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.

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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.