Your Sewage Facilities

In San Francisco there are 3 sewage treatment facilities (https://sfwater.org/modules/showdocument.aspx?documentid=5801):
1. North Point We-Weather Facility 
Located near Fisherman’s Wharf on Bay Street, the North Point Wet-Weather Facility (NPF) is the City’s oldest facility and was the main treatment facility until 1983.
2. Oceanside Treatment Plant 
Located on the Great Highway between the San Francisco Zoo and Lake Merced, the Oceanside Water Pollution Control Treatment Plant (OSP) is one of a few plants in the United States built largely underground. The OSP is San Francisco’s youngest wastewater facility providing all-weather wastewater treatment of flows from the Westside of the City, which ranges from the Presidio to Lake Merced.
3. Southeast Treatment plant 
Located in Bayview/Hunters Point, the Southeast Treatment Plant (SEP) is nestled in the midst of a mixed industrial/commercial/residential area, with some neighbors only a street’s width away. The SEP is San Francisco’s largest wastewater facility, responsible for treating flows from the Bayside of the City in addition to Daly City and Brisbane.

Campaign for Tap Water

Bottled water is far more expensive than tap water. Moreover, a lot of bottled water in the U.S. is taken from the municipal water sources. That means the companies put the same water you can get from taps and raise the price for it.
If I had to develop a campaign about the pros of drinking tap water I would create something informative and visually clear. 
This is one of the examples I found on Google on the following website
https://almavasola.wordpress.com/2013/01/28/provokateur-tap-water-campaign/https://almavasola.wordpress.com/2013/01/28/provokateur-tap-water-campaign/

Consumer Confidence Reports (CCR) and water quality

• 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?)

The majority of San Francisco water sources come from groundwater and some water comes from the surface. San Francisco water system has its origins in surface water. The main source of SF drinking water is soil runoff 

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

Copper and lead (from internal corrosion of household water plumbing systems) ranges in SF drinking water may be slightly higher than the average (or max)

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

I didn't see any unexpected chemicals in SF water. Copper and lead may be found old houses water, but that is due old plumbing system, which I found reasonable. However, I am not happy about it.

• 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.

According to the EPA, lead is a toxic chemical, which may cause serious health complications such as permanent lead poisoning: hair loss and even brain damage. 

Too much copper can cause adverse health effects, including vomiting, diarrhea, stomach cramps, and nausea. It has also been associated with liver damage and kidney disease.

• Where does your water come from? The source! Track it from the source to your tap.

San Francisco water source originates from spring snowmelt flowing down the Tuolumne River to storage in Hetch Hetchy Reservoir. San Francisco well protected Sierra water source is exempt from filtration requirements by the United States Environmental Protection Agency (USEPA) and State Water Resources Control Board Division of Drinking Water (SWRCB-DDW). https://sfwater.org/index.aspx?page=634 

• What did you discover about your water quality?

I talked about the water quality and condition of pipes with my landlord. As far as I know, our water is safe and the pipes are in good condition. 

• Do you use a filter for your water?

Yet I do use a Brita filter for water all the time. 

• What are you trying to filter out?

My water filter protects me from too much mercury, copper, chlorine and cadmium. 

• Do you drink bottled water?   How does this square with what you learned when you watched the Story of Bottled Water (see next exercise)?

I rarely drink bottled water when I am home because carrying it is heavy and I prefer using the water filter. 

The public health importance of safe drinking-water

Clean water is the base of life. It is critical for humans, all species, animals, crops, plants, health, etc. Access to clean, safe water can prevent deaths, diarrhea, infection spreads,  dehydration, and other health complications.  
40 years ago rivers were so polluted that they were lifeless and dangerous for human health. The Chicago River, for instance, as it is illustrated in the video was polluted so dramatically by human actions that it became entirely unusable. By implementing water protection laws and the Clean Water Act in 1972, the government took control over such a vital natural source. Protecting chemical, biological and physical integrity of water the U.S. Congress protects and maintains natural water sources. Additionally, the Clean Water Act assures in eliminating the discharge of pollutants into the nation s waters. 

Chemical/fragrance policy

A lot of people mean something that smells nice or perfume when they say "fragrance." However, exposures to fragrance can cause various health care complications and symptoms such as a headache, respiratory or neurotoxic symptoms, eye/nose/throat irritation, etc. Chemicals in fragrance are the number one cause of allergies. By implementing an "ideal" fragrance-free policy, we may, first of all, consider educating healthcare workers on all levels and patients and clients as well. Secondly, I believe every individual deserves to know what particular risks and health complications of every single product, which contains fragrance, may cause. Overall, I believe that the best option would be to create a policy, which would sound like "Every single product, e.g., cosmetics, shampoo, deodorant, air freshener, etc. that smells, or odors should be avoided in health care facilities (or other places depending on the organization policy and preferences). 

Radon

Awareness campaigns are designed to attract public and individual attention to the pressing issue, inform, educate and encourage dialogue. They intend to make the public more aware of a problem and encourage people to change their behaviors. 
If I were given a chance to design a radon awareness campaign I would probably develop ads, which include infographics and ads that are humorous but encourage awareness. 

Here are a couple of examples I found in Google that represent my vision of radon awareness campaigns.
 
My target population will be primarily homeowners, which is why I would post those awareness materials in as many sites as possible: billboards, social media, TV, auto radio, magazines, and websites.  
Potential stakeholders are the American Lung Association, American Cancer Society and Cancer Prevention, Cancer Survivors, Local Public Health Centers, Certified Radon Testers and Mitigation Specialists, the California Department of Public Health, California Department of Housing and Community Development. 

National Library ToxNet

To review and describe the health effects associated with exposures of the substances listed below, I used the National Library's ToxNet resource. 

• Urea formaldehyde (found in a pressed board, a common building material)

Health risks associated with the exposure of this chemical include irritation of the eyes, nose and throat. The compound is considered cancerogenic and may lead to dose-related non-neoplastic nasal lesions. Non-neoplastic nasal lesions are inverted papillomas that considered benign but may cause symptoms such as pain and discomfort, epistaxis, headaches, vision changes, or nasal obstruction. 

• Bleach (a cleaning/disinfectant product)

Health risks associated with the bleach also include cancerogenic risk factors. The exposures of products containing bleach may lead to adenoma and adenocarcinoma. These tumors are located in the duodenum (the first part of the small intestine immediately beyond the stomach) and are associated with DNA changes in the lining of the colon. 
The most common presenting symptoms are bleeding (acute or chronic), abdominal pain and discomfort, nausea, weight loss, or intestinal obstruction. 

Transportation

In general, San Francisco public transportation seems well-developed, and the  San Francisco Department of Public Health has addressed essential considerations such as noise annoyance, vehicle-pedestrian collisions, and mortality attributable to air pollution, using inputs such as traffic volumes and population changes. My personal experience of using public transport is rather low because I have a foot injury and have always preferred a car. Otherwise, my foot becomes swollen due to standing and hurts. I understand that my behaviors do not contribute to the improvement of the air quality. However, I have recently decided to try biking and will do as soon as I get a bicycle. What concerns me still is that there are many hills in my are and in the city, so I am not sure how I will cope with it. Nevertheless, it worth trying!
 

Air Pollution

• Who and what are the top polluters in your zip code?

• What percent of the homes in your zip code have lead-based paint?

7 percent of houses in San Francisco 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)

A Superfund site is an are in the U.S. that poses risks and considered as a candidate for cleaning because it was or has been contaminated by wasted hazardous chemicals. 
The Superfund site in my zip and in San Francisco is TREASURE ISLAND NAVAL STATION-HUNTERS POINT ANNEX. Overall, San Francisco ranked Cleanest/Best by some Superfunds sites. 

• What can you tell us about the Superfund sites that are near where you live?

The EPA Hazard Ranking System scores for TREASURE ISLAND NAVAL STATION-HUNTERS POINT ANNEX 

• What did you learn about the air quality in your zip code?

Here is what I discovered about San Francisco air quality

The pollution standards index is GOOD and the percentage of days with good air quality is 88%. This fact makes me proud. Top air pollutants in the area I live come from the airport and Golden Gate Bridge highway. 

• How about the water quality?

Regarding the water quality, I was upset to know that in Clean Water Act Comparative Rankings San Franciso water considered above the national average and dirty. 

SAN FRANCISCO County contains a portion of 3 watersheds:

San Francisco Bay

San Francisco Coastal South

San Pablo Bay

Interestingly, the leading source of water quality problems is in Urban Runoff/Storm Sewers, which seems justifiable due to the features of the landscape and geographic location. 

• How did your zip code fair on a social justice / environmental justice basis?

When I looked at Distributions of Environmental Burdens in San Francisco, I was surprised by the fact that in the distribution of burdens by race Whites ranked higher than people of color. Cancer risks are quite close in low and high-income classes. Overall, high income and highly educated population have lower rankings in most categories, which I found predictable as we have studied in MPH and MSBH programs. One of the most surprising facts I explored was that renters have lower risks in all categories compared to homeowners. I wonder why? Because of the inspection and regulations?

Environmental Justice Blog

While I was reading the Environmental Justice Principles, I was fascinated by how well-defined, eloquent and descriptive they are. However, one thought I had was disturbing: I wish everyone knew and followed those principles. Interestingly, cultural humility, economic and social levels, and environmental health are all connected. This was new to me since I have never thought of ecological health through social determinants. Of course, I know about worse living conditions in low-income classes, but it seems much more than that. How would you involve individuals of all races and from different socioeconomic levels in the process of improving the environment? The Environmental Justice Strategy article briefly talked about it in the Public Education and Training section. But how would you explain to the poor and low-income individual that he or she needs to care about the environment while what they care about the most is what to eat? I firmly believe that we need to support vulnerable populations so they would have a chance to become a part of environmental movements. The article written by Joan Martinez-Alier, Leah Temper, Daniela Del Bene & Arnim Scheidel (2016) clearly explained how many determinants are present in the environmental justice movement. Hard to imagine the complexity of it. However, a lot has been done to improve the situation. I am quite excited and hopeful because we have all the resources and opportunities to make significant changes!

Vulnerable Populations

After watching the Richi Manchanda talk, I came to the same conclusion. We cannot blame doctors for everything that happens with our health. Doctors are physically not capable of checking our living and working conditions. Those things must be under our own control. I really appreciated his vision of our future in medicine. There is definitely a need for environmental health specialists, who will help us in analyzing and improving our living conditions. I think the idea has great potential.
On the other hand, the Little Things Matter video did illustrate to me how urgent and vital it is to work on those aspects of individual and public health. Unbelievable! I couldn't believe that the IQ level has decreased because of environmental exposures. It sounds frustrating to me! Our education has become more complicated, our overall knowledge has increased, and the school program per se has grown more difficult. However, the IQ level has decreased. Isn't it horrifying?!
The video and readings have talked about reproductive health among males and females. I don't want to repeat those facts listed in the study materials. What I was glad to know is that we have been learning from our mistakes. We have the power and opportunities to make positive changes in our personal lives, in our communities, and on a macro level.



Conclusively, I do care about vulnerable populations, such as pregnant women, infants, children and individuals of all races. It is also true because I live in the society where we all connected and have an impact on each other much more then we think. Children are our future! It is essential that everyone starts with him or herself and that is how we make bigger changes.

Biomonitoring

I was shocked after watching the  CNN YouTube news special on "Body Burdens" of Potentially Toxic Chemicals with  Anderson Cooper. I have never expected that there are so many different harmful exposures and chemicals each of us is affected by on a daily basis. Moreover, the effects of those exposures are detrimental to our health, wellbeing, and lives in general. On the one hand, there are many certain things that we have a no or very little control of. On the other hand, as it was stated in the video, luckily not all those exposures are necessarily harmful. Yet we don't know for sure, and we don't have enough information about many exposures. Thus, it is not possible to say for sure that some of the exposures are malicious or not. For instance, we may think at the moment that something is not deleterious, but at the same time, we may just not know enough. That is scary!

After all, after watching the video, I kept thinking if I wanted to do the body burdens test. I guess I don't. Of course, I am not saying that I do not care about my health or health of my beloved ones.  There are things I can control, and there are many things I can't change. At the particular moment, unfortunately, I don't think I can improve my living situation, housing, or the environment. I feel healthy, and I believe that my emotional and psychological health is essential. Therefore, if I am not capable of making changes, I should better take care of those things I can change and do not worry about things I can't change. 

Ken Cook and Advocacy Organizations on Toxics in Personal Care Products

After watching the Safe Cosmetics 101 Youtube video I found that I am using a minimum of 17 products every day. Those include personal care products and cosmetics. I listed them below

1. Shampoo

2. Shower gel
3. Hair mask
4. Toothpaste
5. Facial cleanser
6. Face cream
7.  Hair oil
8. Eye Gel
9. Body lotion
10. Perfume
11. OPI nail polish
12. Hand soap

Cosmetics:

1. Concealer
2. Eyelash
3. Eye Pencil
4. Highlighter
5. Eyebrow Gel

 Around one or twice a week I may use eyeshadows and other decorative cosmetic products. However, I believe that the list is far from being complete. I have always been choosing my cosmetics and personal care products from well-known brands and bought them in authorized stores. However, after watching the video I realized how low is my knowledge about the products and how wrong it would be to say that I protected myself from chemical and hazardous exposures!
I kept thinking about creating a policy that would warn consumers about hazardous ingredients of personal care products. Even though at the particular time, it may be close to impossible to eliminate all harmful ingredients from care products, people should have their rights to know about all the ingredients and its' effects on health.

Ken Cook from at Environmental Working Group Video raised a number of important questions about the effects of chemicals and exposures. Imagining the complexity and importance of chemical effects is quite frustrating! During every single day of our life starting from our mothers' bodies we have been exposed to multiple toxic chemicals. Good is that we know that and can minimize those hazardous effects. Each individual should consider those health effects of toxic chemicals. Our well-being is our responsibility and our personal choice. 

National Library of Medicine's Household Products Database

Unlike personal care products, I find myself less skeptical about the hazardous effects of household products. Maybe it is because I know that almost all cleaning procucts contain chemicals and chose to use those products against bacteria. 

In order to conduct an environmental risk assmessment of my household products, I used the National Library of Medicine's Household Products Database. I chose to assess two household products. 

The first product I assessed was Lysol Mold & Mildew Remover Complete Clean with Bleach, Pump Spray-Old Product. 

 

Health rating 3

Precautionary Statements: Hazards to humans and domestic animals. Warning: Causes eye and skin irritation. Do not get in eyes, on a skin or on clothing. Vapors may irritate. Use only in well-ventilated areas. Avoid prolonged breathing of vapors. Not recommended for use by persons with heart conditions or chronic respiratory problems such as asthma, emphysema or obstructive lung disease. HARMFUL IF SWALLOWED. For sensitive skin or prolonged use, wear rubber gloves.

 The second product was Clorox Clean-Up Cleaner with Bleach, Fresh Scent, Pump Spray

 Health rating 2 

This chemical is considered hazardous by the 2012 OSHA Hazard Communication Standard (29 CFR 1910.1200) Warning. Causes mild skin irritation. Causes serious eye irritation. 

• Were you surprised to find out the toxicity rating of your household products? I was not surprised by toxicity ratings since I knew that both of these products contain a lot of chemicals and always used protective tools, such as gloves and ventilation. 
• Did you decide to change any of your consumer behaviors based on your findings? Since I am aware of the hazardous effects of both household products, I always use rubber gloves and open windows while using those products. I don't think I will change my consumer behaviors because based on findings. I love when it is clean and safe at home and I believe that it is reasonable to protect yourself from the potential side effects of those products rather than do not use them. To me keeping my home clean is critical. 
• Should everyone know about this risks and why don’t they? Yes, everyone definitely should consider the hazardous effects of cleaning products and protect themselves from those effects. Unlike personal care products, I think, most of us are aware of the toxicity of household and cleaning products. I remember, while we were making a list of exposures in class, all of us named household and cleaning products toxic. 

Personal Care Products

I chose to assess two of my personal care products, which I use every day.
The first product was

Vaseline Intensive Care Aloe Soothe Non-Greasy Lotion, Aloe Fresh

Another product was 

Aveeno Active Naturals Daily Moisturizing Body Wash

• Were you surprised to find out the toxicity rating of your personal care products? I was quite surprised when I found out that both of my daily care products are moderately hazardous! I have never thought about immunotoxicity of any of my daycare products! 
• Did you decide to change any of your consumer behaviors based on your findings? Both of my products are moderately hazardous and the highest risks are in allergies and immunotoxicity in both of them. I think I will use them to the end, but quite likely won't buy them again. I do not have allergies; however, immunotoxicity scares me. I should consider healthier market options. Luckily market allows doing that easily.  
• Should everyone know about this risks and why don’t they? I believe everyone should know about the risks because we have our rights to know and, thus, make personal decisions about every product we use. A few of us think about potential hazardous toxic side effects of daycare products mostly because we have a lot of concerns and problems on a daily basis and tend to disregard "smaller" risks.