M6.7 Obesogens

According to the Seasonal Food Guide, as of late September in California, these are some of my favorite foods in season:

• apples
• Asian pears
• Avocados
• broccoli
• bok choy
• cantaloupe
• mushrooms
• persimmons 
• potatoes
• winter squash
• watermelon

I am surprised watermelon is on the list because I thought it was a summer fruit and my family mostly eat them during the summer. My family likes to eat seasonally, so in my household, I usually have Asian pears, persimmons, and apples around this time. I think it is a great idea for hospitals to serve seasonal and locally grown foods because similar to what the article is stating, this can model healthy eating behaviors. It is ironic for hospitals to serve unhealthy foods to patients who are ill.

I have never heard of obesogens until this class. And until reading this article, I always thought obesity was caused by poor diet, not from a chemical compound. Learning that obesogens can alter people's metabolism and predispose them to weight gain suggest that there are other interventions to address obesity other than pushing people to eat healthier and exercise more. 

One of the obesogens I searched up on Toxnet is perfluorooctanoic acid (PFOA). It is used in fire-fighting application, cosmetics, greases and lubricants, paints, polishes, and adhesives. Workers who produce or use PFOA can breathe it in or have direct skin contact. With the general population, they can breathe it in, consume it through food and water, and have direct skin contact. PFOA is found in small amounts of blood and is extremely persistent. In some human studies, exposure to PFOA was associated with increased cholesterol levels, increased risk of high blood pressure, thyroid disease, and liver damage. 

M6.6 Use of Antibiotics

1. Antibiotics Resistant 101: How Antibiotic Misuse on Factory Farms Can Make You Sick

• I have learned about the human health risks from using antibiotics in food animals by watching a documentary from Frontline called "The Trouble with Antibiotics". It is frustrating to know that Congress and FDA has not done much to address this growing publc health threat. It is also concerning that humans would do anything to grow food animals faster at the risk of human health, directly and indirectly. It is scary to think that we will one day live in a world where antibiotics will not work anymore and there are superbugs flourishing around us. 

2. Nearby Livestock May Raise 'Superbug' Risk

• The government should really take this as a sign to regulate antibiotic use in livestock. Like Dr. Kluytmans said, public health officals need to figure out the routes of transmission so they know how to contain MRSA. Without proper procedures, MRSA will continuosly spread and will become difficult to contain. If an epidemic arises, it is a clear sign that public ehalth officials aren't doing their jobs since there is evidence available about the increasing prevalence of MRSA present among individuals. 

3. Scientist Discover That Antimicrobial Wipes and Soaps Maybe Making You (and Society) Sick

• This article reminded me in college where I would see this one guy in class who would always wipe his individual desk with what might be an antimicrobial wipe before he sat down. And I'm just there thinking, what does it really do if he's just going to sit down on the seat that he didn't wipe? I always carry hand sanitizer with me to use after I get off the bus and before I eat. Since this article is citing that there is no evidence that antimicrobial products are effective and it may be making us sick, I am thinking I should stop using hand sanitizer and just go to the bathroom and wash my hands with regular soap instead. 

4. Antimicrobials in Hospital Furnishings: Do they help reduce healthcare-associated infections?

• I am shocked to learn that there is little data on the safety and efficacy of using antimicrobial in furnishings and its potential unintended consequnces, and yet hospitals, of all industries, are using this practice to reduce the spread of infections. Like the report has stated, the research community needs to implement more studies to establish safety and efficacy of antimicrobial usage. I don't think it is right for some hospitals to use non-evidence-based practices because it goes against how health professionals operate their work. 

M6.4 Industrial Farming

The first time I heard that the bees are vanishing was due to the spraying of pesticides. That is when I learned that bees are important pollinators and without them, a lot of plants and fruits would not grow. I thought it was only happening in America because of our use of pesticides, but I shockingly learned from "Vanishing of the Bees" that it is happening all around the world. I was also shocked to learn that some companies are inhumanely maintaining the beehives by killing queen bees to insert an artificially-made queen bee and also through artificial insemination.

The closet factory farm near SF is in the Marin County for dairy and the Santa Cruz County for layer chickens. I was not aware that those farms were near me, and now that I am aware, I will choose to not buy my eggs that are from Santa Cruz. I think factory farming is not humane and I don't want to support that.

I currently do not compost, nor have I done so in the past. My grandma does and therefore seen how composting can help with growing vegetables. The vegetables that my grandma grew with compost were really good quality and delicious. I would consider using compost to someday grow some of my vegetables when I have the time.

M5.7 Your Sewage Facilities

The 3 sewage facilities in San Francisco are:
1. North Point Wet Weather Facility
2. Oceanside Treatment Plant
3. Southeast Treatment Plant

M5.5 Campaign for Tap Water

If I were to develop a nationwide campaign to get people to drink tap water instead of bottle water, the campaign slogan would be "Ditch the bottle, drink from tap." My message to the public is to not produce any more waste from drinking packaged water, instead drink fron the tap where no plastic is being used, which will then end up in a landfill that will take thousands of years to decompose.

M5.4 Consumer Confidence Reports (CCR) and Water Quality

This is the link to San Francisco's annual water quality report 2017 https://sfwater.org/index.aspx?page=634

The city's major water come from the Tuolumne River, which flows through Central California, from the Sierra Nevada to San Joaquin River. Additionally, the city's water source is supplemented with surface water from the Alameda Watershed and Peninsula Watershed. The report states that the Sierra water is well protected, therefore they are exempt from filtration requirements by the United States Environmental Protection Agency and State Water Resources Control Board Division of Drinking Water. The city's water receives the following treatment to meet all appropriate drinking water standards for consumption: ultraviolet light and chlorine disinfection, pH adjustment for optimum corrosion control, fluoridation for dental health protection, and chloramination for maintaining disinfectant residual and minimizing the formation of disinfection byproducts. These were no detected contaminants high enough for required action. It is said that SF's water is really clean, so my family do not filter our water. However, we always boil our water before we drink it. I do not drink bottled water because the packaging from it produces waste, it does not taste too great, and it is more expensive than the tap water I can get from home. My reasons for not drinking bottled water are the same reasons presented from the Story of Bottled Water video. 

M5.2 The Public Health Importance of the Clean Water Act

Without the Clean Water Act, industries will be free to discharge pollution into the waters whenever and however they please and people will be drinking and using low-quality water. The Act set regulations for discharging pollutants into the waters and these standards protect the health of the public, as well as the environment. Exposure to pollutants poses a great health threat to the communities who come in contact with the polluted waters, therefore because of the Act, it prevented pollution-related health issues from occurring. Additionally, it lessened the number of pollutants into the environment which, as a result, destroy natural habitats and negatively affect the ecosystem. I think the most important public health significance is that the Act set the standards for water quality so people are able to drink and use high-quality water.

M4.6 Radon

If I were to create a national awareness campaign about exposure to radon it will consist of educating the public about what is radon, where it is commonly found, why it is important to know if they are exposed to radon, how to test for radon, and if tested for radon, what steps can be done to address exposure. The campaign will be implemented on television and social media to reach all ages. The campaign should also be in multiple languages to reach the populations with limited English proficiency. If the campaign has enough grant money, free radon tests will be mailed out to residents who need it. Possible stakeholders would be EPA and local/regional environmental health and lung cancer organizations.

M4.5 Think about it / Group Exercise

I have a sensitive nose and have a slight case of asthma so a fragrance-free policy at a workplace would be beneficial for me. An ideal fragrance-free policy in a workplace will consist of educating the employees about how scents can cause health problems, a list of all banned scented items, and a list of alternative fragrance-free items they can use instead. Just like how there are 'no-smoking' signs, having 'fragrance/scent-free' signs posted at the workplace can remind everyone to not have on or use items with fragrance. The policy should also state what a person may be asked to do if they are wearing scents, such as remain in a separate room, change clothes, removing the scent etc. Since we spent a lot of time a workplace, having a fragrance-free policy decrease our time exposed to harmful fragrances. People sometimes also do not know that fragrances bother them because they think their health problems are caused by something else. Eliminating these scents at work might alleviate or even solve their health issues caused by scents and they will concentrate better at work.

M4.2 Blog Assignment: National Library ToxNet

Chlorine is a yellowish green gas and it is an irritating, pungent odor from concentrated bleach. Exposure routes are from breathing in the vapor and  through direct skin contact. High vapor levels causes irritation and burns to the skin, eyes, nose, and throat, and really high levels of exposure can cause loss to oxygen which can lead to cardiac arrest or respiratory arrest or even death. Increased asthma symptoms have been associated with exposure to chlorinated water in swimming pools. I don't really use bleach to clean a lot, but whenever I do, the smell really stings my nose and I get shortness of breath from breathing in the fumes. I have a slight case of asthma which is why I am more sensitive to the fumes. 

M3.5 Transportation

Growing up and living in San Francisco, public transportation was and still is my main form of transportation. I am very grateful that my city has such a great public transportation system because I can do anywhere in the bay area without a car. Muni and Bart are very accessible, connecting you to anywhere in the city and other bay area communities. I like how they provide two different price points for people with different incomes so lower-income people can afford public transportation. In a non-traditional sense of how it contributes to my health, affordable and accessible public transportation makes my life easier to travel to school, work, grocery stores, and other areas in the city. I don't have to stress out about buying a car, maintaining my car, paying for car insurance, and buying gas, in which they also affect my financial health. In how public transportation affects my physical health, it encourages me to walk more and I get my daily number of steps in. According to the American Public Health Association, public transportation produces 95% less carbon monoxide, 92% fewer volatile organic compounds, and 45% less carbon dioxide compared to private automobiles. SF is very populated, so if everyone drives a car, our air quality will be very poor, harming my community's and my own physical health.

M3.4 Air Pollution

 My zip code is 94112, which is in San Francisco.
The top polluters in my area are:

The top pollutants in my area are:

About 7% of the house in my area have lead-based paint.

Superfund sites are toxic waste sites identified by EPA as a priority for cleanup because they pose dangerous risks for human and environmental health. There is one Superfund site in my area which is the Treasure Island Naval Station-Hunter's Point Annex located at the Hunter's Point Shipyard. From 1945 to 1974, the site was a shipyard and from 1948 to 1960 it was the Naval Radiological Defense Laboratory (NRDL). NRDL activities contaminated soil, dust, sediments, surface water and groundwater with petroleum fuels, pesticides, heavy metals, polychlorinated biphenyls, volatile organic compounds, and radionuclides. The soil at the site contains naturally occurring asbestos and metals. Cleanup, maintenance, and monitoring are still on-going. 

In my area, 88% of the days the air quality is good, and 12% are moderate. The Air Quality Index score is 31 (good). 

Pertaining to water quality, the percentage of surface waters with impaired or threatened uses is at the 90 percentile, and the number of impaired waterbodies is at the 70 percentile. 

According to the environmental justice tracker, the difference gap that stands out the most is the distribution of burdens by income for the releases of toxic chemicals variable. Low-income families are more affected compared to higher-income families with a ratio of 2.59 (159% more likely). Similar to the categories of families below poverty (2.63 ratio) and kids below poverty (2.60 ratio).

M3.3 Environmental Justice

If 3 out of the 4 commercial hazardous waste landfills were located in predominately black communities, I find it hard to believe that it is a coincidence. To me, it seems like there is a discriminatory intent to locate those facilities at those communities. It sends out a loud message that 'black lives don't matter, so let's build the hazardous landfills in their communities and they can hold the burden of suffering from those toxins'. In relation to social determinants of health, if a baby is born into one of those communities with those hazardous waste landfills, they are predetermined to be exposed to environmental health hazards. Being born black into a predominately black neighborhood sets the stage for being exposed to the kinds of health issues that are associated with race and income levels.

M3.2 Vulnerable Populations

I really like Dr. Rishi Manchanda's idea of training physicians and clinicians to think upstream when diagnosing a patient's condition. Thinking upstream can help physicians and clinicians identify the patient's vulnerabilities of their health condition. If physicians and clinicians asked broader questions about the patient's home and work environment, they can sooner recognize if the patient is from a vulnerable population, where these group of people are linked to more adverse health outcomes. Knowing that critical information opens up a lot of opportunities to pinpoint the root issues of the health condition. Addressing root issues, similar to what Dr. Manchanda was speaking about in his TED talk, is a more effective solution because it solves the health issue almost complete. Compared to just prescribing medication, pills can only remedy the issue for a short while. Like what Dr. Tyrone B. Hayes said, finding the cure is important but finding the cause is more necessary.

M3.1 Biomonitoring

If I were given these hypothetical lab results, I would not be too shocked by the results because I am well aware that I use a lot of different kinds of personal care products and makeup products where some of these chemicals are found. The lab results are a confirmation that the harmful chemicals really are present in my body because although I know our bodies can absorb chemicals from personal care products, the full realization wouldn't hit me until I see actual evidence taken from my own body. My first thought would be how do I rid those chemicals from my body and how do I avoid them. The lab results would be a loud wakeup call for me to get myself to be more educated about the chemicals I expose myself too.

M2.4 Ken Cook and Advocacy Organizations on Toxics in Personal Care Products

The phrase "silent pandemic" from Ken Cook's presentation stood out to me. Symptoms do not occur right away when the toxic chemicals from our personal care products enter into our bodies, which is why most people, including myself, don't think much about the hazards of using personal care products. Like Cook mentioned, women buy and use the most personal care products, therefore having the most exposures to toxic chemicals from personal care products. It is shocking to know that I am exposing myself to more than 160 chemicals every day! Cook proposed and outlined amazing policies to protect consumer and children's health. It is frustrating to know that the government does not have those policies in place because they seem like a "no-brainer." The government should already have policies that prevent the use and selling of chemicals that have not been tested positive for safe use.

M2.3 National Library of Medicine's Household Products Database

The two cleaning products I looked up in the National Library of Medicine's Household Products Database are Amway Legacy of Clean Dish Drops Dishwashing Liquid and Clorox All-Purpose Cleaning Wipes. From the site I found that the dish detergent has no toxicity score, however it has potential health risks. This product can irritate the eyes and respiratory tract, and aggravate pre-existing skin, eye, and respiratory disorders. Additionally, this product produce ethanol vapors, a carcinogen identified by the International Agency for Research on Cancer. These findings were surprising to me because my mom bought this product from a recommendation of a family member who said it was a safer alternative than other commercial brands. Another surprise is that the Clorox wipes are not considered hazardous with a toxicity score of 0. I thought this product would contain a few toxic chemicals because it is such a big commercial brand and widely used. Similar to the personal care products exercise, this exercise was another cue for me to make a health behavior change. From now on, I will research about cleaning products before I make the decision to buy and use the products. To reiterate from my previous blog post, I think the public have the absolute right to know about these hazards. I think companies should be transparent about the toxic chemicals in their products and that the government should hold those companies accountable.  I think a lot of consumers, including me, do not know about these risks because we expect the government to regulate these products and make sure they are safe before companies are allowed to sell them, just how they would with drugs.

M2.2 Personal Care Products

The two skincare products I chose to look up in the Safe Cosmetics Database are Jack Black Intense Therapy Lip Balm SPF 25 and OGX Conditioner Nourishing Coconut Milk. The lip balm had a hazardous score of 3 and the conditioner had a hazardous score of 5. I am very shocked that my conditioner received a moderate score because the product is advertised as free of any harsh chemicals and are made from sustainable ingredients. I also did not think lip balm products would be an area of concern because I always thought it was a simple product with only a few ingredients to make. Doing this exercise was a huge cue for me to start changing my consumer behaviors because the hazardous ingredients in the cosmetic products can really damage my health. I think a lot of consumers, including me, do not know about these risks because we expect the government to regulate these products and make sure they are safe before companies are allowed to sell them, just how they would with drugs. I had that expectation and that had led me to stay uninformed about harmful personal care products. I think everyone has the right to know about these risks because like Rachel Carson stated in her book, Silent Spring, since we are the consumers who endure and suffer from these risks, the public has the right to know. When the public is ignorant about these risks, we are unable to make informed decisions.