Final Blog on Environmental News

I read this interesting article on Ghosts of the future published by the Washington Post on the history of the earth which began 4 billion years ago, evolving over time.  Fossils, glaciers and tectonics changed the earth and fossilized the animals and organisms giving us the topography we have today.
By this history, it has an impact how we as humans treat our planet.  The earth's climate is changing due to the exponential population growth and use of fossil fuels, this cannot keep pace with the 4 billion years of natural history of the earth.  The life forms on earth are becoming extinguished, our planet is hurling towards the "point of no return" (Washington Post, 2019).

Humans are the first species with the power to alter the planet and predict its consequences, so our actions can predict our future.  No, we won't become fossils but we can become humans who live in a profound toxic world that is vacant of natural history, geography and an organic environment.

Final Blog: Highlights of the course

I cannot believe that this is my final blog, and I hope I continue to blog on issues that matter to me and to the world around me.  I have learned new communication and publication skills with blogging.  The topics on the various environmental and occupational exposures were all interesting and I learned so much.  I have become more conscious about pollutants, wastes and hazardous materials and how these elements affect our health.  Through this course, it has allowed me to care for my patients differently by interviewing them not only about their health history but also about their social, residence and occupational histories.  I truly believe that the environment we live and work in has a significant effect on our health.  The economy we support and rely on also affect climate change and our resources.
I recently returned from Iceland and I learned that the people of Iceland use their own resources to be self-sufficient.  They do not import anything they can produce.  Icelanders are a conservative and organic users of their natural resources.  I liked their sustainability, putting money back into the country's workforce, economy and market share.  They keep the land as natural as they can so there were no over developed areas of fast food places, shopping or rows of restaurants other than in the downtown tourist area of Reykjavik.  It was beautiful and comforting to see and know, especially after the knowledge I obtained in this course.
I think the small group blogging was a good way to view others perceptions on issues that affect them, their colleagues and environment.  It allowed me to express my thoughts without inhibition and read new ideas and thoughts from my fellow bloggers.  Small group blogging was efficacious, worldly and challenging.

Blog #26: Radiation

Ionizing Radiation from the use of Cell Phones

The video on cell phones emitting ionizing radiation was well worth my time in listening to Dr. Davis.  I have always wondered if glioblastoma was linked to long-term cell phone use.  I have heard of studies in the media about cell phone use and cancers, particularly brain cancer.  It never occurred to me about infertility in the adults and birth defects in the unborn with the use of cell phones.  It was a very interesting lecture by Dr. Devra Davis.

When I went to my settings and found the 'Legal and Regulatory' link, I skimmed through a lot of nonsense information about copyright, warranty and license, I kept scrolling down to find information about risk factors on cell phone use but I ran out of patience trying to scroll for the information, no wonder consumers are not aware of the risks, its not easy to find!

I agree and endorse nurses who advocate and support educating the public and their patients on the hazards of cell phone use because where else will the public get it from?  They would have to do their own research or be enrolled in courses like this to be educated and informed.

Position statement on technology and health: Provide scientific research from credible sources, then state your position statement on the health risks of cell phone use.  Publish this statement to the public health authorities and the cell phone companies so they can develop the appropriate infrastructures to use the devices safely, like it was illustrated in Dr. Davis' video.

"Cell phones are attributed to low fertility, birth defects and some forms of brain cancers"

Blog #25: Greening Healthcare

Green Healthcare

 It has never occurred to me to think 'green' in the health care industry until now.  With the informative sessions in this course, I have come to appreciate the environment more, and none so more than in the healthcare setting.  I have always worked in a hospital setting for the last 25 years, and it has always irked me on how hospitals waste so much supply of their instruments, patient care supplies, medications and equipment.  An opened package for one item caused the entire medical supply package to be discarded.  At one hospital I worked at, any sterile packages that were opened and not used went into the mission storage supply to be distributed to less affluent countries but for the most part, very little of the sterile and clean supplies were recycled.  One example is, plastics that are not contaminated with human secretions are not allowed to go into recycling including the water and soda pop bottles and cans that patients and staff use.  When I asked why couldn't these items be sent to a recycling center, I was told because the items came from a hospital, it could not go to a recycling plant for fear of contamination.  Instead, these recyclables now fill our our landfill sites.

I belong to the ANHE for a fellowship program on environmental health and I am currently working in my community to improve land use zoning and development.  There is also the Environmental Justice Foundation (EJF) that deals with environmental and occupational issues in the more vulnerable populations.

I like the idea of 'green health care', it has to involve every aspect of the contributing industries, occupations and the growth of the economy.  

Blog #24: Energy

Energy and Health

The production of energy globally has both negative and positive impacts on the health and the environment.  Reading and watching the articles and videos on current energy sources were very informative and have opened my mind and thoughts of the progress and destruction that energy use has made.  Energy has caused global engineering success with innovative advances in providing the basics of food, shelter and water.  On the contrary, it has also caused depletion of our earth's natural and man-made resources, destroyed our ecosystem and increased the disease trajectory in the world's population.  Knowing what I know now after this educational session on energy and health, I have enough information to advocate and lobby for more sustainable and re-usable energy sources.  The graphics depicted from the reduction of greenhouse emissions was eye-opening and impactful on how I use and conserve energy with my own personal practices.  I can support organizations and industries that promote a safer and cleaner environment when they implement or plan on implementing renewable resources for building and engineering.  The videos and readings were very informative and well promulgated with clear understanding of the content and the audience they were trying to reach.

The current government incentives that are available state and local wide are, monetary incentives and rebates for electric vehicles, parking spaces that are designated for EV which are located closer to the retailers' entrances.  There are carpool lanes to get you to places faster.  There are charging stations located at convenient stops.  I am not sure about this measure, but I think the license fees are cheaper if you own an electric vehicle. I know in Vancouver, in my home city, the parking spots are free for energy efficient vehicles. This is a big incentive, since parking a car is expensive in Vancouver.

Blog #23: News today on Indoor Farming

Indoor Farming to combat climate change

The safety challenges of outdoor farming are becoming more acute with climate change and unexpected shifts in pests and bird migrations.  Indoor farming is a solution to eliminating green house gases as our planet gradually gets hotter and the population increases.  The solution by one company in Baltimore is to use LED lights and the natural lighting to grow and farm food, producing more and having a lesser impact on the green house emissions.  Since climate change is warming the earth, impacting the seasons and weather, the natural environment, including marine and land wild life, it is difficult to produce the amount of food from the unpredictability of climate change.  (News released by the Washington Post on November 19, 2019).  Companies such as this operates and produces food for the planet in an ecological and sustainable way through massive greenhouses, thus, moving us forward into the 22nd century!

Blog #23: Climate Change

Climate Change and Our Health

1. Climate change is predicted to have multiple effects. Are you prepared, as a nurse, to address the effects that are likely to be experienced in your community?
2. Are there ways in which the nursing community can use our trusted voices about health to strengthen climate change policies and practices?

1. As I go through this course on environmental health, I am more aware of the negative health and environmental effects that are currently happening now and will happen in the near future if our conscious effort to reduce our carbon emissions is desensitized and unamended.  I am solely prepared to advise my community but I can educate them on the effects of climate change, its causes and prevention.   Using the fact sheet on climate change put out and endorsed by the Obama Administration is a good place to start my community education and preparedness on the health effects from climate change.

2. Since I have been informed and constantly reminded that our profession in nursing is the most trusted and reliable voice to influence change in policy and public safety, that, by using media and scientific data to convey our message and concern to policy makers, elected state and city officials and the general public that the need to address climate change will be impactful.  One of the ways to influence awareness and action is through nursing and environmental disciplines to project the immediate need to change the way our society does things in order to preserve the planet and improve our green house gas emissions.  Strong bodies that are made up of medical professionals and scientists have the greatest influence on policy change.  Like the Obama Administration, they used reliable bodies of knowledge and experience to influence them release reports about climate change into the healthcare sectors. 

Blog #22: Occupational Exposures

Ergonomics

1. Consider your findings on your MSDS about the potential dangers associated with the chemical/product you looked up.
   • Was the MSDS an adequate tool for a worker to use to gain an understanding about the potential health risks and how to protect him/herself?
   • Consider that the general public reads at a reading level at or below 6th grade, and that's if English is their first language. Was the MSDS still adequate? 
2. How did the occupational health organization's health and safety program you chose relate to your health and safety issues?

I looked up Toxnet on household bleach I use for cleaning my house, and I found an article on bleach affecting women with increase in occurrences in asthma and other respiratory diseases.  I found this article interesting that women are mainly affected because house cleaning is usually performed by women. I tried to use baking soda but it just doesn't quite clean my bathroom sinks and showers adequately, so instead, I wear a mask and keep the bathrooms ventilated while I clean.  I am not exposed to any occupational hazards at work other than ergonomics.  I have an adjustable computer desk and chair that I find helpful from preventing neck strain.  I have windows in my office to let in natural lighting and I have good ventilation with heating and cooling, all keeping me safe and comfortable.  The occupational health and safety did not really apply to me.  When I was an oncology nurse many years ago, I administered IV and oral chemotherapy where I used PPE to handle and dispose of chemotherapy drugs and wastes.

The MSDS is still adequate for the general public but not for people who cannot read or write English.  In those cases, the MSDS information should be printed in the more common languages people can read and write.

Blog #21: Heath Policies

Health Policies

1. Take a look at your local news or listen to the news on the radio or TV over the next week and see if you can identify policies that will affect environmental quality. Can you see a direct or indirect relationship to human health?
2. Do you know the name of your local elected officials - local, state, and national?
3. Are there health policies that you typically track by yourself or through your professional nursing organization or nursing union? How might you get more involved in promoting environmental health policies

To answer question #1, the local news constantly covers the wildfires in California but there are no health policy issues mentioned in the news.  However, I do see the negative health effects as a result of the poor air quality in the valley.  There are numerous clinic visits with respiratory illnesses, such as, exacerbation of asthma and COPD, in addition, to new symptoms of allergies.  These patients are needing more potent inhalers or short term steroid therapy for exacerbations.

Local elected officials for Fresno county for public health officer is Sara Goldgraben MD, MPH, MBA.  Our state public health officer and director of the CDPH is Sonia Angell MD, MPH.

The disease I currently follow is Valley Fever (coccidioidomycosis) and recent health policies that have developed through the process of regulations and policies act.  There is a Bill out S.3114- Combat Valley Fever Act.  This Bill, which was put out in June 21, 2018 serves to track coccidioidomycosis cases in the national registry.  Ms. Harris introduced this Bill.  Valley Fever is my DNP project.

Blog #21: Environmental News Today

Venice, Italy Flooded

On November 15th, 2019 CNN reports extreme flooding in Venice, Italy.  Hundreds of young adults came together through word from telegram social media group to help clean up the streets of Venice, and help drain households and stores. They, approximately 1700 young adults, also collected waste that impact the lagoon's ecosystem.  The lagoon's natural ecosystem cannot repair itself from the pollutants brought in by natural disasters and by mankind, such as, from cruise ships.

Blog #20: Food and pharmaceutical wastes

1. What are the roles that nurses can play in addressing food waste?
2. How can nurses exert leadership in addressing pharmaceutical waste?
3. After watching the TED talk about a young woman who chose to live a zero waste life, consider the changes that you might be able to make in your life to live a zero waste life.

Addressing food wastes, can be done by promoting it through the media (newspapers, social media sites, television), all these avenues can make the public aware of the amount of food wastes that occurs.

Nurses can address pharmaceutical wastes by not giving into insurance companies on prescribing more than 30 days, they do this to increase compliancy.  I feel that it is the person's responsibility to take charge of their own health care maintenance.  

The zero waste lifestyle concept is an effective message to consumers, however, I do not feel it is realistic to get to this point in one's life for most of the population.  In today's world of bigger, better, more and cheaper, consumerism is attracted to this methodology.  As for me, I know I do not have the time or patience to make my own products but I do make the effort to create less waste by using bottled water infrequently, not using disposable utensils if I can help it, try to buy products that are ecofriendly in the packaging and to use products that are sustainable.

Blog 20-Environmental News Today: Trump is an 'Oil' president

Does America Have an Oil President?

According to CNN on November 6, 2019, Jane Fonda, an environmental activist, stated on CNN that our president is bought off by the fossil fuel industry.  The climate crisis is an impending doom to our very fragile earth, and if people in power like our president do not support or address climate change, it will ultimately leave us in a state of emergency of global warming and depletion of our earth's resources.  Many countries already are combating climate change with the conservation of energy and limiting waste, for example, in recent news today, Germany invested billions of dollars to change the beer pack plastic rings on the cans to recycled cardboard in order to reduce plastic and reduce the harm to wildlife.  The U.S. is a powerful and influential country that sets the course and benchmark for change that other countries follow.  If our president limits fossil fuel extraction and production,  he will exemplify the recognition of the world's climate crisis.

Blog #19: Sanitation

Wastewater Treatment Plant

1. Do you know where the sewage treatment facilities are in your community?
• Consider their locations - is this an environmental justice concern? 

When I googled 'sewage treatment plant near me', two treatment plants came up.  The first one was for a raw sewage plant out in the rural part of Fresno county, at Jensen and Cornelia in the southwest part of Fresno, mostly farmland but there are communities out in this area, with the majority of the residents are Blacks and Hispanics.  The Jensen plant is a secondary treatment plant with effluent odors.  The second wastewater treatment plant came up in my neighborhood in the northeast part of Fresno, but this plant is a tertiary wastewater treatment plant that is recycled water used for irrigation for facilities like parks and golf courses.  This area has two affluent country clubs that most likely utilizes this water source.  The northeast communities are predominately white and professionals.

The location of the two treatment plants could be considered as an environmental injustice.  The one in the northeast part of Fresno has a lesser environmental impact on the surrounding communities since this plant is a tertiary recycled wastewater plant used for irrigation.  On the other side of town 22 miles away from my neighborhood is a secondary wastewater treatment plant located in the rural part of Fresno impacting at a greater force to the residents around it.  

Environmental news for this week

California Wildfires

The numerous and relentless California fires are not only causing havoc and physical strain to the landscape, personal properties and the resources but it has more of a detrimental effect on the lives of the residents that are exposed to the fine and course particulate matter (PM) that they breathe in the air.  Our skies around Fresno are looking gray and I can see the pollution in the near distance, however, I am no where in close proximity to any of the fires to the north or south of me.  I see the PM laden on the cars and trees.  Our air is so dirty that I cannot run outside, and when I am out, I suddenly start sneezing and coughing, so I can only imagine what it must be like for the individuals who are evacuating to nearby towns only to be intoxicated with all these gases and PM.  As a health care professional I can only predict that I will see more patients at my clinic with respiratory illnesses or exacerbation of their diseases due to the air pollution from the fires around California.

Blog #18: Pesticides

Treat our earth like a nest egg

Reading and watching the videos on the use of pesticides were appalling and eye-opening on the amount that is currently being allowed on the market.  Not only were the videos were at my dismay but what was found in my food I had eaten the day before shocked me.  The chicken I had contained 14 pesticides, the Brussels sprouts and asparagus had about 11 pesticides, and to my surprise, the bottled water I consumed had pesticides in to too.  I drink bottled water because I do not trust our city water because of the chemicals and pharmaceuticals that seep into the ground water.  I also wondered prior to taking this course, if the pesticides ever got absorbed into the meat of the fruit and not just a residue on the outside.  Nonetheless, I am grossly shocked to know how our government is regulating our consumerism, and how we are treating our gentle and giving earth.  

Then I do agree with organic, sustainable and preservative farming and agriculture.  We do not need to expend every resource it has given us, so then, why aren't we treating our world like a nest egg?  Our attitudes and practice towards organic sustainable agriculture will ensure the nest egg we have relied on for thousands of years, to continue to produce, protect and regenerate for a thousand more years to come.

The public should be informed through media sources and doctor visits on how to live and eat healthier by giving them the facts about pesticides, that it is not all good.  In fact, most of the pesticides according to the literature are harmful, causing birth defects and chronic diseases.  Maybe we should not just talk about calories and exercise, maybe we should talk about the root of the problem to our populations at risk, I think this will be a good start.

If there are postings about pesticide use in my children's playground, I would take them somewhere else to play, maybe a community center.  There is no guarantee that the pesticides are kid-proof.

I am more aware of the effects of pesticide poisoning but I would need more education and exposure to the clinical cases to be 100 % prepared and confident.  I do have a clearer understanding on the exposure risks to pesticides.

Blog #17: Food Safety

Food Safety

Consider what you ate today and where the ingredients came from? How many health standards might have been invoked?

The food I ate today, came from a globalized market because they were products bought at my local grocery store.  According to the video on food safety and production, not all ingredients are local.  The product boxes may state product of the U.S.A., it doesn't mean that all the ingredient s are from the U.S.A.  I do read the labels and the ingredients before buying the product.  Codex Alimentarius is an international organization for food safety in its production, process, and distribution to ensure it is good quality food free of contaminants and bacteria.  This organization ensures adequate food safety standards for human consumption and for trade in commerce.  The food I bought and ate went thought the Codex on, animal feed and welfare, antimicrobial resistance, the technology (biotechnology) used to process and package the food, void of contaminants that are not intentional, nutrition and labelling and use of pesticides. Although I did not buy organic, I expect that the food I consumed today was safe.

What vulnerable populations do you work with that could benefit from education on food safety?

I work with all age groups but the people I take care of are for the most part educated and of working class. I can educate the population that I take care of to have them read the food labels carefully and where they buy their food in order to prevent risk of contamination from poor quality food sources.  Pregnant women would be one vulnerable group to educate in buying local and organic since we have been educated and made aware of pesticides that cross over into the placenta, causing fetal damage and endocrine disruptors for both mother and baby.

Given the increase in antibiotic resistance infections, especially those that are hospital acquired, what are some initiatives that nurses can propose to promote safe uses of antibiotics in agriculture (through food purchasing decisions at home and in our institutions) and from other sources that create risks for the development of resistant organisms?

Teach and inform patients to buy local from smaller farms, this ensures that they are not buying from CAFOs.  Concentrated animal feeding operations (CAFO) use antibiotics in the feed and water to prevent illnesses caused by overcrowding and unsanitary conditions of animals.  The meat products that we consume are contaminated with antibiotic-resistant organisms, particularly, E. Coli.  With this information, it is pertinent to advised patients to cook their meat thoroughly.

Nurses and other health professionals can steward the safe use of antibiotics through advocating for policy change in the agricultural industry.  We have the knowledge power to convince policy makers to change how our agriculture is conducted affecting consumerism and public health with unnecessary and unsafe use of antibiotics in our slaughter animals for human consumption.  One alternative and trending food product is plant-based foods instead of meat.  By adding this option on the hospital menu for both patients and staff can reduce the consumption of antibiotic laden meat products to a more healthier one.

Blog #16: The power of Health Care Purchasing.

Farm to Hospital Theory

I quite liked the articles and videos in this week's modules on agriculture.  The power of health care purchasing allows a more farm to hospital service to the public by providing more organic foods produced through regenerative farming practices.   The article discusses about the power of health care institutions having the power in purchasing organic produce and meats in a more local commerce rather than corporate commerce on food purchasing.  By purchasing large quantities from organic agriculture, it allows the sustainability of organic farming.  This method of farm to hospital of large health care institutions who focus on local and regional farming impacts on the public and the environment closer to home making the affects are more noticeable.  By having a large purchasing market for produce, organic agriculture will slowly and steadily push out large factory farming, ultimately, improving the population's diet and nutrition, decreasing acute and chronic diseases and preserving the environment from deterioration and pollution.

Blog # 16: Environmental news

Animal Agriculture

The public nowadays are concerned about where their meat and produce come from, and farmers are moving towards improving animal welfare that will impact climate change.  This movement is due to the transparency of agriculture in its modern and onerous time.  Twelve states have banned extreme animal confinement, resulting in more use of green space in the natural environment for animals to roam and eat from the earth.  Producing less meat products are driving consumers to eat more plant based foods.  Through this shift in food consumerism, it is predicted to have less pollution, odor, better operating systems and food delivery.

How does this consumer movement on the type of food consumption effect climate?  The authors of a recent article states that by using ecological regenerative systems that mixes with animal agriculture, plants and fungi, will be more intuitive to nature.  This ecological movement will ultimately decrease greenhouse gases because the type of diet people consume is more conservative in energy used to raise animals, process the meat and ship it to the consumers.  The earth, people and animals all benefit from this change in diet and industry.

Blog #15: Drinking water

Drinking water in California

Certain areas of California have contaminated drinking water, for example in Kettleman city.  Areas near agriculture are more prone to contaminants due to their proximity to pollutants from farming and dairy.  My source of drinking water come from municipal wells.  Fresno city's watershed is at Millerton dam.  I do use a home osmosis system throughout my household with carbon and Nacl pellets.  Although, our city water is treated through our water treatment plant, I don't trust the quality of the water because of its chlorinated taste.  I know this because I taste the difference in the tap water in Vancouver, Canada to Fresno's tap water.  The tap water in Vancouver tastes pure and it taste like your drinking the better quality of bottled water on the market.  My water system is filtering out the chemicals used to treat my drinking water.  When I go to the gym or when I'm at work I do drink bottled water, and yes, I did watch the video on the 'story of bottled water'.  The information surprised me so now I look at the source and where it's bottled.  Evian is bottled water that I trust and drink as opposed to the lower grades of water.  Even the lower grades of bottled water are filtered with reverse osmosis and is considered clean compared to our tap water, which I will not drink.

Blog #14: Water

Water

Watching the videos on water consumption and contamination and reading articles about mercury contaminating the communities water supply does not reassure me that the ground and surface water is safe where I live.  I live in the central valley in the city of Fresno, far from any agriculture or cattle farms.  However, nearby communities are surrounded by agriculture where pesticides are used on our crops and fields that leach into the soil and contaminate the air.  The pesticides contain volatile organic combustibles (VOC) and mercury that make up particulate matter (PM) contaminate the surrounding areas that have dairy, ranches and fields of crops.  Although my risk of ingesting highly contaminated water is a lot less than in communities who live in close proximity to these industries, the videos explain that ground and surface water can carry contaminants for miles from the polluting source.  I have a reverse osmosis filtration system in my home and I drink bottled water when I am not at home.  To summize, I am not convinced that my community has safe drinking water.

Resources that I can rely on to ensure clean drinking water, is through the county's public health department.  Our water quality is monitored on a regular basis.  There are no NGOs in my community advocating for clean water because of where I live but when I drive out towards the rural agricultural parts of of the central valley, such as, Kettleman City, there are signs about clean water and water conservation.

I think policy lobbying is a good way to make legislators aware of the problem, after all, any public protest, boycott and policy proposal have resulted in improvement in the health of communities as history shows.

Blog #14 Environmental News today

Rethinking waste and plastic thrash in Bali

I read Bali in the headline, so I had to read it.  I am traveling to Bali in late November, it has always been one of the many places I have wanted to visit.  The beaches of Bali are pristine, as I imagined but the current news posted a waste land of garbage on one of its beaches.  During the rainy season, from November to March, tons of trash is washed ashore, leaving an unsightly mess.  It is called 'garbage season' in Bali.  It makes me not want to go.  This garbage strewn site is a result of increasing tourism, lack of infrastructure and an unofficial plan on how to dispose and recycle garbage.  Countries ranked as poorly managing plastic are: China (#1), Bali (#2) and the U.S. (#20).

The news reports that only half of the waste is properly managed both in recycling and landfills, the other half ends up in the ocean, so when the water rises in the rainy season, all this garbage washes up on shore.  Now the Bali government had banned plastic straws, plastic bags, and polystyrene (s synthetic aromatic hydrocarbon polymer to make car parts, instrument panels, used in food service industry for food trays, containers, disposable eating utensils, and foamed cups, plates and bowls).

Blog #13: Radon, CO2 and VOCs

Radon Campaign

Using local media, advertisements in popular magazines and in health clinics are the main targets for the awareness and education of radon.  I would use my organization the Alliance of Nurses for Healthy Environments (ANHE) to make the public aware, just as health care providers promote the influenza vaccine for the prevention of the flu.  The stakeholders accountable for the health of the community will be the local public health department and the PCPs who must educate their patients and the public on radon exposure, testing, prevention and resolution.  If radon is the second leading cause of lung cancer, then it is only prudent to supply every home with a radon detector, along with smoke and carbon dioxide detectors.  This policy will ensure a preventable environmental catastrophe and health of the community.

Carbon Monoxide Exposure

Following the recommendations of the CDC video on carbon monoxide (CO2) poisoning, during the patient's health visit, it is important to ask about the home and work environment.  What are the sources of potential CO2 exposures that could negatively affect the health of my patient.  Like annual exam screening questions, CO2, radon and VOCs exposure can be asked on the patient assessment paperwork.  The PCP will review the health questionnaire and manage the patient from the information provided.

VOCs

I have at least three if not more VOCs in my home because I am a clean freak and germaphobe.  I like to clean with bleach and other chemicals that are contained in my cleaning products.  When I do use them I vent the rooms but sometimes, the ventilation is not adequate enough for the stronger VOCs I use, as a result, I have a sore irritated throat for about 2 days.  Learning more about toxic environmental exposures in this course, I have become more selective on the cleaning products I use.  My workplace has many VOCs as well from disinfectants to the cleaning supplies used in the office.

Formaldehyde

I would have them watch the video on the Brazilian blowout, then educate then that formaldehdye use and the risk of crossing over into the baby via the placenta.  Formaldehyde is not only toxic to the mother but it can also cause birth defects while the baby is in uterus because it is carcinogenic.

Blog #13 Environmental News on Valley Fever

Valley Fever Expansion by the end of the 21st Century

This news about Valley Fever (VF) is of interest to me because this is my topic for my DNP project.  The report recently released in Irvine, California that climate change is affecting the spread of VF.  VF is currently endemic in Arizona and California's San Joaquin valley because of the valley's hot and dry climate.  The spores live in undisturbed dirt but when soil is disturbed through farming, agriculture and dust storms, these activities can carry the micro-spores in the air where people who are exposed to dust and soil, can breathe these spores, resulting in a respiratory infection.  Scientists predict, due to climate change will cause the fungal infection's range to spread from the central valley northwards and through to the mid-west of the United States by 2095.  This vast infection to the geographical range can increase health care expenditure only exponentially.  How can global warming and the rise of VF can impact the populations' health? It is through education and awareness of the disease so it can be diagnosed and treated sooner before dissemination can occur.  Hence, my DNP project is educating the primary care providers on clinical symptoms of VF, its screening methods and treatment modalities.

Environmental news today: High levels of PFAS found in milk!

Biosolids: mix of human wastes with toxic chemicals are spread on crops!

Released October 5th, 2019: human sludge wastes should be in landfill but instead some waste management companies are repackaging this sludge and selling it as fertilizer, for crops that humans and animals consume.  This sludge waste contain PFAS and other pharmaceuticals that are left in the sludge.  The report states that 60% of sewage sludge produced by waste treatment plants will be spread on farmland, gardens, schoolyards and lawns.  Human sludge contains nutrients, nitrogen, and phosphorus but it also contains large amounts of PFAS , hormones, plastic worms, bacteria viruses and pharmaceuticals that humans consume and in the pipes of the sewage treatment plants.  The EPA however, insists that spreading is toxic waste is safe.  A university study found that 75% of people living near farms that spread biosolids had health issues like burning eyes, nausea, vomiting, boils, rashes, and some even contracted MRSA.

Maybe that's why we have such an unhealthy society in the U.S.  We cannot possibly blame it all on lifestyle but more of what we eat and how the U.S. produces food for human and animal consumption.  It is downright appalling!

Blog #12 Indoor air quality

Indoor Air Quality

An environmental assessment in the home or school is an extremely valuable tool kit to use to determine the cause of acute illnesses.  I never knew there was an environmental health nurse that could assess one's home or school to find risks of  indoor pollutants such as, mold, radon or CO2. So to answer the question, if schools in my area have an environmental health team, I'm not sure.  In fact, I am not sure if any of our school nurses know about Environmental Risk Reduction through Nursing Intervention and Education (ERRNIE).  

It is best to use the city's health department to conduct an ERRNIE assessment to see if our kids in schools are actually being exposed to these pollutants.  Like the 'YouTube' videos show that one would have to physically look at the rooms for ventilation, leaks and cracks to assess the school's indoor air quality.  I think it's a good measure to to be done on a yearly basis in order to keep or kids healthy.  From a community health standpoint, implement a policy or make the parents aware through the ERRNIE to be activists in this health concern.

Blog #11 The built environment and transportation

I agree with the readings and the  video by Jan Gehl fro Copenhagen, Denmark about the speed of the built environment affecting population's green space and the affect on social living.  I found it quite interesting since I have never thought along that concept of urbanization and living.  Reducing green space means reducing space for gathering, social activity, physical activity and relationships.  Mega cities are the root of the lack of green space, resulting from advancement in  architecture, and that Gehl's describes as 20, 60 and 120 miles per hour.  The rapid growth of buildings isolates the people and crowds them with the amount of traffic and buildings.  Gehl's  concept of living with a good and active quality of life in an urbanized city is promising and needs attention now.

I do believe that having an efficient transiting system will serve the communities well who live in an urban and cosmopolitan city.  When I traveled in Europe, their transportation system is efficient and everyone walked there.  Despite their rich diet of carbs and cheeses, don't forget the wine, very few people are overweight.  There aren't an abundance of fast food places either.  I think the car is way too convenient and there are laws that enforce drivers to be mindful of bicyclist and pedestrians, even in Fresno.

Blog #10 Indoor Air Quality

Indoor Air Quality in Poverty Stricken Communities

I found the article on household air pollution quite interesting.  I have never have thought about air pollution indoors until I read this article published by the WHO.  They report that approximately 3 billion people cook on open fires fulled by kerosene, biomass (this is a new word for me) and coal.  Just to clarify that 'Biomass' consists of wood, animal dung and crop waste to make a fire.  This way of cooking leads to adverse health effects such as pre-mature deaths, stroke, MI, COPD and lung cancer.  In children under 5 years of age, half of the deaths are from pneumonia caused by particulate matter (soot) from the household air pollution.  

Household air pollution is more problematic in third world and developing countries.  As a result, the Global Alliance has set  a goal to have households to adopt clean cooking stoves by year 2020 with the aim of eliminating deaths from cooking by 2030.  This statistic is astounding to me because it was not known to me about the risks of indoor air pollution.  In order to achieve the 2020 goal, there are alliances from different disciplines that must contribute their expertise in this issue.  Expert advise and experience comes from specialties like. epidemiology, climate science, global finance and gender equality.  

I am being presumptuous in stating that my house has no air pollution caused by my indoor cooking methods, however, I do like to BBQ and I use a gas grill but sometimes I use a charcoal grill doused in fire starter to fuel the fire.  After reading this article, I think I will limit my outdoor cooking, and only use a gas grill.  Even though all this combustion cooking is done outdoors, who is to know if any of the smoke or fumes remain inside my home or on my food.

Blog #9 Air Pollution

Air Pollution

Reflecting to this week's readings and educational videos on air pollution, I found the content interesting, not only because it is a constant factor of our everyday lives and the negative health impact it has on the health of populations, but also I had a very limited knowledge on what makes up the air pollutants.  The 1970 Clean Air Act set emission standards on the six major air pollutants which are: carbon monoxide, lead, nitrogen dioxide, ozone, sulfur dioxide and particulate matter (PM).  The PM is a combination of extremely small particles of liquid droplets made up of acids, organic chemicals, metals and soil and dust.  The modifiable PM are from mechanical, industry, vehicle emissions and tobacco smoke, and now more recently from e-cigarettes vapors.  I read the PM in the air can contribute to over 800,000 premature deaths worldwide.  This number is substantive and it shocked me of its magnitude.
I accessed the environmental screening for hazardous air pollutants and I found that lead found in 50 cities in California was ranked from #1, the worst city with air pollutants, which is L.A., following into #2 place is San Francisco, #3 Alameda, #4 place is San Diego and 5th place is Fresno; the least polluted city is Calaveras. These statistics came from number of housing units that contain lead in the homes.
My next investigation was on the ultra violet (UV) index for Fresno, where I work and live.  This UV index is reported daily with a range from 0 - 10+.  Today on 09/26, the UV index is 7, making it unhealthy and high risk of sunburn.  The website for air quality publishes protection guidelines for the public to follow to lessen the impact of poor air quality on the health of individuals.  The air quality advisory recommends with a UV index of 7, people should stay indoors or in the shade between the hours of 10 a.m. to 4 p.m. when the sun is the strongest.  The site also advises to wear wide-brimmed hats, sunglasses and UVA and UVB SPF 30 sunscreen and long sleeves if one plans on going outdoors.
My third investigation was through the Lung Association website on PM pollution, it was a report card on the air quality across the U.S.  I put in the zip code for Fresno (93720) and the annual grade is a fail with PM measuring 29.0.  San Francisco got a D for today and a pass for the annual average of 2.3.  The cleanest cities year round are: Cheyenne, Wy, Kahului-Lahaina-Wailulku-Honolulu, HI.
The journal articles and the videos are all relevant to my practice in Internal Medicine where I work.  By educating parents of children about how air quality can impair lung function and growth are both important information, and it is particularly important to sensitive individuals with asthma.  The short term health effects are significant in the quality of life for all ages but the long term health effects are also concerning since most of the PM affect the cardiovascular and respiratory systems, causing early mortality.

Environmental News from EHN - Blog #9

This week on Environmental News

The Environmental Health News reports today about what happens when you flush?  The title intrigued me so I read on, and not to my surprise, the article reports how chemicals from the products we use in cosmetics, hygiene products, cleaners and laundry soaps end up in our waterways.  This is not new information, however, what is new about this information is that our sewage treatment plants are designed to breakdown and convert organic wastes into carbon dioxide, nitrates and phosphates, all of which are found in our natural environments.  In contrast to the synthetic ingredients found in the products that we use everyday are not naturally occurring compounds that are found in our environment, these synthetics are called 'xenobiotics', meaning it is not a chemical or substance found in the natural world.  Some chemicals such as: sorbitol, sodium fluoride, sodium hypochlorite, paraben, chemicals that are in our soaps and shampoos are xenobiotics.  These chemicals are not broken down and pass through the sewage system unchanged and end up in drinking water, streams, rivers, groundwater and oceans.  The message of this news post is that pollution does not have to come from the corporate world of industries that dump thousands of gallons of contaminated water into our waterways but it also comes from human wastes that are not organic!


Post credited to William H. Schlesinger from ehn.org

Blog #8

Environmental Justice and Environmental Racism

Environmental justice and environmental racism are new terms for me.  I have seen environmental injustices around the cities I have lived in or have visited but I never put the term to use or even entertained the idea as 'racism' or 'injustice', I have always just thought of the people who live in these areas are poor and have no other choice to live.  It has never occurred to me how and where developers use land for use in industries that pollute by noise, particulate matter from motor vehicles or heavy machinery, strip the use of water resources and reduce the green space of the neighborhoods affected.  Land use does define a certain population or race made up of people of color and people of lower educational and socioeconomic statuses.  These people, according to the readings and videos burden the nation's pollution problem and toxic waste sites, rendering adverse health effects and health outcomes.  If this is the case, then it is policy making that is discriminatory, deliberately targeting communities of color.

I have not encountered any environmental events in my community, but now that I am more aware of the social injustice and environmental issues, I will have to pay more attention to this.

The social determinants of health is influenced by environmental health.  Among migrant farmers for example, who work in soil disturbing activities, live in close proximity and work in soil and dust, so when I think about the social determinants affecting a population in my DNP project, I do think about environmental justice.  I my clinic I do ask about occupational, recreational and domestic exposure to dust and soil as part of my social determinant assessment.

Blog #7

Environmental News

Air pollution reaches the placenta during pregnancy by a pregnant woman breathing in polluted air from motor vehicles and fuel burning industries, this is known as Black Carbon (Davidson, 2019).  This was discovered in a scientific study in Belgium where donated placentas from mothers showed soot-like carbon on placentas.  The placenta is barrier to many toxins but with this study, this was not the case.  The researchers have associated air pollution and an increase in miscarriages, premature births and low birth weights.  

Blog #7 The Little Things that Matter

I liked Bruce Lanphear's video on the impact of toxins on infants' brains as they develop and potentially have a decrease in their IQ by 57% by being exposed to toxins like mercury, lead, PCBs and PBDEs, either by the ingestion or inhalation of the chemicals.  His video was dramatic on the statistics and the body burden a child holds from the environmental exposures.  He also reports that the FDA reassures the public that low levels of these neurotoxin cause no harm but he differs to the contrary.  Bruce reports that in Europe, a toxicology report must be submitted to the FDA before being released into the environment or to be used in human consumption.  He makes a few noteworthy points in ways to avoid exposure to toxins: write a letter to your state or federal representative, require industries to test products before going to market (I thought the U.S. and Canada did this already), eat fresh or frozen food, choose organic if possible, avoid canned and processed foods, in pregnant women, they should eat fish with low mercury levels, avoid pesticides around the home, check your home for lead hazards and dust floors and surfaces to help reduce exposure.  I thought it was a very good video that explained the topic clearly.  Based on this information by Bruce Lanphear, avoidance of these toxins can be incorporated into prenatal and neonatal care, as well as for the child's annual health visits.  A simple pamphlet or discussion at a prenatal visit is all it takes to get the information out.

Blog #6

Environmental Health News

The article on the Deepwater Horizon spill site was released 09/08/19, reporting how the oil-soaked site 40 miles off the Louisiana coast caused by an oil spill from the Deepwater Horizon oil rig during a drilling operation has caused an endocrine disruption in the deep sea crabs and shrimp.  The title of the article attracted me to read it entirely.  The summarize, the article reports that chemicals released from old degraded oil has caused an abnormal functioning of the sex hormones in deep sea crabs and shrimp, causing them to migrate in droves to mate.  These crustaceans are contaminated and are sick so there is no commercial harvesting of them for human consumption, but other marine life higher up in  the food chain eat them, and in turn, human consumption of fish can pass on the toxins.

This was an interesting article to read on how the food chain hierarchy can eventually affect human life.  This oil spill happened in 2010, and to this day, the environmental impact is as immense as it was nine years ago.

Body Burdens:

The video by Ken Cook about 10 Americans who were tested for chemicals in their blood, from pesticides and industrial chemicals that these 10 American workers were exposed doing farm work, spraying pesticides on the crops.  However, the chemicals found in the 10 Americans were banned over 30 years ago.  Ken Cook reports in his video that the chemicals most like was transmitted during inutero.  The body burden of chemical exposure in the air, water, food, cosmetics and occupation are main components of chemical exposure. His testimony is supported by an article I read on 'Modern Environmental Health Hazards: A Public Health Issue of Increasing Significance inAfrica'.  This article by Onyemaechi & Sanders, 2009, state that increasing urbanization and industrialization, the modern environmental health hazards (MEHH) can supersede the traditional health hazards are critical contributors to environmental disease burden.  Examples of MEHH pollutants: mercury, this element causes neurological deficits; it can be ingested, inhaled or transferred through the placenta and the blood brain barrier in a pregnant woman.  Lead is another naturally occurring heavy metal, it is also a neurotoxin and a cardiovascular threat.  This metal can be found in water, dust, soil, ceramics, pencils, crayons pipes and paint.  With pesticides, the breakdown products are DDT and DDE, these are neurotoxic and an endocrine disruptor, causing infertility.  Air toxins from urbanization and industries that emit automobile emissions.  There is also indoor air pollution from domestic fuel used in  homes with wood and coal, cigarette smoking.  Water contamination is another source of pollution to the body from chemicals dumped into ground and surface waters.  Lastly, industrial and domestic wastes that can pollute the land and the surrounding environments.  

Now that I know the sources and modes of transmission, I can educate my population of patients, who are in occupations that might expose them to MEHHs, and pregnant women who work in industries that have high chemical exposure that not only affect their health but also the health of their baby.

Blog #5

Environmental health news

This environmental health news I read recently from ehn.org, which I subscribe to, posted a recent finding on a common insecticide used in agriculture is affecting migrating birds that use the fields for food and water.  The article reports that the insecticide, neonicotinoid is harming migrating birds and also affecting the bee population as well.  This pesticide is used commonly on corn, cotton, sorghum, soybeans and a few other fruits and vegetables to prevent destruction of the crops, however, this insecticide affects the migration delays and weight loss of migratory birds.  A study done in Saskatchewan, Canada tested the neonicotinoid on a certain species of migrating birds that use the agricultural fields to refuel, what the researchers found was, these birds that were exposed to the a neonicotinoid caused an anorexic response resulting in rapid weight loss, and the birds did not leave the stopover site to continue their migration, both effects could result in the birds survival.  According to the researchers, this delay in migration process can affect the birds' nesting and reproduction cycle.  The researchers also state that since 1966, 74 percent of bird populations have declined in North America, that rely on farm habitats. 

When I read the report, I did not find the headliner a new concept but rather I found the article to be interesting in how the researchers explained the decline of migratory birds, and how this particular component in the pesticide acts as a neurotoxin to migratory birds.  

Blog #4

Perchlorethylene

I chose this topic because I have read in my past studies that persons who work in a dry cleaning facility are more at risk for cancers.  In this blog, I am prompted to consider a few topics for discussion.  Perchlorethylene (perc), also known as Tetrachloroethylene is a widely-used chemical to dry clean fabrics, manufacture textiles and degreasing metal mechanisms.  This topic interests me because I use my local dry cleaner weekly where there is a young mother working with her newborn infant.  After reading the EPA article, I am concerned about their health and risk exposures. The EPA has published a hazard summary article on the negative effects of perc on persons who inhale the vapors  when working in dry-cleaning. Some of the acute effects are irritation of the upper respiratory tract and eyes, kidney dysfunction and neurological effects such as mood and behavioral changes, impaired coordination, dizziness, headaches, sleepiness and unconsciousness.  Some of the chronic effects are: impaired cognitive and motor function.  The EPA reports that persons who have been exposed working in dry-cleaning have had numerous types of cancers including bladder, non-Hodgkins lymphoma and multiple myeloma.  The EPA has classified perc to be carcinogenic to humans.

For the most of the consumer population and for the occupational workers in dry-cleaning, it is unknown to them the hazards that lie within the working environment.  I have never heard of "wet cleaning", something I have to research and investigate.  As for making personal choices in order to reduce the use of perc, I would need to dry clean less and buy clothing that I can wash myself.

Blog #3

Environmental Health News

The current blog is noted from the recent environmental health news from ehn.org.  This is a website where I receive weekly environmental reports from around the world.  The most trending and popular habit amongst teens is the use of e-cigarettes, also known as vaping.  It is known from frequent media that the act of vaping causes unknown chemical exposure and toxins to the individual who vapes, but a current news release as of August 29, 2019, states that secondhand vape exposures are on the rise for teens.  The secondhand smoke study was published in JAMA Network Open Journal showing evidence of exhaled aerosols containing compounds of nicotine, heavy metals, aldehydes, glycerine and flavoring substances that are related to several negative health impacts not only to the individual who is smoking the e-cigarette but also to bystanders.  Some of the negative health impacts due to vaping can cause heart disease, stroke, anxiety, depression and asthma symptoms.  These negative health effects are similar to traditional tobacco use and exposure, which is the reason why companies have now manufactured e-cigarettes thinking it might be a safer product for addiction.  However, no studies were done to assess the long-term impact on the health of the individual or the exposed group, yet it is approved by the FDA for consumers.  There are now policies enforced by schools and certain venues on not allowing any kind of smoking but there should be stricter government policies on vaping.

Profile

Blog #2

Consider the role of nurses and other professionals in environmental health

My goal of an environmental improvement project is to address two issues:  the first, is to implement an educational program on Valley Fever to PCPs in the rural and occupational health clinic in Fresno County.  The project will be designed to teach PCPs on Valley Fever symptoms, etiology of the disease, its process and routes of infection in order to diagnose the disease sooner than later, and to screen vulnerable individuals who might be exposed to the coccidiodes spore.  My second project is through the Alliance of Nurses for Healthy Environments (ANHE) working on land use in the South industrial area of Fresno, where communities around this area will be exposed to air and noise pollution from the development of the land around them for the State's high speed rail system.  My role with ANHE is to assist in the preparation of an environmental impact report through my community based organization called 'Building Healthy Communities' to the city of Fresno on the environmental impact it can have to this population of individuals who live around the high speed rail site.  This project will not prevent the development of the project but with the presentation of evidenced based literature, the city will consider filtering the impact of the pollution anticipated.

Blog #1:Module introduction

• Define environmental health

My definition of environmental health encompasses social, physical and mental well-being that can be impacted either positively or negatively from the surrounding environments we live in.  Studies have illustrated that there are many pollutants that can cause disease and disabilities from noise, particulate matter, microorganisms, chemical and vapors produced by industries in close proximity to communities.  Mental stress from increasing urbanization takes away green space from the communities affected.  Particulate matter from automobiles and commerical vehicles release pollutants in form of particulate matter, causing most respiratory diseases we know today; the most common and prevalent disease is asthma.  If communities live near agriculture, they are exposed to pesticides, herbicides and insecticides, chemicals then seep into the soil and ground water affecting the health of populations who consume it's products.  

My DNP project is on Valley Fever, it is caused by a microorganism, a fungal spore that is aeroilzed and inhaled by people who work in soil disturbing activities such as soil tilling, construction, and wild land fire clearing.  The fungus spore is called coccidioides, and the disease is also known as coccidioidomycosis.  This illness affects people who are more vulnerable to this infection by the occupations they engage in or the communities they live in from the surrounding soil-disturbance industries.

• List the environmental health risks in my home

I used the Davis-home-environmental-health-and-safety assessment tool to assess any hazards in or around my home.  I had few products in my home that I regularly use for cleaning.  I also use a pest control service, knowing fully that these chemicals seep into the soil and inhaled by the person spraying.  However, I do have fire and carbon-dioxide sensors in my home, and I do subscribe to a home safety company for theft, fire and emergency services.  I do not live near any industries with construction around my neighborhood around fracking, incinerators or agriculture, and I do not use well-water.  There is some minor residential construction within a 2 mile radius from my home.

Consider the role of nurses and other professionals in environmental health

My goal of an environmental improvement project is to address two issues:  the first, is to implement an educational program on Valley Fever to PCPs in the rural and occupational health clinic in Fresno County.  The project will be designed to teach PCPs on Valley Fever symptoms, etiology of the disease, its process and routes of infection in order to diagnose the disease sooner than later, and to screen vulnerable individuals who might be exposed to the coccidiodes spore.  My second project is through the Alliance of Nurses for Healthy Environments (ANHE) working on land use in the South industrial area of Fresno, where communities around this area will be exposed to air and noise pollution from the development of the land around them for the State's high speed rail system.  My role with ANHE is to assist in the preparation of an environmental impact report through my community based organization called 'Building Healthy Communities' to the city of Fresno on the environmental impact it can have to this population of individuals who live around the high speed rail site.  This project will not prevent the development of the project but with the presentation of evidenced based literature, the city will consider filtering the impact of the pollution anticipated.