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!