M10.8 Occupational-related disease

Byssinosis is a lung disease caused by prolonged inhalation of textile fiber dust and primarily affects workers in cotton processing, hemp or flax industries. According to Corn (1981), recognition of byssinosis came late. In the late 1960s, medical professionals stated that the disease does not exist within the American textile mills. It is not until the 1970s the science community showed that it does exist. With the mobilization of public opinion, changes in social attitudes, new scientific evidence, and the Occupational Safety and Health Act led to setting standards to control and eradicate byssinosis called the Cotton Dust Standard There is the Task Force for Byssinosis Prevention and they include OSHA, the National Institute for Occupational Safety and Health, the Department of Agriculture, the National Cotton Council, the American Textile Manufacturers Institute and the Union of Needletrades, Industrial and Textile Employees. The last regulatory review of the standard was done in 2000, and the new amendment stated that "textile manufacturers that use an improved method of washing raw cotton to eliminate the risk of 'brown lung' will be exempt from all provisions of the OSHA cotton dust standard."

Citations:
Corn, J. K. (1981). Byssinosis—An historical perspective. American journal of industrial medicine, 2(4), 331-352.
https://www.ehstoday.com/news/ehs_imp_34273

M10.5 Occupational safety and health organization

The organization I chose to explore is CalOSHA and I selected their respirable crystalline silica safety program to read up on. Construction workers have potential exposures to respirable crystalline silica, and since my dad is a construction worker, this program caught my attention. Respirable crystalline silica can cause silicosis (lung fibrosis), lung cancer, and other serious health effects. The program set standards to control employee exposures to respirable crystalline silica. The standards are:

• requires all employers to protect employees from exposures that exceed the "permissible exposure limit" (PEL) for respirable crystalline silica
• applies to occupational exposures in construction, except where exposures will remain below the "action level" under any foreseeable conditions
• applies to all occupational exposures except construction work, agricultural operations, and exposures from the processing of sorptive clays

By learning about this type of exposure among construction workers, I want to ask my dad if he has any knowledge about his occupational health risks. 

M10.1

My dad is a contruction worker and some of the health and safety issues he experinces are:

• pain from physical overexertion or working in uncomfotable positions
• exposure to lead, wood dust, asbestos, paints, solvents, and other toxic chemicals or materials
• working in hot weather and being over exposed UV rays
• working with hand tools, powered tools and heavy powered equipment
• loud noises
• working at heights
• electrical hazards

According to the hierarchy of controls, these issues can be addressed with personal protective equipment. My dad has equipment to protect himself such as wearing hard hats, gloves, masks, and googles. It is unfortunate that these health and safety issues can be addressed by removing or replacing the hazard– my dad need to work with hand and powered tools and use wood, paints, and other solvents in order to build things. A barrier that my dad might or may have experienced in exercising his right to a healthy and safe workplace is a language barrier since he is an immigrant and does not understand and speak English very well. 

M10.2 MSDS and ToxNet

I decided to look up the Material Safety Data Sheet of a nail salon worker and chose to read up about a base coat product. The product contains the hazardous chemicals trimethylbenzoyl diphenylphosphine oxide and hydroxyethylmethacrylate. The health risks associated with these chemicals are potential allergic skin reaction, damage of fertility or the unborn child, and repiratory issues. 
The precautionary statements are:

• Obtain special instructions before use
• Do not handle until all safety precautions have been read and understood
• Avoid breathing vapors
• Contaminated work clothing should not be allowed out of the workplace
• Wear protective gloves, eye protection
• IF ON SKIN: Wash with plenty of Wash off immediately with soap and plenty of water

I believe that the safety data sheet is an adequate tool for nail salon workers to understand about the chemicals they are working with because the data sheet lists out the ingredients and its potential health risks, first aid measure, firefighting measures, accidental release measures, and handling and storage instructions. However, the worker will need to be at a 6th grade reading level to understand. In California, many nail salon workers are Asian immigrants and do not read or speak English, therefore this population are most likely not reading the data sheets and are not educated about their occupational health. 

M9.4 Heavy Metals

I am curious about CDC's thought process of setting the acceptable blood lead level of 60 μg/dl during the 1970s. If there were no significant meta-analysis studies that proved at which blood lead level was dangerous, how did CDC decide on that blood lead level? Then when newer studies were published, and CDC decided to drop that level to 10 μg/dl, I am still confused on why they chose that level. Since there are studies showing the serious health effects lead exposure, I would assume CDC to put out a statement to inform the public that even if there is no safe level established, due to findings of negative health effects, any type of exposure to lead should be taken seriously. I feel that just by lowering the acceptable blood lead level is not a preventative measure to protect public health.

M9.3 Green Chemistry

This is my first time hearing and learning about green chemistry. After learning how we are always surronded and exposed to toxic chemicals, it is relieving to know that there are safer and "greener" alternatives. I am also glad to learn that there is the Green Chemistry initiative to address the issues of toxic chemicals so in the future we can have greener and safer alternatives. The 12 principles of green chemistry take on a preventitative lens so little to no harm can be done when a new chemical product or process is created. I think the principles are great measures that scientists must strictly abide to when innovating a new chemical product because they are safety measures, so if not followed, there will be public health consequences. If the green chemistry principles had been applied when plastic was invented, the Earth would be so much different. We would not have so much landfill and pollution, and animals and sea creatures' life and habitat would not be harmed.

M9.2 Six Chemical Classes

After learning about the six classes of chemicals, I realized humans are always in contact and exposed to those chemicals. We are always surrounded by these harmful chemicals and I feel like it would be a challenge and at times a hassle to avoid all of those six classes of chemicals. I do want to live healthier and I plan on slowly replacing with safer alternatives. It was also shocking to learn that even if some products label themselves as free of certain toxic chemicals, the replacement is just as or more harmful than the previous one. Knowing this, I will not automatically trust labels with these kinds of statements, and I will take matters into my own hands and do my own research.

The chemical I choose to learn more in-depth about is antimicrobials because I always thought it was a good chemical. I was surprised to learn that this class of chemicals is hurting our health by killing beneficial microorganisms on our bodies. I understand why antimicrobials would be used in soaps and items we touch a lot like yoga mats and kitchenware, but I was surprised antimicrobials are in toothpaste and cosmetics as well.

M8.5 An Ideal Chemical Policy

I think the Lousiville Charter for Safer Chemicals outlined the essential elements for an effective chemical safety policy. Those essential elements are: 

1. Require safer substitutes and solutions
2. Phase out persistent, bioaccumulative, or highly toxic chemicals
3. Give the public and workers the full right-to-know and participate
4. Act on early warnings
5. Require comprehensive safety data for all chemicals
6. Take immediate action to protect communities and workers

Other elements outlined in the Lautenberg Act are:

1. Requires safety finding for new chemicals
2. Health-based safety standard
3. Give EPA authority to require testing of chemicals

One of the flaws of the Toxic Substance Control Act is that it mandates there needs to be evidence that a chemical posed a risk before it could require testing. Waiting for evidence wastes time and more people can be exposed during the wait. Effective public health protection starts with acting on early warning signs. Prevention is a key service of public health, and prevent means that health professionals cannot ignore warning signs, even if there is no significant evidence. Health professionals need to act on early warning signs in order to produce significant evidence. 

M8.4 Chemical Policy Reform

The background paper I have chosen to read is "Give the Public and Workers the Full Right-to-Know and Participate." The paper talks about how the public has the right-to-know because they are the ones who are constantly exposed to toxic chemicals through the air, water, land, food,  and consumer products in every setting of their lives. I agree with the paper that if there is full disclosure of toxic chemicals, there will be more meaningful discussions about policy changes. In order to have persuasive policy briefs, relevant data is essential to convince those who are in power to make changes. The paper also stated that advocating right-to-know helps people communicate simple ideas to overcome polluters' money and influence. Polluters' may have the power now through their money and influence, but that power and influence can be shifted onto the public if they are given the information about the toxic chemicals they are exposed to. By knowing the harms, the public will be able to make informed decisions, and if a whole mass of people does not support companies that have toxic chemicals in their products, those companies lose money and eventually their influences. Supporting the right-to-know can lead to industries put human health first rather than profits. 

M8.3 Pesticides

My last meal was pasta with vegan sausage. The spaghetti product was made from whole grains, the tomato sauce was made from organic tomatoes, and the vegan sausage was made from wheat gluten. From the website, it stated that wheat grain has 4 pesticide residues, which are deltamethrin, azoxystrobin, boscalid, and metconazole. Conventional tomatoes contain an astounding 35 pesticides residues! Of these pesticides, 3 are known or probable carcinogens, 12 are suspected hormone disruptors, 6 are neurotoxins, and 3 are developmental and reproductive toxins. Tomatoes are on the list of EWG's dirty dozen, so I am glad I have chosen an organic tomato product. The public health implications are that the government needs to ban these chemicals being used on the foods that we consume and the government needs to incentive growers to grow foods organically. 

M7.8 Topic of Interest of Literature Review

My topic for my literature review is octinoxate and its health effects. Octinoxate is one of the most widely used ultraviolet radiation filter in personal care products, specifically in sunscreens. The federal agency that provides information about and have authority over cosmetics is the Food and Drug Administration (FDA). The agency has a voluntary Cosmetic Registration Program where manufacturers can register their products that are being sold in the market. The law does not require cosmetics to be FDA-approved in order to go on the market, however, the agency can regulate them. The two major laws relevant to cosmetics sold in America is the Federal Food, Drug and Cosmetics Act (gives FDA the power to oversee the safety of food, drug, and cosmetics) and the Fair Packaging and Labeling Act (requires all consumer products to be label what they are, their contents, and where they were manufactured). Since FDA does not require safety testing of ingredients in personal care products, people are exposed to potentially harmful chemicals. In May 2017, the Personal Care Products Safety Act was introduced by California Senator Dianne Feinstein to the Senate, and it is cosponsored by California Senator Kamala Harris. The act "amends the Federal Food, Drug, and Cosmetic Act to require cosmetics companies to register their facilities with the Food and Drug Administration (FDA) and to submit to the FDA cosmetic ingredient statements that include the amounts of a cosmetic's ingredients." 

M7.7 Agency's Role

The United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) protects and promotes agricultural health, regulates genetically engineered organisms, administers the Animal Welfare Act and carries out wildlife damage management activities. APHIS established in 1972 and is a relatively new agency. Their mission is "to protect the health and value of American agriculture and natural resources." This agency works 24/7 to protect the nation's animal and plant resources from agricultural pests and diseases. If there is a detected pest or disease, the agency implements emergency protocols and partners with affected States to quickly manage or eradicate the outbreak. This agency has a great impact on environmental quality. Its immediate impact is to make sure that the foods are safe to be consumed. Its other impact is to protect wildlife, which plays an important role in keeping the ecosystem healthy and balanced. If the ecosystem is not healthy, it will consequently impact climate change, which then harms human health. 

M7.4 Local environmental services

Below is a list of SF Department of Health environmental health services. Their breadth of services is very comprehensive as the department addresses all types of environmental issues. The programs that surprised me were the Tattoo, Body Piercing, and Permanent Cosmetics and Massage program because these services do not have to do with the environment, but arguably they are so since they are people's built environment.  

1. Hazardous Materials Waste Program:
• Review soil sampling
• Provide oversight and cleanup 
• Regulate petroleum storage, chlorofluorocarbon recycling, and medical waste
• Prevent accidental releases
2. Childhood Lead Prevention Program:
• Provide education and outreach on lead exposure prevention and lead health effects
• Inspect locations where children live and spend time to enforce Health Code requirements for lead hazard prevention
• Provide case management support to families of children with lead exposure
• Collect and analyze all blood lead testing data in San Francisco
3. Noise Enforcement Program– enforces local regulations regarding fixed-equipment noise, such as ventilation equipment, generators, and compressors
4. Vector Control Program– provides services and education to eliminate rodents, mosquitoes and other insects and animals that contribute to the spread of diseases such as West Nile Virus
5. Apartment Inspection Program–conducts routine inspections to ensure that minimum levels of sanitation are being maintained by property owners
6. Agriculture Program–provide services such as monitoring pest conditions and pesticide use in nurseries, and enforcement relevant to growing plants, including cannabis
7. Water Programs– protect the potable water supply from cross connections, ensure safe construction and destruction of wells and soil borings, and oversees swimming pools, spas, and on-site nonpotable water systems
8. Air Quality, Smoking, and Tobacco Program– implement local laws relevant to pollutants in the air, including tobacco and tobacco-derived products
9. Weights and Measures Program–protect consumers by inspecting and testing commercial scales, gasoline pumps, taximeters, liquefied petroleum gas dispensers, and electric meters
10. Tattoo, Body Piercing, and Permanent Cosmetics Program– ensure that tattoo, piercing and permanent cosmetic facilities are clean and practice sterilization 
11. Massage Program–  issues permits to massage practioners and businesses in the city and ensures their compliance with San Francisco Health Code Article 29