Climate Change

What do you personally find most troubling about climate change?
Everything about climate change is terrifying. Particularly, I find that the intensity of storms, destabilization of nations and extinctions  to be alarming. Also, lack of sustainable agriculture and loss of cities due to rising sea levels. These issues are alarming because we are already seeing these effects globally and nationally. I can only imagine how much worse it can get if we don't act soon combat climate change. What is also troubling is that people still don't believe that climate change exists and that some think that it's not their problem. With the severity of storms in the last few months, such as hurricane Harvey, hurricane Irma and the North Bay wild fires, people need to realize that climate change is everyone's problem.

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

The greatest attention should be on prevention and education at all levels. As an individual, there needs to be more educational information and incentives by local/Federal levels to reduce the impact of climate change. It would be beneficial for public health professionals to partner directly with scientists to create an educational program that can help educate the general public about the dangers of our current lifestyle and how we are pushing our planet to be unsustainable. Individuals need to be educated not only on their individual impact on the climate, but also of the power they have to speak up and promote legislative change. On a Federal level, there needs to be a robust educational program for all members within the government on how the climate affects health, the environment, agriculture, the oil/fuel industry, the economy, national issues and global issues. Federal legislation should also assist prevention efforts by providing incentives for going green and begin to crack down on the oil/fuel industry. On a national as well as global level, education should still be the primary focus, but should also focus on phasing out or eliminating toxic chemicals.

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?

Climate change is one of the biggest threats not only to the environment, but to human health and sustainability. Climate change is caused by our current lifestyle, such as unsustainable agriculture, reliance on plastic, greenhouse gas emissions, burning of fossil fuels, and usage of toxic chemicals/substances. This is causing our environment to degrade at a rapid rate and is causing irreversible damage. Climate change can cause the melting of the polar ice caps which results in increase sea levels, extinction of species including us, increased intensity of natural disasters, increase in health issues, reproductive harm, and destabilization of societies. These changes are already being seen, in the U.S. alone, we experienced hurricane Harvey, hurricane Irma and the North Bay fires just in the last few months. All of these events were essentially unprecedented and are tied to climate change. If we don't stop soon, it will be too late and we will not be able to fix the harmful effects of climate change. 

Zero Waste

The Zero Waste video was inspiring, considering that it was a young woman who was advocating a zero waste lifestyle that she has sustained for 3 years. As she explained in the video, it's not easy to get away from plastic since it is in almost everything that is used on a daily basis. Personally, I will start to take steps towards eliminating my reliance on plastic, beginning with my produce and lunches. I currently use "BPA-free" plastic containers, a water bottle and plastic utensils. I'm going to switch over to a stainless steel water bottle, glass containers and regular flatware. Also, I will start to buy fresh from the farmer's market, since the majority of the produce there is not packaged in plastic. Since I do like DIY and products with names that I can actually pronounce, I think I will start to try to DIY some of my products. I already currently use natural hair products (i.e. pure coconut oil, pure grapeseed oil, etc), and will start to look at DIY deodorant, toothpaste and cleaning products. The plastic bag charge on a large scale has definitely helped reduce some of the burden of plastic in the Bay Area. I think that in addition to this, there should be a plastic bottle ban (i.e. prepackaged bottled water) to create a bigger impact on the sources of waste. Small changes and increased legislation will help reduce our waste as a society.

Occupational Safety and Health Organization

National Institute for Occupational Safety and Health (NIOSH) relates directly to my health and safety, especially since I work for a research hospital. The NIOSH was created under the Occupational Safety and Health Act of 1970, with the goal of creating a research agency focused on the study of worker safety and health, and empowering employers and workers to create safe and healthy workplace (CDC, 2016). NIOSH programs examine current burdens on the workforce, quality data, partners within the industry as well as all stakeholders at a national and international level, and is transparent with information pertaining to work processes. burden today’s and tomorrow’s workers.The NIOSH is under the CDC and seeks to determine the number of workers at risk for a particular injury or illness, the seriousness of a hazard or problem, and the chance that new data or approaches can make a difference (CDC, 2016). The research conducted under NIOSH directly affects me since the research conducted helps to prevent work place hazards, exposures and to ultimately protect employees. 

Source- https://www.cdc.gov/niosh/about/default.html

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Heavy Metals

Lead has been a known toxin for years and there has been a major shift in recent decades in the U.S. to prevent lead exposure, especially in children. The article on lead describes that lead has a sweet flavor, often found in dishes, moonshine liquor, cosmetics, and some traditional remedies. There has also been a  reduction of lead-based paint in the U.S due to the toxic affects of lead. According the the article, lead affects the CNS, kidneys, blood pressure, weakness, reproductive harm, renal failure, clumsiness, cognitive impairment, attentional impairment. This is especially frightening considering children are still at critical stages of their development and can have permanent damage from lead exposure. The article on a lead outbreak in Nigeria explained that 400 children under age 5 died due to lead poisoning. This was a result of soil contamination from gold mining and the increased demand for gold. It was great that the international community came together to create an intervention to treat and prevent future crises, but was unfortunately after 400 innocent lives were lost.

Green Chemistry

Green chemistry is going to pioneer the path to local and global sustainability. According to the module, green chemistry works to reduce pollution by minimizing or eliminating the hazards of chemicals and keeping hazardous chemicals out of the environment to begin with. I thought I knew what green chemistry was, but realized I haven't really seen it in daily or work life. Before reading this module and watching the clip, I assumed green chemistry was the "green" household products I saw at Target and Whole Foods that are supposed to be gentler/natural cleaners. The 12 principles of green chemistry are all straight  forward and it's great that these principles all work together to prevent harmful chemicals from being used in the first place. These principles should be adopted along with stricter efforts to eliminate the current waste and pollution. As seen in the Great Pacific garbage patch video, the effects of non-biodegradable materials wreaks havoc on local ecosystems and species. Green chemistry and increased clean up efforts will help alleviate the burden of chemicals and chemical byproducts on the environment.

Literature Review Topic

The topic I chose for my literature review is Bisphenol A (BPA) and endocrine disruption.

What agencies at the local, state, federal, and/or international level provide information, regulatory oversight, or are otherwise implicated in addressing that topic?
The FDA is responsible for determining the safety and efficacy of products and drugs available to the general public. They are responsible removing or amending the usage of chemicals or products that are proved to harm human health or that are toxic. In addition, the FDA consults with the National Institutes of Health, the National Toxicology Program, the Environmental Protection Agency, the Consumer Product Safety Commission, and the Centers for Disease Control and Prevention.

Source:
https://www.fda.gov/newsevents/publichealthfocus/ucm064437.htm

Ideal Chemical Policy

The Louisville Charter provides an excellent blueprint for an ideal chemical policy reform. Beginning with finding safer substitutes and solutions, individuals can make these changes to pave the way for the usage of safe chemicals on a broader scale. This is essentially the low hanging fruit on the list of reforms but it can have a profound impact to reduce individual as well as community exposure to toxins in the environment. On both an individual and community level, phasing out persistent, bio-accumulative or highly toxic chemicals can have a significant impact, especially when combined with offering safer substitutes and solutions. From a public health protection perspective, the Louisville Charter prioritizes for reform to take immediate action when it comes to protecting communities as well as workers. On a community level, this reform also seeks to give early warnings, require comprehensive safety data for all chemicals and give the public and workers the right-to-know and participate.

These are all important elements to consider since they promote overall awareness and education for the general public in order to keep people safe. With this approach, it looks at the system as a whole and seeks to create reform at all levels. I think that this should be implemented nationwide and potentially include a larger educational or advertising component to make this information widely available and easily accessible by the general public.

Chemical Policy Reform

The Louisville Charter seeks to reform chemical laws to protect human health and the environment. The Louisville Charter proposes:

1. Safer substitutes and solutions
2. Phasing out persistent, bio-accumulative or highly toxic chemicals 
3. Giving the Public and Workers the full right-to-know and participate 
4. Acting on early warnings
5. Requiring comprehensive safety data for all chemicals
6. Taking immediate action to protect communities and workers

All 6 of these elements provide important safeguards for humans and to minimize potential exposures to toxic chemicals. I think that the first element, finding safer substitutes and solutions is a great place for everyone to start making a reform. It allows you to keep on using products that are deemed necessary/needed while providing a safer and healthier alternative. Small steps like this can have a large impact and pave the way towards compliance and overall reform.

Blog: Pesticides

For dinner last night, I ate chicken breast and broccoli. I found that chicken surprisingly had only 7 pesticide residues. However, half of these pesticides are known or probable carcinogens, suspected hormone disruptors, neurotoxins and contain developmental or reproductive toxins. The broccoli I had last night contains 33 pesticides, which include known or probable carcinogens, suspected hormone disruptors, neurotoxins and developmental or reproductive toxins. I eat broccoli and chicken at least 5 times a week which is really disturbing considering that these are commonly consumed by people who are dieting and body building. It makes me concerned that those of us who are trying to lose weight or get in shape are putting ourselves at risk by eating "healthy." Many meal plans advocate consuming chicken, healthy leafy greens, and fruit, but misses to inform people of the risks associated with consuming these products. Both broccoli and chicken contained pesticides that unfortunately affect honeybees.


We should be publicizing and informing the public about the pesticides that are in the food that we're consuming. I think that there needs to be stricter regulations imposed on the usage of pesticides and stronger enforcement by the government on the agricultural industry. There also needs to be increased advertising on the dangers of pesticides, education and information on food packaging to make the public aware of the effects of their food choices. In addition, we also need to reduce our dependence on pesticides since they are negatively impacting the bees and exposing us to harmful chemicals in the environment.



Source: http://www.whatsonmyfood.org/food.jsp?food=BR

Source: http://www.whatsonmyfood.org/food.jsp?food=PR

Agency's Role

Department of Health & Human Services 

The Department of Health & Human Services has the goal of protecting the health of all Americans, especially those who are the most vulnerable. The HHS has a large impact on Americans, with some of it's biggest organizations being the NIH, the CDC, Agency for Toxic Substances and Disease Registry, Medicare/Medicaid and the FDA. This department contributes to a wealth of ongoing research and literature on health conditions, provides research funding, examines environmental toxins, conducts epidemiological assessments, disaster preparedness, drug safety and assistance to Americans who cannot afford insurance or traditional healthcare. Research under the HHS not only looks at diseases and medication efficacy, but takes on a public health approach. The HHS conducts vigorous research on poverty guidelines, protection of human subjects in research, community health data, statistics and reports on births, deaths, diseases, health care spending, and the health profession workforce.  In addition, the HHS is constantly growing and learning due to the constant research being conducted within most of the organizations within the HHS. Being the the HHS encompasses a wealth of services, I feel that the HHS has a multi-faceted approach that creates a significant impact on Americans and their overall well being. 

https://www.hhs.gov/programs/research/research-hhs-operating-divisions.html

Local Environmental Services

In light of the recent and devastating fires in the North Bay, the Bay Area Air Quality Management District has been getting a lot of attention. The BAAQMD website provides a wealth of resources on regulation, current research, annual reports, air quality, permits, current air quality plans, climate, grants, and pertinent information at a community level. One of the easiest tools to see on their website is the Air Quality Index Levels of Health Concern, which is a color coded and up-to-the hour map of the Bay Area, that shows the air quality around the Bay Area. It is also very helpful that this website provides information on the direction of the wind, Spare the Air Day Status and 5-day projection of the Bay Area air quality. This site also provides links to other local organizations and resources to keep yourself safe from smoke or bad air quality.

It was interesting to learn that the BAAQMD offers a Wood Smoke Reduction Incentive Program that is currently wait listed. This program provides rebates to homeowners who make improvements to their homes in order improve air quality and reduce particulate matter pollution, especially during the cold winter months. Another great feature about the BAAQMD site is that it provides agendas for local board meetings, conferences and workshops.

Source: http://www.baaqmd.gov/

Obesogens

1. Utilizing the first article, discuss what is locally grown and what is currently in season in your area.
Based on the first article, I agree that buying local is beneficial for the environment because it is sustainable, healthier, requires less transport, less pollution and can reduce the demand of commercial farming. In Union City, I'm lucky to have a good variety of locally grown and seasonal fruits and vegetables. Currently, avocados, cranberries, dates, dragon fruit (Pitaya), figs, grapefruit, guavas, kaffir limes, kiwis, kumquats, lemons, limes, oranges, passion fruit, pawpaws, peaches, pears, persimmons, pomegranates, organic golden flax, and tunas (Cactus Apples) are all in season in Union City.

Source: https://www.localharvest.org/store/fruits.jsp

2. Discuss your thoughts on seasonal/local foods and hospital menus. 
Personally, I love to purchase and support seasonal/local foods. I like that I know where some of my food comes from, and it's nice to be able to support local businesses. Also, I've found that many local products are fresher and taste better. It's great that major stores like Safeway have sections that are specifically for local foods and that they highlight local foods. In regards to hospital menus, I notice that they are becoming more environmentally friendly. Currently, UCSF Medical Center has implemented plant-based products in the cafeterias and will sometimes showcase it as one of the main dishes on the hospital menus.

3. Find a Harvest Calendar for your state (or a state you are interested in) utilizing the link in the first article (found underneath the example Harvest Calendar for New York State). 

Southern and Central California Harvest Dates, In Chronological Order

CROP	MONTH
Asparagus	March -April
Strawberries	Apr.10 - June 30
Blackberries	June 1 - July 30
Blueberries	May 15 - June 30
Boysenberries	May 10 - July 5
Cherries  (more detail)	May 5 - June 30
Apricots	May 10 to August 15
Peaches	May 20 - September 5
Nectarines	May 20 - September 15
Olallieberries	June 1 to July 31
Plums	June 1 - September 5
Pears	August 10 - September 10
Green Beans	June 15 - September 15
Peas	June 15 - September 15
Corn	June 25 - September 30
Raspberries	July 1 - September 15
Grapes	July 10 - October 15
Apples	July 15 (early apples) - September 25
Tomatoes	July 15 - September 15
Okra	July 15 - September 15
Almonds	August 20 - December . 13
Figs	September 05 - October 31
Persimmons	September 20 - October 31
Walnuts	September 25 - Jan. 10
Oranges	All year round, depends on the variety. See this page for examples

Source: https://www.pickyourown.org/CAharvestcalendar.htm#AGOeBVX64f5lFzfc.99
4. What are your thoughts on the second article? Have you heard of obesogens before?
Obesogens is a very interesting article on a topic that is often overlooked. I never heard of obesogens before taking MPH 632 and I'm really surprised that I didn't hear about it sooner. Obesity is continuing to rise, yet the medical community focuses more on diet and exercise. It's scary that the articles reports that there are 15-20 different chemicals that can cause weight gain and may be contributing to the obesity epidemic. Expanding on previous readings in MPH 632, BPA is mentioned in the article. It's still very disturbing that BPA is found in receipt paper, medical devices, and in the lining of some canned foods, things that we generally do not have much control over.

5. Pick one of the potential obesogens discussed in the article and using your resources from earlier modules (such as toxnet), do some research on this potential obesogen. Share what you found! 
The article mentions perfluorooctanoic acid (PFOA) as a potential endocrine disruptor and a PPARy agonist. In addition, the article mentions that almost all Americans have PFOA in their blood and that kids have higher levels due to exposure to PFOA. PFOA is said to be in carpets, furniture, nonstick cookware, waterproof clothing, Scotchguard repellent and some microwavable items. According ot Toxline, PFOA exposure in childhood puts adults at a predisposition to be overweight and obese.


Source: https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~pTD1MX:1:@od@@/cgi-bin/sis/search2/d?./temp/~UstcPW:0@

Use of Antibiotics

Both articles on Antibiotic Resistance 101 How Antibiotic Misuse on Factory Farms Can Make You Sick and Nearby Livestock May Raise "Superbug," Risk, both provided clarification on an alarming topic. Reading these articles made me disgusted with the farming industry. I've heard things about the rise of antibiotic resistant bacteria among humans but never realized that one of the main culprits was our food sources. These articles report that livestock is given antibiotics to prevent infection and promote faster growth, which in turn, accelerates the development of antibiotic-resistant (AR) bacteria in humans. This is causing humans to contract illnesses that are very difficult to combat since they do not respond to antibiotics the way they should. It's scary to learn that the only thing you can somewhat control is by going plant-based and refraining from animal products. The article on Antibiotic Resistance 101, does however, recommend that you can buy organic, look for a label stating that the meat has been raised without antibiotics, or to buy directly from the farmer, which allows you to ask the farmer directly about his or her practices. It's upsetting because you cannot necessarily be certain that your meat is free from of antibiotics and that you can never be certain what your meat is exposed to. It's very upsetting that everyone's health is being put at risk for the benefit of the farming industry's pockets.

The article, Scientists Discover That Antimicrobial Wipes and Soaps May Be Making You (and Society Sick), provided some valuable information. I'm guilty of using antibacterial/antimicrobial wipes because of may of the same reasons that other people use them. I too, am naive and think that using antimicrobial products will somehow shield and protect me from the grime of the world. From sticky surfaces, blood from meat, or coming into contact with anything gross, I reach for a wipe. Otherwise, I'll use antimicrobial soap. At work, I'm exposed to triclosan-based soap and I'm required to "gel-in" before going into a patient exam room. What really surprised me about this story is the effects of these chemicals on society as a whole. I never even thought about the effects of triclosan going into the drains and being ingested or absorbed by fish, which can be passed on to us. Also, fish have had reproductive issues after being exposed to triclosan, making me wonder how triclosan affects human reproductive health. Tying into this article, the article about Antimicrobials into the Manufacture of Hospital Furnishings, raises similar concerns. While it seems that this type of furniture is good in a hospital setting since many sick individuals are seen in hospitals, it is unfortunately not beneficial because it is also contributing to antibiotic resistance. 

Industrial Farming

1. Your thoughts about the vanishing of bees (what else have you heard/seen about this issue?)
The Vanishing of Bees was a very informative and eye-opening. I've heard in various articles that bees are dying in mass but honestly never thought too much of it. This documentary defines the vanishing of bees as "Colony Collapse Disorder," which wreaks havoc on small and commercial farming alike. This documentary made me realize how vital bees are to the environment and how much of an impact they have on the food supply. It was inspiring yet upsetting that bee keepers had to plead to law makers and go to extensive lengths to persuade law makers to pay attention and protect the bees.

2. Dirt!: The Movie
Dirt! made me realize that the dirt and soil that we step on is more valuable than meets the eye. This movie made me realize that dirt and soil are nutrient-dense and vital to our food supply. In addition, it contains various bugs and other organisms that turn compost and other waste into nutrients for the soil. Unfortunately, much of the industrial farming industry and agriculture are ruining dirt and soil, leaving this precious resource depleted. With this in mind, we need to be more mindful of how our activities are impacting the dirt/soil and make more conscious choices to improve our dirt/soil. Composting and reducing the impacts of industrial farming are good starters to improve our dirt/soil.

3. Were you able to discover if there is a factory farm near you? Were you already aware of farms near you? What do you think about this? 
I did not find a factory farm located near me.

4. Composting: Do you currently compost? Have you composted in the past? Do you know anyone who composts? Would you consider composting, after learning about its benefits from the movie? 
I currently do not compost since I do not have any plants and I don't particularly enjoy gardening (I hate bugs!). I did compost in the past when I was younger when my grandparents used to grow a vegetable garden. Currently, I don't know anyone who composts. I would definitely consider composting even though I don't garden and donate my composts to local gardens or gardeners due to the benefits of composting.

Sewage Facilities

Union City has 1 sewage plant, the Alvarado Treatment Plant under the Union City Sanitary District. It's located in a more industrialized part of Union City and it close to the bay water and the San Mateo Bridge.

Campaign for Tap Water

To get people to people to drink tap water instead of bottled water, my campaign slogan would be: "Leave Polluting Plastic in the Past and Turn to Tap Water."

Consumer Confidence Reports (CCR) and Water Quality

1. 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?)

The source of my drinking water comes from a variety of sources including treated surface water from the Sacramento-San Joaquin Delta and/or Lake Del Valle via the South Bay Aqueduct, purchased water from SF that is surface water originating from the Hetch Hetchy Reservoir or locally in the Calaveras or San Antonio Reservoirs in the Alameda Creek watershed. The other two sources include blended water from the Niles Cone Groundwater Basin, runoff from the Alameda Creek watershed, blended water from the Peralta/Tyson and Mowry Wellfield Water Blending Facility and from desalted or desalinated water produced at the Newark Desalination Facility from brackish local groundwater. Water in my community originates from local ground water, blending facilities, desalination facilities, aquifers and watersheds.

2· What chemicals were found in your water that were higher than expected? Fluoride, Trihalomethanes, Bromate, Disinfectant Residual (as Cl2), and 5 Haloacetic Acids (HAA5) were found to have higher than expected levels in my water.

3. What chemicals did you NOT expect to find in your water?
I was really surprised and concerned to find radium-226 and disinfectant residual in my water.

4. 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.
According to ToxNet, fluoride, trihalomethanes, bromate disinfectant residual and 5 haloacetic acids can potentially impact pregnant women and fetuses. These chemicals are associated with spontaneous abortion, birth defects, Down Syndrome and smaller than average neonates.

Water Quality

1. Where does your water come from? The source! Track it from the source to your tap. 

My water comes primarily from a Alameda County Water District's blending facility that blends purchased San Francisco water and local groundwater that comes from the Niles Cone Groundwater Basin which underlies the Tri-City area and is replenished through infiltration from local rainwater, runoff from the Alameda Creek watershed, and water from the South Bay Aqueduct.

2. What did you discover about your water quality? 

I discovered that ACWD works to inform the public of Public Health Goals (PHGs) or Maximum Contaminant Level Goals (MCLGs), despite that PHGs are non-enforceable goals and are based solely on public health risk considerations.

3. Do you use a filter for your water?
I currently use a Brita filter.

4. What are you trying to filter out? 

I use a Brita filter to filter out chlorine taste, odor, zinc, copper, cadmium, and mercury.

5· Do you drink bottled water? How does this square with what you learned when you watched the Story of Bottled Water? 

I occasionally drink from bottled water, but I'm pretty good at bringing my own reusable BPA-free water bottle. The Story of Bottled Water really emphasizes how quickly plastic water bottles are clogging our landfills and adding to pollution levels. I've learned a lot about the negative impact of bottled water and it goes in line with the video on the Story of Bottled Water.

Public health importance of safe drinking-water

After completing this module, it’s fascinating that even thought we are 60-70% comprised of water, we as humans do not pay much attention to how quickly we are depleting our planet of clean drinking water. It’s frightening to see how quickly Earth is being depleted of resources and that it is also causing physiological changes to countries. It’s not surprising that the U.S. consumes the most water per capita and that the population has significantly boomed, creating a higher demand for water. It’s scary to see that we are rapidly depleting our ground water, especially from the agricultural industry and that it can be polluted by these industries. The Clean Water Act of 1972 assisted with controlling U.S. water pollution with specific goals as well as deadlines. This act target pollution from factories, sewage treatment facilities, pipes, agricultural run-off, construction site waste, and requires permits with NDPS to dump from point sources. The Clean Water Act assisted with providing the framework for bills and regulation of clean water in the U.S. This act will continue to be important and should be expanded to protect our water supply from being depleted.

Fragrance

Fragrances have several potentially negative health effects and many people don’t realize how offensive their fragrances are to some people. Especially working in the healthcare industry, it’s very irritating to the respiratory system when patients wear heavily scented perfumes or body lotions. To properly develop a fragrance-free policy, I believe that it is best to begin with examining existing policies. Current policies are mainly seen in healthcare, advising patients to be fragrance-free for their appointments. However, this is not particularly effective, since patients still show up smelling heavily of fragrance. Patients may be unaware that the scent they have grown used to is offensive to others. I feel that the best approach to developing a chemical/fragrance policy to decrease body burdens and exposures is an educational approach. 

Initially, it would be beneficial to research the most commonly used beauty products and fragrances. For example, this may include strong scents such as Chanel No. 5, Bath and Body Works sprays/lotions, and baby powder. From there, creating education materials pertaining to products people recognize will create a bigger impact instead of stating complex chemicals. Educating patients, students, and staff on the potential dangers of their fragrances and making them applicable to products they use will make people more accountable. I would also want to include the effects of exposure to the chemicals in products on individuals as well as others. For exposures related to cleaning products, I would implement a policy where rooms will be unusable until the fragrance has cleared. For example, the Saniwipes used in medical facilities has a 3-minute dwell time, which would be the time that the wipes still emit odor and are present.  Also for heavily scented or deep cleanings, I would have staff conduct cleanings when patients or students are not around to reduce the overall body burden. 

Radon

It was very shocking to learn that radon is the second leading cause of lung cancer and that personally I was also unaware of the silent effects of radon. 

My radon awareness campaign would consist of the following steps:

1. Create educational materials and a course to educate communities on radon

2. Partner with local DPH’s to create culturally competent materials for communities to be distributed at community events (i.e. farmer’s markets, health fairs, etc.)

3. Provide free radon kits, informational materials and assistance for low-cost mitigation professionals for at-risk communities

4. Locate community leaders to assist communities to assist with tracking, monitoring, and reporting levels of radon and exposures to radon

5. Partner with local DPH professionals to conduct community assessments every 2-3 years depending on the overall risk within the community

I would partner with community leaders, local DPH’s, local government officials, real estate agents, upstreamists and primary care physicians. 

Transportation

Personally, I commute daily from the East Bay into Inner Sunset. I drive to Bart, take Bart, and then take Muni to get to work daily. My experience with both Muni and Bart is overall not great, but it's the most convenient method to get to work. Both Bart and Muni tend to be delayed and stretched to capacity, often leaving no room to sit let alone breathe. Many riders on Bart are also rude and I've seen people pushing others onto the train to pack into an already full train. The Bart cars are poorly maintained, with ripped seats, leftover food, drinks and garbage in the trains. I get concerned about my health and safety being on Bart due to these issues as well as the recent increase in theft on Bart. The cleanliness of both Bart and Muni is concerning especially since both attract a lot of homeless people when it's cold and raining. A lot of times the stations and individuals smell like human waste.

Personally, I feel like Bart and Muni riders are more of a health concern due to the crowded trains and the lack of cleanliness. Pollution from Bart and Muni is probably not as significant as the pollution from cars. Despite the issues with public transportation, it reduces the numbers of cars on the road meaning less pollution from cars. This in turn should result in better health for the communities they serve and better overall air quality. Pollution from roadways and freeways does negatively impact the health of many communities and decreases air quality. Reform and investment into a safer and more efficient public transportation system would benefit commuters, communities and overall air quality.

Air Pollution

Community: Alameda County

Zip Code: 94587




Who and what are the top polluters in your zip code?
The top polluters include:

Rank	Facility	City	Pounds
1	NEW UNITED MOTOR MFG. INC.	FREMONT	499,459
2	ARCH MIRROR WEST	NEWARK	44,985
3	PACIFIC GALVANIZING INC.	OAKLAND	23,445
4	ACME FIBERGLASS INC.	HAYWARD	14,147
5	U.S. PIPE & FNDY. CO. INC.	UNION CITY	13,995
6	HEXCEL CORP.	LIVERMORE	13,107
7	OWENS-BROCKWAY GLASS CONTAINER INC. PLANT #20	OAKLAND	12,179
8	ISOLA LAMINATE SYS. CORP.	FREMONT	10,099
9	BORDEN CHEMICAL INC.	FREMONT	8,107
10	OATEY CO.	NEWARK	7,200
11	AXT INC.	FREMONT	7,097
12	ENGINEERED POLYMER SOLUTIONS INC. (DBA VALSPAR COATINGS)	HAYWARD	4,409
13	CLEVELAND STEEL CONTAINER CORP.	OAKLAND	3,900
14	U.S. DOE LLNL EXPERIMENTAL TEST SITE (SITE 300)	TRACY	3,899
15	WYMAN GORDON CO.	SAN LEANDRO	3,333
16	TRIANGLE COATINGS INC.	SAN LEANDRO	3,288
17	W. R. GRACE & CO. CONN. DAREX CONTAINER PRODS.	SAN LEANDRO	2,327
18	ROHM & HAAS CO.	HAYWARD	2,012
19	GILLIG CORP.	HAYWARD	1,854
20	B & P MARBLE INC.

The top polluter is New United Motor Mfg Inc, which upon closer inspection, is ironically Tesla. The polluters in Alameda county are from companies that work with or produce fiber glass, metal products, rubber, plastics, textile mill products, stone products, glass, electronics, and chemicals.

What percent of the homes in your zip code have lead-based paint?
3% of houses in Alameda County have a high risk of lead hazards.

Are there Superfund sites in your zip?  
There are 2 reported Superfund sites in my zip code, both under Lawrence Livermore Laboratory. US Dept of Health and Human Services defines a Super fund as any land in the United States that has been contaminated by hazardous waste and identified by the EPA as a candidate for cleanup because it poses a risk to human health and/or the environment.

What can you tell us about the Superfund sites that are near where you live?
According to the scorecard website, Lawerence Livermore Laborotory is owned by USDOE and operated by University of California. It was used in the 80's to test high explosives and housed several solid waste landfills, with waste from the LLNL main site, Site 300, and Lawrence Berkeley Laboratory.

What did you learn about the air quality in your zip code?
The air quality in my zip code ranges from good to moderate. However, in 2003, the reported maximum PSI level was high, but it may not be the case currently. The main air pollutants in my county were reported to be ozone pollutants.

How about the water quality?
The water quality in my area isn't that great, since many bodies of water are contaminated with various pollutants. My area is 100% contaminated by mercury in lakes, estuaries, bays, coasts, reservoirs and ponds. It was shocking to see that California is ranked #2 in the US for states with the highest amount of animal waste.

How did your zip code fair on a social justice / environmental justice basis?
Alameda county is fair on a social justice/environmental justice basis. There were not too many significant differences overall, but a few that stood out were in regards to income and race. For example, lower income families, lower income children and non-whites were reported to be disproportionately affected by facilities emitting air pollutants

Environmental Justice

Social determinants of health are factors that tend to adversely affect health, such as socioeconomic status, environment, and race/culture. Due to social determinants of health, primarily socioeconomic status, many African Americans reside in low income neighborhoods, which tend to house off-site commercial hazardous waste landfills. In 1987, the Commission for Racial Justice found that race was the strongest variable in predicting the location of waste facilities (Bullard & Johnson, 2000). Other than socioeconomic status, African Americans have been a historically marginalized population in the United States. Stemming from decades of slavery, medical mistreatment, segregation, socio cultural inequalities, legal mistreatment, and socioeconomic status, the idea of “Black Lives Matter,” was created. The notion of environmental justice is tied into the “Black Lives Matter,” because this movement is demanding that people acknowledge and remedy generations of mistreatment of African Americans. This movement is also bringing to light the structural, social, political and economics inequalities that exist for African Americans in the U.S.

According to the EPA, environmental justice advocates fair treatment, protection from health hazards and equal access for all regardless of race, color, ethnicity or income. I have a budding interest in environmental justice because of how it relates to health equity for all and can have the power to allow all communities to thrive.

It’s very common to see that minorities are housed near freeways, have lack of access to fresh food options, have more crime and pollution. It was upsetting read that environmental racism is still an ongoing issue in modern-times. I was in shock to see how many places there are in the U.S. that are known to be toxic, such as Mossville, LA which has been referred to as “Cancer Alley.” It’s upsetting to see that there are so many toxic areas with known health issues that are still inhabited by minorities. If places are that toxic, no one should be living there. It’s sad that despite the evidence and people getting sick, that no one is doing anything to make it stop.

Vulnerable Populations

In Dr. Rishi Manahanda's presentation he coined the phrase, "one’s zip code matters more than our genetic code." This deeply upset me but at the same time made me feel intrigued. Dr. Manahanda's talk advocated an upstream approach to health care, to address health conditions that were being exacerbated by the conditions in which they live in. Dr. Manahanda describes using an upstream to approach that begins where patients work and play in order to create a system to connect people outside of the clinic. The usage of community health workers who understand the communities they serve can assist with mitigating the effects of poor living conditions.

The second video, Little Things, explained how even low levels of childhood exposure can have a lifelong impact on humans. It's frightening to learn that mercury, flame retardants, PCBs, BPA, PBDEs, pesticides and lead are found in children throughout the U.S. Exposures to these toxins while in the womb can cause IQ levels to drop in children as well as permanent cognitive damage from exposure in children/fetuses. The cumulative impact of multiple toxins can also be detrimental.

After reading New EWG Database Reveals 16,000 Foods That May Be Packaged with BPA and discovering the harmful effects of BPA, I realized how important it is to be aware of BPA free branding/packaging. According to the article, scientific studies link it to cancer, infertility, diabetes, obesity and brain, nerve and heart disorders, and to cause reproductive problems.

Despite all the mounting evidence pertaining to the harmful effects of environmental exposures, the US is still focused on sedentary lifestyles and diets as the culprits to the obesity epidemic. We are only focused on sedentary lifestyles and diets out of ease. From a political standpoint, would be more costly and time consuming to stakeholders at the state and Federal level to mandate changes to decrease chemical exposures that are linked to obesity. Causing a policy change could also cause rifts among stakeholders who have strong ties in industry, chemical production, and other potentially toxic industries. In the grand scheme of things, it's easier to push the problem of obesity on the individual to incite an individual to change instead of an entire system. The government should seek to find ways to decrease exposure to chemicals linked to obesity to curb the epidemic, but will probably continue to use the easy way out of blaming lifestyle and diet. 

Biomonitoring

We are all essentially products of our environment, whether or not we'd like to be. It was eye-opening and scary to learn that what you consume, sleep on, live near and the products you use can be polluting your body. This video made me very uncomfortable to what I may have been exposed to as a child and what I may currently be exposed to as an adult. I was upset and shocked upon hearing about how children have higher levels of chemical exposure than adults. It’s very upsetting since children are still developing and more sensitive to potentially permanent impairment from chemical exposures. Chemical exposures are reported to be contributing to the epidemic of chronic disease among american children ranging from developmental disabilities, cancer, asthma, and birth defects. It was also deeply upsetting to learn that the EPA DOES NOT require manufacturers to test effects on human health before approval to put the product on the market. I believed that if any group was responsible for product safety that it would be the EPA. I don’t understand why the EPA wouldn’t want to ensure product safety for products that can greatly impact everyone’s health. What makes this even worse is that it takes only 90 days to test products and would probably help reduce the rise of childhood chemical exposure.

Household Products

I honestly don't put too much thought into household products, since I usually wear gloves or cover my nose/mouth when using heavy-duty products such as bleach. In regards to household products, I commonly use Clorox Disinfecting Wipes and Tide 3-In-1 Laundry Pods.

According to the National Library of Medicine's Household Products Database, Clorox Disinfecting Wipes rank 1, posing a slight health risks. Risks associated with these disinfecting wipes included possible eye, skin and respiratory irritation from the liquid and irritation to the GI tract if ingested. I'm pleasantly surprised that I can keep using Clorox Disinfecting Wipes (they're so convenient) since they pose a low toxicity rating.

I couldn't find the Tide 3-In-1 Laundry pods, but the next closest thing was the Tide Tide Pods Detergent + Stain Remover + Brightener, Ocean Mist. The National Library of Medicine's Household Products Database ranks this as a 2, meaning it poses a moderate health risk. These risks include the same risks mentioned from the Clorox Disinfecting Wipes, but also include skin dryness, nausea, vomiting, diarrhea, as well as eye contact irritation. I wasn't too surprised by this and I probably won't change my consumer behaviors based on these finding since I usually do not come into direct contact with these liquids. 

With both of these products, I feel that most people should and do know about the potential risks associated with the chemicals in these products. Since these products pose slight to moderate health risks, I probably will not be changing my consumer habits anytime soon.

Personal Care Products

As a self-proclaimed product junkie, I'm always on the hunt for the latest beauty products. While I like to think I'm a fairly conscious consumer in regards to additives such as silicone in hair products, this is the first time that I've actually had to stop and consider the other toxic effects. For the purposes of this assignment, chose to examine an old staple and a newer product that I use often. One of the tried and true products I've used for years is TRESemme Tres 2 Hairspray. I wasn't too surprised when I saw the potential health risks associated with TRESemme hairspray. Generally when most hairsprays are sprayed, they tend cause cough from fumes or can be irritating if your eyes and mouth aren’t closed. The overall toxicity rating was rated moderate, with the highest concerns being irritation, allergies and immunotoxicity, mainly due to the fragrance. For this product, I probably will not change my consumer behaviors since it is a product that I don’t use frequently.

The second product I reviewed was Mixed Chicks Leave-In Conditioner. I’ve seen rave reviews from many women online who wear their hair natural and decided to start using it as well within the last year. I was really surprised Mixed Chicks Leave-In Conditioner had endocrine disrupting chemicals, bio-accumulation and developmental/reproductive toxic chemicals. What was surprising to me many of the toxic chemicals in Mixed Chicks are due to parabens. I’ve seen many products advertising to be “paraben-free, sulfate-free, etc,” but honestly didn’t really think too much of it until now. This product contains propylparaben and butylparaben which are a high concern since they can cause biochemical or cellular level changes, endocrine disruptions and skin/lung/eye irritation. I will definitely consider other leave-in conditioners based on these findings and definitely think that there should be more dialogue on the dangers of parabens. I think that most people don't know about the risks of parabens (myself included), due to the already overwhelming market of beauty products on the market.


Ken Cook
The Ken Cook video was extremely eye-opening and informative. It’s surprising that the topic of pollution in people is something that isn’t commonly researched. I thought it was interesting that he collected blood form 10 Americans to be sampled for 413 chemicals. Cook stated the usual sources of exposure like food, air, or water, did not account for the chemical ingredients that were discovered in the lab tests. 287 chemicals were discovered in the lab results due to beauty products. It’s ironic because most people do not pay much attention to everyday beauty products such as tooth paste, gel, and facial cleanser. It was scary learn that industrial pollution begins early in life. Exposures to these toxic chemicals commonly will be exposed to unborn children through the umbilical cord and are considered to the most vulnerable. Many of these chemicals are known to cause cancer, hormone disruption, infertility, birth defects, neurotoxicity and can be toxic to the immune system. This can be very alarming to expecting parents and can cause significant negative impacts on the developing child. This is causing increases in health issues and disorders such as an 84% acute lymphocytic leukemia in children. In order to protect ourselves as well generations to come, we need to better educate the public and push for stricter government control over the safety of our everyday products.