise our food, to generate energy, and for recreational activities, among many other things. It should be pretty obvious that safe drinking water is extremely important for the health of the public. It is amazing that only 0.007% of the 366 quintillion gallons of water on earth is potable. We need to safeguard what clean water we have, taking care not to pollute it. The Clean Water Act of 1972 helped to control water pollution in the United States by setting water quality standards and regulating pollutant discharges.

Think About It: Fragrance-Free Policy

Fragrance is in a lot of our personal care products. Shampoo, soaps, laundry detergent, deodorant, perfume/cologne, makeup...the list goes on and on. Because the use of fragrance is so widespread, it is a daunting and seemingly impossible task to implement a fragrance-free policy in an institutional setting. One thought for how this could be implemented include an information session where the potential adverse health effects of fragrance is presented along with suggestions for alternative products. If possible, using fragrance-free products should be incentivized. Perhaps, there could be a personal care product swap where individuals bring in their personal care products with fragrance and can exchange them for fragrance-free products or even receive some kind of monetary incentive so they can purchase alternative, fragrance-free products. Along the same lines, an event can be organized to feature vendors who sell fragrance-free products. On the opposite end of the spectrum of incentives, the institution can formally ban fragrances and put in place a disincentive, like a fine. This may, however, be very difficult to enforce.

Radon Awareness

The short but very informative video, "Are You Breathing Radon?," published by the Huntsman Cancer Institute had three important elements that I think would be necessary in a national awareness campaign. First, the campaign should identify the health hazards of radon. Second, how radon can be detected using low cost and easy-to-use test kits should be emphasized. Third, action steps for dealing with unhealthy levels of radon should be outlined. This would be done by providing hotline phone numbers and/or identifying local radon experts. Potential partners or stakeholders at the national level to consider are the United States Environmental Protection Agency and the American Lung Association. State or local level partners or stakeholders might include radon service providers. 

National Library TOXNET

Using the U.S. National Library of Medicine TOXNET database, I did some research on urea formaldehyde. Urea formaldehyde is used in resins and other building materials like plywood. It is also used in textiles and electrical devices. It was banned in 1982 for use in home insulation. Adverse health effects include skin sensitizer and asthma. Thus, this is an exposure concern for those in occupations that use this chemical and also for the general population who live and work in homes and buildings that have been built with materials containing urea formaldehyde.

Using the same database, I found a study published in 2016 (citation below) that investigated whether bleach used in household cleaning, or the domestic setting, is associated with respiratory outcomes like asthma among women. The case-control study found that the use of bleach 4-7 days/week was significantly associated with non-allergic asthma (aOR = 3.30). Furthermore, a significant trend between bleach use frequency and bronchial hyperresponsiveness in women without allergic sensitization was observed (p = 0.04). Though bleach is useful in keeping our whites white and as a disinfectant for cleaning purposes, bleach has adverse effects on respiratory health. The paper suggests that these adverse effects pose a public health concern and may warrant a reconsideration of the use of bleach.

Matulonga, B., Rava, M., Siroux, V., Bernard, A., Dumas, O., Pin, I., Zock, J., Nadia, R., Reynaert, B., and Moual, N. L. (2016). Women using bleach for home cleaning are at increased risk of non-allergic asthma. Respiratory Medicine, 117, 264-271. http://dx.doi.org/10.1016/j.rmed.2016.06.019

Transportation

For me, personally, driving is the most convenient and cost-effective mode of transportation. To travel from the BART station closest to my home to my workplace would cost me nearly $20 roundtrip. It would also take close to an hour and a half to get to work. Driving costs less and requires less than half the time it would take to use public transportation. The monetary costs and time costs are not the only factors in my decision to drive. The issue of safety plays a major role as well. Fairly recently in the news I have heard stories of stabbings and shootings and a needle prick on BART. In fact, a couple of incidents occurred at or near the BART station that is most convenient for me to use. If the cost and time didn't already dissuade me from using this form of public transportation, the fear for safety definitely does. Before moving to the Bay Area last year, I lived in Washington, DC where I did not have a car. I walked to a lot of places and used public transportation to get around the city. I really enjoyed it. I feel like I led a much healthier, less sedentary lifestyle there. I would prefer this as I know using public transportation is better for me and for the environment, but until it is cheaper and safer, I will probably continue to drive.

Air Pollution

Using GoodGuide's Scorecard, I was able to answer the following questions about Alameda County:

• Who and what are the top polluters in your zip code?
• The top 3 polluters in Alameda County and the amount of pollutants they each release are: New United Motor MFG Inc. (499,459 pounds), Arch Mirror West (44,985 pounds), and Pacific Galvanizing Inc. (23,445 pounds). The top 5 chemical pollutants released in Alameda County are: glycol ethers, xylene, n-butyl alcohol, toluene, and 1,2,4-trimethylbenzene. 
• What percent of the homes in your zipcode have lead-based paint?
• 3% of houses in Alameda County have a high risk for lead. 
• Are there Superfund sites in your zip?
• The Superfund was created by Congress in 1980 to clean up the most hazardous and polluted waste sites.  
• There are 4 Superfund sites in Alameda County. They are: Alameda Navy Air Station, AMCO Chemical, Lawrence Livermore Lab Site 300 (USDOE), and Lawrence Livermore Lab Site 300 (USDOE). 
• What can you tell us about the Superfund sites that are near where you live?
• Two of the four Superfund sites in Alameda County contaminated the drinking water source. 
• What did you learn about the air quality in your zip code?
• Alameda County ranked among the top 10% of dirtiest/worst counties in the U.S. as far as number of days that the national air quality standard for ozone was exceeded. Despite this, the report also says there is good air quality 86% of days (poses little to no health hazard) and moderate air quality 13% of days (poses moderate health hazard to a select few)
• How about the water quality?
• Alameda County ranked in the top 20% for dirtiest/worst counties in percentage of surface waters with impaired or threatened uses. Pesticides make up for 80% of impairments, followed by mercury (16%) and metals (12%) among other pollutants. The county also ranks above average for the number of impaired waterbodies.
• How did your zip code fair on a social justice / environmental justice basis?
• People of color were worse off than whites in releases of toxic chemicals (OR 1.06), cancer risks from hazardous air pollutants (OR 1.12), and facilities emitting criteria air pollutants (OR 1.83). Low-income families were worse off than high-income families in cancer risks from hazardous air pollutants (OR 1.11) and facilities emitting criteria air pollutants (OR 1.96). 

Environmental Justice

Before reading "Environmentalism Was Once a Social-Justice Movement," I thought of environmentalism as what is described in the article as "mainstream environmentalism" versus what the article describes as the "environmental-justice movement." I thought environmentalism was all about protecting the beautiful, natural landscapes and scenery...the mountains, the valleys, the oceans, the forests, and so on and so forth. I never really thought of "environment" as our houses, schools, and workplaces. I now appreciate, understand and side with the case that these are the most important environments and the environments we should care most about. It is a disconcerting issue when the safety of these environments and distribution of harmful toxins are determined by poverty and race. I think an environmentalism that is closely tied to social justice, like the environmental-justice movement of the past, is best in addressing this issue and will require collaboration among various activist groups and movements.

Vulnerable Populations

In the readings and videos I've watched this week, it is clear that chemicals have the potential to affect human health adversely throughout their lifetime. From the video, Little Things Matter, it is said that "the way we regulate toxins, which assumes there is a safe level, fails to protect children." Children are especially vulnerable to the adverse effects of toxins and we really should be doing more to ensure their safety and protection. In a previous class, I learned that children are a sympathetic population, meaning, as a society we are concerned and care a lot about children. So, it is curious to me why more policy and action related to the exposure to and regulation of toxic chemicals are not being written and put into practice to protect this vulnerable population.

I was also asked to consider and reflect on the following questions this week: 1) Why are we still only focused on sedentary lifestyles and diets when addressing obesity in the US? and 2) Why are we not also looking at ways to decrease exposures to those chemicals that may be contributing to the epidemic? In the 2015 presentation on reproductive health and the environment, Dr. Tracey Woodruf pointed out that doctors are the interface with patients. They have authority and are trusted. She pointed out that doctors think that one's environment is important, but at the same time they lack familiarity with the topic and they don't know what to do about it. Perhaps this is why focus has not shifted or even expanded to include environmental exposures as determinants of health. This situation was perhaps alluded to in the Ted Talk, What makes us get sick? Look upstream., given by Dr. Rishi Manchanda. In treating his patient with chronic headaches, he was the first of many doctors to ask about her home. And, in fact, her home was unsafe and was manifesting in her headaches and her son's asthma. Did other doctors not know to ask these questions about the patient's living environment? Did they think about the potential health effect of her living situation, but just did not know how they would go about addressing the issues that are not typical medical practice? Dr. Manchanda mentioned that there are not enough "upstreamists" and that we need more. I think increasing the awareness and education about environmental exposures among doctors, social workers, public health professionals, and the general public are important to begin changing the narrative and addressing harmful environmental exposures.

Biomonitoring

After watching the CNN News Special on "Body Burden" and reviewing the hypothetical lab results of chemicals found in me, I am feeling concerned, failed, and hopeless. I am concerned because the chemicals on the hypothetical lab report, for the most part, are foreign to me. I could not begin to think where or how I was exposed to most of the chemicals on the list. Could I possibly avoid or remove something in my life that would reduce my exposure to these or is the exposure not something I could personally control? I am also concerned because the potential health effects are very serious. As a woman who would like to have children in the future, the potential for infertility and reproductive issues as a result of chemical exposures is scary. One thing I found very concerning in the video was Anderson Cooper's blood test coming back positive for PCBs, which was banned in the 1970s, and a chemical he was likely exposed to from fish that he ate as a child. PCBs, then, are persistent. Do we know if or how this will affect his health? The video also mentioned that the Environmental Protection Agency (EPA) does not require manufacturers to study, and therefore report, the effects of chemicals in their products on human health. Hearing this, I feel failed by government. I also feel hopeless and confused. If the EPA is responsible for regulating chemicals, it is ridiculous and mind boggling to me why testing the safety of chemicals is not required.

Personal Care Products: My Response to Safe Cosmetics 101

In responding to the opening poll of Safe Cosmetics 101, I listed and tallied the number of personal care products I use daily and arrived at about 18. These products include: shampoo and conditioner, body and face wash, hand soap, lotions, makeup, deodorant and perfume, and toothpaste. As the lecture went on, so many feelings ran through me. Anger, frustration, disgust, disappointment, betrayal... With the number of personal products I use on a daily basis, how many toxic chemicals am I being exposed to each day and how will this impact my health in the future? This is very concerning and frightening.

One segment of the lecture that specifically caught my attention was the segment on formaldehyde and 1,4 dioxane. Formaldehyde is produced by other ingredients in products and 1,4 dioxane is a byproduct of manufacturing and these harmful, carcinogenic chemicals do not need to be listed on containers. I began reading the labels on some of my own personal care products and found key ingredients, like "PEG," that point to the presence of breast carcinogen, 1,4 dioxane, on many of the labels. Additionally, I thought it was very interesting and concerning that "trade secret" protection regarding fragrances impacts what is disclosed to the customer on product labels. I couldn't help but think, is the health and wellbeing of people really less important than competition in the beauty industry? What are our priorities? I agree with the lecturer that we need to put pressure and responsibility on manufacturers to remove carcinogens from personal care products.

Before this lecture and this class, I did not really think about the chemicals in my personal care products and whether or not they are harmful or toxic. I guess I just assumed they weren't because surely they had to be tested for safety and meet specific regulations to make it into the consumer's hands, right? It is outrageous and mind-boggling that this is not the case. I am really thankful for the work and progress that has been made regarding this public health issue that the lecturer pointed out and confident that I can make better choices in personal care products to decrease my exposure to harmful agents.

Household Products

Anyone that knows me well, knows that I love to clean. Two products that I use regularly and on most of the surfaces in my bathroom and kitchen are Clorox Disinfecting Wipes and Comet. Using the National Library of Medicine's Household Products Database, I found that the Clorox Disinfecting Wipes is not considered hazardous by the 2012 OSHA Hazard Communication Standard nor are any ingredients considered carcinogenic. The overall health hazard rating is 1 (slight). The product, however, can cause eye, skin, respiratory, mucous membrane, or GI tract irritation. The Comet Disinfectant Powder Cleanser had a health hazard rating of 1. Like the Clorox Wipes, Comet can be a mild irritant. The manufacturer's MSDS does not present carcinogenicity of ingredients. This worries me slightly and has me questioning whether the manufacturer is withholding information or if there just is not enough data on the ingredients regarding carcinogenicity. Because both products are only slightly hazardous, I will probably continue to use them both but will take extra precautions, like using gloves, to minimize contact exposure.

Personal Care Products

Two personal care products that I use twice a day are Dove Beauty Bar, White and Cetaphil DermaControl Oil Control Foam Wash. Using EWG's Skin Deep Cosmetics Database, I found that both products scored a 4 (moderate hazard). The ingredient concerns that scored a moderate or high hazard in the Dove Beauty Bar were fragrance (high) and Cocamidopropyl Betaine (moderate). Two of the concerns of this product are irritation to skin, eyes or lungs, and organ system toxicity. There were 8 ingredients in the Cetaphil product that scored a moderate or high hazard. The concerns regarding this product are contamination concerns, persistence and bioaccumulation, and like the Dove Beauty Bar, irritation and organ system toxicity. This was especially concerning to me because I think my dermatologist actually recommended I use this product. The overall data availability for both products was listed as limited. If these products scored a moderate hazard on limited data, I am afraid that it is a lot less safer than it seems. Knowing all of this information, I plan to look into safer alternatives for face and body washes. I am really glad I was introduced to EWG's Skin Deep Cosmetics Database. It has given me greater awareness of what I am putting on my body. I will definitely use this tool to make changes in my personal care routine.

My Home Assessment

The Home Environmental Health and Safety Assessment Tool was very useful in assessing the general safety of my home. The assessment prompted me to (for the first time...yikes!) walk around my apartment to inspect appliances, smoke detector, etc. as well as do some research into the quality and safety of my water supply. For the most part, I was pleased by the results. The one area I am most concerned about, but can easily address moving forward, is emergency preparedness. I realized I do not have a disaster plan or emergency phone numbers. Additionally, I have some emergency supplies but they can definitely be better organized and supplemented. I was most surprised to see questions regarding air fresheners and tuna fish, but it became clear why these questions were asked after watching Dr. Sattler's video explanation. This goes to show that harmful exposures can exist in many things, even things least suspected.

Home, Work, School, Community Exposures

After discussing chemical, biological and radiological exposures in class last week, I was overwhelmed by the number of exposures that exist at home, work, school and in the community. As a class we came up with a good, long list, but by no means was it an exhaustive list. It personally frightens and concerns me that I do not know of all the harmful agents that exist in my environment. I was surprised that the majority of exposures we came up with can be found in the home. Though this is disconcerting, the home is a place where we have the most control over our personal environment. I am hopeful that I will be more informed and have the tools to make better decisions regarding my cleaning supplies, personal care products, detergents, etc. by the end of this semester. This was an eye-opening activity and I look forward to (with some unease) learning more.