M5.7 Sewage Facilities

The Riconada Water Treatment Plant

Since 1967, the Riconada Water Treatment Plant has served the Santa Clara Valley Water District. The plant processes 80 million gallons of water a day for the following cities: Santa Clara, Campbell, Sunnyvale, Cupertino, Mountain View, Monte Sereno, Saratoga, Los Altos, Los Gatos, and Los Altos Hills. Water purification is completed using microfiltration, reverse osmosis, ultraviolet light. The facility is currently under construction to ensure it continues to meet water quality, seismic stability, and safety requirements. 

The San Jose-Santa Clara Regional Wastewater Facility

This facility is located in San Jose and processes water for eight cities and four sanitation districts: San Jose, Santa Clara, Milpitas, Cupertino Sanitary District, County Sanitation Districts 2 & 3, and Burbank Sanitary District. As the largest tertiary treatment plant in the Western US, the plant treats 110 million gallons of water per day. The facility will be undergoing a thirty year Capital Improvement Program that aims to improve the infrastructure for more cost-effective and efficient processing. 

Resources

https://www.sanjoseca.gov/Index.aspx?NID=1663

http://www.sanjoseca.gov/index.aspx?nid=4544

http://www.sanjoseca.gov/index.aspx?nid=1665

http://www.valleywater.org/Services/RinconadaWTP.aspx

http://www.valleywater.org/SVAWPC.aspx

M5.5 Bottled Water

National Campaign for Tap Water

One of people's largest motivators is money. The video explained that bottled water is 2000x the price of tap water. Notably, several bottled water companies simply use filtered tap water for their products. Other companies do not even meet the same quality standards as tap water. Therefore, buying tap water results in an equal or lesser value product for an astronomically higher cost. This may the most effective strategy when attempting to change behavior of adults. The campaign would also focus on targeting children, teens, and young adults. They are large consumers due to the convenience aspect of bottled water. Parents often pack bottled water for lunch or after school sports. Schools could ban bottled water on campus to help support the campaign. Ambassadors could travel to schools and universities around the country to educate youth and young adults about the dangers of bottled water. This was a successful tactic while I was in college and it influenced me to sign a petition to ban bottled water. Since then, I have not drank out of bottled water. These combined strategies will make for a successful campaign.

Campaign Slogan: "Clap! Clap! Drink outta the tap!"

M5.4 Consumer Confidence Reports

Water Quality 

1. What is the source of your drinking water? 
• Cal Water uses local groundwater and purchases water from Santa Clara Valley Water District (SCVWD). This water is supplied by South Bay Aqueduct, Lake Del Valle, and San Luis Reservoir, which all draw water from the Sacramento-San Joaquin Delta watershed. Local sources of water are the Anderson Reservoir and the Calero Reservoir.  
2. What chemicals were found in your water that were higher than expected?
• No chemicals exceeded the established standards. The following list includes the chemicals, elements, and particles tested for: gross alpha particle activity, radium 228, uranium, aluminum, barium, hexavalent chromium, chromium, fluoride, nitrates, perchlorate, selenium, turbidity, total organic carbon, haloacetic acids, trihalomethanes, chloramine, copper, lead, boron, bromide, calcium, chloride, color, hardness, iron, magnesium, manganese, molybdenum, pH, sodium, strontium, sulfate, dissolved solids, vanadium, and chlorodifluoromethane.   
3. What chemicals did you not expect to find in your water?
• There are several chemicals and contaminants in the water from manmade sources. I would prefer to drink water without these additional chemicals. Some examples include the following: barium, hexavalent chromium, chromium, nitrates, perchlorate, selenium, and chlorodifluoromethane. 
4. What are the associated health risks with the chemicals found in your water?
• Chlorodifluoromethane: also known as freon 22 is from refrigerator run-off. Limited data are available about the risks associated with freon 22. Case studies show that exposure is associated with CNS depression, cardiac arrhythmias, atrial hypertension, dizziness, nausea, and coma.   
• Chromium: is most often discharged from electroplating factories, leather tanneries, wood preservation, chemical synthesis, refractory production, textile manufacturing, and steel mills. Presumed to be carcinogenic, mutagenic, and teratogenic.   
• Perchlorate: used in rocket propellant, fireworks, explosives, flares and matches. Water contamination from historic aerospace operations. Health effects include: antithyroid, gastric irritation, nausea, vomiting, fever, skin rashes, lymphadenopathy, nephrotic syndrome, leukopenia, agranulocytosis, pancytopenia, and fatal aplastic anemia. 
• Selenium: natural element that is discharged from petroleum, glass, and metal refineries. Additionally, it is found in livestock lot runoff. Health effects include CNS dysfunction, liver damage, heart damage, liver damage, and teratogenicity.  
5. What did you discover about your water quality?
• Overall, I was pleased that no chemicals exceeded the standards established by regulatory bodies. Additionally, Cal Water does not add extra fluorine to the water because it is naturally occurring within the area. Lastly, Cal Water treats with chlorine to reduce microbial contamination. However, there are other alternatives to treat the water for microbials, which include ozone and ultraviolet lights.  
6.  Do you use a filter for your water? If so, what are you trying to filter out?
• No, I do not use a filter for my water. 
7. Do you drink bottled water? 
• No, I do not drink bottled water. I quit drinking bottled water five years ago. Since then, I have been trying to convince other members of my family to do the same. 

M5.2 Safe Drinking Water

Water

On average, the human body is comprised of about 70% water. As you can see, it is essential to live! But in today's world, more people have a mobile phone than those who have piped water. Unfortunately, 2.5 billion people lack access to adequate sanitation and 780 million lack clean water (UN, 2013). This results in about 7 million deaths annually (UN, 2013). So what are the waterborne illnesses that can make us sick? According to New Health Advisor there are several diseases that are easily spread through contaminated water. 

• Cholera: a bacteria called vibrio cholerae causes diarrhea, vomiting, and abdominal cramps.
• Amoebiasis: this amoeba causes one of the most common waterborne diseases. Symptoms include severe diarrhea. 
• Dysentery: caused by a bacteria that results in fever, vomiting, abdominal pain, and severe diarrhea. 
• Hepatitis A: a virus that is spread through the fecal-oral route. The most common symptoms include fever, nausea, vomiting, diarrhea, and fatigue. 
• Intestinal worms: a variety of parasitic worms can cause diverse symptoms such as malnutrition, anemia, growth restriction, and ulcers. 

Young children, the elderly, and those who are immunocompromised are at increased risk. Severe dehydration from diarrhea and vomiting can lead to fatality. In addition, water is also contaminated with chemical pollution from industrialized manufacturing. High levels of pollution can lead to increased levels of cancer, infertility, and endocrine disruption. Policies, like the Clean Water Act of 1972 and the Safe Drinking Water Act, help by implementing regulations on our drinking water. However, the Clean Water Act is not easily regulated. Only two-thirds of the waterways in the US meet the standards set by the bill. The Safe Drinking Water Act ensures that all public water systems are closely monitored for microorganisms, toxins, lead, chemicals, and disinfectants. Unfortunately, this bill does not have any control over the quality of bottled water. Since bottled water makes up a large majority of human water consumption, many people are drinking poor quality/possibly contaminated water. With an increasing population, it is more important than ever before to learn how to better preserve this precious resource.    

Resources 

http://www.newhealthadvisor.com/Diseases-Caused-By-Water-Pollution.html

http://www.unwater.org/water-cooperation-2013/water-cooperation/facts-and-figures/en/

M4.6 Radon

A National Awareness Campaign: Radon

Radon is an odorless, radioactive gas that is produced by uranium in the soil and rocks. Radon seeps into the home through cracks in the foundation. Radon has serious side effects as it is the second cause of lung cancer, leading to 21,000 deaths per year. However, not many people know about radon or that their home could contain high levels. 

For a national awareness campaign, I propose a partnership between real estate companies and public health departments to help increase the general public's knowledge of radon. For example, realtors could ensure radon tests are completed during home inspections. If high levels are found, the realtor should then advocate for certified radon remediation professionals to complete a thorough inspection. The solution to fix high levels of radon generally includes running pipes through the home that are connected to fans, which draw radon out of the home. Additionally, not every state requires that the results of radon tests be reported. Moving forward, all states should mandate radon test reporting so potential home owners are informed. Lastly, realtors generally maintain relationships with their clients, therefore, realtors should remind their clients when radon tests are due every several years. This way homeowners know the importance of testing and have a reliable source to remind them to do so.

Resources

http://www.consumerreports.org/radon/is-it-safe-to-buy-a-home-with-an-elevated-radon-level/

M4.2 National Library ToxNet

Urea Formaldehyde

According to ToxNet, formaldehyde is mostly used as a fumigant on animal farms and processing plants. Other uses for formaldehyde include: material preservative, antimicrobial, disinfectant, and specimen preserver. Low level inhalation can cause upper airway irritation and lower airway irritation. Contact with formaldehyde can cause skin reactions and eye irritation. More serious side effects include cancer of the nasopharynx, leukemia, sinonasal cancer, infertility, anemia, and low birth weight infants. Animal studies found that drinking water contaminated with formaldehyde can cause gastrointestinal cancers. Lastly, cells exposed to formaldehyde were found to have gene mutations by direct DNA damage and inhibition of DNA repair mechanisms. 

Exposure to formaldehyde can have significant health consequences. While studying anatomy and physiology, I dissected several pigs that were preserved with formaldehyde. The smell would burn my respiratory tract despite there being vents within the laboratory. Hopefully, I did not cause any permanent damage to myself while working in the lab with preserved specimens. 

Bleach

Matulonga et al. (2016) found that women who frequently (at least once per week) cleaned with domestic-grade bleach were found to have higher rates of non-allergic adult-onset asthma when compared to non-users. Positive associations were also found between the frequent use of bleach and bronchial hyperresponsiveness, asthma like-symptoms, and chronic cough. According to the Asthma and Allergy Foundation of America, the financial burden of asthma reached $53 billion (direct and indirect costs) in 2007. It is estimated that this figure has grown significantly since then. Asthma, despite being common, can cause significant harm to individuals and society at large. 

This study further proves that cleaning products "approved" for home use may not be as safe as we assume. Careful consideration should be taken when using harsh chemicals in the home environment. 

Resources

https://www.toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~gTIS5n:3

https://www.toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~StSKy7:1

http://www.aafa.org/page/cost-of-asthma-on-society.aspx

M3.5 Transportation

Public Transportation in California

There are many benefits to living in an area with public transportation, both for the community as a whole and for the individuals who live there. For example, men who commute to work are less likely to be overweight or obese. In fact, one study found that people who commuted to work instead of driving by automobile lost one pound of weight per six weeks of commuting. As for the community, public transportation makes the roads safer by decreasing fatal accidents. Additionally, it reduces social inequities by connecting diverse people and providing reliable access to resources. In terms of the environment, public transportation produces 95% less carbon monoxide and 45% less carbon dioxide when compared to automobiles. 

California's public transportation efforts are proving to be relatively effective. Here is a partial list of rankings and scores: 

• CA is in the 80th percentile for persons who take shared transit as a commute mode.
• CA is in the 89th percentile for persons who ride their bikes as a means of transportation. 
• CA is in the 100th percentile for complete street policies.
• CA is in the 93rd percentile for miles of travel by walking.
• CA is in the 95th percentile for physical activity from transportation. 
• CA is in the 89th percentile for traffic accident fatalities in an automobile.

As you can see, California has made significant strides in promoting the use of public transportation. Nonetheless, due to the sheer volume of people living here, many people still drive automobiles. This increases the risk for fatal traffic accidents (as seen in the above statistic). Additionally, California is a large state and not everyone has access to public transportation. More planning and infrastructure building should occur to ensure equitable access to all. 

M3.4 Pollution

My Community's Pollution Scores

1. Who or what are the top polluters in your zip code?

   
As of 2002, the top five polluters were: 

• Owens Corning Corporation
• Hanson Permanente Cement
• Strongwell Corporation 
• Chevron 
• Headway Techs Inc. 

2. What percent of the homes in your zipcode have lead-based paint?

1% or 3,600 homes have a high risk of lead hazards. Notably, 12% of children under the age of 5 are living below the poverty line. 

3. Are there Superfund sites in your zip?

A Superfund site is a portion of land that has been contaminated with hazardous waste, which could pose risk to the health of the environment and the population living there. The EPA has identified it as a possible clean-up site due to these risk factors. 

    The top 5 nearby Superfund sites include: 

• Advanced Micro Devices, Inc. 
• Advanced Micro Devices, Inc. (BLDG 915)
• Applied Materials
• CTS Printex, Inc.
• Fairchild Semiconductor Corp. 

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

I have never heard of any of these companies before, which makes me think this is an outdated list. Companies in the Silicon Valley are mostly tech start-ups or are related to computer technology/computer parts manufacturing.

• Advanced Micro Devices, Inc: Develops computer processors and other computer parts
• Applied Materials: Makes semiconductor chips, flat panel computers, smartphones, televisions, and solar products
• CTS Printex, Inc: Manufactured circuit boards until 1985. The EPA has completed soil cleanup of this area and groundwater cleanup is still ongoing. 
• Fairchild Semiconductor Corp: Develops power analog, power discrete, and non-power semiconductors.  

5. What did you learn about the air quality in your zipcode?

I learned that my county has ranked among the dirtiest/worst 10% counties in terms of person-days in exceedance of national air quality standards for the ozone and in terms of an average individual's added cancer risk from air pollutants. Previously, I felt my community was relatively healthy. After review, I realize that many of the companies in the area cause significant pollution. In fact, only 75% of days have good air quality. During the early 2000s, I do recall several spare the air days where we were not allowed to run outside during recess. 

  

    The top five companies responsible for air pollutants include: 

• Kaiser Cement Corp. 
• Owens Corning
• Raisch Products
• Cardinal Cogen A Joint Venture
• Stevens Creek Quarry Inc. 

6. How about the water quality?

As of 1998, 16% of the county's surface waters had a reported problem. Additionally, 29 waterbodies reported problems to the state. The most significant water pollutants are metal and pesticides.

The county ranked 37 out 57 counties in terms of animal waste. Animal waste spillage is known to cause water contamination. 

7. How did your zipcode fair on a social justice/environmental justice basis?
    Persons of Color are:

• 52% more likely than Whites to be exposed to toxic chemicals.
• 13% more likely than Whites to be at risk for cancer due to hazardous air pollutants.
• 12% more likely than Whites to be exposed to air pollutants emitted from facilities. 

    Low income families are: 

• 20% more likely than high income families to be exposed to toxic chemicals. 
• 10% more like than high income families to be at risk for cancer due to hazardous air pollutants.
• 28% more likely than high income families to be exposed to air pollutants emitted from facilities.

  Other pertinent statistics include: 

• Non-high school graduates are 70% more likely than high school graduates to be exposed to toxic chemicals. 
• Working class people are 36% more likely than non-working class people to be exposed to toxic chemicals. 
• Children living below poverty are 22% more likely than children above poverty to be exposed to air pollutants from facilities. 

My county of residence still has work to do to eliminate environmental racism. Based on the graph above, one can see the disparities between minority populations and income differences. The differences are particularly startling when comparing low-income minorities to low-income whites. The only group with less burden of disease for this income category is Native Americans, which is the smallest demographic group in the area. 

M3.3 Environmental Justice

Environmental Justice

2016 was a year filled with a variety of environmental justice issues that were highlighted on a national platform during the presidential race. The environmental justice movement is tied to the social determinants of health concept. The environment that we live in greatly affects our health outcomes. The water we drink, the air we breath, and the house we call home can make us sick, as well as our future generations. In fact, 60% of low socioeconomic status (SES) African Americans live in areas that are situated in close proximity to toxic waste sites. Exposure to such chemicals not only affects their physical health, but also affects their mental health, IQ status, and susceptibility to commit crime. These outcomes are costly to individuals and families, further widening the financial divide between the haves and have nots. This environmental racism perpetuates a cycle that is meant to disempower those of minority backgrounds. Notably, African Americans, regardless of their educational/occupational achievement or SES, will have higher mortality rates than their counterparts of different races. 

This is a moral and ethical issue that should be addressed. African Americans in the US have responded to police brutality and continued racism through the "Black Lives Matter" (BLM) movement. According the the BLM website, the movement is "working for the validity of Black life" and is "a call to action and a response to the virulent anti-Black racism that permeates society." The BLM movement and environmental justice movement are tied because they are fighting for the rights of Black lives, especially those who are disadvantaged. However, environmental justice will not be occur until we as a collective community learn to live cleaner, waste-free lives. 

M3.2 Vulnerable Populations

What makes us sick?

Dr. Manchandra raises some interesting points about our current healthcare system. The United States has a sick care system and not a health care system. As healthcare providers, we excel at intervening once a person already has a disease. However, we significantly lack the resources to prevent disease. He states numerous times that health begins where we live and work. Notably, scientists now believe one's health is more influenced by zipcode than genetic code. In fact, the first environment that we live in—the womb—can already predispose us to significant adverse health outcomes. Dr. Lanphear further explains that fetuses exposed to chemicals will have significantly altered health outcomes. For example, as a mother's PBDE or OP pesticide blood levels increase, the lower her child's IQ will be. This is demonstrated in a dose-response relationship. Additionally, the cumulative impact of multiple chemicals can have an extreme affect on the child's health and development. Dr. Miller poses that exposure to toxic chemicals is a human right issue as this is an unsolicited trespassing on our bodies and the bodies of our children. Unfortunately, those of lower socioeconomic status are at greater risk for exposure. Social determinants of health are often the root cause of disease. If we had more forward thinkers and those willing to address the "upstream" problems, we could start curing disease instead of treating symptoms.   

Public health professionals play an important role in addressing social determinants of health and creating policies to mitigate exposure. They look at the health of the whole person and of the community. Moving forward, we should create regulations that require companies to prove the safety and efficacy of chemical before putting them in products sold to the general public. It is outstanding that several chemicals known to cause harm are not even efficacious (example: PBDE or triclosan). 

M3.1 Biomonitoring

CNN Video with Anderson Cooper

I was shocked to discover that children often have significantly higher blood levels of toxins and chemicals than their parents. In the case of lead, children more readily absorb it into their bloodstream than adults. The cause for this is unknown, and it may be true for other chemicals as well. Manufacturing companies argue that just because a chemical is present in the body does not mean that it causes disease. However, evidence suggests that even low doses of certain chemicals can cause notable changes within the body. For example, low levels of BPA were found to increase weight, especially in females. These important findings suggest that we must start addressing environmental exposures for the sake of our children and their futures. 

This movie has inspired me to get my own blood levels drawn for evaluation (see below for discussion). It would be so interesting and scary to find out the many foreign substances my body contains. Anderson Cooper had high levels of phthalates due to persistent makeup use. I assume my phthalate levels would also be high for this same reason. Phthalates can cause infertility, a growing problem for women under the age of 25. The blood tests also identified that Cooper's body had traces of chemicals that were banned decades ago. He was most likely exposed as a child and the chemicals still remain today. Thus, suggesting that some of these chemicals have extremely long half-lives. The interaction of different chemicals within the body may potentiate their effects. More research is needed to understand these effects further.

Hypothetical Lab Results

My hypothetical lab results found that my body contains dioxins, DDT, organophosphates, lead, solvents, PCBs, and phthalates. All of these chemicals are unsafe at any level in the human body. Despite this being very scary, it is also a real possibility that my body does actually contain the majority of these chemicals. I am most concerned about the reproductive side effects many of these chemicals cause. Several of my friends are struggling with infertility and I see what an emotionally and physically challenging process it can be to get pregnant. Having worked in the NICU, I have also seen the consequences of delivering prematurely. With technological advances in IVF, people who were unable to conceive previously, are now able to have children. Even with these advances, I think people should be more open to the adoption process. However, there is still a lot of stigma and challenges associated with an adoption. 

M2 Household Products

Household Products Database

For this assignment, I chose one product that I commonly use around the house to clean and one pet product I assume could be dangerous. 

The first product is Total All Purpose Cleaner by Soft Scrub.  

Overall, this product was given a health rating of 2 (moderate) and a flammability rating of 1 (slight). Acute health effects include: eye irritation from direct contact, gastrointestinal discomfort (nausea, vomiting, abdominal pain, diarrhea, lethargy) with ingestion, and respiratory tract irritation from inhalation. Prolonged exposure can irritate the skin, but no chronic health effects are suspected. The chemicals include: fragrance, sodium octyl sulfate, sodium hydroxide, sodium hypochlorite, and sodium dodecyl diphenyl oxide disulfonate. None of which are known to be carcinogenic substances. 

This information is similar to what I expected. In fact, I thought that this product could have more serious side effects than what is listed in the database. For example, I was surprised to learn it was not carcinogenic. Nonetheless, I wear gloves when cleaning with this product to lessen my chances of exposure. 

The second product is Topical Treatment for Fleas and Lice by Bayer Advantage.  

Overall, this product was given a health rating of 2 (moderate) and a flammability rating of 1 (slight). Acute health effects include: respiratory tract irritation (coughing, sore throat, and runny nose), nausea and dizziness with inhalation, and eye irritation (reddening, tearing, and stinging). Long term exposure can cause skin defatting due to solvents. Of note, this product does not contain any carcinogenic substances. The active chemicals in this product are pyriproxyfen and imidacloprid. 

I was surprised to read that this medication was not neurotoxic because lice treatment for humans can be. This is good news because I often forget my dog had his flea treatment and pet him with my hands. I am happy to know that I am not inadvertently exposing myself to an overly dangerous substance. Regardless, I will try to be more mindful of when he has his treatment and ensure washing my hands afterwards. 

The Future

In general, I would like to move away from cleaning with antimicrobials and other harsh chemicals. In a home environment, such strong substances are not necessary. I also feel like I get exposed enough at work to harsh cleaning products, and should try to limit my exposure elsewhere. I have heard that Method products are safer and more gentle. However, there is little information in the database about the safety of these products. 

On a related note, I was happy to find out that the government finally banned antibacterial soap for use by the general public. This will help to reduce the formation of MDROs. 

General Knowledge

The government requires that MSDS sheets be publically available, but few consumers actually look at these to determine the safety of the products they use. I think companies should do a better job of ensuring that the public is more informed about their purchases. This could be accomplished by easy to read infographics that come printed on the product's label. In addition, the government should regulate the use of toxic chemicals in household products. 

M2 Personal Care Products

EWG's Skin Deep Cosmetic Database

For this assignment, I chose two skincare products that I frequently use and assume are generally healthy due to the brand's marketing. 

The first product is Ever Straight Brazilian Keratin Shampoo by Organix (OGX).

OGX touts that their products are eco-friendly and sulfate free. This is evidenced by their tagline: "beauty pure and simple." I was shocked to find out that the product contains diazolidinyl urea, a formaldehyde releaser! Formaldehyde is harmful because it is carcinogenic. In addition, the shampoo contains fragrance and iodopropynyl butylcarbamate, which can both precipitate organ system toxicity, allergies, and immunotoxicity. Notably, both of these components are ecotoxic, which contradicts their marketing of an eco-friendly product. 

The second product is Skin Tone Correcting & Beautifying BB Cream by Kiehl's.

Kiehl's is another company that boasts it uses only the "finest naturally-derived ingredients." Due to this, they charge a premium price for their products. I use this BB cream as an alternative to foundation because it is supposed to be better for your skin.  Again, I was saddened to find out there are some harmful products contained in this face cream. Oxybenzone, SD alcohol 1, homosalate, octisalate, and phenoxyethanol cause the following issues: biochemical or cellular level changes, immunotoxicity, endocrine disruption, developmental and reproductive toxicity, organ system toxicity, and allergies. These are linked to serious health risks and cannot be ignored!

The Future

I really enjoy makeup and skin care products. I think it is fun to try new things and experiment. However, I have a few staples in my regimen that will be difficult to part with. I also am under the impression that all-natural products tend not work as well. Nonetheless, no beauty product is important enough to risk cancer or infertility. 

I talked to my friends over the weekend about some safer makeup brands, which I will be looking into more closely. Sephora has an entire section of natural makeup brands that hopefully are actually natural. From now on, I intend to check products on the database before buying them. 

General Knowledge

I think it is extremely important for consumers to be fully informed about the risks associated with these products. In healthcare, we need to get consent from a patient before we treat their disease. Because these products can have serious health risks, it should be mandated that consumers are notified of such risks. I wish the government took more of an active role in protecting people from these harmful chemicals and issuing sanctions against companies who endanger the health of so many people. 

Safe Cosmetics and Chemical Connections Videos

I found many aspects of these videos troubling and maddening. As previously mentioned, I use many different personal care products and naively assumed these products contained chemicals that were being monitored to ensure safety. Unfortunately, this is not the case. In fact, of the 12,500 chemicals most commonly contained in personal care products, less than 20% have been evaluated for safety. To make matters worse, the government has little control over recalling products that are known to contain dangerous chemicals. In addition, there are no industry standards on what defines "organic" or "natural" thus, allowing companies to market their products using these terms however they see fit. Another startling fact is that many compounds are not even listed on ingredient labels. One study found that over 40% of chemicals in fragrances were not listed in the ingredient list. This is extremely unethical and deceptive to the consumer. 

Being a nurse, I have added risks due to my workplace environment. I am exposed to harsh equipment and surface cleaners, antiseptics, medications, chemotherapy, and radiation. A study containing 1500 nurses, found that nurses with higher exposure to medication, chemotherapy, and radiation were more likely to have increased rates of cancer, asthma, miscarriage, and birth defects. While working with children, I have seen first hand the hardships that can occur when a baby is born with serious birth defects. It is life-changing for all those involved. I want to minimize my risks for this and the many other harmful side effects associated with chemical exposure. Additionally, the products healthcare professional use to clean their hands, can be equally as harmful. In one given shift, I will perform hand hygiene (with either Purell or antibacterial soap) well over 100 times. Many antibacterial products contain the compound called, Triclosan, a known thyroid disrupter. Because there is no evidence supporting the use of Triclosan, I strongly advocate for this substance to be removed from the products to better protect those of us who have high levels of direct exposure. 

What is most maddening about this situation is the lack of policy change that has occurred in recent decades. The Food, Drug, and Cosmetics Act is only a 2 page document that was created in 1938. The Toxic Substances Control Act from the 1970s does not require health and safety testing of new chemicals, nor did it perform health and safety tests on the 62,000 chemicals grandfathered in under this law. A new bill (The Safe Chemicals Act) was introduced in 2013. It calls for stricter safety requirements and monitoring. Sadly, this bill was read in Senate and referred to the Committee on Environment and Public Works in April of 2013. No updated information has been posted since then (https://www.congress.gov/bill/113th-congress/senate-bill/696). It is impossible to effect change on a large scale without any government regulation. The first step towards a healthier tomorrow is lobbying for change on a policy level. Congress must make this a priority and see to it that the American people are better protected from unsafe and unregulated chemicals.