Final post

I still remember how much I was excited before starting the class.  Although I had an online class previously, I learned more how to work with people online from this class.  Advantage of the online group working is that I can work whenever I have time for.  I am taking another nursing class, so it was not easy for me to find time to meet with group of people.  Therefore, it was very convenient for me to take the online class.  Another big advantage for me was I could learn how to express my opinion from the blogging.  Also, I learned how people share their opinion with respect and open mind. I remember how much I was worried how to reply for my group’s blogging at the beginning of semester.  It was very interesting to know that everyone has different opinion and there is a not always right answer.   I also enjoyed sharing my own products or issuing such as the personal care products blog and air pollution in my area.   I learned a number of environmental statuses where I live.  In addition, I had a fun preparing my presentation for the topic I am interested.  I could enjoy more because I like the topic I chose.  It was great opportunity to research air pollution in South Korea as I always wanted to know more.  I am proud of myself that my knowledge has been improved through this class.    

M14.4

a.) As we begin to think about being active and prepared, explore this website (Links to an external site.)Links to an external site. and the links that are specific to your region or area of interest to learn more about health (physical and psychosocial) and environmental impacts or preparedness needs for these disaster precipitators.

My interest is earthquakes.  Although I don't live in San Francisco, the earthquakes can affect anywhere around SF, which I am concerned whenever I hear the possibilities of having the earthquakes from the news.  There are various resource for the earthquakes in the website; health impacts; psychosocial impact; health recovery.  Regarding to psychosocial information, parents can learn the impact of the earthquake in children and how they can support their children after the earthquake.  The NCDMPH provides disaster preparedness in children with detail information.  They had "Pediatric Disaster Preparedness Curriculum Development  Conference" in March 2011.  They focused the concerns for children who experience the disaster.  This enable for parents to prepare physically and psychologically for their children for the disaster.  

b.) In California we have the Disaster Healthcare Volunteers Site (Links to an external site.)Links to an external site., where healthcare professionals and those with healthcare experience can express a desire to be a volunteer should a disaster happen. Is there something similar where you live?

In Santa Clara county, I found "Medical Volunteers for Disaster Response(MVDR)".  The people in this group are registered nurses and physicians as well as social workers and mental health professionals.  The main three areas that are managed by this team are medical/health emergencies, disasters that cause injury to large number of people, and community outreach.  I looked over the package for MVDR. According to the package, their mission is "to improve the health and safety of communities across the country by organizing and utilizing public health, medical and other volunteers to support medical response locally and throughout the State."  The members in the team have professional licensure or certification.  They need to complete some training.  In order to be a member of MVDR, person must be citizen of U.S, able to stand for long periods of time and able to lift up to 25 pounds.  It was interesting to know that there are 4 different levels of membership depending on age, interests, professional training, life experiences, level of obligations to other volunteer or paid positions, etc.  The highest level is 4 called "leader".  They need to attend a 6 training and 2 exercises per year at minimum.     

I also found one called "Community Emergency Response Team".  They are not medical professionals like MVDR, but they get trained some basic disaster response skills.  After training the skills, they are able to help people in community when professional responders are not immediately available to help.  

https://www.sccgov.org/sites/ems/Pages/mvdr.aspx

http://www.cityofpaloalto.org/services/public_safety/get_involved/cert.asp

M10.1 Occupational health

1) Consider your workplace or a workplace of one of your family members. Are there chemical, biological, radiological or ergonomic issues? Using the industrial hygiene hierarchy of controls, how might you address the issues? How are they being addressed in reality?

My boyfriend works in the hospital. Therefore, there is a biological issues.  He could be exposed to all the virus or infectious disease in the hospital just like any other employees who work in the hospital. In particular, he is a surgeon, which also can cause ergonomic issues, from standing long hours.  By using the industrial hygiene hierarchy of controls, the firs thing he can do is eliminate the hazard.  However, that is not possible because that is what his job to take care patient who has possible infectious disease. Also, he cannot substitute, which is next level of hierarchy.  The third level of hierarchy is engineering controls.  With this level, he can do some since there are isolation rooms in the hospital for patients who have active infectious disease.  However, this cannot always protect him.  This is because he has to treat these patients no matter what.  Fortunately, he can control with last 2 levels in the hierarchy of controls.  There are specific policy in the hospital how the surgeon treat the patients who have active infectious disease.  Also, he puts personal protective equipment whenever he needs to.  In reality, these are addressed in most time.  However, I have seen some employees including doctors in the hospital did not have the right personal protective equipment when they took care particular patients who required.        

2) What might be the barriers to workers exercising their rights to a healthy and safe workplace?

The barriers I can think of is money for personal protective equipment.  As I mentioned just above, I have seen people who did not wear the personal protective equipment.  The reason for that was not only because the employees chose not to wear, but also there were not enough personal protective equipment.  There should be enough personal protective equipment in the hospitals, so no employees do not loose chance to protect himself or herself.    

Climate Change

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

After watching all the videos and looking the website, I found people's acknowledgment of seriousness of climate change is most troubling.  I guess many people already know that our climate has been changed for many years.  However, I don't think they are really understand and know how serious it is now.  We feel like there are some time to solve this problems, but this is not true anymore.  I want everyone to feel that we need to do something against climate change. As people in the video mentioned several times, this is time to act to do something for climate change.  We are actually late according to the video, but still can make it better if we start to do something.  Small changes can make big changes eventually, but it has to be everyone who do act.  This can start from our home by saving the energy, using healthy products or foods.    

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

As a public health professional, I think we need the greatest attention is loss of sea ice in the Arctic due to global warming.  I remember the documentary video about melting of the sea ice in Arctic.  It was tragic and made me depressed.  I saw lot of animals dying from warmer temperature and loosing the ice.  That was already happened from long time ago, but we still don't see any improvement.  We need to understand that the animals in the Arctic are dying because human are using the environment in wrong way.  As soon as possible, we need to fix to protect our animals.  One idea I suggest that we can promote the "zero energy home" like zero waste on the last lecture.  When we build the house, we can make better ventilation  system in order to keep the heat in the house without using too much heater.  Also, we can use solar energy instead of gas or oil.      

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?

The climate has been changed for many years.  It impacts on environment negatively.  Due to increased of temperature, which is called global warming, the water has been rising and the severity of storms and other nature disaster has been rising as well.  Also, the climate changes causes the air-borne and water-born disease.  For example, the Lyme disease happens more with longer summer season.  Another example, we get sick from eating sea foods that has toxin due to climate changes.  In many ways, the climate changes has been threaten us as I mentioned. In particular, children and older people are more vulnerable.  The rate of Asthma or other lung/heart disease are associated to the climate changes.  Because of warm temperature, the disease such as West Nile Virus or Dengue are happened more often. There are many ways we can resolve this issue.  We should finish the foods we have in order to decrease the waste.  Also, we can use public transportation whenever it is possible instead of driving our own car, which contributes to the air pollution.  At home, we can reduce the temperature of heat by wearing more cloths or putting the rugs to keep the warmth.  Some countries or cities have already have been preparing by building levees, which can protect the cities when water floods.  However, it costs a lot of money, so many poor countries such as Bangladesh does not have the water defense system.    

Zero Waste Life

This module was very interesting to think about how to make zero waste life.  This module reminds me "minimal life" that has been popular as a new life style change recently.   After reading and watching the materials in this module, I tried to think what I can make my life to zero wast life. Surprisingly, there are few small things that I already have been doing since I was young child.  I would say this is partly from South Korea culture I have learned when I was young.  In particular, Korean parents always teach to their kids not to waste of foods and save materials as much as they can.  For example, my parents were mad if I didn't finish my foods and they told me to think about how much effort the farmers made for each single rice.  After I thought about them, I felt bad and tried to eat my portion of foods.  I still try not to make left over foods.  In order to finish my foods, I tend to choose small amount foods in the menu because I don't want to waste of foods.  Another example, I recycle used paper.  In particular, my printer only print out one side of paper at a time and I did not want to throw it away.  I save them and use when I study.
There are various methods I can approach for Zero Waste Life.  In the video, Lauren mentioned about buying second hand clothes.  Additionally, I can donate my old clothes instead of discarding.  I am little shame, but have too many clothes that I need extra space for store them.  I keep them because I got bored to wear.  However, I don't want to dump them because they are still fine to wear.  It would be great if other people can wear from donating.  Or I can open "flea market", which people can exchange their old products each other.  Another idea I can implement is using cloth menstrual pad instead of using tampons or pads that have been used commonly in the market.  The pads that we buy from the market are not recycled and produce large amount of waste.  On the other hands, I can recycle the cloth pads many times, which is beneficial for environment. Another benefit of cloth pads is that it is more safe for women's health.  I have very sensitive skin and get irritated from using pads I bought from market.  I am happy to change my self first and hope this small change becomes bigger in the future.

MSDS and ToxNet

I obtained the Material Safety Data Sheet from Stanford University Hospital.  The product name is Nitric Oxide.   

• What are the health risks associated with this chemical?
• It is harmful when people inhaled. It can cause respiratory tract irritation, nausea, vomiting, stomach pain, chest pain and difficulty breathing.  Also, it can cause irritation in eye and skin as well. 
• Is the chemical a carcinogen?
• Yes, but it is controversy. 
• What personal protective equipment or special precautions should be taken when working with this chemical?
• For respiratory : Any supplied air respirator operated in continuous flow mode.  Any chemical cartridge respirator with a full face piece and cartridge providing protection against the substance.  
• For hand : Appropriate chemical resistant gloves. 
• For eye : Splash resistant safety goggles.  
• For skin and body : Appropriate chemical resistant clothing. 
• If this is a chemical found in your workplace, what training/education were you given about any risks associated with this chemical
• For handing, secure cylinder when using to protect from falling.  Also, use suitable hand truck to move cylinders.  
• For cleaning up, stop leak if possible without personal risk.  Avoid contact with combustible materials.  Keep unnecessary people away, isolate hazard area and deny entry.  Ventilate closed spaces before entering. 
• For extinguishing media, do not use dry chemicals, carbon dioxide or halogenated extinguishing agents.  Flood with find water spray. 
• For fire fighting, move container from fire area if it can be done without risk.  cool containers with water spray until well after fire is out.  Let the fire burn.  

I could find large amount information about the Nitric Oxide in the ToxNet database regarding to health effects, emergency treatment, pharmacology or animal toxicity studies.  Based on the research from ToxNet, Nitric Oxide affects negatively on human health in many aspects.  Although MSDS contains major information to know for employee, it would be more helpful to find the information from databases such as ToxNet.  The database contains more specific information to protect workers.     

Occupational safety and health organization

Among various organization, I chose WHO to look up their program.  They have lots of programs, but I simply chose the occupational health.  I looked up the occupational and work-related diseases.  The WHO Global Plan of Action on Worker's Health improves the diagnosis, reports and registers occupational diseases and building capacities for estimating the occupational burden of disease (WHO).  Then, I looked up the graph for global estimated of occupational burden of disease.  In 2004, the airborne particulates was the highest risk to lead the death in low and middle income.  I also discovered that only 15% of employees in the word have access to specialized occupational health service to prevent occupational risks, health surveillance, training in safe working methods, first aid and advising employers in occupational health and safety. The Global Plan of Action works for full coverage of all workers, including small and medium-sized enterprises, agriculture, and migrant and contractual workers, with essential interventions and basic occupational health services.  Their interventions and service for workers' health would protect me when I work as a nurse in the future. I can have specialized health services for my job.  Also, they will promote the healthy workplaces, so I can have an safe working environment. This is really important for me who will work in the hospital where the safety environment.. For example, needlestick juries is also one of the program in WHO in order to reduce the infection caused from needle sticks.  I found the average 1-9 nddlestick injuries occurs every year in 20 countries.

  Reference :  

http://www.who.int/occupational_health/en/

Heavy metal

Lead Poisoning
In the early history, I did not know that the victims were wine drinkers.  Since the "upper-class" people in Rome had wine regularly, it impacted these people as well as lead workers.  I was also surprised that the "childhood lead poisoning" has been discovered "only a century ago". I assumed it would be very difficult to investigate what caused the children's disorders due to lack of technology at that time.  Thanks to development of technology after, we know that children are more vulnerable for lead exposure.  In the 1960s, the scientist found that children start to show the symptoms at dosage over  60Å g/dl.     They continued to conduct the study "to discover effects of lower blood lead levels" and the limit level of lead in the blood dropped to  10Åg/dl from  60Å g/dl.    The on-going studies still are still required about it.  The important fact that we need to remember is that the lead exposure in early childhood will cause the problems in their later life.  For example, Fergusson et al discovered "elevated lead levels were associated with poorer reading scores, more failure to graduate from high school".  Regarding lead and behavior, it was interesting to see "the recent decline in crime rate" associated to "decreased exposure to lead".  It is important to know that lead exposure affects social behavior as well as other health issue.   As we have learned with any other chemical toxicity, the best and most effective method to treat is prevention! In lead poisoning, it is significant after they discovered that there was no difference between treatment group and control group.  I appreciate for people who supported to remove the lead from gasoline or house building in the late 1970s.  After that, we obtained the benefits of health and economy by increasing our IQ! I am wondering if I didn't get exposed by the lead, how much my IQ could have been increased!

An environmental health response to a severe outbreak of childhood lead poisoning in NigeriaCasey Bartrem

I remember that I used to play with soil when I was a child.  Unfortunately, not all children cannot enjoy this due to environmental issue nowadays.  It is very sad to see children died in certain area.  They could have saved more children if they had higher level of education, resources or economic status.  As public health students, it is also happy to know that there are organizations such as NGOs that help for this people. Their aims are effective and safer to remediate.  Thanks to their intervention, the blood lead level decreased amazingly.  This shows we can definitely decrease the lead poisoning in other area as well.   

Green chemistry

I have not ever heard about green chemistry in English, but might have in my native language.  Although it is unfamiliar term, I like the meaning of the green chemistry.  It is very meaningful in term itself and provides us hope for green and healthier environment.  The list of 12 principles are all required to be green chemistry.  First principle is "prevent waste", which I think is most effective and easiest method for us to perform.  Prevention is easier than fixing after problems rising. In the previous video about 6 classes chemicals, all of the presenters asked us at the end of video if we really need the products that contains toxic chemicals or metals.  In many times, we can use alternative products, which will reduce the waste at the first stage.  Second is "maximize atom economy".  This seems more researchers or scientists' job to focus. To be honest, I am not 100% sure how maximized atom economy would benefit for green chemistry.  However, it is efficient methods economically (Can someone explain about it briefly?)  The third principle totally makes sense.  It can go with first principle as I mentioned about alternative products.  By using less hazardous chemical syntheses, we can prevent toxic waste.  The fourth principle is even better than the third principle because it is "safer" to use.  The fifth principle is focused on solvent and reaction condition specifically.  As we just have learned from 6 classes chemicals, organic solvents cases various health problems especially in the young.  Therefore, it is significant to invent safer chemicals for them.  The sixth principle is what I have thought about my house.  My house is old, so the ventilation is not good.  It costed so much money from running the heat last few months.  I decided to build house with good ventilation when I have a chance in the future.  One of our classes also covered about the seventh principle.  In particular, agricultural products produces lots of toxic chemicals.  The positive thing is that more people have been aware that problems, which leads to healthier environment. For the eighth principle, we should avoid anything that produces additional reagents and waste.  Can anyone think of the example for this from our classes? The ninth principle is interesting. Catalysts are smart and effective chemicals.  I am curious how and where it can be used more specifically.  Regarding to the next principle, I hope we can apply this principle for all the chemicals.  Accumulation is serious problems in lots of chemicals.  For example, lead cannot be eliminated, but accumulated in our body.  It would be highly beneficial to invent chemicals to degrade.  The 11th and 12th principles are very important as public health providers.  It is difficult to improve our environment without analyzing.  Also, we need the chemicals that does not produce toxic from accidents, which happen everywhere.  

six classess

1. Highly Fluorinated Chemicals (PFOS, PFOA)

It is found in the materials that are used for oil and water repellency according to the video.  The examples are carpeting, apparel, waxes, food packaging materials, or non-stick cookware.  It was interesting to learn that this chemicals are not found in nature, but only from manufacture, and disposal.  As video explained, first it makes in door air toxic , which would affect out door air as well.     In similar way with other chemicals, it spreads into human from nature.  Fluorinate chemicals are produced by factories and exposure to the furniture and landfill.  Finally human get exposed including infant.  I have no doubt that this would be global issue since we use them for lots of products.  However, do we really need for that much products?  As video suggested, I think we can decrease the use of this chemicals for various products.  Especially we know this chemical can cause health problems such as thyroid disease, sexual hormonal imbalance.  Therefore, it is significant to find the alternative chemicals, which harm less than PFOS and PFOA.  Unfortunately, there are not many datas for the alternative chemicals. As a public health provider, we should support research for alternatives.

2. Antimicrobials
Triclosan and Triclocarban (TCC) are antimicrobials as we took classes about it earlier in the semester.  In similar with highly fluorinated chemicals above, it is toxic, widespread exposed and vulnerable for young children.  Although the toxicity of antimicrobials has been know for many years, we still use many products that contain antimicrobials.  Especially, people who work in the hospital use disinfectant frequently, which contain antimicrobials.  Most of time, we can use soap and water instead of disinfectant.  As video mentioned, we need to know that there is "no proven benefit over hand washing with soap and water".
It was interesting to see the graph of 'Rapid uptake during a short shower'.  It was the opposite than I expected.  The short shower leads us to be exposed in high rate of TCC.  This would be due to rinsing the chemicals from water for a longer time.  I would not use antimicrobial product when I have kids since I learned that it cause endocrine disruption and increases allergy.  
It is interesting to know that many people have false belief about the chemicals.  Fortunately, more research support against to antimicrobials.

3. Flame Retardants
The products that contain fame retardants has been used a long time ago in electronics, building insulation, polyurethane foam and wire.  However, in 1972, it was found in the baby's sleep wear and children's urine.  At that time, they didn't research the harmful effect of flame retardants.  While they conducted the research about effect of flame retardants in particular of children' pajama, they started to notice the danger of this chemicals, which causes the death in animals and babies.  In particular, pregnant women can easily pass to the baby via placenta and breastfeeding.  The reason people used flame retardant was the benefit of withstand of flame. However, recent research showed no evidence of benefit from flame retardants.  Fortunately, several new policies to limit this chemicals were set up later in California.  However, the furnitures that were made before Jan 1, 2014, still contain this chemical.  Therefore, consumers should ensure the furniture they bought does not contain it.  Also, we should still ask when we buy new furniture if that contain the chemicals or not.  

4. Bisphenols and Phthalates
This chemicals cause endocrine disruption mentioned several times by above chemicals. This is an "exogenous chemicals, or mixture of chemicals, that can interfere with any aspect of hormone action." Since they are widely used in plastic, we can find them almost everywhere in foods, water, soil and air.  There are 3 reasons why need to be concerned by them.  First, it effects on very low concentrations. Second, it effects permanently in prenatal and early childhood exposure. Lastly, it effects on multiple generations.  In particularly, Bisphenol A is used in hard plastics, which is resistant to heat.  The examples of this are flame retardants, which I just talked about, and thermal cash register receipt paper.  People can easily get it hand to mouth behavior.  The effects on human's health are similar with other chemicals I talked above.  These are reproductive, thyroid, and immune metabolic system.  Also, it causes neurodevelopment, or asthma in childhood.  The important fact we need emphasize about this chemical is that small amount is very effective to cause the problems in particular young children.   Good thing is that the U.S government banned the baby bottle and sippy cup in 2012 as well as food packaging and receipt paper.  In many other development countries, it has been banned too.  I am curious how the government of my country(South Korea) reacts on this.
Regarding Phthalate, it is used for making plastic softer and more flexible.  Also, it used in fragrance to last longer.  It is good to let people know that Phthalate is used in last long fragrance since they tend to buy fragrance that last longer.  This is also easily taken by human like Bisphenols.  This is also banned by the U.S government.  Especially, toys that children play is in high risk for exposure. We need to consider to use alternative products such as glasses or stainless steel.  After learning of the truth of the bottled water, I use more tapped water! Also I learned that I should avoid to have receipt if I don't need.   The U.S government should set the specific law for labeling to BPA and phthalates.  I suggest to educate to read the label property before purchasing the products.    


5. Organic Solvents
The basic function of solvent is used in 4 different part.  These are the dissolved materials, carrier solvents, cleaning and stripping, and mixing medium.  There are 2 kinds under hydrocarbon solvent, which are aliphatic organic solvents and aromatic organic solvents.  Regarding the aliphatic organic solvents, we can find this in painting or coating.  Regarding the aromatic organic solvents, it also found in printing or adhesive. There are also 2 kinds under chlorinated solvents, which are methylene chloride and perchloroethylene.  Next category is called oxygenated solvents, which are more familiar to me.  These are ethyl acute, acetone, and alcohols.  Since it is used in personal care products, it is widely spread. The last category is water, which is organic solvent in nature. However, the water can't dissolve something, so we use other solvents more.  The health effects from this chemicals are similar above chemicals except for contact dermatitis.  In the opposite to flame retardants, it is flammable.  Human mainly absorb the organic solvent by inhaling.  In reality, we cannot avoid organic solvents, but we can reduce by using alternative products. For example, the products based on water is good option.  Again, the government should regulate stronger to limit the selling in the market.  

6. Certain Metals
As video mentioned, we need metals for our lives.  However, some of the metals such as lead cause serious health effects on animal and human.  Lead, arseni, and mercury are example of metals we concern.  These heavy metal can affect us even with small amount of dosage.  It can be acute or long-term deepening on the time exposed.  The video reminded me how the metal interacts with our body. For example, lead attaches to red blood cells and replaces calciums in bones.  In addition, it gets stored in muscle tissue as long term effect.  As we learned in the previous class, it is recommended to check the level of metals in our bodies.  In particular, it is significant for the babies and the young due to neurologic problems.  I learned that there are 2 different categories of products; intentional and non-intentional. Regarding intentional products, it was good to know that we get the metals via tattoo or certain baby's toy such as rubber duck.  I remember I bought that toy for my nephew long time ago and now feel guilty.   For unintentional products, I did n't expect the mascara. I don't remember to read the label for this on the mascara.  Unfortunately, we cannot eliminate them from us as video explained.  However, I hope we can reduce the amount we get exposed by more strict law that ban the use of highly toxic metals and by inventing alternative metals.  Lastly, we need to get educated how to dispose in proper way.

An ideal chemical policy

After studying all the materials for this week, there are some parts that are essential for an ideal chemical policy.  The most essential I would like to focus is that we should be able to trust our government.  We need to trust the law the government regulates releases only safe chemicals.  In other words, the government should manage strictly the environmental policies and the federal agencies.  It is sad that I cannot trust the government or other federal agencies easily anymore after discovering bad news about the chemicals.  However, it is our job as public health care provider to build their trust again.  Many people including myself do not investigate or research how much toxic chemicals or pesticides we are exposed by.  Some people don't even doubt about toxic chemicals if they see the label as "Organic". All of the elements for The Louisville Charter for Safer Chemicals would contribute for the strict law,  but I would emphasize more on "require safer substitutes and solutions" and "give the public and workers the full right-to-know and participate".  
Regarding to "require safer substitutes and solutions", it is a serious problem that the United Stated "do not prioritize the production and use of inherently safe chemicals".  They should set the goal to make safer substitutes and solutions with specific guidelines.  In addition to, the government should ensure that the alternative products are really less hazardous than the previous products.  This is because "the replacement is often just as hazardous or simply a reduction of the quantity or concentration of the toxic substance that has been targeted" in most time.  It would take a lot of money, but the government should increase the fund for the agencies who regulate the chemicals or the companies, which produce environmental friendly chemicals.        
I learned that the most effective way to prevent all the disease or crisis is education.  I think it would be applied into public health in same way.  Under the ideal chemical policy, the next step (after having a strict law by the government) we can do is educating people.  This represents "give the public and workers the full right-to-know".  We will continue to be exposed by toxic chemicals if we don't get educations.  We would not know when, what, where and how we get exposed.  This is also because of "limited practices currently inform workers and communities of some toxic chemical sources and exposures".  Therefore, we need to be smarter to see which environment we are surrounded by.  We need to know what are alternative solution for reducing the toxic chemicals if we indicate that.  For example, the school can provide the class about the chemicals.  Also, health care providers can teach the asthma patients to avoid the triggers that causes the asthma.  The informations for the patients might be the specific areas or date/time they should not go out side.  Also, educating the importance of wearing mask for the patients is another example.  In terms of pesticides, people who use the pesticides directly should get educated to wear the protective tools, so it won't go inside their bodies.

Chemical policy reform

Require safer substitutes and solutions
I think it is one of the most significant to remove the hazardous chemicals "by altering production processes, substituting safer chemicals, redesigning products and systems, rewarding innovation and re-examining product function."  In our group's ideal chemical policy, I suggested that we can use the car alternatively by suing the number of car plate for the air pollution.  Also, Samuel suggested the policies that reduce exhaust from both industrial, commercial, private, and public vehicles could reduce the total particulate matter levels within the air.  In addition to that, he suggested the use of air conditioning and articulated filters, decreasing indoor combustion for heating and cooking, and smoking cessation in order to reduce indoor levels of particulate matter.

Phase out persistent, bioaccumulative, or highly toxic chemicals
Fragrance could be persistent, bioaccumulative and highly toxic chemicals when they are used directly into human body.  Samuel explained that "the policy which would help in possibly reducing personal exposure to adverse chemicals within fragrances, would be to require companies and manufactures to disclose the chemicals used within the fragrances of their products."

Give the Public and Workers the Full Right-to-Know and Participate 
Elena emphasized the educations about the importance of knowing the Air Quality Index(AQI) for the parents.  She suggested that "pediatricians and nurses should discuss this with parents when a child is diagnosed with a respiratory disease." This is one of the most effective way to provide the full right to know in the public.   

Act on Early Warnings
Our group didn't mention policy for this category.  Especially, it is not easy to prevent until we experience the new chemicals.  I can suggest that the government should regulate the law strictly about the new chemical before they release it. 

Require Comprehensive Safety Data for All Chemicals 
Providing the data for all chemicals is not a choice, but rather mandatory.  However, many fragrance companies keep secret their ingredients since it would affect on their business.  For fragrance policy, I and Elena suggested that the companies should create labels with detailed information about which chemicals they used.   

Take Immediate Action to Protect Communities and Workers
Elena suggested using of the application that automatically send alerts to the parent about the AQI for the day. This leads the parents and people to act immediately in the communities. This will prevent the exposure of certain limit of chemicals "that pose a health hazard" in the air.    

Pesticides

The foods I ate last night were asparagus, butter pork and wheat flour.

 Asparagus: 9 pesticide residues were found.  These are methyl(4.4%), chlorpyrifos(3%), linuron,(1.4%) carbaryl(0.8%), and cyhalothrin(0.5%) etc.

Butter : 19 pesticide residues were found.  These are DDE(78.5%), permethrin trans(27.2%), bifenthrin(25.4%), permethrin cis(25.3%), cyhalothrin(19.5%), spinosad (4%), piperonyl buttoned(2.4%), and propargite(0.9%) etc.

Pork : 3 pesticide residues were found.  These are carbaryl(2.8%), piperonyl butoxide(2.6%), and 1-naphthol(0.3%).

Wheat flour : 16 pesticide residues were found.  These are malathion(49.4%), chlorpyrifos methyl(20.7%), methoxychlor (2.9%), piperonyl buttoned(2.6%), pirimiphos methyl (2.1%), trifluralin(1.4%), and fluridone(0.6%) etc.

What do you think about this?
I was surprised that I have been consuming this much pesticides.  Although I don't even know most of the name of pesticides, I did not want to have the pesticides in my body.  I had a dinner at the restaurant last night, but I consider to eliminate the pesticides when I eat at home.  I use the fruit& vegetable washer I bought from Whole Foods as this picture.  However, I am always wondering how much this spray will wash off the pesticides from the foods. I am not even sure if this products can remove the pesticides based on their explanation on the label.  

   In term of public health, we should claim to announce to the people globally.  The advertisements or campaign about the problem of pesticides that is run by the government can help people to aware how serious it is.  In particular, we really have to fight with FDA to approve only foods that doesn't over the limit of pesticides(I doubt that we can eliminate the pesticides 100% ).  However, I think the most important thing is that more people need to aware that this is the problem.

Topic of interest

I decided to research about out door air pollution in South Korea.  Out door air pollution has been major environmental problem recently.  Mainly it is from China every specific seasons.  I would apply the lessons I have learned from the class into the Korea.  In particular, how it affects to the vulnerable population such as children or the old.  Also, I want to find out which part of Korea is more affected by air pollution from China.  Finally, I will research about how government regulate the air pollution compared to United Stated.  I would like to know any suggestion that I can write about!  So please feel free to write the comments about it!  Thanks!!

Agency's role

Among various federal agencies, I chose office of environmental management(EM) under the department of energy(DOE).  They agency's mission is to complete the safe cleanup of the environmental legacy brought about from five decades of nuclear weapons development and government sponsored nuclear energy research.  They reduced the risk and environmental liability by embracing a mission completion philosophy.  For example, EM constructs and operates facilities to treat radioactive liquid tank waste into a safe, stable form to enable ultimate disposition.  They also secure and store nuclear material in a stable, safe configuration in secure locations to protect national security.
The waste management is one of EM's major mission.  They are dedicated to safely disposing of waste and seeks cost effective and environmentally responsible project execution methods.  The nuclear materials disposition is one of example for waste management. DOE also complies with all applicable environmental laws and regulations and establishes its own environmental requirements to ensure workers, the public, and the environment is protected from hazards associated with all Department operations.  DOE provides assistance to the field to implement these policies, works in resolving environmental protection issues, and provides feedback to enhance environmental performance throughout the Department.  DOE is committed to promoting environmental justice in all its activities in keeping with Executive Order : Federal Actions to Address Environmental Justice in Minority Populations and Low-income Populations.  Also, DOE's goa is to carry out all operations in a manner that protects the public and the environment and complies with all applicable environmental laws and regulations.

local environmental services

I found many services in my county.  The followings are what I found:
1. Active living, healthy eating
The center engages residents, schools, businesses, and community leaders in environmental approaches to make health an easier choice.  The goal is to create a healthy, safe Santa Clara County where all residents have plenty of opportunities to be physically active, and have access to healthy, affordable foods where all communities can prosper.

2. California children's services (CCS)
The program provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children under age 21 years with CCS-eligible medical condition.

3. Emergency medical services
When disaster strikes, whether it's a car crash or earthquake, there is a system of care in place that ensures you will get the emergency medical service you need.  The emergency medical service agency oversees and regulates the emergency medical services system in Santa Clara County.

4. Immunization program
They offer community immunization, education, an training, provide information and resources, and partnerships with private and public organizations working collaboratively to reduce vaccine-preventable diseases.

5. My community's health
The public health department has a team of epidemiologists working together with mappers, health planners, writers and media personnel to present data on the health status of Santa Clara County residents.  Date on births and deaths, disease as well as health behavior help to guide the development of public health policies and programs.

6. Traffic safety and active transportation
Motor vehicle crashes are the leading cause of death due to unintentional injuries in Santa Clara County.  Creating a safe environment where people can live, work, and play requires addressing all of the risk areas that impact the health and well-being of Santa Clara County's residents.

7. Adult immunization and travel clinic
The clinic offers adults immunization and TB screening these followings:

• Flu
• Hepatitis A - 19 years old or older 
• Hepatitis B - 18 years old or older 
• Hepatitis A/B Combo - 18 years or older 
• Injectable Polio (IPV)
• Measles, Mumps, Rubella (MMR)
• Menactra or Menomune (Meningococcal Meningitis)
• Prevnar 13 (PCV13)
• Pneumococcal (PPSV)
• Shingles - 60 years or older
• Rabies 
• TB Skin test (TST) and return visit 48-72 hours for reading
• TB Risk Assessment Questionnaire
• Tdap (Tetanus/Diptheria/Pertussis)
• Varicella   
  
  
  They offer the services for immigrants and travels.  
  It was interesting to find out that my county has various health department.  In particular, the services for children focus on their health because children's health is important part of public health.  They can learn well when they are healthy.  The communities will be surrounded by more healthy adults after growing up.  Also, I was impressed by how my county made an effort for the residents to improve their health.  The one thing I found interesting was called "Healthy worksite environmental assessment tool".  Since the health of an organization is contingent upon the health of its workforce, it is significant to investigate the specific risk factor of health in the county.   For example, the heart disease is second leading cause of death in Santa Clara County.  In recent research, 50% of Santa Clara County residents have one or more risk factors for diabetes.  Although chronic disease such as heart disease is reason for health problems, having healthy lifestyle can prevent the residents as well.  Therefore, this worksite can "play a leading role in creating healthier work environments where healthy lifestyle choice are the easy choice through a comprehensive health promotion program".  They are already reducing chronic disease by using the Healthy Worksite Environmental Assessment Tools.  The followings are the prioritized efforts :
  • Administrative and Organizational Supports (7 questions)
  • Health Promotion Activities (8 questions)
  • Healthy Beverages at Work (16 questions) 
  • Healthy Food at Work (16 questions)
  • Breastfeeding Accommodation and Promotion (7 questions)
  • Physical Activity Promotion (13 questions)
  • Tobacco-Free Worksite (6 questions)

Industrial Farming

Your thoughts about the vanishing of bees
It was interesting movie about vanishing of bees.  I did not know the importance of bees in our nature before watching this video.  They indicate environmental quality.  The bees can not get healthy nutrients if environment is not healthy, which affects on human's health as well.  Like one of people in video said "when bees are disappearing, there is something wrong in nature", we need to find out what causes them to vanish.  I felt bad when I saw how bees were struggling in the video.  The pesticide that we use is found from bees' body.  Also, we feed them fake sugar, which was described as "junk foods for children".    
The colony collapse disorder(CCD), which leads death of bees, is abnormal phenomenon in nature.  It is not only happening in the U.S, but many other countries such as Europe or Asia. It is worldwide issue that I as a public health student must think how we can contribute for this issue.  I was surprised that U.S even imported the bees from Australia.  However, I thought if they don't fix the main reason to cause vanishing of bees, theses bees also would disappeared. As Michael Pollan mentioned, the it is the monoculture that caused problems for nature including bees in the video in large picture .  We are made from what we eat.  Majority of foods are based on corn, so we are actually corns!(I could not believe this before I read Omnivore's' dilemma by Michael Pollan).  In order to solve this issue, we need to be against monoculture. We can simply use organic foods(we need to know what is really organic foods in the market since there are many foods that is labeled as organic, but they are not).  Furthermore, we can have our own garden.  The garden is also good place for our children to learn about nature. Yes, it is hard to fix everything at once, but each person can make small change and it will be big change in the future.

Dirt!: The Movie
In my opinion, this video also tells us that it is significant to protect our environment. The video reminded me how much soil is important in our lives.  That small amount of soil contains a lot of organisms that benefit environment.  I don't even remember when was the last time that I touched soil except for when I was child.  The soil that I usually played with when I was child was not even closed to dirt.  It was very dry and did not contain any nutrients for environment.  I would like to have garden for my future child.  I think it is great idea for my child to be exposed by soil.  They can enjoy all benefits from soil, which will help their intelligent such as creativity.            

Were you able to discover if there is a factory farm near you?
No, I could not find any factory farm near my place. 

Composting
No, I have not composed in the past and until today.  I saw people who live in country, but not many people who live in apartment.   However, I would like to try composting after I learned the benefit for environment.  My little change can also make a big difference in the future.   

Obesogens

• Utilizing the first article, discuss what is locally grown and what is currently in season in your area.  
• I could not find this article, but I found a lot of foods that are locally grown and seasonal in my area(Palo Alto). These are the followings :
• Vegetables - artichokes, asparagus, avocados, beets, boo toy, broccoli, brussels sprouts, cabbage, carrots,cauliflower, garlic, kale, lettuce, mushrooms, olives, onions, potatoes, scallions, spinach, squash.
• Fruits : apples, asian pears, dates, grapefruit, guavas, kiwi, lemons, limes, oranges, strawberries.  
• Discuss your thoughts on seasonal/local foods and hospital menus.
• As I learned from this assignments, it helps our environment if we eat more seasonal and local foods.  This is because it is natural way to grow the foods.  In order to eat non seasonal foods, the farmers have to use toxic chemicals and it breaks the natural system of farming.  Regarding of eating local foods, we can get fresh and healthier foods near by our place instead of importing from far away.  Additionally, it will help the small and organic farms near by your place, which would produce more healthier foods eventually.  I think hospital should use these seasonal and local foods as well.  This would help development of local and small farms.  Also, the patients who would eat healthy foods would be healthier too. 
• 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). 
• I found the harvest calendar for Northern California.  I go to the farmer's market every Sunday near by my place and I know what to buy now.  In particular, it is good to know that California harvest majority of strawberries in the U.S as a strawberries killer.  
• What are your thoughts on the second article? Have you heard of obesogens before?
• No, I have not heard of obeseness before, so it was interesting article to read.  In public health, the obesity is the one of the provocative issues to study.  In particular, it has been increasing in the U.S including other developing countries.  People usually related the obesity to the diet.  However, I heard some people just get fatter even though they eat normal amount of foods.  This article might explain for them relating to obesogens-"dietary, pharmaceutical, and industrial compounds that may alter metabolic processes and predispose some people to gain weight".  I also have been dieting for many years and have been frustrating from not loosing weight even after strict diet and enough exercise.  However, I did not know about this new fact about the diet.  The obesogenic effects "may pass on to later generations through epigenetic changes, heritable modifications to DNA and histone proteins that affect when and how genes are expressed in cells, without altering the actual genetic code".  There are many ways to get this chemicals into our bodies.  Now I will add to avoid the products that might cause the obesogenic effects in my diets, so I can prevent the obesity of my future generation as well.   
• 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! 
• The potential obeseness I chose is Phthalates. Is is "a group of chemicals used to make plastics more flexible and harder to break".  We can find them in hundreds of product such as  "vinyl flooring, adhesive, detergents, lubricating oils, automotive plastics, plastic clothes, and personal-care products(soaps, shampoos, hair sprays, and nail polishes)".  People can be easily exposed to Phthalate "by eating and drinking foods that have been in contact with containers and products containing Phthalates".  Additionally, we can breath them through air that "contains phthalate vapors or dust contaminated with phthalate particles".  It is more vulnerable for young children than adults due to "hand-to-mouth behaviors".  Although it is unknown that how this affects on human's health, "some types of phthalate have affected the reproductive system of laboratory animals".  CDC conducted the research to find out "the amount of phthalates that have entered people's bodies", analyzing urine.  The followings are what they have found : 
• CDC researchers found measurable levels of many phthalate metabolites in the general population. This finding indicates that phthalate exposure is widespread in the U.S. population.
• Research has found that adult women have higher levels of urinary metabolites than men for those phthalates that are used in soaps, body washes, shampoos, cosmetics, and similar personal care products.
• Although, higher level of phthalates does not mean that they will have more adverse health effect, it needs to have more research the health effects from phthalate.  
• https://www.cdc.gov/biomonitoring/phthalates_factsheet.html

ANTIBIOTIC RESISTANCE 101: HOW ANTIBIOTIC MISUSE ON FACTORY FARMS 

CAN MAKE YOU SICK

It is impossible not to use antibiotic in current environment even though we know that the resistant to antibiotic will develop until any antibiotic can't fix new bacteria. Antibiotic in industrial agriculture is supposed to be used for sick animals, which can make people get sick if they eat them.  However, after "researchers discovered that a small, constant dose of antibiotics helped animals grow faster", animals have been feeding with antibiotics for fast growth.  I was shocked by this fact.  I mean they were healthy animals, but they take antibiotic for human's selfish purpose! And who would eat all of antibiotics that animals consume? That is us! Eventually, we end up eating all antibiotics by eating animals, which contain large amount of antibiotics!  Whose responsibility for this problem is that? As the article mentioned that "once AR(antibiotic resistant) genes have developed and spread, they are exceedingly hard to control", how could the antibiotics have been using easily in industrial agriculture without restriction?  Now, we know that "antibiotic use in agriculture may affect resistance patterns in bacteria that live naturally in the human digestive tract" and it seems late to know. Personally, I love to eat raw beef or fish, which is one of the traditional Korean foods(good thing is that I only eat in the restaurant. They know better how to cook the raw meat in safe way). This article reminded me that eating raw meat is one way of spreading antibiotic resistant. Even though I don't eat the raw meet, I can get still sick by touching undercooked meat, which I was lucky about.  In my perspective, I would consider AR is another form of disaster in nature.  Not only farmers who grow them can get  MRSA, but also neighbors of farmer can get it too.  

It was interesting to see how much different between Europe and U.S to approach for this issue.  EU has banned "non therapeutic use of antibiotic for growth promotion". While Europe was banning the antibiotics for growth, "the sales of antibiotics for agriculture increased by 16 percent in the U.S".  AR is very serious problem in public health and we have responsibilities to prevent deaths from AR.          

     

"CDC estimates that at least 2 million American each year experience Antibiotic-resistant infection, leading to at least 23,000 deaths"

NEARBY LIVESTOCK MAY RAISE 'SUPERBUG' RISK

It is scary to hear about the bacteria that is impossible to destroy.  These bugs became stronger and stronger from chemicals that human used to kill them.  It was used to be associated with "hospitals and other health care facilities".  However, currently, it can attack the livestock as the article said and that infect human as well.  It is public health professionals' duty to investigate how and where human get infected from MRSA.  The epidemic information about MRSA is significant for public health in order to prevent spreading of infection.  This would impact on farmer and market in negative way.  

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

It is fun to read since I am one of people who use antimicrobial wipe and soaps frequently.  After having clinical experience as a nursing student, cleaning with antimicrobial became one of my habit in normal life.   However, "Most people who use antibiotic soap are no healthier than those who use normal soap. AND those individuals who are chronically sick and use antibiotic soap appear to get sicker".  Therefore, the antimicrobial wipes that I use for my table and soap did really do something for my body.  In fact, it could be harm for my body.  Furthermore, I realized why using antimicrobial wipe is bad for environmental health.  The result of using antimicrobial soaps is feeding strong bacterial or affecting fish spreading in the water.  I like how the author wrote because it really convinced me not to buy antimicrobial wipes or soaps at home anymore.  However, we still need them in particular at the hospital where vulnerable people stay.    

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

This article was helpful to remind people who use antimicrobials at the hospitals probably more than anyone else.  It is rule to disinfect our hand and objects each time although we know there is no way we can remove all the germs and bacterial.  Yes, we need to clean the bacterials that would be harmful to the patients.  However, it is the time to think about that we sometimes over protect from bacterias, which can cause more serious problems later. This is because we cannot see the bacterias within human's vision. As a result of developing stronger antimicrobials to kill new bacterias, we ended up having super bugs such as MRSA.  As I mentioned above, it is an another form of disaster in public health.  I know it would be very challenge to make a balance when to use antimicrobials in the hospitals since infection is one of most sensitive issue to take care of the patients.   Even if all surgery and procedure were successful, infection can kill the patients.  Therefore, it is important to learn what CDC guide for "preventing transmission of infectious agents in health care setting" and know the difference between disinfection and cleaning to adjust when to use them in different situation.            

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