Occupationally-related disease

I chose to analyze Pneumoconiosis (Black Lung)

Pneumoconiosis is the lung disease, which is caused by long-term exposure to coal dust and primarily occurs among coal workers and coal miners. The illness per se is similar to silicosis or tobacco smoking. 

My grandfather was a coal worker and heavy smoker. We, unfortunately, lost him when I was around ten. He died from lung cancer when he was 60 years old. 

 Black Lung is not a new disease. First, it was discovered about 5, 000 years ago in Bronze Age China. In 1846 Scottish physician Archibald Makellar sketched out the picture of the disease from observing coal workers, who were exposed to the dust. Makellar named the condition “black phthisis.” In 1950 thousands of coal workers heavily suffered from pneumoconiosis. In 1960 the coal workers’ pneumoconiosis (CWP) crisis reached its pique. United  Mine Workers of America went on strike in 1968. In response to that Congress passed the Federal Coal Mine Health and Safety Act, or Coal Act for short in 1969. The Act was signed into law by Richard Nixon. At the beginning of the 1970s, the Act went into effect. Between 2000 and 2009 the number of CWP cases grew up. That led to the need of changing coal workers protection standards, strengthening safety rules and improve protection tools. Eventually, the National Institute for Occupational Safety and Health obliged industries to implement and assure in the quality of new standards. NIOSH also implemented the Coal Miners Surveillance Program. The program included not only Exray screenings but also lung function testing by using spirometry (how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale). Researchers hope now that those early screenings and preventive measures will help in preventing miners from disabling. 

Occupational safety and health organization

I chose to look up WHO occupational health program. When I looked at their website, I saw an article "More than 90% of the world’s children breathe toxic air every day" recently published on October 29, 2018. The report provided detailed information about toxic air exposure, pressing the environmental issue and its hazard effects. Additionally, the article offered key findings, recommended actions, steps to minimize poisonous effects and BreatheLife air pollution campaign www.breathelife2030.org
I think it is an excellent example of timely response towards air toxicity issue. We all know that the air we breathe has become more and more toxic and hazardous. I am quite glad that one of the most significant organizations has addressed this problem! That does give hope for us and our next generations. 

M10.1 Video

My sister in law is a bioengineer and used to work in a molecular biology laboratory in Moscow, Russia. I know that they had all personal protective tools for protecting themselves against toxic chemical exposures. Luckily, scientists are quite professional and know enough about the importance of personal protection and most of the time follow safety rules strictly.  However, I believe one of the risk factors for them, in this case, is neglect as the most common human factor. Therefore, the only one thing I may recommend to strengthen protection is reinforcing control over workers wearing all necessary personal protection equipment. For instance, as we talked in class, sometimes people tend to neglect wearing respirators because it is not comfortable.  I think we may also consider double checking the ventilation and workplace conditions.
I think regarding barriers the main factor is the expensiveness of personal protection equipment, which makes it not available for individual purchase. As I know, sometimes workplace equipment may be old. IThus, ensuring that protective tools work well and are up-to-date (comfortable and wearable) may help to ensure lab workers safety.

Blog about MSDS and ToxNet

I was not able to obtain an MSDS from a friend or relative. I looked up USF on-line MSDS. My twin brother's wife is a bioengineer, and I looked up succinic acid on this website https://msdsmanagement.msdsonline.com/c81d1269-21dd-4be9-9d4b-d3479c784635/ebinder/?SearchTerm=&UserSearchSuggestID=0&DocumentSourceTypeID=0&DocumentApprovalTypeID=0&ArchivedStatus=A&LocationLevel=0&LocationID=0&LocationStatus=1&GroupID=0&IndexedDataTypeID=0&IndexedDataID=0&QuickFilterTypeID=0&ReturnNarrowResults=false&SmartSearchTermID=0&PageSize=100&PageNumber=1&SortFieldID=0&SortHow=desc&CustomSearchTerm=&ManualSearch=false



The chemical is dangerous to the eyes and skin. Therefore, eyeglasses, gloves or full-body suit is recommended for protection. Inhaling is also harmful. In the case of most contacts, it is recommended to rinse the exposed area. The product is not cancerogenic under appropriate doses: "No component of this product present at levels greater than or equal to 0.1% is identified as probable, possible or confirmed human carcinogen by IARC."
On the ToxNet website, all the information matched. There were more details and more description of animal studies, but nothing that might contradict MSDS.
Conclusively, I asked my sister in law, and she confirmed that she received proper training and always used personal protection against hazardous exposures.

Heavy Metals

I was outraged when I found out that childhood lead poisoning actually led to a number of children deaths! That is beyond being frustrating! Every child death is a huge tragedy for a family and each person.
The lead exposure issue means that because of manufacturers and for someone else's profit there was that much harm to children! It is so unfair! I imagine myself living in a situation where I can't afford choosing, testing or preventing my home and/or community from lead exposure. And before the government or officials realize that the provided harm is so much terrifying, I do not have any tools to help it. I would not be able to protect my children from lead poisoning. That is not because I don't love them or not doing everything I can for them.

Even though, as it was described in both articles, the issue was addressed; my question is when we will first think and test before causing dangerous exposures? These exposures, e.g., lead poisoning, in fact, are the consequences of our actions.  Therefore, we first cause harm and then heroically deal with it.

Green Chemistry

I do support the idea and the main principles of Green Chemistry! It does make me feel better when I know that there is such a vital organization, full of professionals, which takes care of the environment, provide a scientific base, review and consider environmental policies and overall helps us in protecting and maintaining the healthy environment! 




When I think of examples of Green Chemistry, I first think of the examples of bottled water, as it explained in the video and as we discussed in class and in previous modules. Secondly, my topic of interest (the overuse of antimicrobial products) falls into this category. There are campaigns and calls to action regarding the reduction of routine use of antimicrobial agents. Triclosan was also banned in some products, and there are already existing regulatory policies about the use of this ingredient. 
I also think that the 12 principles of Green Chemistry are quite comprehensive and well-designed. However, principle #11 attracted my attention: 
Analyze in real time to prevent pollution: Include in-process, real-time monitoring and control during syntheses to minimize or eliminate the formation of byproducts.
As a huge fan of prevention and a believer in the benefits of preventive measures, I think that we need to emphasize this principle. There might be a need I more campaigns and educational materials for the public. Educating and informing the public is always one of the most effective ways of helping individuals making personal healthier choices. Like with bottled water, we probably cannot completely eliminate it from our modern life, but we definitely can reduce the use of bottled water by talking to the public. 

Six Chemical Classes

No wonder I decided to write more about the overuse of antimicrobial and antibacterial products. I did my literature review on this issue and not going to repeat it here. Yet I was not able to find an explanation of what initially caused that pandemic excessive worry about getting an infection. I think it is interesting from a historical perspective. There were times, mainly in Europe, when bathing and washing was considered harmful, dangerous and even against religious views.  Modern trends dictate us completely opposite behaviors.
Therefore, I wanted to explore this phenomenon in a bit more depth. I found quite an interesting resource, the Toxic Free Future, which summarized main arguments and concerns towards the overuse of antimicrobial products. Here's the link https://toxicfreefuture.org/healthy-living/healthy-homes/antimicrobials/ Most importantly, the information in the link proves my personal thoughts about the chances of a healthy person without immune pathology to getting an infection. We live in an unsterile world. There is no need in trying to create a germ-free environment. Of course, I don't mean that we should stop cleaning. However, why and when did we lost our faith in our immunity and organism natural protective capacity?

If you have any thoughts and guesses about what caused the issue of overuse of antibacterial products to occur, please share.  

Ideal Chemical Policy

I think there are a few critical components of the ideal chemical policy. First, the public has the right to know and have information about chemicals and toxins. Secondly, there must be comprehensive data about safety and chemicals. Then we need to try eliminating the most dangerous and toxic chemicals and replace them with less harmful alternatives. The ideal chemical policy must also include programs, which will protect communities and workers.
As I previously said in my blogs, I personally believe that the most important part is providing sufficient and up to date information to the public. Every person has the right to know! This, in its turn, will allow individuals to protect themselves and avoid toxic products with harmful health effects. I think this is one of the most critical and at the same time effective mechanisms. With the knowledge about harmful, poisonous effects, people are more likely to chose less chemical products. Additionally, people will know how to protect themselves from unavoidable chemical exposures.

Chemical Policy Reform

I chose the Background paper #3:

Give the Public and Workers the Full Right-to-Know and Participate

In my previous blog, I just talked about the policy that would provide information about chemicals and pesticides. The paper states that the public has the right to know and that adequate disclosure should provide sufficient information about the harmful effects of pesticides. I think that we need to raise public awareness first. It may be impossible to eliminate all pesticides, but it is possible to support individuals in making healthier choices. Systematic routine report about toxins and chemicals should be an effective way of educating the public.  However, some issues need to be addressed here. First, agencies have no mandate to collect comprehensive export data. Second, there are severe gaps in public record data regarding the identities of substances shipped, quantities exported, names of shippers, and destination countries. Some steps have been made recently to address these problems. I feel positive about it because it looks evident that the government and public care and work towards improvement. 

Pesticides

Using http://www.whatsonmyfood.org/ resource, I examined my last night meal fruits and vegetables: watermelon, sweet peas (organic, not frozen), green grapes. Out of those fruits, 2 were not organic and might contain pesticides.

I was shocked! I knew that it may contain some pesticides, but 26! I may say that I used to love watermelons and ate tons in Russia during the season. I found that the taste of those organic ones in Russia and those I bought in the U.S. is entirely different. I stopped eating a lot of watermelons because I don't like how it tastes: tastes like soap. Yet it is quite frustrating that there are that many pesticides!





















This is horrifying! Have any of us ever thought that pure grapes may be so toxic? I haven't. I should reconsider my food choices and try to eat organically grown foods any time it's possible. I understand that any fruit and vegetable is better than none. However, since I am a fruit lover, I believe I need to pay attention to toxicity. In my case the exposure may be high: I eat fruits and vegetables every day.
Public Health wise I think there definitely should be more information about the adverse effects of pesticides. I wonder if there are campaigns with number, pictures, which visualize there horrifying facts about pesticides. I do believe implementing such campaigns and providing more educational materials to the public should help every individual with making a healthier and better choice. Yet there is a significant amount of individuals who cannot allow themselves buying organic food due to financial restrictions. Organic food is twice more expensive. Ideally, the government may support local farms and help them in maintaining their business. Because organic farming is more expensive, with some supporting programs on the governmental level, it may be possible to lower the price of organic products.

The topic of interest

My topic of interest is the overuse of antibacterial agents. Originally, antibacterial products were created and implemented as prevention of transmission of disease-causing microorganisms among patients, particularly in hospitals. However, after some time they became widely popular in healthy households and have been added to many regular products even though the health benefits of it haven't been proved. The issue is that the overuse of antibacterial products, such as soaps, sanitizers and wipes in households may lead to growing number of resistant microorganisms. Moreover, these agents may alter natural microflora, affect the natural development of the immune response and, thus, lead to a higher risk of allergies. 

Levy, S. B. (2001). Antibacterial household products: cause for concern. Emerging Infectious Diseases, 7(3 Suppl), 512–515.

The National Center for Biotechnology Information raised concerns about the problem of overuse of antibacterial soaps. The agency is a part of the United States National Library of Medicine, a branch of the National Institutes of Health. The U.S. Food and Drug Administration (FDA) has also addressed the issue. In fact, on September 2, 2016, the FDA banned 19 supposedly antibacterial additives commonly found in over-the-counter soaps. CDC alongside with WHO work on addressing the legal issues Associated with Antimicrobial Drug Resistance and creation of an effective public health strategy against the development of antimicrobial drug resistance. 

Fidler, D. P. (1998). Legal Issues Associated with Antimicrobial Drug Resistance. Emerging Infectious Diseases, 4(2), 169-177. https://dx.doi.org/10.3201/eid0402.980204.

The agency's role

I chose to look closer at the U.S. Senate Committee on Environment and Public Works. In 1837, the Senate created the Committee on Public Buildings and Grounds to oversee the development of the Federal buildings in the young, but growing Federal City of Washington, DC. After multiple revisions in 1977, the name of the committee was changed to the Committee on Environment and Public Works. The committee's oversight extends to programs in five cabinet-level departments and seven independent agencies.  The nature of the agency's role in protecting the environment lays in many areas: 

1. Air pollution.
2. Construction and maintenance of highways.
3. Environmental aspects of Outer Continental Shelf lands.
4. Environmental effects of toxic substances, other than pesticides.
5. Environmental policy.
6. Environmental research and development.
7. Fisheries and wildlife.
8. Flood control and improvements of rivers and harbors, including environmental aspects of deepwater ports.
9. Noise pollution.
10. Nonmilitary environmental regulation and control of nuclear energy.
11. Ocean dumping.
12. Public buildings and improved grounds of the United States generally, including Federal buildings in the District of Columbia.
13. Public works, bridges, and dams.
14. Regional economic development.
15. Solid waste disposal and recycling.
16. Water pollution.
17. Water resources.

Local environmental services

There are some environmental services in San Francisco, such as the San Francisco Department of Public Health San Francisco Department of the Environment Staff, San Francisco Environmental Sustainability, SF Environment, Recycling (Zero Waste), etc. All together those organizations provide evaluation, regulation, control and protection of the city environment. I was personally surprised that there is a specific agency for regulating recycling in the city. The Zero Waste website provides all the information about recycling, reusing, composting and disposal. It was such a pleasure to find out that local services and residents do care about keeping their environment safe!

On the SF Department of the Environment website, I found information about recycling, climate change, buildings and environments,  toxics and health, transportation, energy, education and equities. I found the Green Buildings program described on the website quite amazing! Such a brilliant idea about reshaping SF urban environment to improve the performance of new and existing buildings. Another terrific example is the San Francisco Electric Vehicle Readiness Plan. I have always been amazed by the rapidness of technological progress. When I was born, the idea of electric cars was a fiction.  

Obesogens

• Utilizing the first article, discuss what is locally grown and what is currently in season in your area.

After reviewing articles from the module, I also found an easy to read and convenient website https://sfenvironment.org/vegetables-fruits-in-season-bay-area 

I found that the following products are currently in season:

Fruits

Apples
Avocados
Dates
Figs
Grapefruits
Pears

Vegetables

Greens (Arugula, Kale, Collard Greens, Swiss Chard)
Bok Choy
Brussel Sprouts
Broccoli
Cauliflower
Eggplant
Fennel
Okra
Snap Peas
Tomatoes
Winter Squash

• Discuss your thoughts on seasonal/local foods and hospital menus. 

I definitely support the idea of providing locally grown organic foods to hospitals. Making hospital menus based on local harvest calendars should increase health outcomes and support local businesses. 

• Find a Harvest Calendar for your state (or a state you are interested in) utilizing the link in the first article (found underneath the example Harvest Calendar for New York State). 

Here's the link to the California Harvest Calendar I found http://www.pickyourown.org/CAharvestcalendar.htm

And here is the link to a seasonal food guide in California https://www.seasonalfoodguide.org/

• What are your thoughts on the second article? Have you heard of obesogens before?

I have heard about obesogens before. I find it concerning and frustrating. People can try to avoid processed food or junk food and try to exercise more. But far not everyone is aware of obesogens.

 

• Pick one of the potential obesogens discussed in the article and using your resources from earlier modules (such as toxnet), do some research on this potential obesogen. Share what you found! 

USE:
PFOA is used in fire-fighting applications, cosmetics, greases and lubricants, paints, polishes and adhesives. 
EXPOSURE:
The general population may be exposed by breathing in the air, eating food, drinking water and skin contact with dust. If PFOA is released to the environment, it will not be broken down in the air. It can travel long distances in the air on particles that eventually fall to the ground. 
RISK:
Health risks associated with exposure to PFOA are unclear. Increased cholesterol levels, increased risk of high blood pressure, thyroid disease, and liver damage have been associated with elevated blood levels of PFOA in exposed humans in some studies. Additionally, there is a long list of other potential adverse effects. The potential for PFOA to cause cancer in humans is currently being evaluated by the EPA. However, it has not been assessed by the U.S. National Toxicology Program 13th Report on Carcinogens. (SRC)

Use of Antibiotics

ANTIBIOTIC RESISTANCE 101: HOW ANTIBIOTIC MISUSE ON FACTORY FARMS CAN MAKE YOU SICK

 I found this article eye-opening. It does deliver the critical point that we are in danger because of the overuse of antibiotics. By using low doses in industrial farming, we primarily train bacterias to resist antibiotics. To me the process is somewhat similar to vaccination: we use small doses of microbes or viruses so our organism can fight them and build an immune response. 

After watching the module videos and reading the article, I came up to a conclusion that we are obsessed by the idea of "sterilizing" and killing microbes. Why did we become so overly concerned about infections and why do we use antimicrobial and antibacterial products so often? As it was stated in the article, we even overuse antibiotics in farming. We definitely need to reconsider the use of antibiotics. Where are our faith in nature and our immunity?

NEARBY LIVESTOCK MAY RAISE 'SUPERBUG' RISK

As a doctor, I know all the danger and health risks of Staphylococcus aureus. It can cause some illnesses from skin infections to pneumonia. The fact that we are getting close to the time when diseases caused by such a banal microbe will be untreatable is quite scary! 

SCIENTISTS DISCOVER THAT ANTIMICROBIAL WIPES AND SOAPS MAY BE MAKING YOU (AND SOCIETY) SICK

 This article I found simply terrific! It was twice more interesting for me to read because it is my chosen topic for the literature review. I agree that the wold became overly concerned about contamination. Most of us do not suffer from immunodeficient conditions and our organism can fight many infectious agents we contact on a daily basis. 

My currently pregnant sister in law is using antibacterial wipes and hand sanitizers all the time even when she's at home. She perfectly illustrates those "people who wipe the world around them", as it was stated in the article. In fact, we live in a world that is far from being sterile and there is no point of trying to kill all microbes. 

 

A REPORT ABOUT THE NEW PRACTICE OF INCORPORATING ANTIMICROBIALS INTO THE MANUFACTURE OF HOSPITAL FURNISHINGS

I hope we will find the way to reduce healthcare-associated infections. These infections are quite resistant to antibiotics and hardly treatable. Yet we do need to consider all the pros and cons of using new products with antimicrobial properties. What if by using it we can decrease the number of in-hospital infections? What if this is the way to reduce resistant infections?

 

Dancer, S. J. (2014). Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clinical Microbiology Reviews, (4), 665. https://doi.org/10.1128/CMR.00020-14

Retrieved from https://cmr.asm.org/content/27/4/665 

Blog: Industrial Farming

I believe that harm caused by human actions and our intervention into natural processes and ecological systems, such as pollination, is a quite severe public health issue. This does require attraction of public attention and immediate actions. Otherwise, we are in danger of ruining our natural sources and habitats.
I found the movie exciting and educational. I was amazed by the varieties of cultures, farming methods and attitudes toward farming. Additionally, I think it's important to mention that we can and should use natural sources rather than antibacterial agents antibiotics. Because I have been thinking a lot about the overuse of antimicrobial and antibacterial products lately, I wholeheartedly agree with the statement that our society should find alternative ways for farming.
I didn't find any factory farms in San Francisco. There are some dairy farms in Marin County and many dairy, broiler and layers farms in Sonoma County. I wasn't surprised by the fact that there are no farms in San Francisco. I think it is reasonable that farms are located not far from the city. 
I do compost. I used to use compost bags, but recently bought a bin for compost products. Sorting trash, in general, makes me feel better and gives me a filling that I contribute to the common good. In the past, I had not composted because when I was living in Russia people were not sorting trash. However, we composted in our country house.