What You Eat Can Kill You

FAT TOM. Not, a fat Tom, but F-A-T space T-O-M. This acronym stands for Food, Acidity, Time, Temperature, Oxygen, and Moisture, which all deal with what is needed for bacteria to reproduce on food, according to the Central District's Health Department's (CDHD) video titled "Basic Food Safety Course - Part 1 Introduction."

Foodborne illnesses were reported to cause 76 million illnesses, 235 thousand hospitalizations, and 5 thousand deaths in 2007 in the U.S., according to the video. The CDC's most recent report stated that there are an estimated 47.8 million illnesses, 127,839 hospitalizations, and 3,037 deaths annually in the U.S. caused by foodborne illnesses.

In order to continue to reduce these numbers, like many of the other diseases and health concerns we have looked at on this blog, being knowledgeable about the topic is one of the best preventions.

Foodborne illnesses, as the name suggests, are started when something happens with the food, such as a contamination. There are three main types of contaminations, according to the video: chemical, physical and biological. Chemical and physical are much like they sound: harmful chemicals that get into the food when the food is not properly stored and physical objects that usually get into the food during preparation. Biological are a little more complex because it deals with natural or introduced organisms that are in the food. Typically the unnatural organisms are introduced when the food is improperly handled.

There are five types of biological contaminants, according to the video. These are bacteria, virus, protozoan, fungus and yeast, and parasites. Fungus and yeast are not known for causing illnesses but for causing food to spoil. These normally become present when the food is in an acidic environment and water activity is low. Preventing parasites is all about cooking and storing the food properly, as well as obtaining the food from a well-trusted, approved source. Parasites are most commonly found in fish, pork, and wild game. Protozoans need living organisms to thrive. A couple examples given were giardia and cryptosporidium. For more information about these check out the post titled "Wondering about Water Quality." Viruses, such as Hepatitis A and Norovirus, also need a living host. It is important to note that viruses are not killed as simply as people think; it takes more than just hot and cold holding.

Photo by Allison Cook. Meats, like the ones used to make this
meatball, are at risk for containing parasites. It is recommended
to only buy meat from well-trusted sources. 

Bacteria are the tough contaminants since they can grow just about anywhere. The top five bacteria, or pathogens, causing foodborne illnesses, according to the CDC are: Norovirus - causing 58% of the reported foodborne illnesses, Salmonella - causing 11%, Clostridium perfringens - causing 10%, Campylobacter spp. - causing 9%, and Staphylococcus aureus - causing 3%.

Luckily, we have FAT TOM to help us out when attempting to combat bacteria contaminations, according to the video. Please note, when talking about bacteria, it is all about what it takes for them to reproduce.
'F' stands for "Food." Foods that are high in carbohydrates (carbs) and/or in protein are liked by bacteria. Some foods in this group include seafood, poultry, meat, and cooked plants (like potatoes and corn).

Photo by Allison Cook. Pasta is a food that is high in carbs
and therefore falls under the 'F' precaution in the FAT TOM
acronym. These foods needs are favorites of bacteria.

'A' represents Acidity. Bacteria needs foods that are neutral or slightly acidic.
'T' stands for Temperature and Time (hence why there are two 'T's). Food between the temperatures 41 degrees Fahrenheit and 135 degrees Fahrenheit are in what's called the "danger zone" and can only remain within this zone for a maximum of four hours before it is considered potentially hazardous. This is because it is within this temperature zone that bacteria reproduce.
'O' represents Oxygen. There are two types of bacteria: those that need oxygen (aerobic) and those that don't (anaerobic).
'M' stands for Moisture. Bacteria need a water activity of 0.85 or more to thrive. For reference, it was stated that plain water has a water activity of 1.0.

Before we wrap this blog up, it is important to talk about some of the more commonly transmitted diseases that start in people and are transmitted through food. The CDHD put out a video titled "Basic Food Safety - Part 3: Poor Personal Hygiene," which talks about not only what the most common people-to-food-to-people diseases are but how to prevent the transmission from happening.

According to this video, Hepatitis A, Shigella, Salmonella Typhi, and Shiga-toxin producing E. Coli are the three most common types of commonly transmitted diseases through food. The video has four recommendations for preventing the spread of these illnesses: Washing your hands, showering or bathing daily, wearing clean clothes and reporting the illness as soon as you are aware that you have it.

The video highlights how important it is that food employees properly wash their hands. 20 seconds was the CDHD's recommended amount of time to spend scrubbing your hands with soap and water. It was also pointed out how important it is to clean under fingernails and in between your fingers because of how easy it is for our skin to pick up and hold contaminants. Finally, it is stated that one should dry their hands under a warm air dryer or use a single-use paper towel.

Photo by Allison Cook. As many mothers always said, it is
very important to wash your hands before eating. What they
didn't say was it's crucial to wash them before cooking. By
keeping good hygiene, you lower your risk of transmitting
diseases through the food you prepare.

There is one other virus that was mentioned earlier that needs to be touched on: Norovirus. This infection, also called the Cruise Ship virus, is very easily spread and is difficult to get rid of, according to Mayo Clinic. Mayo Clinic explains that the virus can withstand both the cold and the heat and is resistant to many disinfectants. The main ways one can obtain Norovirus is through eating or drinking contaminated food or water, touching a contaminated surface and then touching your mouth, and just being close by to those who have the infection. It is the latter way of obtaining that explains why it is sometimes called the Cruise Ship virus. Some symptoms to watch out for are vomiting or feeling nauseous, cramps, muscle pains, fever, and water/loose diarrhea. While the virus will only last one to three days, a person will shed the virus through using the bathroom for as long as two weeks.

Please, take the time to learn about the environmental hazards around you and take the preventative measures. As someone once said, "Prevention is Better Than Cure."

Just Trying to Breathe

Have you ever felt like you couldn't breathe? Started coughing or wheezing without really understanding why? Well according to Spare the Air, you may have been experiencing symptoms related to air pollution. Depending on an individual's current health status and what the pollutant is will determine the severity of the symptoms, but the ability to breathe is crucial to all of us if we wish to survive.

A photo, by Allison Cook, of a map shown on the EPA's site. This map
depicts the air quality condition of different major cities in the state of Ohio.
A viewer also has the ability to zoom in and out to see other states and
countries'.  The level of concern, described later in this post, are important
to how one will be affected by the air quality.

The two pollutants that Spare the Air mentioned were Ozone and Particulate Matter (PM). Let;s start with ozone: while ozone is fine up in the atmosphere where it belongs, ground ozone can be very harmful to our health. It forms, primarily, from mobile vehicles emission of nitrogen oxides (NOx) and volatile organic compounds (VOCs), which then react with ultraviolet rays coming from the sun. When exposed, the airways constrict which forces the respiratory system to kick into overdrive.

The Ohio EPA has several State Implementation Plans (SIP) that control the amount of the different air pollutants. SIP include everything from development plans that show how the certain areas that are not yet reaching the National Air Quality Standards will attain them, to plans that show how areas will maintain proper air quality.

The 2015 Eight hour Ozone Standard, according to the Ohio EPA, is 0.070 parts per million (ppm), which is .01 ppm below the original 1997 standard, and 0.005 ppm below the 2008 standard. The standards were lowered to these numbers, according to The Environmental Analyst, because studies released in 2008 were finding that healthy people's systems could mostly handle 0.060 ppm but this evidence had to be balanced against economic costs.

Now let's look at PM. According to Spare the Air, PM is a mix of soot, nitrates, sulfates, dust, smoke, metals, water and/or tire rubber. Some are direct exposures, such as smoke, while others are formed in the atmosphere, such as gas reactions like nitrogen oxides. Unlike ozone, PM's effects are more linked to the size of the actual particles than they are the amount in the air. The finer the particles, the greater the problem. This is because smaller particles are able to get deeper into the lungs and possibly into the bloodstream, therefore PM exposures are not just dangerous to one's breathing but also to their heart.

Before one can understand the SIP, they must understand there are two types of PM classifications. The first is known as PM10, also known as coarse dust particles, according to AirNow. PM10 are anywhere from 2.5 micrometers to 10 micrometers in diameter. As the name suggests, these particles are mostly in the form of dust and can come from roads or crushing or grinding activities. The other category is PM2.5, also know as fine particles, which are 2.5 micrometers or smaller in diameter. These can only be seen by using an electron microscope and are made from combustion (a variety of kinds from wood burning to motor vehicles to power plants). It is the latter type of particle that the EPA has a SIP for.

The 2012 Annual Standard for PM 2.5, according to the Ohio EPA, is 12.0 ug/m3, or micrograms per cubic meter of air. This is below the previous two standards: 1997's annual standard was 15.0 ug/m3, and 2006 had a 24-hour standard of 35 ug/m3. The 2012 standard came into effect on April 15th, 2015. The reason for the delay is the back and forth between what people can handle economically and what is necessary to protect people.

A few other SIPs listed on the Ohio EPA's website are Sulfur Dioxide, Nitrogen Oxides, and Lead, as well as six other more industry-specific ones. This blog post will look at the first three listed.

Sulfur Dioxide only seems to have one SIP at the moment, according to the Ohio EPA. It is called the 2010 One-hour SO2 Standard. The standard is set to 75 parts per billion (ppb). This SIP appears to be still in the works, with Round 3 of the Statewide nonattainment area recommendation letter to the US EPA have been sent out on January 13th of this year.

Nitrogen Oxides appears to only have one SIP as well, and it is concerned specifically with Nitrogen Dioxide (NO2). The 2010 One-hour NO2 Standard, according to the Ohio EPA is 100 ppb. The US EPA had set this one-hour standard as well as kept the pre-2010 annual standard of 53 ppb. It is shown that Ohio is attaining these standards.

Finally, in 2008, according to the Ohio EPA, the US EPA changed the standard of lead from 1.5 microgram per cubic meter (μg/m3) to 0.15 μg/m3. It appears that there are a few areas in Ohio, including Cuyahoga County, Fulton County, and Logan County that had partial nonattainment areas. All three of these areas appear to have documents that state their plans to fix the problem. The effective date for Cuyahoga's and Fulton's plans were both in July 2015 and Logan's was in September 2014.

So now there are two questions that need to be answered: 1. How does the Ohio EPA get these SIPs? And 2. How's the air quality near me?

So, let's tackle the first question. As mentioned before, the standards are actually handed down to the states from the US EPA. The US EPA has something called National Ambient Air Quality Standards (NAAQS). NAAQS originated from the Clean Air Act, according to the US EPA. The Act required the EPA to set these standards for pollutants that could be harmful to both the public'sand the environment's health. Within the NAAQS there are two types: Primary and Secondary. Primary standards are meant to protect the health of the more sensitive parts of our population, including children, the elderly and those with asthmatics. Secondary standards are meant to protect the public's welfare, including minimalizing damage to buildings, crops, and animals and maximizing visibility.

There are six "'criteria' air pollutants," according to the EPA, and they are: Carbon Monoxide (CO - under a primary standard), Lead (Pb - under both primary and secondary standards), Nitrogen Dioxide (NO2 - one-hour standard is primary and annual standard is under both primary and secondary), Ozone (O3 - under both primary and secondary standards), Particle Pollution (PM - broken up by 2.5 and 10 and then broken further under 2.5 but overall both are under both primary and secondary standards), and Sulfur Dioxide (SO2 - one-hour standard is primary and three-hour standard is secondary).

We'll end by answering how the air quality is near you, the reader! The Ohio EPA has a document titled, "Air Quality and Your Health" which talks about the Air Quality Index (AQI) and also gives a link to a map which can show the viewer the real-time air quality for their town (or at least a city near them). Below the 5 big cities in Ohio are listed with the Air Quality Forecast for Sunday, March 26th, and Monday, March 27th. The embedded link on the city will take you to the page so you will be able to look at the current date's forecast. But first, we must understand the different colors which correlate to the levels of concern. Each color is given a word or two and a numerical value. The numerical value is supposed to correspond with the level of pollution.

Green is "Good" and is assigned numbers 0 to 50. If a city is shown green, then it is thought that there is little to no health risk.
Yellow is "Moderate" and is assigned numbers 51 to 100. If a city is marked yellow, then the quality is acceptable but there may be a small health concern for a small group of people who are unusually sensitive to pollution.
Orange is "Unhealthy (for Sensitive Groups)" and is assigned numbers 101 to 150. If a city has an orange mark it is only a concern for those in sensitive groups (i.e. children and elderly), but the general public should be fine.
Red is "Unhealthy" and is assigned numbers 151 to 200. This marking means that everyone is at risk to experience health problems.
Magenta is "Very Unhealthy" and is assigned numbers 201 to 300. These cities have emergency level conditions and the whole population is even more likely to experience health problems.
Brown is "Hazardous" and is assigned numbers 301 to 500. There is a health alert and the effects are much more serious.

A photo, by Allison Cook, of the chart pictured in "Air Quality
and Your Health," as described above.

The numbers and categories listed are each city's predicted high for each day. These forecasts are off of AirNow.

Cincinnati's AQI for March 26th is 60, which falls under moderate. March 27th's is a little bit higher at 65, but still falls under moderate. The pollutant which seems to be pushing these numbers is PM, which match the AQI's for the city.

A photo, by Allison Cook, of the map shown for Cincinnati on AirNow's site.
As one can see, this area is colored yellow, or moderate, for March 26th.

Cleveland's AQI for both March 26th and the 27th are just shown as being good.

A photo, by Allison Cook, of the map shown for Cleveland on AirNow's site.
This area is colored green, for good, for March 26th.

Columbus's AQI for March 26th is 50, which falls under good. March 27th's is a little lower, meaning it is still marked good, at 46.

A photo, by Allison Cook, of the map shown for Columbus on AirNow's site.
The area surrounding the capital is colored green, for good, on March 26th.

Dayton's AQI for March 26th is 53, which falls under moderate. March 27th's is a little bit higher at 57, but remains under moderate. Like Cincinnati, it appears to be the PM that is driving the city's AQI to be moderate.

A photo, by Allison Cook, of the map shown for Dayton on AirNow's site.
This area is colored yellow, or moderate, on March 26th.

Youngstown's AQI for March 26th is 50, which is good. March 27th's is slightly lower at 46, and falls under good as well. It is important to note that Youngstown is not given an exact mark on this page.

A photo, by Allison Cook, of the map shown for Youngstown on AirNow.
Youngstown is not specifically marked on here, but the city is located SE of
Cleveland and NE of Columbus. This area of the map is green, or good, on
March 26th.

What's the Harm in Using a Cell Phone?

For a device as widely used as a cell phone, most people wouldn't think there was much of any harm in using one. Unfortunately, there should be some concern when looking into the radiation side of things.

Phone by Allison Cook. Everyone seems to have a cell
phone today, which is why it's scary and surprising that
they may pose a risk to our health.

To begin, radiation deals greatly with the electromagnetic spectrum. According to Safe Space Protection, most things in the natural world, including humans, produce waves from this spectrum, but they are very low in intensity. EMFs, or artificial waves, are what can cause problems and they are made by many forms of technology, including power lines.

Cell phones fall are under the very low-frequency category within the nonionizing radiation part of the electromagnetic spectrum. The section below the one cell phones is in is known as extremely low-frequency (ELF) waves, which have the longest wavelengths and can be found coming from power lines that help run household appliances. These waves can cause harm, but only when the body is exposed for long periods of time and are in close proximity to the body.

Photo by Allison Cook. If you were to read the manual that
comes with your phone, you would be adviced to hold it
away from your head. The closer a phone is to the body,
the greater risk that a tumor or some form of cancer will form.

So if cell phones are supposedly so low in frequency, what's the problem? Well, there is a little more to it. The "non-ionizing part" mentioned earlier is what's key. According to the American Cancer Society, it's the RF waves that come off the cell phone's antennas that can cause issues but only to the tissues closest to the phone that absorb the most amount of energy. RF waves are used to send signals to the cell towers and fall in between radio and micro-waves. All of these, also collectively under the category non-ionizing radiation, cannot directly damage DNA and therefore do not have enough energy to cause cancer. The way people can get exposure to RFs is when they hold their phone right up against their face while using it. The longer someone is on their phone, the more RF energy their tissues will absorb and the closer someone is to a tower, the less energy a phone uses.

The biggest concern in many of the articles read was that by holding a phone close to one's head, said person would be at risk of getting a tumor. The American Cancer Society reported two types of tests done to determine if this were so. The first was Lab Studies, which use animals and cells in a dish and are careful to control outside variables. These studies resulted in the conclusion that cell phones do not give off enough energy and therefore there was not a clear causational link between the phones and cancer. The second was Human Studies, which were case studies and it was noted that the majority of these looked specifically at brain tumors. This came up with a variety of results, but most studies found the following: people with brain tumors did not report using their phones more than the controls nor was there an increase in brain tumors with the increasing number of people using cell phones nor was is found that the tumors occur most often where cell phones most often make contact to the head. On top of this many big name agencies, including the CDC, FDA and NIEHS all say something along the lines that as of now, there is not enough evidence to show a link between cancer and phones.

This does not mean there isn't one. Safer Phone Zone published a list of 10 things anyone can do to reduce any risk. For example, by simply keeping your phone away from the body at night and while carrying it during the day (out of bras and pockets, away from pillows and nightstands) and putting it on airplane mode or off-line, you can minimize, or completely stop, the phone from emitting the electromagnetic waves. Switching sides of the head throughout a call may also spread out the exposure, and by waiting until the person being called to pick up before putting the phone closer to the head will limit the amount of exposure.

In the end, the best anyone can do is be aware and conscious of the risks, even if they may be minimal.

Photo by Allison Cook. As a society, we don't just have
phones; we have laptops, iPad and all sorts of other technology.
What else could cause a harm by radiation?

Before this blog closes, there is one more thing that must be mentioned: WiFi. Time published an article in September 2016 about how WiFi send out electromagnetic radiation just like phones. The article talks about how much more dangerous WiFi was, but now there seems to be a question of which is worse. Time claims that putting something between the person and the router can help reduce exposure.

Round Up the Fact about Glysophate

Glysophate is a chemical widely used as a herbicide according to the EPA. But, it wasn't always used as an herbicide.

The story really began in 1964 when Stauffer Chemical patented the chemical as a metal chelator, according to  GMO Free USA. With this patent, the chemical was used to clean commercial pipes and boilers. In 1974 a new patent was made and a new use was found for Glysophate. The patent was filed by Monsanto and the chemical became used for what it's known for today: a herbicide.

According to the National Pesticide Information Center (N?ic), the chemical is used to kill broadleaf plants and grasses by applying it to their leaves. It is mostly used to control weeds in industrial agriculture and forestry. Since the chemical is non-selective, it will kill the majority of plants.

A photo (by Allison Cook) of an image of a broadleaf weed. Glysophate can
be sprayed on the leaves to kill the plant. Since the chemical is non-selective,
the majority of plants will be killed by the spray. A solution to this is genetically
made crops that are resistant to the chemical, or Roundup Ready (named after
the main herbicide the chemical is used in).

Many websites stated that Glysophate is widely used particularly in the US. GMO Free USA mentions that in the USDA's report more than 2lbs/planted acre of glyphosate-based herbicide was applied to genetically modified corn in 2010.

A photo (by Allison Cook) of an image demonstrating how the chemical is
sprayed at most industrial farms. These tractors are how so much of the
chemical is sprayed over such a large amount of land.

National Geographic reported that most corn, cotton, and soy in the US are treated with the chemical. The article also pointed out that after seeds became genetically made to tolerate Glysophate the use of the chemical soared. To take a more narrowed look at just how much is used in the US, the article noted that in 2012, about 5 million acres of edible crops were treated with the chemical in just California alone.

A picture (taken by Allison Cook) of a photo of the herbicide Roundup on
shelves at a store. Roundup and Glysophate are known together by many people.
Glysophate is the leading chemical in Roundup that allows it to work so well.

The scary part about this large amount used in the US is that this only accounts for 19% of the amount used worldwide, according to EcoWatch. The article was written in 2016 and the amount of Roundup sold was 3.5 billion pounds in the US and 18.9 billion pounds worldwide.

In many of the articles, the crops genetically modified crops are called "Roundup Ready." As mentioned earlier, there seems to be a connection with the creation of these crops and the amount of chemical being sold.

These crops were built to be resistant to the Roundup herbicide and therefore when applied, the chemicals would only kill weeds, according to the EcoWatch article.

So what does all this mean for the health of us humans and the environment?

According to the National Geographic article, Glysophate is not one of the chemicals included in the US government's monitoring of pesticide residues on food or of the amount in human tissues and blood. That said we have no idea how much we are exposed to. The article also mentioned that in 38 states the majority of surface waterways contained Glysophate, but very little was found in groundwater. This later statement can be explained by the fact that the chemical binds tightly to soil. Unfortunately, if the soil particles are swept up into the air, though, the chemical will linger in the atmosphere for a pretty long time before it becomes part of the water cycle. That would be another explanation for National Geographic's statement about 70% of rainfall samples containing the chemical.

There is the question of "what about the food sprayed with the chemical?" None of the websites mentioned this directly, but N?ic did report that if you were to touch a plant or crop that was still wet with the spray you could expose yourself to it if you don't wash your hands. N?ic also mentions exposure through contact, via it be on skin or in the eyes, and inhalation, by breathing in the spray. Finally, it is noted that the chemical is not likely to evaporate after application.

If someone is exposed, the reported effects do not seem to be too bad. According to N?ic, depending on how one is exposed will cause irritation to the exposed area. For example, if one were to inhale the spray, he/she's nose and throat may become irritated. It is when the chemical is ingested that the effects become more serious: burning of the throat and mouth, vomiting and diarrhea. The chemical does not pass through the skin very easily, so if ingested the majority of the chemical will exit the body through the restroom. There have been deaths reported in the cases of ingesting the chemical being intentional.

GMO Free USA reported that in a 2014 study that a larger portion of sampled individuals had both a chronic disease and Glysophate in their urine. This study also found the chemical in dairy cows, which lead to the suggested conclusion that the chemical bioaccumulates in the body. This, GMO Free USA claims, is contradictory to what the industries say.

That seems to be a problem with this chemical: what the industries let the public know versus what outside researchers find seems to contrast. While this may not be a surprise, it makes it difficult for us to know exactly what the chemical is doing to our bodies. Many websites reported that no solid link had been found yet between the chemical and cancer, but that does not mean the link does not exist. It's just a matter of access to the chemical and the victims.

The one thing that seems to be confirmed is the increase of superweeds since the rise in the use of Glysophate. EcoWatch reported that superweeds are weeds that have built up a resistance to herbicides. Because of the increase and emergence of these superweeds, there has been an increase of using more dangerous herbicides.

Wondering About Water Quality

Have you ever wondered about what's in your water? Have you ever feared about the diseases you could get from getting the simple act of drinking a glass of water? According to a Chapman University Blog, 27.9% of Americans have a fear of pollution in drinking water. That's the 26th fear listed out of about 79 different fears. Now depending on where the randomly sampled participants are from, some have bigger reasons to be afraid than others.

According to the Ohio Department of Health (ODH), many Ohio residents get their water from ground or surface water. If a resident does, they must have the source tested for basic contaminants as soon as construction or any other alteration is made and they must then take special precautions to ensure the water stays okay to drink during the system's lifespan. ODH lists three tests that must be passed in order for a system to get approved by the owner's local health district:

• Total Coliform Bacteria - evaluates the cleanliness and/or condition of water wells. Also, determines if a disinfection system is working correctly.
• E. coli - indicates sanitary condition of the supply.
• Nitrates

But what this blog will be focusing on is 6 different things that can affect a private water supply, or really any water supply if the conditions are right.

Coliform Bacteria

According to the ODH, there are actually 16 different species of coliform bacteria and most of them are relatively harmless. In fact, coliform is found in the intestines of warm-blooded and cold-blooded animals, including humans, where it aids with digestion. These 16 species are known as total coliform bacteria and typically live in large numbers. 

A subgroup of the bacteria is called fecal coliform, and it is within this subgroup that harm to health comes into play. To begin, the subgroup is defined as separate because they are only found in warm-blooded animals fecal waste and they grow at higher temperatures than the bacteria in the total coliform group. One species of the six fecal coliform species is E. coli. Within the E. coli species, one rare strain is found to cause dangerous outbreaks and illness. The ODH has emphasized the fact that this strain is rare, but also mentions how it is often covered by the news because of the potential outbreaks it can cause.

It is because of the fecal strains that water must be tested for it. Domestic sewage and other sources containing animal and human waste can contaminate water which then soils absorb. If a human were to eat a plant that has grown by a contaminated water source or drinks from a contaminated source, he/she could get sick. The key word is could - ODH reported that a person does not automatically become sick, but if the organisms are present in the water, other disease-causing organisms could be present too. If a person were to become sick from the contaminated water, the ODH reports that the person will probably experience diarrhea and cramps. 

The best way to prevent a coliform bacterial contamination it depends on the water source. For groundwater, wells should be built well enough to have minimal or no bacteria, but if some were to be found, all that can be done is to have the well professionally cleaned to clear any mineral and bacterial slimes that have built up. For springs, ponds, and cisterns (an artificial, underground tank that stores rainwater, according to Merriam-Webster), owners should filter the water, as well as use treatment devices. If bacteria is still found then the owner needs to make sure the disinfection system is working properly and is maintained. 

On top of prevention, the ODH has standards for private water systems regarding both total coliform bacteria and fecal coliform bacteria, specifically the E. Coli species. For the latter, pretty much all water samples are looked at for E. Coli because the test is quick - with results being available in just one day - and inexpensive. Within the total coliform species, there are two standards depending on the water system being used, how it was constructed and whether disinfection is required. If the system is newer or recently altered it is required to meet "a coliform count standard." If a system requires continuous disinfection, then it is required to meet "a total coliform negative standard," which just ensures the equipment used to disinfect is working correctly.

Coliform bacteria is categorized under microbiological contaminants on the ODH page about water quality. The next category is known as Primary Pathogenic microorganisms, or microorganisms that can cause disease in healthy people with dose and exposure. E. Coli is listed under this group as well as under microbiological contaminants. There are three other disease causing things listed under this primary pathogenic group that this blog will touch on: Cryptosporidium, Giardia, and Harmful Algal Bloom Cyanotoxins. 

Cryptosporidium

According to the Centers for Disease Control and Prevention (CDC), Cryptosporidium is a microscopic parasite that lives in the intestine of infected humans and animals. It is passed by the stool of the infected being. Many would think that chlorine-based disinfectants would kill the parasite, but unfortunately, this parasite is resistant. On top of the resistance, the parasite is equipped with an outer shell that gives it the ability to live outside a body for long amounts of time. The disease that Cryptosporidium causes is known as Cryptosporidiosis, but both are commonly called Crypto. The disease is categorized as a diarrheal disease and is one of the most common causes of waterborne disease over the past two decades. This disease is found all over the world, including the US. 

To prevent getting Crypto, the CDC recommends practicing good hygiene, avoiding potentially contaminated water, being extra cautious while traveling and avoid sexual contact with feces during sex. Additionally, it is asked that if a person were to have diarrhea not to swim, and if infected not to swim for an additional two weeks. If a child has diarrhea, it is recommended to keep them away from child care facilities until it stops. Finally, the CDC asks that children are taken out of pools every sixty minutes for a bathroom break and babies' diapers are checked every thirty to sixty minutes. 

If a healthy person were to get Crypto, according to the CDC, no treatment is really necessary. It is only recommended to drink fluids to manage diarrhea and prevent dehydration. A way to remove Crypto parasites is with a water filter, but it has to be designed to remove them. Any filter that is reverse osmosis or has an absolute pore size of less than 1 micron should remove Crypto. Also "tested and certified to NSF/ANSI Standard 53 or 58" removal or reduction should also remove Crypto. 

Giardia

According to the CDC, like Crypto, Giardia is also a parasite that is found in the intestine and gets passed through feces. Giardia also has a protective outer shell that allows it to live outside the body for longer periods of time. The diarrheal sickness giardia causes is called Giardiasis, and it too is one of the most common causes of waterborne diseases. Unlike Crypto, though, giardia are found mostly in the US. 

Photo (by Allison Cook) of a picture from the
CDC's website. This shows Giardia at a
microscopic level. These parasites cause a
disease known as Giardiasis, which is very
similar to Crypto in effect.

The prevention methods for giardia are very similar to those recommended by the CDC for Crypto, such as practicing good hygiene, avoiding potentially contaminated water and avoid contact with feces during sex. In addition, CDC also warns about washing foods with contaminated water and recommends avoiding eating uncooked foods when traveling to places with poorer water and food treatment. Finally, the CDC asks that in areas where either the sick pet or person was be cleaned. CDC asks that when disinfecting, cleaning hard surfaces and cleaning carpets and softer material covered furniture, that gloves are used.

The best treatment, according to the CDC, for a giardia infection is to take medication. Depending on an infected person's past, immune system status and nutrition different drugs work better than others, which is why it is recommended to talk with a doctor about the options for treatment. 

As for removing Giardia, the CDC does not talk about the parasite's resistant to chlorine-based disinfectants but recommends a very similar process as the process to remove Crypto. 

Harmful Algal Bloom Cyanotoxins

According to the ODH, certain species of cyanobacteria are what cause the harmful algal blooms (HAB). Cyanobacteria, also known as "blue-green algae," are actually naturally found in Ohio's lakes, slow-moving streams, and ponds, and many of the species are non-toxic. For a HAB to occur the conditions have to be just right: shallow water, sunlight, warm temperatures, and an excessive amount of phosphorous and nitrogen.

Photo (by Allison Cook) of a picture from the ODH. While the water in this picture
looks almost like a painting, it is actually a HAB. The coloring illustrates why
the algae got the name "blue-green algae."

Those cyanobacteria that are toxic are called Cyanotoxins and are divided into three subcategories: neurotoxins, dermatotoxins, and hepatotoxins. Neurotoxins cause problems with the nervous system, dermatotoxins cause skin problems and hepatotoxins cause problems in the liver. The ODH lists three common ways that people come into contact with HABs: Drinking contaminated water, whether it be during a drinking water advisory or accidentally during a recreational activity in the contaminated water, inhaling, in the form of mist, and skin contact.

Depending on how a person is exposed, will impact how the person is affected. Drinking contaminated water has the most severe effects, including severe diarrhea and vomiting, difficulty breathing, kidney, neuro and/or liver toxicity, and potentially death. Skin contact may cause hives, rashes, and/or blisters. Inhaling contaminated water could cause a sore throat, allergic reactions, asthma-like reaction and/or runny eyes and nose. It is also important to note that humans are not the only ones who can get sick because of HABs, pets are at risk too. For both humans and animals, it is recommended to seek medical help if they are thought to be infected.

Photo (by Allison Cook) of picture from ODH. Recreation is one of the main ways
people are exposed to HAB waters. The health effects most likely to be contracted
from recreational activity are less problematic so long as the individual does not
drink or swallow the water. Still, it is advised to be cautious if recreating in or by
HAB infected waters since skin contact and inhaling mist caused by the recreation
activity can still cause issues for an individual.

The ODH lists two types of advisories that come with HAB-contaminated water, and each advisory depends on the type of toxins causing the bloom. The first advisory is a drinking advisory. If 0.3 μg/L (micrograms per liter) of Microcystin, 20 μg/L of Anatoxin-a, 0.7 μg/L of Cylindrospermopsin or 0.2 μg/L of Saxitoxin are found it is advised that children under the age of 5, the elderly, pregnant or nursing woman, people with liver problems, people with immune system problems, and people undergoing dialysis treatment do not drink the water. When levels, respective to the order the toxins were listed previously, hit 1.6 μg/L, 20 μg/L, 3 μg/L and 0.2 μg/L all people, pets, and livestock are told not to drink the water. The second advisory type is recreational. When toxins hit 6 μg/L, 80 μg/L, 5 μg/L, and 0.8 μg/L, respectively, then it is considered a "Recreational Public Health Advisory" and a sign must be posted to warn people. When toxins hit 20 μg/L, 300 μg/L, 20 μg/L, and 3 μg/L, respectively, then the advisory is a "Recreational No Contact Advisory," which means a sign is posted telling people the levels are above the threshold and going in the water is not recommended. 

The next category after primary pathogenic microorganisms is "Opportunistic Pathogens," which normally do not harm people who are healthy but instead are just a problem in populations such as the elderly, those with compromised immune systems and infants. Next are "Inorganic Chemical contaminants," such as metals like lead and iron, and then organic chemical contaminants. Finally, a category called "Radionuclides"comes up. This blog will look into Radon, which is one of five things listed in this group.

Radon

According to the EPA, Radon is a radioactive gas that naturally occurs and can cause cancer. It is formed from the breakdown of uranium underground. It has no taste, color or odor so it is very difficult to detect. While there are actually two main sources of radon, both air and water, this blog post's focus is on water quality, so we will only look at Radon in drinking water.

Radon tends to enter the water through dissolving and accumulating in groundwater and therefore can get into well water. It is when the water is used in a house that some of the gas escapes into the air. There is an emphasis on the fact that radon is only a problem for homes that get their water from underground sources because radon in surface water escapes into the air long before it reaches the tap. If exposed to radon through drinking water, people are at a higher risk of getting lung cancer over the course of their lifetime. 

While the EPA reports that there is no federally enforced standard currently for radon in drinking water, they have made a proposal. The proposal requests that any public water source that contains more than 4,000 pCi/L (picoCuries per liter) be shut down. This proposal will also force States to take action in lowering radon levels.

The final water quality issue we will look at is Turbidity, which is under the ODH's "Other Parameters" category. 

Turbidity

According to the Water System Council, turbidity is the cloudiness of the water. The cause of the cloudiness can come from a variety of fairly harmless sources or from increased levels of disease-causing organisms. If it is caused by high levels of organic matter than it may be difficult to successfully disinfect the water.

The Water System Council reported that higher levels of turbidity usually mean higher levels of disease-causing microorganisms, which means that health effects can range from nausea to cramps to diarrhea to headaches.

Photo (by Allison Cook) of a picture from Google Images. This shows the
different levels of turbidity in water. According to the Water System Council
it is more effective to treat water at lower turbidities than at higher ones.

The EPA's standard, according to the Water System Council, is 1 NTU for drinking water standard. NTU stands for nephelolometric turbidity unit, and it is the amount of light that can pass through a water sample. The more particle means a higher number. Most well owners will not notice levels below 5 NTU.

Lead the Fight Against Lead Poisoning by Getting the Facts

153,010. That's the number of Ohio children, under the age of 6, that were tested for lead poisoning in 2014 according to the Ohio Department of Health's Annual Report for 2015.

Lead poisoning, according to Merriam-Webster Dictionary, is when someone is chronically intoxicated due to the body absorbing the heavy metal. Symptoms of this type of poisoning include abdominal pain, weakening of limbs or paralysis of muscles, lack of appetite, nausea, diarrhea, and fatigue.

According to the Ohio Department of Health (ODH), lead poisoning is a serious threat in the state of Ohio. While there are several potential sources in our environment - including cosmetics, foods, and contaminated soils and water - the most probable cause seems to be from lead-based paint. This is specifically a problem in houses with lead-based paint, which could be any home built prior to 1978. Not every home containing the lead-based paint is at risk of giving it's residents the poisoning. Only when the paint begins to deteriorate and becomes part of the dust that it becomes a problem. By keeping the house clean and the paint maintained, you can decrease the chance of exposure.

A photo of the photo-collage created by the Summit Count Public Health on
their annual report. The house being worked on was originally a home with
lead-based paint and its residents were found to have lead poisoning.

Being tested is another way to help prevent lead poisoning in both children and adults. 26,111 Ohio adults, or people over the age of 16, and 154,880 children were tested in 2011. That is roughly 1.57% of the population in 2011 (population total according to the US Census Bureau).

To break the numbers down even further, the reports look at the confirmed levels of lead in the children tested's blood. While there isn't a "safe level" of lead, the government has stated that 5μg/dL, or 5 micrograms per deciliter, is the point that the child is said to have lead poisoning. In other words, when a child is tested and his/her blood is found to have 5μg/dL of lead, they are considered to have elevated blood levels. This threshold was recently lowered from 10μg/dL in November 2014.

In 2014 3%, or 4,596 tested children, were confirmed to have 5μg/dL of lead in their blood or higher, and 0.85%, or 1,298 tested children, were confirmed to have 10μg/dL or higher. Now, it is important to remember that this is all of Ohio. If we were to look at the ODH's County Data Sheet and, for example, look at Summit County, which contains the major Ohio city of Akron, we would find that in this county 154,440 children were tested in 2012. Of those 9,039 children were found to have at least 5μg/dL. That is 5.85% of the children tested. According to the Summit County Public Health's 2015 Annual Report, Summit County was given a "lead hazard control grant" and with the money from the grant 50 homes have been made lead safe.

Above: A photo of a picture of Summit County off
the ODH Annual Report. Below is a legend describing
the colors. on the map. As you can see, the main city of
Akron has the darkest colors which indicate that there is
a very high probability that a child will have an elevated
level of lead in his or her blood.

Aside from being having awareness in your home about when the house was made, if it's walls are painted with lead-based paint, and therefore keeping the paint maintained and your house clean, and having children tested, what else can be done? Well, being knowledgeable of the topic. Throughout the annual report, there are many references and "advertisements" for talks and ways to donate to the cause.

A photo of the "advertisements" in the ODH's Annual
Report. These advocate being aware of your home and
environment, getting your children tested and being
knowledgeable of lead poisoning. 

Zap Away Zika with Knowledge

Zika is a disease that comes from a mosquito known as the Aedes mosquito. According to a New York Times article published in July of 2016, the World Health Organization (WHO) had "declared an international health emergency over the spread of the Zika virus." But what exactly is the virus? How does one "catch" it? How does one know they have it? Is the US at risk? And most importantly, how does one avoid it?

Let's start at the beginning, back in 1947 that is. It was during that year that the virus was discovered in a forest in Uganda known as the Zika Forest. According to the WHO, it was found in monkeys by a group that was trying to monitor yellow fever. It wasn't until 1952 that it was found in humans. Back then, according to the New York Times article, it was thought to be a common virus in the African and Asian regions of the world, and it seemed rather contained in those until around 2013. Around this time Brazil had begun to see a "mystery disease," and by 2015 the mystery had been solved: Zika had traveled across the ocean. Today, the virus has spread northward to the southern United States.

A photo (by Allison Cook) of the map found in the New York Times
article showing areas around the world infected with Zika. 

The mosquito that transmits the disease also is a carrier of yellow fever, dengue fever, and chikungunya, according to WebMD. All four viruses seem to be passed in a similar way: an infected person is bitten by the Aedes mosquito and then that same mosquito bites someone else, giving the new victim the disease. It has only been recently found that Zika can also be given to someone through the act of sex. While only female mosquitos will bite a person, and therefore are the main problem with the spread of the disease, both female and male humans can pass the disease along to their sex partners.

To be more specific, the virus is thought to be found in semen, blood, saliva, eye fluids and urine. The blood is key when dealing with mosquitos. Below is a photo of an illustration done by the New York Times to show how the virus gets from the infected person, into the mosquito and then into the new victim. Basically, it is through the mosquito's saliva that the virus travels to get from one person to the next.

A photo (by Allison Cook) of the illustration used by the New York Times
to show how the Zika virus is spread by mosquitos. 

Now that a person has the virus, how do they know? Well, according to both the New York Times and WebMD, only 20% (1/5) of victims show symptoms. WebMD reported that if a person were to develop symptoms that they could appear any time between 3 days to two weeks after an infected bite. These symptoms do not last long, only lingering from several days to a week, but it is crucial that the sickly person calls their doctor as soon as symptoms develop. New York Times reported that the best way for the virus to be detected is by a urine or blood sample within the first couple weeks of symptoms showing. 

What are the symptoms? According to the WHO, "symptoms are similar to other arbovirus infections," or viruses transmitted by arthropod vectors. These symptoms include fever, joint and muscle pain, rashes, red eyes, and headaches. 

The CDC reported on their website that the symptoms are usually mild enough that people do not get hospitalized, and therefore may not know they are infected. According to WebMD, there is a rare chance that victims can get a disease known as Guillain-Barre syndrome, which causes partial or complete paralysis of the legs for a usually temporary amount of time. While there have only been 13 cases of this link in the US, studies have shown an increasing link between the two diseases. 

The larger concern is the link between Zika and pregnancy. It is thought that the disease can cause fetal microcephaly. Microcephaly is when a baby is born with a smaller than usual head, which most of the time is not an issue to a developing child according to the New York Times. In the cases caused by Zika though, it is a more severe form of microcephaly which may stop the growing of the brain as well as make the brain smoother. There is also a chance that the nerves connecting the brain to the ears and eye could be damaged and the child may suffer from seizures, constantly. It is also noted that microcephaly can be caused by many other infections and may be a result from drug use or alcoholism.

A photo (by Allison Cook) of the CDC's illustration that links to their page
about the potential threats to a pregnant woman's unborn child(ren). 

Unfortunately, there is no cure for microcephaly, but there's hope for those who get Zika. According to the WHO, since the symptoms are very mild there is no specific treatment; just lots of rest, common medicines to treat any pains and drink lots of liquids. It should also be noted that there are no vaccines available at this time. 

Some would say though that the best cure for something is to prevent it from happening. The Who suggests avoiding mosquito bites by wearing clothing that covers your skin and that is lighter colored, wearing bug repellants, keeping physical barriers (such as doors and windows) closed, and sleeping under mosquito nets. It is also advised to practice safer sex or avoid having it at all in regions where the disease can be found or with people who may be infected. The New York Times also advised that women who could have been exposed should take these extra precautions for at least two months and men for at least six months. 

Who Ya Gonna Call? The AAPCC for all Poison Problems.

1-800-222-1222 is a number we should all have memorized. Why? It is the American Association of Poison Control Center's (AAPCC) phone number. 

Picture by Allison Cook. The homepage of the American Association of 
Poison Control Center (AAPCC).

According to AAPCC's 2015 Annual Report, from 2000 to 2015 the poison centers have logged 18,324,650 information calls. 2015 alone had 560,467 calls and of those, 34.96% were under a category known as Drug ID. Interestingly, though, this popular call type has actually seen a decline since mid-2008. It is good to note that these numbers include both calls about humans as well as animals. 

Of the human exposures, the call data is broken down even further by age and gender. 47.63% of the exposures were males, and just over half, 51.54% of the males were children, which are defined by the AAPCC as humans under the age of 19. On the other hand, 51.85% of the exposures were females, but only 48.04% were children. Overall, children five and younger were roughly half, 46.9%, of all human exposures. 

The majority of these human exposers, 87.2%, were acute cases. This means that the subject was exposed to the toxin either once, repeatedly or continuously for less than 8 hours. Chronic, meaning repeated or continuous exposure for more than 8 hours, exposures made up 2.05% and acute-on-chronic exposures, single exposure followed by a repeated, continuous, or intermittent exposure for more than 8 hours, made up 9.35%.

Now that the breakdown of the calls has been presented, we can start to break down the data in a different way: why were these people exposed? The largest reason was unintentional exposure, 78.4%. This can be broken down further by general, therapeutic, misuse, environmental, bite or sting, occupational, food poisoning, and unknown. The most common of the unintentional was "general," 52.5, followed by therapeutic at 12.7% and misuse at 6%. After unintentional, the intentional exposures contributed 17.6% of the cases and Adverse Reaction contributed 2.4%. Under 1% of the reasons was unknown reasoning (0.8%), malicious (0.3%), contamination or tampering (0.3%) and withdrawal (0.1%).

If we cross the reason with the age, we will find that the majority of unintentional cases, 62.16%, occurred with children 5 and younger. The majority of intentional cases occurred in adults, or people 20 and up. In fact, with all other reasons except unintentional, the majority of cases happened to adults.  

The most common route of exposure in humans was ingestion, making up 79.56% of all routes and 83.63% of all cases. Next was dermal making up 6.62% and 6.96%, respectively, and inhalation or nasal came in a close third making up 6.01% and 6.32%. 

Finally, the data can be broken down by scenario, "of therapeutic error regardless of reason" (pg. 937). The most common scenario was inadvertent double-dosing at 30.1%. Among that 30.1 percent, 59.16% were adults 20 and up. The second most common scenario was incorrect medication given or taken making up 14.6% of cases, and 60.5% of these cases were adults 20 and up. While the scenario "confused units of measure" comes in eighth, it was the most common for children 5 years or younger. 

So, what can be done to bring the numbers of exposures down, especially in children? The AAPCC has eight alerts, or categories, of important information on their home page. Below is the alert title, a couple quick facts from that alert's page and a direct link to the page.

Photo by Allison Cook. The main page of the alerts. These alerts are the
most up-to-date information and issues faced by the population when 
dealing with poison. 

1. "Bath Salts" - Also known as "Cloud 9" and "Bliss." Not actually bath salts, but instead powerful, untested illegal drugs. In 2016, 382 exposures were reported to poison centers. The most common age group among these exposures was young adults in their 20s. http://www.aapcc.org/alerts/bath-salts/

2. "Current Annual Report Highlights" - just a quick fact sheet of 2014's annual report. http://www.aapcc.org/alerts/current-annual-report-highlights/

3. "E-Cigarettes and Liquid Nicotine" - Mostly concerned with children 6 years or younger being exposed to these substances and becoming very sick. There are proactive recommendations on how to keep children and pets from being exposed to these harmful substances. http://www.aapcc.org/alerts/e-cigarettes/

4. "Food and Mushroom Poisoning & Recalls" - Food poisoning is caused by food that infectious organisms contaminated and either they or their toxins are ingested. The contamination can happen at any point between production and serving. The Centers for Disease Control and Prevention (CDC) estimate roughly 48 million Americans will get sick from food poisoning. http://www.aapcc.org/alerts/food-poisoning-recalls/

5. "Hand Sanitizer" - There is a large concern with children ingesting hand sanitizers and becoming at risk of alcohol poisoning. It is recommended only a dime-sized drop is applied and the sanitizer is rubbed in completely, leaving hands entirely dry. http://www.aapcc.org/alerts/hand-sanitizer/

Photo by Allison Cook. It is recommended to only use a dime-sized drop of
hand sanitizer and rub it completely dry into your hands. Also, keep an eye 
on children when they are using hand sanitizers to ensure they do not ingest 
it. When not using, keep out of their reach.

6. "Laundry Detergent Packets" - Also a concern with children, but in this case ingesting the highly concentrated liquid packets.  In 2016, 11,528 exposures to children 5 years and younger to these packets were reported to poison control center. http://www.aapcc.org/alerts/laundry-detergent-packets/

Photo by Allison Cook. A Tide Pod is just one of the many
types of laundry detergent packets. While they may be
handy for a quick load, they are highly concentrated and
can be harmful to children.

7. "Opioid (Narcotic) Pain Medications" - Opioids are medicines that are pain relievers. The CDC reported 28,000 deaths in 2014 from these. CDC also has determined that the U.S. is in the middle of a "prescription painkiller overdose epidemic." http://www.aapcc.org/alerts/opioids/

8. "Synthetic Cannabinoids" - More commonly known as "synthetic marijuana," this illegal substance is anything but marijuana. The chemicals found in the substance are made to be abused and, therefore, are extremely addictive. In 2016, there were an estimated 2,695 exposures called into the poison centers. http://www.aapcc.org/alerts/synthetic-cannabinoids/

Aside from becoming informed about the different and current toxic issues we are facing, it is also important for us to be aware of the most common substances that the AAPCC gets calls for. This is important because by being aware of these we can be more focused on preventing these exposures from happening. 

In the 2015 annual report, there is a list of "the most common 25 substance categories," (pg. 941). The most frequent substance involved in human exposures was analgesics, or painkillers, which made up 11.11% of all substances and 9.55% of single substance exposures. Coming in second was "Cleaning Substances (Household)" and "Cosmetics/Personal Care Products" came in third. The substance with the "greatest rate of exposure increase" (942), was "Sedative/Hypnotics/Antipsychotics."

Above all, it is critical to keep any item or substance that could cause harm to children out of their reach and to read instructions on both medications for you and for children carefully. And remember, if there is an incident of poisoning or you are unsure if someone has been poisoned, call 1-800-222-1222.