Final Blog

Final Blog

In this semester, it was useful to get to know more about the resources and sources that provide accurate information about products and environmental hazards. Toxnet is the best! The videos were so poignant and moving...they really had an effect by inspiring me to have a greener lifestyle. I even accepted a summer internship at the Center of Environmental Health. This semester, it has become even more real to me that improving and maintaining environmental health is unjustly a low priority in the current political agenda. We need more lobbying in the government.

Because I was asked to share my opinion about the small group blogging experience, I will be honest in telling you that there were too many steps. I prefer the CANVAS conversation threads, because it keeps everything in one place rather than jumping from blog to blog and memorizing the blog addresses of fellow group members. Perhaps, it may be perceived as "laziness," but it is an unnecessary step in the thousands of things we need to remember.

M14.4 Website Exploration

National Center for Disaster Medicine & Public Health

https://ncdmph.usuhs.edu/KnowledgeLearning/ResilienceThruLearning.htm

     Of all the websites that I explored in this assignment link, I was most drawn to that of the National Center for Disaster Medicine and Public Health, because of its emphasis on resilience through learning. The website provides education and training resources that are accessible to everyone, not only the disaster health workforce. Each page provides background information for the specific disaster types and is organized thematically. Topic pages assist health educators in developing learning content or activities related to various all-hazards events such as:

Influenza

Winter Weather

Wildfires

Hurricanes, Typhoons and Cyclones

Earthquakes

Tornadoes

Explosions & Mass Gatherings

Disaster Healthcare Volunteers Site

https://www.healthcarevolunteers.ca.gov/

     I enjoyed exploring this website, because of the information, resources and volunteer opportunities. I'm inspired to register as a volunteer ICU nurse. It reminds me of the local chapter website for the American Red Cross, which is the most similar organization to the Disaster Health Volunteers that I could think of in my neighborhood. 

12.9 Climate Change

     Although, I believe that Earth has natural climate changes, the current climate change is happening exponentially faster and more extreme than ever before. This is due to human activity and industrialization of the last 300 years. What troubles me most about the current climate change is that all species, including the human race, are not prepared to adapt to the pace and intensity. Other species are affected by the current climate change more than humans...to the point of extinction.

     As a public health professional, I believe that global communities should invest a great amount of attention to being better stewards of the land by minimizing industrialization activities (mining, pesticide use, oil refining...etc.), minimizing waste production and improving waste management systems. 

     I just returned from a one week long medical mission to Honduras during Holy Week. I was appalled at the lack of waste management. They burn their garbage in open burn pits 24 hours a day and 7 days a week...and most of the time garbage is everywhere. The children swim in it and that is why there is skyrocketing prevalence in infectious, waterborne and airborne diseases in Honduras. This is true for most countries around the world, but especially 3rd world countries. Burning trash destroys the ozone layer, which proliferates climate change. Climate change affects food sources and availability for all species. 

10.1 Video Blog

In the medical-surgical ICU where I work, we frequently provide care for oncology patients who are receiving chemotherapy. We are not trained in chemotherapy administration and management, therefore it is a biochemical health hazard for the untrained nursing staff. Using the hierarchy of controls, this is how I would propose to address the issue:

PPE: Protect the Worker with Personal Protective Equipment

• Implement education and training to newly hired nursing staff and annually to all patient care staff on proper use of personal protective equipment when providing care to ICU patients receiving chemotherapy

Administrative Controls: Change the Way People Work

• Facilitate easier access to PPE by ensuring that the unit is well stocked and that it is easy to find
• Provide supportive education and training that is not punitive to all patient care staff (no question is a dumb question type of attitude)

Engineering Controls: Isolate People From Hazard

• Design chemowaste management systems to be more accessible, convenient and user friendly to patient care staff
• Design at least one room in the ICU to be appropriate for chemotherapy

Substitution: Replace the Hazard

• Optimal intervention is to reduce exposure or minimize the effects of exposure through staff education and training

Elimination: Physically Remove the Hazard

• Have appropriate and secure disposal systems accessible to patient care staff

In my ICU unit, the main barrier of patient care staff to exercising their rights to a healthy and safe workplace is lack of knowledge and training. It is the responsibility of management to provide this training, yet they do not see it as a priority, because we are a "medical-surgical ICU," despite the fact that 50% of our patients have cancer and receive some form of anti-cancer treatment. 

M11.5 A Zero Waste Life

Zero Waste Life

Lauren Singer's choice  to live a zero waste life is admirable. It is challenging to live a zero waste life, especially in a society that heavily relies on plastic and a culture of abundance and disposability. Everything is packaged in plastic, which creates perpetual waste.

I purchase my fruits and vegetables from the Farmer's market and I use reusable cloth grocery bags that can be washed. My family and I compost food that is no longer edible and recycle plastic. I'm ok with drinking tap water, but my relatives do not trust it and continue to consume bottled water. I try to use all my products to the end of its life. I have had my laptop for almost 10 years now and I drove my first car for 11 years before it broke down and I had to replace it. I haven't gained weight or grew any taller in the past 10 years, so I keep my clothing. We have reusable tupper ware and we use metal eating utensils.

Unfortunately, I am clueless on how to make my own personal products, but if I were taught and trained, I would be open to incorporating that practice in my daily life. I would walk or bike to work to help reduce the carbon footprint in the world, but work is more than 30 miles away. I walk to the grocery store when I do my errands.

10.5 Occupational Safety & Health Organizations

Occupational Safety & Health Organizations: OSHA

CHOOSE ONE of the following organizations/agencies: OSHA, CAL/OSHA, NIOSH, ILO, WHO, AFL-CIO

Go to their website. Each of these occupational safety and health or labor organizations support a range of occupational health and safety programs. Select a health and safety program sponsored by one of these organizations, read about it.

Provide a short summary on your BLOG and how it might relate to your health and safety.

Employers will find that implementing these recommended practices also brings other benefits. Safety and health programs help businesses:

• Prevent workplace injuries and illnesses
• In the ICU setting, nurses are at high risk for back and joint injuries due to turning, lifting and providing physical care to physically limited patients
• Improve compliance with laws and regulations
• To reduce or prevent the incidences of back/musculoskeletal related injuries due to patient care, hospital employers are required to provide education, training and equipment on safe patient handling and transfering
• Reduce costs, including significant reductions in workers' compensation premiums
• Preventing back/musculoskeletal injuries in nurses during patient care will reduce the rates of disability compensation and sick/medical leave, which in turn will save employers costs
• Engage workers
• Fostering a culture of learning and accepting new practices will engage nurses to comply to safety standards
• Enhance their social responsibility goals
• Increase productivity and enhance overall business operations
• Fewer occupational injuries, will optimize staffing options and increase productivity

Summary on How to Start the Occupational Health Program

1. Prioritize safety and health in workers.
• Create a safe working environment that minimizes unnecessary exposures 
• Invest in decent healthcare insurance programs
2. As management leadership, lead by example.
• Communicate your commitment to a safety and health program
• Define program goals
• Allocate resources
• Expect performance
3. Implement a standardized reporting system.
4. Provide education and training.
• Provide personal protective equipment
5. Implement inspections.
6. Collect hazard controls by assigning workers to recommend solutions.
• Foster a safe work environment for workers to express questions, concerns and ideas
7. Implement hazard controls.
8. Address emergencies.
9. Seek input on work changes.
10. Make improvements.

10.2 MSDS & Toxnet

MSDS & Toxnet: Warfarin (3-(alpha-Acetonyl)-benzyl-4-hydroxycoumarin; 4-Hydroxy-3-(3-oxo-1-phenyl butyl)-2H-1-benzopyran-2-one)

Obtain a Material Safety Data Sheet (MSDS) from your workplace or from the workplace of a family member or friend.   Material Safety Data Sheets are chemical information sheets created by chemical manufacturers that all employers are required to obtain and keep for any potentially hazardous chemicals in the workplace.

Review the MSDS and answer the following questions:

• What are the health risks associated with this chemical?
• Hemorrhage manifested by hemorrhagic skin rashes and lip, nose, and upper airway bleeding
• Upper airway pain, dysarthria, dysphagia and dyspnea (shortness of breath) may occur
• Vomiting, abdominal pain, and bloody stools are common. Back pain may be noted
• Is the chemical a carcinogen?
• Warfarin carcinogen classification is "NA"
• Classified as a teratogen
• What personal protective equipment or special precautions should be taken when working with this chemical?
• Personal protective equipment such as donning gloves to prevent skin absorption during administration of Warfarin to patients
• Donning protective gloves and clothing when applying rodenticides containing Warfarin
• If this is a chemical found in your workplace, what training/education were you given about any risks associated with this chemical?
• Warfarin is a teratogen
• To prevent skin absorption, it is important for individuals administering Warfarin to don gloves, especially if she may be pregnant
• Warfarin must be disposed in a special black hazardous container to prevent toxic waste in the environment

Look up the chemical using the ToxNet databases you mastered while viewing the enviRN-EVIDENCE program. Were there any discrepancies regarding the potential health effects noted in the MSDS? In your BLOG, write about your findings - about the potential dangers associated with the chemical/product you looked up. Was the MSDS an adequate tool for a worker to use to gain an understanding about the potential health risks and how to protect him/herself? (Consider that the general public reads at a reading level at or below 6th grade, and that's if English is their first language.)

Both MSDS and Toxnet consistently described the major adverse health outcome of Warfarin in humans is hemorrhage and teratogenicity. However, Toxnet elaborated more on how Warfarin is used in rodenticides, which increases risk of exposure to the public beyond the medical population. Although there we no discrepancies regarding the potential health effects of Warfarin noted in the MSDS and ToxNet, both tools are difficult to navigate and understand for the general public. Both tools are not appropriate for a worker to use to gain understanding about the potential health risks and how to protect him/herself, because the language used is too scientific and communicated at a reading level beyond the 6th grade level.