Final Blog!

This class was really tough in a lot of ways, but also very informative. I enjoyed learning about the status of our environmental and occupational health. I feel it was important to understand the risks out there and their impact on public health. Unfortunately, was also very depressing to be exposed to how many risks there are and how unprepared we are to overcome them. So many are integrated into the ways of our country, it seems insurmountable to overcome. That said, there are small avenues in if I keep my eye focused on singular issues rather than the status as a whole. Blogging and sharing our depressions was helpful so I know I'm not alone! It was a unique way to stay engaged with the course content as well, especially in the online weeks.

12.9 Blog: Climate Change

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

I find the irreparable change of our world to be the most troubling about climate change. The fact that species who are not contributing to this at all are being wiped extinct is so troubling to grapple with. This and the destruction of the world for our future generations that I want to contribute to creating is really troubling. 

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

Fossil fuels fossil fuels fossil fuels. I think we need to stop fracking, participating in processes that endorse and include big oil, reduce plastic use, and take steps to preserve and reverse the damage on the environment. 

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?

With the increase in gas emissions from industrialized countries and processes, we are disrupting the earth's ability to breath fully. The gasses are trapped in the atmosphere with the chemical byproducts we put on our plants in them. The gasses trap heat in the atmosphere and melt our icecaps, raise temperatures all over the world and altering our ecosystem. The chemicals in the atmosphere also recirculate into the ecosystem, covering our food products and entering our bodies to disrupt our own biological health. Ultimately, it destroys habitats for animals and our own hormonal systems in our bodies. 

11.5 Blog about a Zero Waste Life

Lauren Singer is very inspiring. It's a bold move to aim for zero waste and she's likely gotten closer than most. I appreciated her approach to making her own home care products as she ran out of others. I think I might adopt that as this class has taught me how little we know about what we buy. I hope to use her blog to find ways to do this and make this more of a lifelong process. Could be good holiday gifts too...maybe.

Watch M10.1 Video!

1) Consider your workplace or a workplace of one of your family members. Are there chemical, biological, radiological or ergonomic issues? Using the industrial hygiene hierarchy of controls, how might you address the issues? How are they being addressed in reality?

My dad works as an electrical engineer and is overall accident prone. For him, these occupational health and safety regulations are very important and also often ignored. He is likely often exposed to chemical and ergonomic issues, among other things. He is often working in people's homes or industrial areas where there are a lot of particles in the air due to his work as well as cleaning supplies with strong chemical agents. Under the industrial hygiene hierarchy of controls, I do not believe elimination or substitution will occur as he is an independent contractor who takes odd jobs that put himself in those perilous conditions larger companies would turn down. I would try for the engineering controls to isolate others from the area, though that wouldn't protect him. For him, I would mandate a HEPA air filter and face mask. This is an important factor for larger companies to implement, though in reality I don't see this being adhered to by my dad.

2) What might be the barriers to workers exercising their rights to a healthy and safe workplace?

Barriers to workers exercising their rights to a healthy and safe workplace can be quite varied. The first that comes to mind is losing their job should their employer find them to be a liability or a nuisance. Another might be they are not put up for promotion since they are deemed a nuisance as mentioned before. Another barrier, which I think may be most common, is not being aware of the rights they have. For example, the tobacco farmers mention no restroom or water and 12 hour days (and a 9 year old working there!) which is illegal. However when in poverty, who wants to shut down the one source of income? These rights should be posted in more readily available areas.

10.8 Blog about an occupationally-related disease

I looked up Pneumoconiosis (Black Lung) as the occupational-related disease to research. This disease is caused by inhaling certain dusts, commonly asbestos fibers, silica dust and coal mine dust (hence the term "black lung", from the coal). This is typically a slow progressing disease over many years, though can occasionally progress rapidly and lead to impaired lung function and eventually death. The way to avoid this commonly work-exposure based illness is proper ventilation and dust control in the work place.

NIOSH has published recommended exposure limits (RELs) over the years, starting in 1995, and updated in 2011. They produced several reports illuminating the dangers associated with coal mine dust exposure on one's health and continue to do so. They currently operate the B Reader Program to identify and recruit physicians capable of detecting pneumoconiosis in coal mine workers. They also run the Coal Worker's Health Surveillance Program for workers to monitor the their health in underground coal mines in the US. The program was initiated in 1969 in response to the Federal Coal Mine Health and Safety Act to increase early detection and treatment. The current "Enhanced" version of this program, also run through NIOSH, includes a mobile health unit that travels to workers in various locations and performs exams.

10.5 Blog about an occupational safety and health organization

I looked up CAL/OSHA's Safe Patient Handling Safety Program. It was a byproduct of The Hospital Patient and Health Care Worker Injury Protection Act (AB 1136), effective January 1, 2012. This law and subsequent program are very useful in the workplace, even for clinical research. Patients will come in for a research visit and sometimes insist on walking even when they are unstable. There was one patient at my first study I remember who routinely did this. If we didn't have the work safety training to know not to lunge after him as he fell, we could've thrown our backs out trying to help him. This used to happen a lot at hospitals, but thanks to this program workplace injuries related to patient care shouldn't be so prevalent. It's just up to the employer and training programs to make sure employees know how to protect themselves.

10.2 Blog about MSDS and ToxNet

I searched for lead within UCSF's Material Safety Data Sheets (MSDS) in an effort to continue our conversation from the last class lecture. Below are the findings: 

• What are the health risks associated with this chemical? 
• Acute Ingestion: may cause headache, nausea, abdominal pains, fatigue, muscle/joint pain, kidney disjunction, wrist drop
• Acute Inhalation: CNS damage, which may result in fatigue, tremors, hallucinations, convulsions, delirium, weight loss, sleep disturbance
• Chronic Exposure: possible anemia, CNS and kidney damage
• Skin Contact: may cause local irritation
• Skin Absorption: not pertinent
• Is the chemical a carcinogen? 
• Yes
• What personal protective equipment or special precautions should be taken when working with this chemical?
• Personal Protective Equipment: gloves (cotton or other cloth), eye protection (safety glasses, goggles, and face shield if molten), clothing (heat resistant leggings and gloves if pouring molten lead)
• Special Precautions: 
• Handling/Storing: "wash hands and arms well after handling and/or before eating or smoking. Adequate ventilation and respiratory protection should be provided when handling dross from solder bath."
• Disposal Methods: "Do not dispose of into municipal garbage. Do not dispose of into sewers or any body of water. Do not dispose of in a landfill site. Follow local or Federal guidelines for disposal. Take to a recycle or scrap dealer, or secondary smelter."
• If this is a chemical found in your workplace, what training/education were you given about any risks associated with this chemical?
• Personally, I was not given and training/education about this chemical which is at my workplace. My role does not directly work with lead, though if it is used on campus perhaps there is a slight exposure risk. I would hope UCSF manages this as we are a hospital treating already sick patients. 

While this was informative, the process to get to this information was very confusing. I think this needs to be covered in orientation and be posted in a more transparent way. I understand UCSF has over 4 million chemicals in its database so they can't share all at once. But the process of finding the website, transferring to the single sign on account, then picking which database to search within and learning how to navigate that system is tedious and discouraging. And not friendly to the average audience. 

9.4 Blog: Heavy Metals

It is so sad to see the continued damage of lead poisoning in vulnerable populations so long after the dangers were identified. Even if not all dangers were known (toxicity level, exposure risks) the fact that there is danger at any dose should be enough to warrant restricted exposure and a halt on the product's use. Reading about the progression of toxic lead levels toward lower and lower thresholds, then seeing how Nigerian children were devastated from gold ore practices is yet another health disparity among countries. It's really quite sad.

9.3 Blog: Green Chemistry

Watching "Digging into the Great Pacific Garbage Patch" was shocking. I thought they were going to highlight garbage dumps, but rather they showed how all the waste from countries surrounding the Pacific Ocean shows up in natural reserves on the north end of Hawaii. The snapshots of animal carcasses with waste inside them and the turtle whose shell grew around the zip tie to look like an hourglass were particularly devastating. I hope green chemistry is adopted nation wide and eventually worldwide. I wish there was more of an initiative for this so the world doesn't end up looking like this:

9.2 Blog: Six Chemical Classes

Watching the Six Classes of Chemicals video was really helpful to understand the different chemicals we are exposed to in our daily products. I chose to learn more about the flame retardants in our furniture and household accessories. I was surprised to hear that flame retardants not only merely delay fires from starting by a few seconds, but also lead to more noxious gasses and fire damage. The main risk for death in a fire is suffocation or lung damage from the smoke and the comparison of the chairs on fire showed the flame retardant-treated chair let off much more smoke. It's so sad because I know that's what happens in California when fires start in houses. So not only are residents at higher risk for having these chemicals in our furniture, but we are also putting fire fighters at more risk by exposing them to these products and their fumes.

8.5 Blog about an ideal chemical policy

An ideal chemical policy for me would undergo the same testing as pharmaceutical drugs. If we put that much effort into controlling substances before a doctor puts them in or on our body, why shouldn't we do that with our environment? There is so much emphasis on including the environment in one's health evaluation at hospitals, I think this should extend to the health of the environment undergoing more medical-level control.

Here is the FDA's Drug Review Process where it details the various phases of approval needed before a drug can be put to market. The exceptions, as with pharmaceutical drugs, is if the person is going to die and this is a consented last ditch effort to save them without substantive evidence. And rather than animal and human testing, this should be placed in lab-made "habitats" and see what happens to generations of species over time, understand the mechanisms the chemicals attack. And - very important - understand what byproducts various chemicals create as that is one of the persistent chemicals found in our diets and bodies now that is wreaking havoc on developmental processes!

8.4 Blog Chemical Policy Reform

Reviewing the Louisville Charter for Safer Chemicals was a ray of light in this dark, cloudy pollutant-filled sky. It's uplifting to see hope that policies are being proposed to correct the careless and widespread use of chemicals in our environment.

I reviewed Background Paper #2: Phase Out Persistent, Bioaccumulative, or Highly Toxic Chemicals. Having researched dioxin, or specifically TCDD, for my literature review I am particularly interested in the upcoming efforts to restrict toxins like TCDD from use. The fact that this paper can site the struggle it took to get court approval to ban asbestos is unnerving. The courts would not ban it and claimed there was insufficient evidence to prove the control action of the chemical. After reading multiple papers on TCDD and its effect on fertility, the research is there and the effect is known. What is still missing is the mechanism by which TCDD acts. We know MS effects neurons and leads to disability and premature death over time, but still do not know specifically by what cellular mechanism. We need to stop introducing new chemicals INTO the environment and only approve them when these mechanisms are understood. Not the other way around!

Thanks for reading my rant :)

8.3 Blog Pesticides

In looking up my meal last night on the What's on my Food website, I was startled to see how many pesticides I consumed. First, I could not find my pumpkin ravioli and cruciferous blend salad. So, instead I looked up my breakfast: my go to morning smoothie.

Ingredients and corresponding pesticides:
Almond milk (almonds) - 9 pesticide residues

• 1 Known or Probable Carcinogens
• 4 Suspected Hormone Disruptors
• 3 Neurotoxins
• 0 Developmental or Reproductive Toxins

Spinach or kale (spinach): - 54 pesticide residues

• 7 Known or Probable Carcinogens
• 21 Suspected Hormone Disruptors
• 11 Neurotoxins
• 7 Developmental or Reproductive Toxins

Blueberries (frozen): 21 pesticide residues

• 4 Known or Probable Carcinogens
• 8 Suspected Hormone Disruptors
• 6 Neurotoxins
• 2 Developmental or Reproductive Toxins

Lemon (optional - couldn't find so used oranges): 12 pesticide residues

• 3 Known or Probable Carcinogens
• 4 Suspected Hormone Disruptors
• 5 Neurotoxins
• 3 Developmental or Reproductive Toxins

I thought I was eating healthy? I've recently switched to purchasing more organic foods, but have still caved for conventional for the Costco 3-pack of almond milk and $4 massive bag of spinach. These pesticide contaminations are simply unfair to the public. Why should we have to do all this homework to learn we are poisoning ourselves while trying to make healthy choices? How has the US not adopted the same policies around pesticides as the EU?! We need better laws here.

7.8 Blog about your topic of interest

My topic of interest for my literature is dioxin and its impact on reproductive health. Formally, this compound is called 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), but we'll keep calling it dioxin.

While this compound is not applied directly to crops, it is the product of chemicals mixing together in nearly every agricultural center. It is then introduced to us via animal products. Because of that, several regulatory oversight areas may overlap when monitoring this: EPA, Interior, USDA (definitely), FDA and OSHA to name a few. This is an environmenatl issue (EPA), impacts fish and game (Interior), is evident in all our animal products (USDA), is a chemical compound that needs to start being regulated like other drugs (FDA), and must impact those working in the fields they are applied (OSHA). My only hope is one of these if not all start actually doing something to stop this!

7.7 Blog about the agency's role

I chose to look at the National Science Foundation's website to determine their involvement in protecting the environment.

[The National Science Foundation (NSF) is an independent federal agency created by Congress in 1950 "to promote the progress of science; to advance the national health, prosperity, and welfare; to secure the national defense..." NSF is vital because we support basic research and people to create knowledge that transforms the future.]

As a funding source for so many researchers interested in promoting the health of others, they are a vital tool in this administration. Frankly, I'm surprised they're not shut down yet. Their annual budget goes to support basic research in the US that is aimed toward helping the American public. Often times, these provide commentary that the environment is making us sicker.

They even have an entire funding area titled "Environmental Research & Education (ERE)". This has its own staff, funding opportunities, and events. The NSF certainly supports environmental health and is itself an act of the federal government investing in the environment. Shh don't tell the 2018 gang!

7.4 Blog about your local environmental services

The SFDPH has so many environmental health services! Their website is also fairly interactive and engaging - with questions like:
"Are you raising mosquitoes?" Mosquitoes need water to grow!

They have the usual that I would expect, from insect control to restaurant scores (I think the environment my food is prepared in is very important). What surprised me is they also manage tattoo parlors which I would expect to be under more business-central supervision. The reasoning appears to be maintaining sterile facilities, but even that I would think to be under the medical sector.

The Department of Environment (https://sfenvironment.org) looks a bit more like a dedicated environmental website. It's main colors are green and blue (like earth cartoons) and the front page is two men holding puppies :) I did not know San Francisco had this agency, but I am not that surprised by what is housed on its site: energy, transportation, zero waste, toxics & health, buildings & environments, education & equity and climate change. With how much construction is always happening here, I was happy to see the "buildings & environments" section with green building tips. I think SF should really lead the way to green homes (although we'd be behind a few other major international cities).

Overall, it's good to see so much of this information presented! I wish EWG was featured more prominently to set citizens up to help themselves since the policies are insufficient.

6.7 Blog: Obesogens

I love living in California - it seems like something delicious is always in season! My mom always did a much better job at shopping seasonally than I do sometimes, but it's fun to revisit. I know some products from Seasonal Food Guide are in season since I see them at the Farmer's Market. Others are surprising - like I did not know that chives had a season. I thought they were always around to be added as needed to whatever recipe. I won't take them for granted so much now ;)

The obesogens were depressing to read about. Considering I just read about DES in "Having Faith" and the reproductive issues it causes, it was sad to see they can also cause undue weight gain. I wonder if the children of women prescribed DES to prevent miscarriages are then obese and infertile - that's just not fair. A quick search on Toxnet shows it does not stop there- - it's carcinogenic too!

6.6 Blog: Use of Antibiotics

The use of antibiotics in farming where Antibiotic Resistance (AR) is passed from animal to human is so depressing. This seems like an unfair assault on those without the means to defend themselves. If the only way to avoid animal products from farms where antibiotics are administered is to buy organic or some other more elite and costly versions of the product, who has agency? Certainly not those in a lower SES. Say this was something an immigrant family did not need to worry about in their home country - who says they'll take it upon themselves to look this up, inform themselves, and make a change in their purchasing decisions? That's asking a lot of a family trying to acclimate to a new country and culture already. It's just sickening that this is the traditional American practice and that it can one day wipe out so many of us. 

The antibacterial products get a similar reaction from me, except that they are not being offered to me as vital nutrients to sustain my life. For that, I will take it down a notch. But coming from such a high level of outrage really only means I'm less outraged, not calm and accepting. When capitalism turns a profit on Americans purchasing items that actively weaken their health, there is a fundamental issue with the system. I'm not talking skittles or candy bars, but cleaning products marketed to fight off sickness. These should do just that! Not poison us and the environment we use them in. 

6.4 Blog: Industrial Farming

I remember hearing about vanishing bees when this news first came to light. It was a big concern as they pollinate so many of our foods. I never considered bee farming as a concern from this issue as I was more focused on the extinction issue. It's so sad to consider! I know we've talked about coal miners losing their way of life, but this paints a new picture as a loss of value in one's expertise. I can really empathize with that.

For Dirt!: The Movie, I am even more convinced to steer away from meat now. Over the past year I've been struggling more and more with consuming it, then I spent the hard at work with my vegan colleague forced to come face to face with my choice and the alternative, then I started this class. I'd say 94% of my meals over the past month have been vegetarian as a result.

I grew up in Sonoma County so I know I grew up near factory farms, I just never saw them. While there are not surprisingly none in San Francisco, I found out from this map that Sonoma County is "extremely" densely populated with them. I wonder what happened in the fires? Was any of the waste from them burned up and inhaled by my family and residents of all the neighboring counties?

Regarding composting - I sure do :) Happy to give it back, even if that movie gave me pause seeing how many chicken carcasses were added to it with who knows how many antibiotics in their system.

5.7 Blog: Your Sewage Facilities

Even though our water travels from as far as Yosemite to get here, San Francisco treats its water on site!

This is a map, courtesy of San Francisco's Public Utility Commission, detailing where each of the 3 sewage treatment sites in San Francisco are. As I live in the Sunset, my sewage is treated at the Oceanside Treatment Plant. I saw they do tours at some of these and I'm morbidly curious to go...maybe when I'm ready to move though. I'm still adjusting to the reality that this is the lifecycle of water ;)

5.5 Blog: Campaign for Tap Water

My nationwide campaign for tap water over bottled water?

Why not use the big corporation's tactics? Scare, seduce and mislead the public! Sincerely though, I would consider hopping on the turtle train? Somehow this has captured the public's attention and we can ride those coattails. Plastic waterbottles are contributing to the ocean waste and I would wager a poor turtle has tried to eat a few of them. If enough footage of animals navigating around plastic bottles were presented with the dollar amount each state paid toward that I think it would be powerful. Especially compared to the true pristine images the plastic bottle companies claim to fill from, but with the dollar cost of running water from there. My campaign would be to tug at heartstrings and go viral with a hashtag like #tapsaveslives or something. Like this guy!

5.4 Blog about your Consumer Confidence Reports (CCR) and water quality

• What is the source of your drinking water?   Where does your water ORIGINATE?  (It is treated at a water treatment plant, but what watershed or aquifer is the sources of the water?)

After reading about the treatment facility processes around the country, it was interesting to look into San Francisco's water treatment process and origins. According to the San Francisco Public Utilities Commission, about 85% of our water comes from the Hetch Hetchy Resorvoir with the remaining sourced from surface reservoirs in Alameda and San Mateo Counties. While the latter two are fairly local, I'm curious what path our water takes when it comes from Hetch Hetchy in Yosemite. 

• What chemicals were found in your water that were higher than expected?

Reviewing the Annual Water Quality Report from 2017 showed me what exactly was in our water last year. I was surprised to see how many chemicals there are, but also realized many are from the disinfection process itself. I hope they're safe to drink! I did not see anything listed in the "Action Level" range according to the chart's key so I am relieved that everything is "safe". Although, after finishing "Having Faith" I wonder if these levels were set with pregnant women and children in mind...

• What chemicals did you NOT expect to find in your water?

Other than the cleaning products, I was surprised to see sulfates and lead. The former I know to buy home products without so am not pleased to see them in my water. The latter reports being at a safe level (15ppb) but is still disconcerting to see on the list. 

• Are there associated health risks with the chemicals found in your water?  (sources for this last question include the EPA, CDC, ATSDR and the National Library of Medicine's ToxNet program.

Both sulfates and lead have health risks associated. While I could not find any health risks associated with "sulfate" (there are many different ones!), lead certainly has some. According to the Hazardous Substance Database, "lead affects the developing nervous system of children, and no safe blood lead level (BLL) in children has been identified." So even at our low quantity of15 ppb, does this mean kids aren't safe?

All this said, I certainly still drink my city's tap water and love that luxury!

5.2 Blog about the public health importance of safe drinking-water

The Clean Water Act of 1972 made a huge difference in the safety of the United States' bodies of water. Before it was enacted, the lakes of many states were unsafe to swim, fish or enjoy really. With the Clean Water Act, the country was able to save the water from contaminants like toxic chemicals being dumped without regulation. The public health importance here is that the water is protected for the community. With the contamination of the bodies of water comes contamination in ground water, then in any water pumped by aquifer, then delivered to the crops grown on that property or even the glass of water the residents drink. By preventing unsafe contamination of the water, drinking water and clean water to grow crops in is preserved. The community health is also preserved by leaving these waters available for recreation and exercise, as well as the mental health from enjoying the view of the fresh clean lakes like the one below.  

4.5 Think about it / Group Exercise

Given that there are potential health effects associated with the fragrances in our personal care products, how might you develop and implement a fragrance-free policy in a hospital, school, or other institutional setting? Consider how you would deal with the fragrances that are in employees’ personal care products. 

The big concern in my office is perfume and scented personal care products. I can't really think of a policy that can be implemented without funding or subsidizing employee purchases. I also think this encroaches on personal rights outside of the office and can't see telling people what to do with their bodies going well. What I could see as successful is an air purifier in the office and free showers. And perhaps an employee meeting to review the risks of toxic chemicals in our care products to provide reasoning for the new approach.

Since I work at UCSF, my mind goes to the environmental health sector or pulmonary division leading didactics on campus and then UCSF initiating a campus-wide policy to restrict fragrances on site. Enforcement would be challenging which is why I think air purifiers and a slow roll out would be needed. That way any hyper-sensitive folks can request to work from home while management introduces each employee to the guidelines and reasons behind it. The goal is honorable, it's just difficult to implement considering it has to do with personal care on personal time.

4.6 Blog Assignment: Radon

What would I do to reduce the excess deaths associated with radon? 

My national campaign would involve a news story and publicly available radon tests. 

I appreciate that there are resources available from the EPA's website to request kits, but the majority of people do not have the time or energy to spend navigating the website and calling the 1-800 number for this kit. My hope is that the data on radon-associated increases in deaths can be made public via a news story, or perhaps there is one very sympathetic story that can be the expose. While I am easily frustrated by the news coverage of petty irrelevant issues, the stations are valuable in getting word out about natural disasters. I would qualify the increase in environmental toxins a natural disaster and think this merits coverage!

Once the public is aware, radon testing kits should be available at the local PDs and libraries. From there, people can take them home and use them and return them within the week. While some may go missing, this will get the tests done to promote public safety. I would hope there is grant funding available or perhaps the radon testing agencies could subsidize this. They could invest in mass testings so the requests for repairs can increase!

4.2 Blog Assignment: National Library ToxNet

"Women using bleach for home cleaning are at increased risk of nonallergic asthma" by Bobette Matulonga, Marta Rava , Valerie Siroux, Alfred Bernard, Orianne Dumas, Isabelle Pin, Jan-Paul Zock, Rachel Nadif, Benedicte Leynaert, and Nicole Le Moual

This study found that bleach use for home-cleaning is associated with non-allergic asthma in women. The study broke bleach use into 3 categories: <1/week, 1-3/week, 4-7/week and found a consistent incline in certain asthma symptoms according to frequency of use (see chart below).

This is compelling as it shows even the products used in home to prevent allergens can be irritating the respiratory system.  I think the key here is to use everything in moderation since enough of anything can hurt the body. I'm glad these researchers tackled this issue as it seems most research focused on work environments but the principle applies to the home as well.

3.5 Transportation

Moving away for college was my first time getting to rely on public transportation. I grew up in the country where no public transit except the school bus would come. Moving to quaint little walkable Davis was amazing! The opportunities to bike to class, walk to the market, jog from my front door around the neighborhood and back - they were wonderful. The weirdest part was coming 'home' and having to drive everywhere. I love the country, but I love a walkable neighborhood too.

From traveling to other cities and countries since Davis, I realized just how bad the US transit systems are. We have pretty unreliable and inefficient city transit here in San Francisco (unless you are off the BART line). We have no way to get north from SF to anywhere in the hot wine country area. The SMART train doesn't even connect all the way which is one of the most frustrating things for me trying to get to Santa Rosa without a car or bus. And if we want to get across state lines, we can take a plane, train or automobile but no quick and easy access to tourist destinations like the Grand Canyon or even Yosemite. In Europe, they have the EuroPass, plenty of trains, banned personal autos in town squares during high seasons, ferries, the works! Even in Thailand the train system is arguably better than the Bay Area's. The health impacts of this, from personal health of not sitting and stressing in the cars to pollution of air and rubber burn-offs from tire after tire rolling on pavement...the clearing of nature for wider and wider roads. If this all went into infrastructure for public transit, the benefits would easily outweigh the costs in the long run.

3.4 Air Pollution

This prompt requested we look at http://www.scorecard.org/ and https://www3.epa.gov/enviro/ to check the main pollutants in our area. I was curious to compare rural Santa Rosa (where I grew up) to metropolitan San Francisco (where I currently live):

It's not surprising that San Francisco County (SF) is ranked higher in toxicity than Sonoma County (SC), but I was surprised that the ranking systems don't directly compare. SF's ranking is based on reproductive toxicants while SC's is based on non-cancer toxicants which remind me of comparing apples to oranges. 

That said as of 2002 SC's top polluters are F. Korbel & Bros Inc. and SF's top polluter is San Francisco Drydock Inc which is a shipbuilding company. These line up, since SC is known for its viticulture and SF is on the bay. Only 1% of SC houses are in the high risk of lead hazards, while 7% of SF houses are. They both had Superfund sites in 2002 - SC had Sola Optical US Inc (a producer of optical lenses that had contaminated drinking water) and SF's is Treasure Island Naval Station-Hunter's Point Annex. I do wonder if SC has more Superfund sites since the fires, but the data was not recent. 

SC air quality ranked among the 30% worst in the country in 1999 and the water quality was bad too which is surprising since they never seemed bad to me growing up! SF's air quality ranked among the 10% worst in the country in 1999 and the water looked similar to SC's. 

The two zipcodes fared poorly regarding environmental justice, but not in a newsworthy sense I think. SC seems to have less of a burden on people of color but again that data is old.

3.3 Environmental Justice

Classic America though, really...we have a system built on minorities and unfortunately it's not a system that has changed very quickly. The story of Chester, PA particularly upset me. I cannot believe the city planners approved this massive incinerating facility directly across the street from a residential community.

The frustrating thing about this sort of structure is that the residents it effects are ones that likely do not have the means to change their circumstances. If that happened in an wealthy community, the residents would likely take all the steps the Chester residents did but get their way. If they didn't succeed by virtue of being more affluent or otherwise privileged, they could of course sell and move. This part is the one that really bothers me. The poor predominantly Black community could not do this so they were exposed to these chemicals and experienced even more health hardships.

3.2 Vulnerable Populations

Among the readings and the viewings for this section, there were many interesting facts to learn. I found Dr. Manchanda's proverb about the friend who swims upstream when children are drowning to really resonate. As her friends were saving the children that were drowning and about to drown, she took off upstream to investigate what was causing them to be in the water. Perhaps I should have already heard this story, but it really describes how I feel the public health profession behaves in the US compared to primary and specialty care clinicians.

I was also particularly interested to hear Tracy Woodruff, PhD, MPH speak as I used to work in the grants department that managed her awards. She is a prolific and innovative researcher and I was interested to hear what she had to say. Unfortunately, it was not good news...but worth taking note. Chronic diseases are rising along with the production and use of chemicals in our environment. While I regrettably don't see these chemicals going away any time soon, I'm concerned about what this means for reproduction in the US. Since the chemicals, as she pointed out, are banned from being used in their own parent company's country the US and developing countries will be the first wave of experimental education. We will have to see how our future generations develop before irreparable damage to our environment is taken into consideration. It's really truly disheartening. Especially (on a more personal note) since multiple researchers mentioned fish and I *LOVE* fish!

3.1 Biomonitoring

If this was my lab report, I would be shocked and really troubled. I'm particularly concerned about reproductive toxins as my sister and many I know have had reproductive issues in the last few years. It also brings to mind the movie Children of Men which explores the concept of infertility as the status quo for the world. While the movie does not go into the cause of worldwide infertility, it makes me wonder which of the chemicals we are exposed to will be the cause of it (or which combination). After watching Anderson Cooper's "Body Burdens" segment, I'm curious how I might get my blood levels checked. I'd be really scared but interested to find out!

2.4 Ken Cook and Advocacy Organizations on Toxics in Personal Care Products

What a passionate guy! This video was informative and really well presented. I appreciate that the speaker, Ken Cook, introduced industrial pollution via "10 people" and proceeded to eliminate all routine routes of exposure for them. He then discloses they are all fetuses receiving these toxins through the umbilical cord. As if women don't have enough to worry about! But it did really paint the picture!

This video again reinforces the need for better governmental regulation of chemicals. The Kid-Safe Chemical Act of 2008 looks like it became of 2010, 2013, and finally of 2015. I'm glad this finally passed, despite its long journey. But there is more work to do since chemicals are still being introduced to our bodies without our knowledge or informed consent. 

2.3 National Library of Medicine's Household Products Database

For household products, I thought a pet-centered and human-centered one each would be a good sampling of what my household is exposed to. I checked them against the DHHS Household Products Database here. 

For my cat, I chose her litter. We use Fresh Step’s Simply Unscented (scoopable). This is not the first litter to go in the cat box, but it’s become the favorite over time for its low dust content and low odor. The scented ones, while successful at masking some unpleasant odors, have a tendency to linger on her fur and come cuddle with me and I find it irritating. I am happy to see that this household supply scores a Hazardous Materials Identification System (HMIS) score of zero. That said, it does contain crystalline silica which is a known carcinogen. From studies reported in this evaluation, the regular lifetime use of this product is not determined to increase risk of cancer form use.

Sadly, we will be throwing out our shower cleaner (now, how to do that safely?). We have an old bottle of Easy-Off BAM Power Cleaner that we’ve been saving for bathroom scrubs. This thing has a score of 3 out of 4 and looks like it’s been discontinued since purchased. What I find particularly concerning is the warning not to breathe vapor or spray when it is recommended for the shower. I’m curious how much is left behind after washing the tub and therefor how much is inhaled through the steam of the next shower. Also, if this was discontinued for any sort of health or environmental reasons what sort of notification system is there for consumers who already purchased it? These labels should be posted on products, not buried in government or non-profit run websites. It’s really a shame this information is not more readily available and the industry is not as transparent.

1.4: List of Environmental Exposures

This exercise for day one was really interesting and a bit disheartening. To begin with, thinking of individual toxins for each environment was harder than I thought it would be since there was so much overlap. It seems like no matter where I look, there is some sort of toxin I am ingesting that I would have to take painstaking measures to avoid. The naturally occurring ones like dust or mold were a bit less alarming to consider. However, I still don't know how to process the fact that there is glyphosate (aka Roundup) on oats and toxic flame retardant chemicals in our furniture that does not even retard flames. 

Almost a week later, and I don't have anything to add to the list as this list was pretty comprehensive. I know it wasn't exhaustive and that sets an ominous tone for the next few months of learning. That said, I am particularly interested in learning more about what I have in my home, school, work and community and how I may avoid it. Everything in moderation, including toxins (as there seems to be no avoiding it) and avoiding toxins (as it seems I'll never be 100% successful). 

2.2 Personal Care Products

I am thrilled to know about the Safe Cosmetics Database from the Environmental Working Group (EWG). I looked up my facewash and face lotion (both Cetaphil Dermacontrol products) as well as my deodorant. I was pleasantly surprised to learn my face lotion had a low score of 1. However, my facewash made for the same line of products scored a 4. This seems largely linked to fragrance, organ system toxicity (non-reproductive), and ecotoxicology. This concerns me slightly since I couldn’t find any more specific data on organ system toxicity, but all the data associated with those scores was either limited or none. However, overall it seems the score of 4 is due to the fragrance which does not actually irritate me so I am not in a rush to change this. I did try to compare it to the Trader Joe’s facewash I keep in the shower, but this product was not registered.

The other product I was very interested in learning about was my deodorant. I use Secret’s Invisible Solid, Shower Fresh (2-pack from Target). I remember reading terrible things about the carcinogenic effects of deodorant and trying many different brands to avoid these. In the end, I felt none actually functioned properly as deodorant so I gave in and went back to generic. This item also scored a 4 on the Safe Cosmetics Database which is curious to me. Reading the ingredients, I see that TALC is listed as a concern. The powder chemical can have traces of asbestos in it, but even without these traces the chemical can still be toxic and carcinogenic. The chemical is prohibited in Canada which makes me think I should start importing my deodorant since perhaps their consumer protection laws are stronger. I am grateful to this website since I now have some shopping to do! I have already started referring my family to check their products against this and plan to continue!

1.5: Environmental Health Home Assessment

After the first lecture, I'm glad to have the opportunity to start assessing what toxins are in my home. I didn't know the answers to all of the questions, but was able to look most of them up online. For example, I know my apartment was built in or before 1978 because it's rent controlled :) We definitely do not have a basement in San Francisco and while we do have an attached garage it is an open carport. We don't have in-unit washer/dryer and this might be the silver lining I never considered for that. I have a cat, so there are no rodents to be found and few insects. That said, I'm sure my kitty and her accessories come with many other toxins. We steer away from air fresheners and strong chemicals, but do use candles and incense and occasionally some strong disinfectants.

I was surprised to realize we do not have a home radon test, but will probably invest in one soon. It was nice to read about San Francisco's water quality and how protected it is. Naturally, whatever toxins we use in California are seeping into it but I'm hopeful that since it starts as snow melt it's not as bad as Flint. Overall, I'm glad this was assigned so I can check back on how I approach every day toxins and start making smarter choices (like actually washing my fruits and vegetables)!

See below for the Home Environmental Health and Safety Assessment Tool:

Introduction

Hello! 

My name is Rachel and I am writing this blog as part of an ongoing assignment for Environmental and Occupational Health Issues in Public Health. This class is part of the core curriculum of the Master of Public Health program at the University of San Francisco. I hope you enjoy reading along!