Final Blog

When I first decided on majoring in Public Health, it was due to my interest in communicable diseases. The environmental aspect of public health had crossed my mind but not my interest. This class changed my thinking. I leave this class with a newfound interest but also with a sense of profound sadness. It's heartbreaking how much damage we are doing to ourselves and the environment. It is even more heartbreaking that most of the effects of environmental toxins are harmful to those who are the most defenseless- babies in utero. This class taught me a lot, such as the importance of being a better consumer, but more importantly how to protect myself and *baby* if I were to ever get pregnant.

I have no critiques for the class other than fewer blogs, haha. Dr. Sattler did an amazing job and I'm glad I took this class with her.

Disaster preparedness

In Oakland/San Francisco we have Disaster Healthcare Volunteers (DHV), and we also have the Medical Reserve Corps, which I believe is open to anyone who would like to volunteer. There are three levels: Level 2,3, and leader. In order to become a volunteer you must take a series of classes that range from earthquake preparedness to terrorism awareness. I'm also aware that the Red Cross has a divison for people who would like to volunteer, I remember looking for the sign up page a while back, but I never followed through.

Climate Change

1. What do you personally find most troubling about climate change?

What I find most troubling is the warming of the Earth. I keep reading about how its going to get so hot and only the rich will be able to escape by affording to travel elsewhere during heat waves. It makes me think of hot cities such as Dubai, or even Texas. What are the chances that one day it will get too hot and we wont be able to go outside anymore in certain places? 

side note: i recently read an article that said Dubai is planning on putting air conditioners outside!!

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

 

So this is something I'm conflicted with. I feel like in terms of climate change public health and other divisions put too much emphasis on the individual person. They pressure them to make change, when in reality the data says that 100 or so companies are responsible for some high percentage of emissions (I think it was like 70%. I'll try and find the citaton). So I think Public Health should focus on making people aware of who those 100 companies are and then pushing for a boycott. 

However in terms of overall attention, I think public health needs to focus on obesity, because its 

1. preventable

2. expensive

3. associated with too many other diseases

3.If you were visiting with a long-lost relative who had never heard about climate change, how would you describe it and its attendant human health and ecological threats?

I simply describe it by saying, that for the past millions of years Earth has gone through cooling and warming cycles. The last one being the Ice Age. However as humans evolved we created things that changed the natural environment, throwing off the natural cycles and creating a new one. One where the Earth warms at a much faster rate and this warming has cosquences such as the melting of glaciers from the last ice age, which produces flooding and which can release previously "frozen" diseases. 

11.5 Zero Waste Life

I enjoyed watching the video about a zero waste life. Recently, I felt proud of myself for buying all-natural deodorant online; however, this video made me realize that although I'm buying better products, they still come in wasteful plastic packaging (shipping boxes). I try and do my part for the environment, but, indeed, I don't do enough. For example, I compost and recycle, yet continue to buy wasteful plastic products. I replace my plastic toothbrushes every 3 months and don't even get me started on my floss waste.
I truly enjoy watching videos like these because it helps make me aware of things. From now on, I'm going to be more mindful about what I buy and what I can make myself and what companies I support.
For example, Lush is a company that makes toothpaste that comes in dissolvable packets, and the containers are reusable!

10.8 Occupationally related disease

Byssinosis, also known as brown lung is a disease caused by exposure to cotton dust, usually in areas that are not well ventilated (American Lung Association). This disease is seen in yarn and fabric manufacture workers. Symptoms of the disease include breathing difficulties, chest tightness, wheezing and coughing (Lee, 2008). 

The Occupational Safety and Health Administration under the United States Department of Labor now has guidelines that provide the exposure limits and measurement methods of cotton dust, and how to reduce it. 

1.  Lee, NS. (2008). "Byssinosis". Merck Manuals: online medical dictionary. Merck & Co. 

9.4 Heavy Metals

So I found that paper regarding lead to be extremely interesting. I feel like we are currently in the same position that we were in when lead was first linked to negative health outcomes. It took decades and clinically symptomatic individuals for lead to be banned in the U.S. 

Once again, it took clinically symptomatic individuals for lead to be banned and we now know that there are effects at lower doses that cause no symptoms! No symptoms! This is why I think we are again in the same position. I think most of the chemicals used today have effects at low doses that show no symptoms, yet we are going to wait for years until we have clinically symptomatic individuals before we do anything about it. 

9.3 Green Chemistry

Green chemistry seems great! How have I never heard of it before? Since I first started reading about chemicals, I have wondered why we haven't developed new safer alternatives. It's awesome to know that there is a field dedicated to it and that I just wasn't aware. I think the 12 principles of Green Chemistry and great, but I'm wondering what products have they created already if any? How long is the process of creating a new product? More importantly, how expensive is it?

9.2 Six Chemical Classes

Highly fluorinated chemicals (PFAS)

PFAS is a chemical that is found in our everyday products. They don't breakdown and can continue to accumulate throughout the years. When incorrectly disposed, PFAS can seep its way into waterways and soil, and eventually into our food and water. PFAS is linked to a variety of negative health outcomes, however the most interesting to me is that PFAS can make certain vaccines less effective. How is it legal for a chemical to be so readily used when it is so toxic to people and the environment? 

Antimicrobials

Antimicrobials are found in many of our soaps, and other everyday items. At first, antimicrobials seem like a necessity. However, according to the video antimicrobials can contribute to antibiotic resistance. Antibiotic resistance is a real problem that more people need to fear. We haven't had a new antibiotic in years, yet resistance continues to grow. What does this mean for our future? 

Flame Retardants

In the video of flame retardants, there was an example of two chairs burning, even though one had flame retardant material, it was burning at the same rate as the one without flame retardant, but what's even more interesting is that the flame retardant chair was releasing more smoke. I also found it super interesting that flame retardants have been linked to hyperactivity and low IQs in children. This makes me think back to the Louisville Charter about waiting to act before banning a chemical. If there is a link why can't we just ban certain chemicals until we can prove that the chemical is not directly harmful to life? 

Bisphenols and Phlatates 

This group of chemicals is known as hormone disruptors and is commonly found in everyday products. I also learned how although a product can claim to be BPA free, it can contain a similar chemical known as bisphenol s or f. This video was a great reminder of how terrible plastics are, and how much I should avoid them, and especially how much babies should avoid them. 

Solvents

This video especially hit home for me because I love to clean, and I am a sucker for products that smell "clean". Every single spray/cleaning product I use has some type of fragrance, and sometimes I overdo it. Luckily, I recently considered signing up for a delivery service that specializes in clean, environmentally friendly products, and now that I know what to look for, I feel like I can make the right choice. 

Certain metals

I love sushi, so I'm glad that salmon is a class of fish with lower mercury rates. Also, I have used skin lightening products in the past and had no idea they could contain mercury. 

8.4 Chemical

I am blogging about Background Paper #4: Act on Early Warnings 

This paper provides the background argument for Reform #4 in the Louisville Charter. 

The Louisville Charter is comprised of 6 reforms: 

1. Require Safer Substitutes

2. Phase Out Persistent, Bioaccumulative, or Highly Toxic Chemicals.

3. Give the Public and Workers the Full Right-To-Know.

4. Act on Early Warnings

5. Require Comprehensive Safety Data

6. Take Immediate Action to Protect Communities and Workers.

In this paper, the authors argue how crucial it is that we take action when early warning signs appear regarding a chemical and its harmful side effects. We have failed to do this in the past, and as a result, many people are living with the consequences of harmful exposure from DDT, asbestos, and PCBs to name a few. 

One key element for a good chemical policy, the authors mention, is how "[a] chemical policy system must put the health of people and ecosystems above all other considerations." This is something that resonates with me, because I am constantly arguing that we disregard the damage we are doing to both the environment, and people, in the name of profit. 

The authors mention how this proactive approach can be difficult since at times it may require to act when science is uncertain, but through epidemiological surveillance, medical observation, and other means we can develop credible evidence for harm and justify the action. 

Ideal Chemical Policy

I believe that an ideal chemical policy should have the following key elements: 

1. Public knowledge and awareness regarding chemicals

2. Vigorous premarket testing of chemicals (similar to the way we test pharmaceutical drugs)

3. EPA approval

4. Replacement of currently used highly toxic chemicals 

5. Protection of communities and workers at higher risk of pesticide exposure

I think chemical policy should take on a similar route as clinical testing, where instead of needing FDA approval, the chemical manufacturers would need EPA approval. When people are buying a pharmaceutical drug they are aware of the side effects associated with it, and they are aware that this product went through significant testing before reaching the shelf. Ultimately, it is up to the consumer to outweigh the risk and benefits and decide to use the product. I believe it should be the same for chemicals. 

I'm not saying pesticides should be tested on humans, I know that is unethical. However, if researchers used mouse models and discovered the mice had extreme side effects then this is something the consumer should be aware of. 

Based on our history, I am arguing for a proactive chemical policy. We should adopt a system where we make sure products are safe before they are released, rather than the one we have now, where we let years go by without taking action. 

8.3 Pesticides

What did you find out about the pesticide residues that may be in or on your food? What do you think about this? What should we be doing about this in terms of public health, not just in terms of our personal choices?

For dinner last night, my girlfriend and I made tacos. We had beef, avocado, salsa, and paired it with a kale salad. As I began to type this blog post I assumed that the kale salad would have the highest level of pesticides. I figured the avocado wouldn't be that bad, and beef didn't even cross my mind. I'm aware this might sound dumb, but I wasn't expecting to find beef on the list of What's on my Food website. I'm aware that some cows are treated with rbGH hormones, but I wasn't expecting beef to have levels of pesticides in it. I was shocked to find that beef has a springy large amount of pesticides in it. To my surprise, beef can contain carcinogenic, and hormone-disrupting pesticides. It can also have pesticides that cause developmental, reproductive and bee toxicity.

The avocado had 0 pesticides.Kale, on the other hand, had 55 potential pesticides. 55!That is absolutely insane!

This is an issue public health must tackle. While public health may not have the resources to fight against large pesticide companies, awareness is a good place to start. If more people were aware of the consequences then maybe they would make more of an effort to buy organic. This leads me to a depressing thought: what about the people who can't afford to buy organic? I am especially concerned for women who are trying to become pregnant and are dedicating so much time to eating healthier. If they choose the wrong foods, they are potentially unknowingly increasing their intake of developmental and reproductive toxins. 

M7.8 Literature Review

What agencies at the local, state, federal, and/or international level provide information, regulatory oversight, or are otherwise implicated in addressing that topic?


There are two topics I am considering for my literature review. First, is the relationship between environmental exposures and autism spectrum disorder. Another option is the relationship between certain environmental exposures and obesity.

Some of the agencies that would provide oversight for these topics would be the Environmental Protection Agency, the National Institutes of Health, the U.S. Department of Health and Human Services. Also local and state-level public health departments. I have been interested in obesity since before I started graduate school, however the recent literature that has been released examing the correlation between air pollution and autism spectrum disorder has really peaked my interest.

M 7.4

http://www.acgov.org/aceh/index.htm


The Alameda Department of Public Health has an environmental health branch that specifically deals with environmental issues that affect the public. This includes issues such as water contamination, food recalls, housing complaints, waste, and other issues.

The website is an umbrella resource for people looking to get more information on specific issues, such as whom to contact for complaints and concerns. The homepage also features local environmental news.
A lot of the news on the Alameda Environmental Health website is news from the county or state department of public health. Currently, most of the news is related to norovirus outbreaks or food contamination.

The website also has a special section for a list of healthy nail salons. I found this to be super interesting. The most interesting part was that there are only ten nail salons on the list. I'm not exactly sure how many nail salons are within Alameda county but considering there are 19 cities within Alameda County I know for a fact it's way more than ten.

M7.7

I chose to examine the Bureau of Land Management which is under the direction of the U.S. Department of the Interior. 

The Bureau of Land Management manages millions of acres of public land in the U.S.They are responsible for the approval of commercial, recreational, and conservation use of public lands. This means they are effectively responsible for a great deal of environmental quality, especially for tribal groups living on public lands. 

In recent years the Bureau of Land Management has faced a lot of backlash for approving certain commercial leases on public lands. People allege that these leases have a direct and indirect impact on the surrounding environment. The impact includes the release of greenhouse emissions as a result of these gas and oil commercial leases. 

The Bureau of Land Management website boasts about being environmentally responsible; however, environmental groups allege that the BLM has a track record of ignoring climate impacts. 

I feel like this is directly correlated to our current administration. Under the current administration, there have been plenty of rollbacks on climate regulations. If the BLM has the power to prioritize commercial interests over the public, then the BLM has the power to directly affect the environmental quality for those who live among it. 

5.7 Sewage Facilities

Where are the sewage treatment facilities in your community? 

Oakland has one sewage facility run by the East Bay Municipal Utility District and it is located near the bay bridge. 

5.5 Campaign for Tap Water

If I made a campaign for tap water, it would be:

5.4 CCR

• What is the source of your drinking water? Where does your water ORIGINATE? (It is treated at a water treatment plant, but what watershed or aquifer is the sources of the water?)

I live in Oakland and my water is treated at the Orinda water treatment plant but it also served as needed by upper San Leandro water treatment plant. The water comes from the Mokelumne River on the western slope of the Sierra Nevada. 

• What chemicals were found in your water that were higher than expected?

Chromium and Total Trihalomethanes (TTHMs) both are linked to cancer. One comes as a result of Industry and the other as a treatment by-product. The lead was also pretty high, but the quality report suggests that the source of lead in the water is a result of corrosion from household plumbing. 

• What chemicals did you NOT expect to find in your water?

I did not expect to find trihalomethanes, and I had to google what chromium was. 

• Are there associated health risks with the chemicals found in your water? (sources for this last question include the EPA, CDC, ATSDR and the National Library of Medicine's ToxNet program).

Lead can have serious health problems, and TTHMs are linked to an increased risk of bladder and colorectal cancers and also linked to heart, lung, kidney, liver, and central nervous system damage. the most interesting thing I found, however, is that some studies have linked TTHMs with reproductive problems including miscarriage. 

I don't usually drink tap water, mostly for aesthetic reasons I suppose. I can be slightly picky about the smell and taste of the water I drink, but to be completely honest I never would have guessed that tap water could be contaminated with so many chemicals that are linked to serious health effects. 

5.2 Importance of Safe Drinking Water

Watching the videos on water facts, groundwater, and the clean water drinking act made me realize how quickly bodies of water are disappearing. It also reminded me of a lecture I had in one of my anthropology classes in undergrad. In my anthropology class, we talked about aquifers and how Porterville, California is sinking at an alarming rate due to groundwater depletion. Ironically, despite sitting on a large aquifer, wells in East Porterville have gone dry because the water from the aquifer is being used for other cities. My professor ended that lecture by saying that he believed the next war would be the water war. This also made me think about how many people are deciding not to have kids due to the uncertainty of the ecological future. It is insane that we continue to pollute our most precious resource. Even with the Clean Water Act of 1972, water pollution continues to happen, and it can take years to repair the damage. I'm specifically referring to the two superfund sites in my county that have contaminated the water.

In such a short amount of time, we have drastically changed the course of our most precious resource, water,  leaving our ecological future hanging in the balance. We need stricter regulations and laws around water usage and conservation.

4.6 Radon

National awareness campaign for radon. 

Many people are aware that smoking can lead to lung cancer, yet, few are aware of that radon exposure may lead to lung cancer as well. I would also assume that many are unaware that they are potentially being exposed to radon daily in their homes!

My national awareness campaign would happen in the form of a Fact Sheet. Similar to the one I quickly created below, but it would contain more information. 

My campaign would specifically target parents of school aged children, social media users, and homeowners. The campaign would align with the two national organizations such as American Lung Association and American Public Health Association. At the county level we would partner with non profit organizations, for example in Santa Clara County we would partner with Healthier Kids Foundation. 

We would spread our message in 3 different ways. 

1. District wide through elementary, middle, and high schools to raise awareness among parents about the potential danger in their home.

2. Through social media such as Instagram, Facebook, and Reddit.

3. Through the mail 

3.4 Air Pollution

Using your zip code (or the zip code from your family home, find out the following and enter info in your BLOG.

According to the scorecard website my county was ranked among the dirtiest/worst 20% of all counties in the U.S. Which honestly does not suprise me. 

• Who and what are the top polluters in your zip code?
• The largest polluter in my country is New United Motor MFG. INC. with a whopping 499,459 pounds. The second polluter is Arch Mirror West with 44,985 pounds. That is a huge difference. 

• What percent of the homes in your zipcode have lead-based paint?
• 3 percent of homes in my county have a high risk of lead hazards. 

• Are there Superfund sites in your zip?  (In your BLOG, make sure to tell us what a Superfund Site is)
• I had no idea what a superfund site was prior to reading this website. According to the EPA, a superfund site is land which has been contanimated by hazardous waste and has to be cleaned up due to health/environtmal risks it may cause. There are four superfund sites within the county. 

• What can you tell us about the Superfund sites that are near where you live?
• Of the four superfund sites in my country, two are owned by the Department of Energy, another is the Alameda Naval Air Station, and the other is owned by AMCO chemical. I also learned that two have previously caused water contamination. Also two of these superfund sites are in mixed residential housing locations. 

• What did you learn about the air quality in your zipcode?
• My county is among the worst for carbon monoxide, nitrogen, sukfer dioxide, and volatile organic compound emissions. 

• How about the water quality?
• Apparently the water quality in my county is among the dirtiest/worst in the nation.

• How did your zipcode fair on a social justice / environmental justice basis?
• For the most part people of color had a high rate of being exposed to air pollutants, and cancer risks. However in almost every category, whites and high income families had a higher risk of being exposed to toxic chemicals. I found that super interesting.

3.3 Environmental Justice

Blog about your observations/thoughts regarding environmental justice.

Minorities in the US are faced with many injustices daily. They have a higher risk of death and disease and often find themselves living below the poverty line and exposed to various toxins. Social determinants, racism, and justice movements are all interwoven. Reading about environmental justice made me realize how closely racism and social determinants are related. The social determinants of people of color are decided by the different types of racism they face, such as environmental racism which is seen with lack of green space in poor communities and institutional racism, which sees people of color affected by higher rates of disease and incarceration.

I think it is in the best interest of those in the environmental justice movement to align themselves with other movements, such as Black Lives Matter. People of color are exposed to various types of racism, injustices and health risks, that even if they overcome one, they remain susceptible to other various others.

3.2 Obesity

Why are we still ONLY focused on sedentary lifestyles and diets when addressing obesity in the US? Why are we not also looking at ways to decrease exposures to those chemicals that may be contributing to the epidemic?

I believe there are two reasons why we focus on sedentary lifestyles and diet when addressing obesity: it's easier to blame the individual, and companies want to make a profit. 

It's common for people to think that the reason why some people are obese is due to them being lazy. Studies show that people who are obese are often discriminated against because of how they look. For example, a study conducted by Flint et al., (2016) demonstrated shocking results: you are less likely to be hired if you are obese. 

It's easy to blame individuals for their problems, and by blaming the individual then you repress the problem. This is especially beneficial for companies. From a company perspective it's their goal to make money to stay afloat. Even though mounting evidence suggets that certain chemicals maybe linked to obesity, they would never admit their role in this problem. They do not care about the individual, they care about profit. Obesity is such a complex problem, and a large contriubuting facotr is obesogenic environments, which are rooted in profit. Despite all of this, no one will ever admit to it. As long as you don't admit to it, it doesn't exist, and isn't a problem.  

Flint, S. W., Čadek, M., Codreanu, S. C., Ivić, V., Zomer, C., & Gomoiu, A. (2016). Obesity Discrimination in the Recruitment Process: "You're Not Hired!". Frontiers in psychology, 7, 647. doi:10.3389/fpsyg.2016.00647

3.1 Biomonitoring

Lab Results from Blood and Urine Samples

The following chemicals were found at levels for which there are no “safe” levels

Chemical(s)	Potential Health Effects
Dioxins	Carcinogen, endocrine disruptor, cognitive disfunction
DDT	Reproductive toxicant
Organophosphate	(pesticide) neurotoxicant, Parkinson’s
Lead	Neurotoxicant, kidney toxicant, insomnia, impotence
Solvent	Liver toxicant, neurotoxicant
PCBs	Carcinogen, toxic to immune, neuro, and repro systems
Phthalates	Repro toxicant (infertility), testicular damage, endometriosis, endocrine disruptor

In your Blog, discuss your first thoughts AND feelings upon getting this news.

After receiving the blood and urine samples, I immediatley feel shocked. I recognize many of the chemicals but am unware with how I would have been exposed to them. I, a public health major, know so much less than I thought I did. How could I be so unaware? This is the craziest thing to me: there are potentially dangerous health effects caused by chemicals in products we use daily or weekly, and most of us are completely unaware. 

I then immediately shift my focus to DDT which has been outlawed in the United States but is continually used in other countries. I realize that this potentially means that if other countries are using DDT agriculturally then not only are those people being exposed to a toxic chemical but potentially so are we if they ship fruits and vegetables to the United States. 

I also feel sad thinking about my potential future as a mother. I'm glad I am aware of these chemicals and their effects now so that I can avoid as many of these as I can when/if I were ever to be pregnant. I think if I were to give birth to a child who had a birth defect that was linked to these chemicals I would be heartbroken. Which makes me feel heartbroken for all the agricultural working women here in the US, and beyond, who are constantly exposed to toxic pesticides. 

I think to sum up my feelings overall tho, I would say I just feel hopeless. It seems like everything is either killing us or the earth, and all for what? To turn a profit. 

Personal Care Products

The two items I decided to review were my conditioner and deodorant. 

My conditioner is Shea Moisture 100% virgin coconut oil daily hydration conditioner with coconut milk and acacia Senegal. I was extremely surprised to find out my conditioner had a rating of 4 which is labeled as moderate. I specifically bought this shampoo because it claims to have no sulfates, parabens, mineral oil, propylene glycol, phthalates, petrolatum or animal testing. This advertising on the bottle led me to believe that I was choosing a "safe" product, so I was a little disappointed to find out the rating oy my conditioner. One of the most harmful ingredients in my conditioner is cetrimonium chloride which is a known human skin toxicant and has had reproductive toxicity in certain animal studies. It is also suspected to be an environmental toxin. 

The deodorant I use is Secret Spring Breeze, and it has a rating of 5 moderately hazardous. This rating was also surprising to me but mainly because I expected it to be higher. The most harmful ingredient in my deodorant is the fragrance which has a rating of 8 for highly hazardous. Most of the ingredients in my deodorant have organ system toxicity concerns. 

I was extremely surprised to learn all the different ingredients in my products that have toxicity concerns. It definitely makes me want to be a more conscious consumer and purchase more safe products. I think everyone should know the risks and then decide for themselves if they want to continue using their current products or shop for alternatives. It is my opinion that consumers arent buy toxic products on purpose, rather they are just completely unaware. 

Environmental Health Home Assessment

This assesment was a bit of an eye opener for me, I was completley unaware of how many things I have in my home that could contribute to a toxic environment. The question regarding the age of my home made me do some research and I realized our home was built in 1925 and then renovated in 1965. We haven't done any renovations since moving in, and it makes me realize I'm unaware if we have done any lead testing. 

The most eye opening thing for me however was the use of candles and plugins in my home. Currently, we have candles and plugins in almost every room of the house, except the kitchen. 

I also realized that while we have food and water in case of an emergency, we do not have a disaster plan, fire evacuation route  and also that our fire extinguisher is expired.  

Introduction

My name is Lorena Portillo and this is my second year in the MPH program at USF. I have an undergraduate degree in anthropology from San Jose State University. Currently I live in Oakland, CA. My health interests are in communicable disease epidemiology. After my MPH I hope to work in academia or in a department of public health.