CHAPTER 19 o Sleep patterns

o Energy level
Mental Health: Public Health Includes Healthy o Concentration
Minds o Memory
World Health Organizations - Most alarming, major depression is often
associated with thoughts of suicide.
- Mental illness account for more disability in
developed countries than any other group of Disturbances of Cognition
illnesses, including cancer and heart disease. - Ability to organize, process, and recall
- Half of adult Americans will develop at least information, to execute complex sequences of
one mental illness during their lifetime. tasks.
Anxiety and Mood Disorders o May be disturbed in a variety of
disorders:
- Most common mental illness in adults.  Alzheimer’s disease is a
- Often associated with chronic diseases, progressive deterioration of
including cardiovascular disease, diabetes, cognitive function
asthma, epilepsy, and cancer.  Dementia
People with Mental Illness Epidemiology
- Have an increased risk of injuries, both National Comorbidity Survey (NCS) conducted from
intentional and unintentional. the fall of 1990 to spring 1992, sponsored by the
- More likely than people without mental illness National Institute of Mental Health, National Institute
to use tobacco products and to abuse alcohol of Drug Abuse, and W.T. Grant Foundation
and other drugs.
- Number of surveys of the US population have
Categories of Mental Disorders: yielded estimates of the prevalence of mental
illness.
o Broad, heterogenous, and somewhat
overlapping. NCS
- Anxiety
- Psychosis - Source of the commonly cited findings about
- Mood disturbance the high incidence and prevalence of mental
- Cognitive deficits illness in the US
- Provides data on the lifetime prevalence of
Anxiety mental disorders broken down by type pf
disorders and total percentage of population
- Important physiological response to
that has the disorder:
dangerous situations that prepares one to
o Anxiety = 31.2%
evade or confront threat in the environment.
o Mood disorders = 21.4%
- Inappropriate expressions of anxiety exists if
o Impulse control disorder = 25.0%
the anxiety experienced is disproportionate to
o Substance disorder = 35.3%
the circumstance or interferes with normal
functioning Behavioral Risk Factor Surveillance System
o Phobias (BRFSS)
o Panic attacks
o Generalized anxiety - State-based telephone survey
- Other manifestations: - Conducts approximately 450,000 adult
o Obsessive-compulsive disorder interviews each year.
o Post-traumatic stress disorder - One question asked every year of all
(PTSD) respondents is the number of mentally
unhealthy days they experienced.
Psychosis - Individual states may choose optional
modules, including some that address other
- Disorders of perception and thought process
mental health issues in depth.
are considered to be symptoms of psychosis.
- Associated with schizophrenia National Health and Nutrition Examination Survey
- Psychotic symptoms can also occur in severe
mood disorders: - Participants chosen are asked questions on
o Hallucinations – sensory impressions number of mentally unhealthy days, as well as
that have no basis in reality. questions designed to measure depression.
o Delusions – false beliefs held despite Pregnancy Risk Assessment Monitoring System
evidence to the contrary, such as (PRAMS)
paranoia
- Asks questions about postpartum depression
Disturbance of Mood to women who have recently given birth.
- Manifest themselves as: Females reported more anxiety disorders and mood
o Major depression – sustained feeling
disturbances than males.
of sadness.
o Bipolar disorder – sustained Males have more impulse control disorders and
elevation or fluctuation of mood. substance disorders.
- Associated with symptoms like
Disturbances in: In all disorders, younger cohorts have a higher
o Appetite prevalence that those over 60 years.
Prevalence of anxiety disorders and mood disorders o Conduct disorders
is only half among those 60 than those of 18 to 19. o Alcohol dependance in the child
Southeastern states have the highest prevalence of Child abuse and Neglect
depression, serious psychological distress, and mean
number of mentally unhealthy days. - Widespread problem in the US
- Associated with:
Reflects the association between mental illness o Depression
and certain chronic diseases: o Conduct disorder
o Delinquency
- Obesity o Impaired social functioning with peers
- Diabetes
- Cardiovascular disease Autism
Causes and Prevention - Severe chronic developmental disorder
- Characterized by severely compromised
- Precise causes of mental disorders are not ability to engage in, and by a lack of interest in
known. social interaction
- Mental disorder causes are viewed as a - Affected children may have wide range of:
product of interaction between biological, o Symptoms
psychological, and sociocultural factors. o Skills
Genetic factors o Levels of disability
- They are referred to as being on autism
- Important in some disorders: spectrum
o Schizophrenia - Prevalence in boys is four to five times higher
o Bipolar disorder than in girls.
o Autism - Evidence for a genetic influence includes the
o Attention deficit hyperactivity disorder twin studies which find that identical twins of
(ADHD) autistic individuals will also have autism in 9
- Schizophrenia out of 10 cases.
o Studies of identical twins find that one
half could have the disorder and the Mood disorders
other does not even though both has - Bipolar disorder, major depression and
the same gene. suicide.
- PTSD - Mortality from suicide increases steadily
o Clearly caused by exposure to through teen years
extremely stressful event. - Suicide
- Prevention of mental illness depends on o Third leading cause of death at that
identification of risks factors that can be age.
targeted in children. o Rare for preteens and young
- Risk factors common in many disorders: adolescents but higher in 15–19-year-
o Individual factor – neurophysiological olds and higher in young adults ages
deficits, difficult temperament, chronic 20-24
physical illness, below average o Among older teens, boys are nearly
intelligence. five times as likely to commit suicide
o Family factor – severe mental as girls
discord, social disadvantage, o Girls are twice as likely to attempt
overcrowding or large family size,
suicide.
paternal criminality, maternal mental
disorder, admission to foster care. ADHD
o Community factor – living in an area
with a high rate of disorganization, - Most commonly diagnosed behavior disorder
inadequate schools. of childhood
- Prevalence four times higher in boys than in
Children girls
- Often treated with psychoactive stimulants
Biological factors and adverse psychosocial - Pharmaceutical treatment is more effective
experiences during childhood may influence risk to when accompanied by behavioral therapy
develop mental disorder. - Concerns have been raised that active boys
Biological risk factor are being over diagnosed with ADHD and is
receiving psychostimulants unnecessarily
- May lead to mental illness in children o Reflects to failure to proper,
including: comprehensive evaluation and
o Intrauterine exposure to alcohol or diagnosis
cigarettes
o Environmental exposure to lead Disruptive disorders
o Malnutrition of pregnancy - Oppositional defiant disorder and conduct
o Birth trauma disorder
o Specific chromosomal syndromes o Frequently found in children with
Maternal depression ADHD

- Increases risk of: Several interventions that focus on enhancing mental

o Depressive and anxiety disorders health and preventing behavior problems have been
found to be effective in enhancing children’s success
in the classroom and minimizing their involvement in - Females have higher rate than males of most
the juvenile justice system anxiety disorder
- Anxiety disorder – have strong genetic basis
Project Head Start - Others more rooted in stressful events
- Probably the country’s best known prevention - Anxiety disorders are treated with counseling
program or psychotherapy or drug treatment
- Advantages are mainly social and include - Veterans of the Iraq and Afghanistan wars
better peer relations, less truancy, less suffer from PTSD
antisocial behavior. o Experience flashbacks to traumatic
events, nightmares, feel stressed and
Mental Health in Adulthood angry during day, hard for them to do
daily tasks such as sleeping, eating, or
- Characterized by:
concentrating.
o Successful performance of mental
- August 2012 – President Obama
function,
o Signed an EO to strengthen access to
o Enabling individual to cope with
mental health care for veterans,
adversity
including suicidal prevention efforts.
o Flourish in their education, vocation,
o Ordered Department of Defense,
and personal relationships.
Department of Veterans Affairs,
- Traits of personal characteristics that
Department of Health and Human
contribute to mental health:
Services to conduct research
o Self-esteem
programs on how to better prevent,
o Optimism
diagnose, and treat these disorders.
o Resilience
- Two types of psychotherapies are
- Traits that are needed to deal with stressful
currently evaluated:
life events
o Prolonged exposure (PE) therapy –
- Confidence in one’s own abilities to cope with
involves helping people confront their
adversity is a major contributor to mental
fear and feelings about the trauma
health in adulthood.
they experienced in a safe way
- Most common psychological and social
through mental imagery, writing, or
stressors in adult life include:
other ways.
o Breakup of intimate romance
o Cognitive processing therapy (CPT)
relationships
– patient is asked to recount his/her
o Death of family member or friend
traumatic experience and a therapist
o Economic hardships
helps the patient redirect inaccurate or
o Racism and discriminations
destructive thoughts about the
o Poor physical health
experience.
o Accidental and intentional assaults on
physical safety Mood disorders
 Such events are more likely to
cause mental disorders who - Including major depression and bipolar
are vulnerable biologically, disorder are a major cause of disability.
socially, and/or psychologically - Prevalence does not differ in sex
- There are effective treatments or mental - Major depression is more prevalent in women
disorders than in men
- Variety of psychotherapy approaches have - Suicide – most dreaded consequence of
been found to be effective mood disorder
o Freudian psychoanalysis to - In the US, men complete suicide four times as
cognitive-behavioral therapy often as women, women attempt suicide four
 Strives to alter faulty times as often as men.
cognitions and replace with - Substance use disorders – also common in
thoughts that promote individuals with mood disorders.
adaptive behavior. - Genetic factors are strongly implicated in
- Drugs for treatment of depression, anxiety, bipolar disorders.
and schizophrenia are found to be effective in - Several medications found as treatment to
correlating alterations that accompany these mood disorders, including:
mental disorders. o Four major classes of antidepressants
o Mood stabilizers: lithium
Anxiety disorders - Psychotherapy often added to drug treatments
- Electroconvulsant shock therapy –
- Most prevalent mental disorders in adult.
sometimes used for severe mood disorders
- Includes:
o Panic disorders Schizophrenia
o Agoraphobia – anxiety about being in
situations from where escape might be - Affects 1 percent of the population
difficult - Characterized by profound disruption in
o Generalized anxiety disorder cognition and emotion
o Specific phobia - Affects language, thought, perception, affect,
o Social phobia and sense of self.
o Obsessive-compulsive disorder - Symptoms include:
o Acute stress disorder o Hearing internal voices
o PTSD (hallucinations)
 o Holding fixed false personal beliefs - Extremes of heat and cold
(delusions) - Ultraviolet rays of the sun
- Onset generally occurs during young - Toxic materials and plants
adulthood - Other living organisms
- Treatment includes: - Pathogenic bacteria
o Antipsychotic medication - Predatory mammals
o Psychotherapy
Groups of people settle down to live together in one
o Family intervention programs
place, they change their shared environment:
Mental Health in Older Adults
- Larger the group, the greater the effect to the
- 55 and older experience specific mental environment.
disorders that are not part of “normal” aging.
- Includes: Archaeological evidence shows that the earliest cities
o Depression were designed with consideration for the health of
o Alzheimer’s disease their inhabitants.
o Alcohol and drug misuse and abuse Early 2000 B.C. cities in India, Egypt, Greece, South
o Anxiety America had devised ways of providing clean water
o Late-life schizophrenia and draining wastes.
- Older adults have the highest rates of suicide,
a consequence of depression - Ancient systems of water supply, drains,
- Risk factors for mental illness include: sewers, are the first evidence of public health
o General medical conditions measures: organized community efforts to
o Admission to nursing home provide healthy conditions for the population.
o High number of medications taken by
Ensuring clean water supply and safe disposal of
many other individuals
wastes are still among the most important
o Psychosocial stressors: bereavement
responsibilities of the government.
or isolation
- Depression prevalent among older people, Role of Government in Environmental Health
especially after loss of spouse.
- Prevention: grief counseling, participation in Environmental health responsibility of government.
self-help groups Environmental exposures: air pollution - beyond
- Depression and suicide prevention strategies control of the individual
are important for nursing home residents.
- Anxiety symptoms not specific to any Government ensures healthy environment by
identified syndrome are prevalent in older various means:
adults
- Providing services directly
- Schizophrenia commonly regarded as an
- Setting standards
illness of young adulthood but can extend into
- Regulating how the services should be
and first appear in later life.
provided
- Symptoms of late-onset schizophrenia are
similar to those in younger patient. US, local governments have provided water for their
- Treatment of mental illness in older adults are citizens.
similar to younger patients.
- Physiological changes due to aging increases Required by law to meet standards set by state and
risk of side effects of drug treatment. federal governments.

Treatment Local government traditionally provide sewage

systems to dispose wastes from individual households
- Most people with mental disorders don’t seek and handle runoff from land.
treatment because they don’t know that there
are effective treatments 1960, Americans became aware that the environment
- Part is fear of the stigma of acknowledging the was deteriorating.
problem Lakes and streams were choked with sewage and
- Major deterrent is the cost of care chemical wastes, killed fish and other wildlife.
- Insurance coverage of mental health care is
inferior of that of physical health. Cities overhung with smog
- In the past hospitalization was the norm for
serious mental illness. Citizens outraged by news stories of neighborhoods
- People went to asylums where they endure poisoned by long-dormant toxic waste dumps.
poor and occasionally abusive condition Late 1960s and early 1970s new laws set standard
- Patients became excessively dependent and for air, water, waste disposal
lost connection to the community
- Inpatient units are used for crisis care First Earth Day, US April 22, 1970
- Housing often a major problem for people with
- Marked beginning of modern environmental
severe mental illness who often tend to be
movement.
poor
- Coast-to-coast rallies and tech-ins
CHAPTER 20
Threat that human activities worldwide are changing
A Clean Environment: The Basis of Public Health the climate of the earth – most difficult environmental
health issue people face
Natural Phenomena in the environment that can
harm human health: Major concerns:
 - Depletion of ozone layer - Increase incidence of leukemia and cancer.
- Accumulation of “greenhouse gases”
o Both affect human health, transcend Medical and dental x-rays constitute largest source of
national boundaries. no background radiation exposure.

Identification of Hazards Some metals have harmful health effects:

Major role of government in environmental health: - MERCURY

o Recognized 19th century to cause
- Identify hazards neurological damage in workers who
- Set safety standards made felt hats – origin of the
expression “mad as a hatter” and
Risks posed by most synthetic chemicals that are inspiration character the Mad Hatter in
discharged into the environment by industrial Lewis Carroll’s Alice in the
processes or disposed by consumers are unknown. Wonderland.
Testing for potential harmful effects is expensive, time o Devastating effects of mercury
consuming, choice of chemical may be politically discharged by plastics factory into
controversial. Japan Minamata Bay in 1950s –
caused 700 deaths varying degrees of
Radiation – environmental health hazard people tend paralysis and brain damage in 9000
to worry about only when it is artificially produced. other people.
o Mercury accumulated in fish, staple of
Exposed to cosmic radiation
the community’s diet
- Where they live o Mercury poisoning in Iraq in 1972 –
- Natural radioactive materials found in soils substance was used as a fungicide on
and rocks seed grain.
 Contaminated wheat turned to
Radon gas - produced by natural radioactive decay of bread, poisoned more than
uranium. 6500 people 459 died.
- Recognized only in the mid-1980s o US, mercury enters environment by
- Prolonged exposure can cause lung cancer emissions from coal-burning power
plant.
Ultraviolet radiation – cause skin cancer and o Developing brains most sensitive to
melanoma toxic effects of mercury
o Pregnant women, women who may
X-ray discovery in mid-1980s aroused great public
become pregnant, nursing mothers,
excitement and led to extensive human exposures
young children advised to avoid eating
before danger is recognized.
fish that have highest average
Early decades of 20th century – x-ray treatments amounts of mercury in the flesh.
cure-alls for variety of ailments, radioactive o Mercury is regulated under both the
ingredients added to patent medicines. Clean Air Act and the Safe Drinking
Water Act.
Mid-1920s – first alarm raised, deaths from kidney o Mercury also found in equipment used
and bone disease of number of workers who painted in school science labs, exposure
watch dials with radium so they would glow in the because of mishandling and breaks.
dark. o Environmental Protection Agency
- Touching paintbrushes to lips to sharpen the (EPA) – recommends mercury-
points, ingesting toxic quantities of the containing fever thermometers is
chemical. banned in many states.
- LEAD
1932 o Metal known to harm the brain and
nervous system, esp. children.
- Rich socially prominent businessman died
o Damages red blood cells and kidney.
from the same mysterious ailment, diagnosed o Believed to be single most important
on autopsy as radium poisoning. environmental threat to health of
- Dosing himself 5-year period time hundreds of American children.
bottles of Radithor – radium-containing patent o Past 3 decades – evidence
medicine. accumulated that even low levels of
Epidemiologic studies that began in the 1930s lead can slow a child’s development,
cause learning and behavior
- Chronic exposure to low levels of x-radiation problems.
caused cancer o Lead scan in blood – federal govt.
recommends all young children poor
One study compared death rates of radiologists with
enough to be eligible for Medicaid be
other medical specialists found that average age at
scanned.
death of radiologists was 5 years younger than other
o Permissible lvls. of lead have been
specialists.
steadily lowered from 60 micrograms
Atomic bombings of Hiroshima and Nagasaki, per deciliter of blood in 1970 to 10
Japan which ended second world war micrograms at present.
o Has been causing lead poisoning
- Damaging health effects confirmed by long- since the time of the Roman Empire.
term follow-up studies of survivors of the o “plumbum” Latin word for lead, English
bombing. word origin, “plumbing”.
 o Water contaminated with lead - o Succession of lawsuits by injured
major source of lead exposure – from workers and their families in 1960s
lead pipes or from lead solder used and 1970s.
with coper pipes. o Manville Corporation – largest
o 1980s – lead significant air pollutant, asbestos company in the US, filed
emitted from tailpipes of motor bankruptcy in 1982.
vehicles that burned leaded gasoline. o Can still be found in brake linings and
o Lead, component of paint, both interior a number of construction materials.
and exterior – banned in 1977. o General public exposed to asbestos
o Alarms about lead surfaced in 2007 fibers released into thin air.
– Consumer Product Safety o 1986 – Asbestos Hazard Emergency
Commission (CSPC) recalled millions Response Act was passed.
of wooden toys painted with lead  Required all primary and
paint, Thomas the Tank Engine. secondary schools to be
o Bush administration – the inspected.
commission suffered cuts and did not o No evidence thus far that exposure
have the staff to monitor the safety of has been significant cancer risk.
many imports o Population of Libby, Montana clearly
o Obama administration – budget harmed by decades of exposure to
increased significantly. asbestos.
- ARSENIC o Vermiculite ore – mined since 1920s
o “king of poisons” heavily contaminated with asbestos
o Common means of homicide through o Death rates from asbestos among
the centuries. residents of the area were approx. 40
o Recognized as an important times higher than the rest of Montana
environmental toxin until the UN and 60 times higher than the rest of
Children’s Fund turned it into one in the US.
the 1970s in India and Bangladesh o Disease registry established to track
o Concerned about epidemics of who were exposed.
cholera, dysentery, and other o Community health center established
waterborne diseases. with federal funds to provide medical
o Organizations led campaign to drill services.
millions of wells so that the population o Libby declared Superfund site and
would no longer need to drink cleaned up.
contaminated surface water. o June 2009, EPA declared public
o People developed symptoms such as health emergency, first time
abdominal pain, vomiting, diarrhea, emergency has declared.
pain, swelling in the hands and feet, o W.R. Grace, company that operated
skin eruptions. the mine, overwhelmed with lawsuits
o Some cases, symptoms progressed to from injured residents. – filed for
progressive nervous system bankruptcy protection in 2001.
deterioration and death o Asbestos exposure a concern as a
o Children of poor nutritional health – result of the 9/11 attacks in World
susceptible Trade.
o Well-water, free of disease-causing
bacteria, found to contain very high Pesticides and Industrial Chemicals
concentrations of arsenic. Silent Spring published 1962 – Rachel Carsons’s
o 80% Bangladeshis affected, WHO best-selling book.
labeled this “the worst mass poisoning
in history”. - Wake up call to the American public, warning
o Studies shows lower concentrations, that chemicals in the environment can cause
long-term exposure to arsenic in harm.
drinking water increases risk of - Launched the environmental movement that
diabetes and cancer. led to sweeping legislation in 1970s
- ASBESTOS - Called attention to the harmful effects of the
o Fibrous mineral valuable for a variety virtually ubiquitous pesticide DDT – chemical
of uses because if its strength and fire can be found in lakes, streams, plants and
resistance. insects.
o Hazards recognized first in an
Use of DDT
occupational setting: Inhalation of high
concentrations of asbestos dust - Banned in the US in 1972
caused stiffening and scarring of the - Number of insecticides chemically related to
lungs of miners and other asbestos DDT also banned in 1970s.
workers, a condition known as - Chemicals including:
asbestosis – disabling and eventually o Chlordane
fatal. o Aldrin
o Workers likely to get lung cancer or o Mirex
mesothelioma – rare cancer of the o Kepone
lining of the chest or abdominal cavity
caused by inhalation of asbestos. Related group of chemicals polychlorinated
biphenyls (PCBs)
- Unlike pesticides these chemicals were still - Common pollutants of air and water are also
entering the environment in large quantities produced by the burning of forests or
and getting into the food chain. household trash.
- Enters through discharge of industrial wastes, o Highly toxic, relatively small exposures
route similar to mercury at Minamata. are thought to cause adverse effects
- PCB contamination in NY’s Hudson River on people’s immune, endocrine,
o Discovered by environmentalists, neurological systems.
1975 - 2001 US joined 90 other nations signing the
o Traced to two General Electric Stockholm Convention on Persistent Organic
Company capacitor plants – been Pollutants
discharging large volumes of PCBs o Agreeing to reduce/eliminate
into the river for more than 25 yrs. production, use, release of 12 of the
- Dredging began May 2009; contaminated soil POPs of greatest concern.
to be transported by train to a hazardous
waste landfill in Texas. Bisphenol A (BPA) and Phthalates
- Dredging expected to continue 5 to 7 years - Components of plastics commonly used in
over 40-mile stretch over the river north of food and drink containers, capable of leaching
Albany. into containers and consumed.
- PCBs - most widespread chemical - Traces found in the blood of almost everyone
contaminant worldwide. in US
- Production halted in US – 1977, they and their - BPA found in hard plastics
chemical relatives called persistent organic - Phthalates used to produce soft and flexible
pollutants (POPs), carried to remote regions materials.
of the globe, including Arctic by air, water, and - Evidence that may be especially harmful to
migratory species. infants and developing fetuses.
- Western Japan 1968 – leak at a cooking oil - Both as well as POPs shown to be endocrine
factory contaminated a batch of the rice oil disruptors in humans and wildlife
with heat exchange fluids containing PCBs o Interfere with normal hormone action
and related chemicals. o BPA can mimic estrogen causing early
- Yusho incident
puberty in females and abnormalities
o Means oil disease in Japanese in male and female sex organs.
o Eighteen hundred people sickened o Phthalates interfere with testosterone
- Eleven yrs. Later similar accident in synthesis in males, causing low sperm
Taiwan counts and abnormalities in the
o Affecting 2000 people with “Yu- development of male sex organs.
cheng” meaning oil disease in
- Study using 1999-2002 data from National
Chinese.
Health and Nutrition Examination Survey
- Two-well known incidents in US during
found concentrations of phthalates in urine
1970s
o Warehouse fire in Puerto Rico, caused
of adult American men were associated with
PCB contamination of tuna meal used increased waist circumference and insulin
for animal and fish feeds. resistance.
o Labeling mixup in Michigan - Evidence shows that exposure to phthalates
contaminated cattle feed with may contribute to the growing prevalence of
polybrominated biphenyls – obesity and diabetes.
chemical similar to PCBs resulted in
Occupational Exposures – Workers as Guinea
human exposure to this type of
Pigs
chemicals through the food supply.
- Most conspicuous and consistent - Workers regularly exposed to large amounts
symptom is chloracne – sever skin rashes of toxic substances on the job than other
and discoloration that show up soon after people.
exposure, may persist for many years. - Many chemicals that people encounter
- Other effects include endocrine, immune everyday have unrecognized effects at low
system defects, fatigue, headaches, aching
doses, causing unexplained cancer,
joints.
neurological disorders, reproductive
- Increased risk of some forms of cancer
disorders.
becoming apparent.
- First environmentally caused cancer to be
- EPA declared PCBs probable human
carcinogen. recognized was from an occupational
- “Coca-Cola babies” – infants born to Yusho exposure: scrotal cancer was common in
and Yu-cheng mothers, small birth and dark 29th century English chimney sweeps.
discoloration of the skin. Faded after few o Soot to which they were exposed
months. contained same carcinogens found
o Infants suffered developmental delays in tobacco smoke.
and persistent cognitive deficits.
Chemicals identified as carcinogens through
- Some of the POPs including dioxins and
occupational exposures include:
furans
o Not manufactured intentionally but are - Benzidine – caused bladder cancer in dye
byproducts of some industrial factory workers
processes. - Arsenic – caused lung and lymphatic
cancer in copper smelters
 - Vinyl chloride – used to make some - Set standards for workers exposure to toxic
plastics, causes angiosarcoma – rare substances
cancer of the liver.
Toxic Substances Control Act of 1976
Mesothelioma – occurs almost exclusively in
- Require testing of potentially hazardous
asbestos workers, have high rates of lung cancer.
substances before they go on the market
Neurotoxins – like carcinogens, hard to recognize and to ban them in certain instances.
because they act over a long period of time.
Federal Insecticide, Fungicide, Rodenticide Act
Nerve poisons – more insidious than carcinogens, 1947
damages: deterioration of vision, muscle weakness,
- Requires govt. approval of these
failure of memory.
substances before they can be used.
Nerve damage - found in shoemakers exposed to
Federal Agencies to set standards for exposure
hexane-containing solvents, dry cleaners exposed
to toxic substances:
to trichloroethylene, pesticide applicators, workers
exposed to neurotoxins. - FDA
New Source of Pollution – Factory Farms - EPA
- Department of Agriculture
Revolution in farming threatens regulating - Department of Transportation
environmental pollution - Nuclear Regulatory Commission
- Consumer Product Safety Commission
Hogs, cattle, poultry crowded into confined spaces
- Occupational Safety and Health
where they can be fed and tended to by automated
Administration (OSHA)
systems.
Clean Air Act of 1970 required EPA to develop a list
- Environmental problems because of this
of industrial pollutants that can cause serious
approach to farming are the huge volumes
health damage and set emission standards for
of waste produced by animals. them
- Farms deal with waste by creating “lagoons”
which the liquids are allowed to evaporate - Only eight had been regulated in 1993
of from which they are sprayed on fields.
Reasons why regulation tends to progress
- Broken lagoons emit gases – ammonia,
slowly:
hydrogen sulfide, methane – toxic to
humans. 1. Sheer volume of potentially toxic chemicals
- People in the farm suffer symptoms: being manufactured in the US
headaches, runny noses, sore throats, 2. Toxicity testing on any single chemical can
coughing, respiratory problems, nausea, be expensive and time-consuming.
diarrhea, dizziness, burning eyes, 3. Each chemical must be regulated
depression, fatigue. separately.
- Seepage from the lagoons pollutes
groundwater that feeds wells used for National Toxicology Program (NTP)
drinking water. - Can only test a few dozen agents each year
- Most farms owned by very few major based on the extent of human exposure
corporations, which have great economic and/or suspicion of toxicity.
and political power.
- Farms should be regulated under the Clean Risk Benefit Analysis
Air Act, but law has never been enforced.
Policy analysts agreed that absolute safety is an
- Clean Water Act requires large livestock
impossible goal and that attempting to avoid risk of
operations to obtain permits but this law has
one sort may increase risks of other kinds.
also been widely ignored.
Too much effort is expanded setting very strict
Setting Standards – How Safe Is Safe?
standards for too few substances.
Tens of thousands synthetic chemicals
By battling to achieve zero exposure to one
manufactured since WWII and in the US 3 to 4
carcinogen, public health agencies may be
billion pounds of them are released into the
neglecting to investigate other chemicals that are
environment each year
potentially more hazardous.
Environmental legislation of the 1960s and 1970s
Argument is also made that prevention of risk must
tried to establish guidelines for identifying
be balanced against other societal goals including
environmental hazards and required standards to
economic well-being.
be set that protected human health and the
environment. Republican Congress elected 1994 tried to roll back
all kinds of regulations under the argument that
Standard setting: air and water quality, radiation
they were irrational and expensive, examples of
and food and drug safety, disposal of hazardous
government interference that had negative
wastes.
economic impacts on business.
Occupational Safety and Health Act of 1970
Clinton administration, political debate focused on
how to achieve effective environmental protection
while minimizing red tape and government - Passed in 1965
intrusiveness. - Take effect with 1968 model-year cars
Bush administration was even more inclined to Clean Air Act of 1970
favor economic and business interests in policy
- Established strict air quality standards
making on environmental and public health issues.
- Set limits in several major pollutants
Hope that President Obama will place a priority on - Mandated reduction of automobile and
the health of the population and the environment. factory emissions
CHAPTER 21 Clean Air Act Amendments
Clean Air: Is It Safe to Breathe? - Strengthening some air quality regulations
- Passed in 1977 and 1990
Air pollution caused by coal burning
Criteria Air Pollutants
- Caused problem. London early 17 th century.
Clean Air Act and its Amendments
Advent of Industrial Revolution
- Require monitoring and regulation of six
- 18th and 19th centuries
common air pollutants, called criteria air
- Air of many cities, blackened with smoke
pollutants
from industrial and household furnaces, - Harmful to health and environment
railroad locomotives o Particulates
1952 o Sulfur dioxide
o Carbon monoxide
- Unusual weather pattern caused severe air o Nitrogen oxides
pollution crisis, London o Ozone
- Layer of cold, moist air hung motionless o Lead
over the city for 5 days - All substances enter air – result of
- Smoke, fumes, motor vehicle exhaust combustion for energy in power plants,
accumulated motor vehicles, solid waste disposal,
- More than 4000 deaths – respiratory and industrial processes.
heart disease attributed to foul air.
Particulate matter
Earlier 1948
- Most visible form of air pollution
- US similar deadly air pollution crisis caused - Smoke, soot, ash - typical of the Industrial
by similar weather pattern Revolution
Donora - Objectionable – reduces visibility, forms
layers of grime on building and streets,
- Small town corrodes metals.
- Population 14,000 – suffered eye, nose, - Have harmful health effects
throat irritation and breathing difficulties
- 20 deaths Groundbreaking cohort study

2008 - Conducted by Harvard Epidemiologists

- Compared health of adults and children
- 60th anniversary of the event over the period of 1975-1988 in six cities
- Town opened Donora Smog Museum with with diff. amounts of particulate pollution in
slogan “Clean Air Starts Here” the air.
- Residents of Steubenville, Ohio, most
US 1950s and 1960s
polluted city in the study
- Air quality deteriorating o More likely to suffer from respiratory
- Due to automobiles symptoms, poorer lung function than
residents of Portage, Wisconsin, the
Los Angeles least polluted city.
- Known for its photochemical smog, Early air pollution regulation focused on limiting
yellowish-brown haze caused by intense total particulate matter.
sunlight acting on the complex mix of
chemicals emitted in motor vehicle exhaust. Smallest particles, most dangerous, can evade the
- Harmful to the health of children, people body’s natural defenses and penetrate into the
with heart and lung diseases. lungs, can be source of irritation.

Efforts by cities and states to regulate pollutant 1987

emissions proved unsuccessful.
- Environmental Protection Agency (EPA)
Mid-1960s o Revised the standard so that the
smaller particles – diameter less
- Govt. began attacking the problem than 10 micrometers (PM10) – were
1965 limited.

- First emission standards for automobiles 1997 and again in 2006

 - EPA focused on even smaller particles - ozone levels in the air, indicator of various
- Issuing increasingly stringent limits for chemicals produced by motor-vehicles
particles smaller than 2.5 micrometers - ozone – important protective component of
(PM2.5) upper atmosphere, low altitudes – effects
are harmful
2012
2008
- Agency proposed further strengthening of
PM2.5 - National Parks Conservation Association
and Environmental Defense Fund
Opponents of stricter regulations tried hard to
o Filed suit to force EPA to clean up
discredit the six-city study and other data
emissions responsible for haze that
- Evidence has continued to strengthen obscures views in many national
- Increased hospitalizations and deaths parks.
associated with higher levels of smallest
Lead
particles.
- Highly toxic metal
Importance of PM2.5
- Can damage nervous system, blood,
- Affirmed in several other studies, including kidneys
Women’s Health Initiative which in 2007 - Posing risk to development of children’s
found that every increase of 10 micrograms intellectual abilities
per cubic meter in PM2.5 almost doubled - Main source of lead as air pollutant was
the risk of death from cardiovascular lead of gasoline – phased out in US during
disease. 1980s

Sulfur Dioxide When an area does not meet air quality standard
for one of the criteria pollutants, EPA may
- Produced by combustion of sulfur- designate a nonattainment area and may impose
containing fuels, coal. measures designed to force the area to attain the
- Irritates respiratory tract standard
- Most significant impact as a precursor to
acid rain – major threat to environment Large number of other toxic and carcinogenic
- Reacts with water vapor to form sulfuric acid chemicals are released into air by local factories,
- Tends to stick to fine particulates in the air waste disposal sites, other sources.
- Sulfur dioxide levels – highest in the vicinity Clean Air Act of 1970
of large industrial facilities, declined by 83%
between 1980s and 2010 - Directed EPA to identify and set emission
standards for such hazards
Carbon Monoxide
As of 1993
- Highly toxic gas
- Produced in motor vehicle exhaust. - Only eight had been act upon: asbestos,
- Interferes with oxygen-carrying capacity of mercury, beryllium, benzene, vinyl chloride,
blood arsenic, radionuclides, coke-oven emissions
- Especially harmful to patients with CVD
Strategies for Meeting Standards
– more likely to suffer heart attacks when
exposed to higher concentrations of the Motor vehicles, primary source of air pollution in
pollutant urban areas
- Affects the brain – headaches impairing
mental processes Standard approach for limiting air pollution
from motor vehicles has been:
Nitrogen Oxides
- Limitation of tailpipe emissions by
- Chemicals responsible for yellowish-brown mandating changes both in automobile
appearance of smog engineering and in fuel
- Respiratory irritants that contribute to acid
rain Significant improvement achieved by the use of
- Main sources: catalytic converters; devices that have been
o on-road motor vehicle exhaust repeatedly improved to meet strict standards.
o off-road equipment Newest cars reduced emissions or carbon
o power plant emissions monoxide and ozone producing chemicals about
Ozone 90% and nitrogen oxides by 70% below those of
cars without emission controls
- highly reactive variant of oxygen
- produced by photochemical reactions in Ban on leaded gasoline almost eliminated lead as
which sunlight acts on other air pollutants air pollutant
including nitrogen oxides Continuing increase in number of cars, however
- very irritating to the eyes, respiratory because of older cars and poorly maintained
system, chronic exposure can cause vehicles continued to emit high levels of pollutants
permanent damage to the lungs
Number of other requirements were added in 1990 utility companies in Midwest and South to
Clean Air amendments force them to comply with the law and
launched investigation of dozens of others
Special attention paid to geographic areas that fail
to meet standards for one or more criteria Younger President Bush took office in 2001
pollutants
- Administration responded to complaints of
Requirements include: utilities by setting out to weaken
environmental laws
- Use of less polluting alternative fuels –
ethanol and reformulated gasoline 2002
- Installation of vapor recovery systems on
- President proposed “Clear Skies Initiative” –
gasoline pumps
replaced New Source Review requirement
- Inspection and maintenance programs that
with a market-based trading system that
require annual measurement of tailpipe
clearly set weaker emission standards than
emissions on cars
- Mandatory remediation on cars that fail the those required by Clean Air Act
test. One exception to Bush’s attempts to weaken air
Another mandate: quality rules; however, in May 2004
- Administration announced rules that require
- Automakers should develop and market
vehicles using diesel fuel to meet stricter
“zero-emission” vehicles-electric cars.
standards on emissions
Number of cars on the road in highly populated - Engine makers required to install emission
areas should be reduced control systems; refineries required to
produce cleaner-burning diesel fuel.
While Americans support most measures to ensure
cleaner air, they consistently resist efforts to move Modest law took effect in 1998
them out of their private automobiles.
- Emergency Planning and Community
Many urban areas have developed with success Right-to-Know Act (EPCRA) – had
policies to encourage carpooling by providing high- unexpectedly beneficial effects in prodding
occupancy vehicle lanes and by taxing parking companies to voluntarily restrict their
spaces discharge of air pollutants
Higher taxes on gasoline as those in most Law passed in response to the infamous
European and Asian countries, would discourage Bhopal disaster in1984
unnecessary driving
- Leak of isocyanate gas occurred at Union
Raising taxes seems to be considered political Carbide pesticide factory in India
suicide by most politicians
EPCRA requires businesses to report the locations
Efficient public transport systems require some and quantities of chemicals stored at their sites.
assistance from public funds
- Allows communities to prepare for
Spikes in gasoline prices due to market forces had emergencies such as leaks and chemical
some beneficial effects in encouraging people to by spills.
smaller. fuel-efficient, less polluting vehicles - Also requires manufacturers disclose
information on kinds and amounts of toxic
Variety of strategies, effective in reducing
pollutants they discharge into local
industrial sources of pollution
environment each year.
- Installation of scrubbers on smokestacks Program, known as Toxics Release Inventory
- Move to less polluting fuels, away from
high-sulfur coal - Credited with reducing industrial releases of
toxic chemicals in US by 54.5% between
New approach included – 1990 Clean Air Act
1998 and 2001, another 30% between 2001
amendments
and 2010
- Creation pf pollution allowances that can be Some critics claim that the terrorism argument is
bought and sold
being used as smokescreen to protect industry
Provision of 1977 Clean Air Act Amendments from lawsuits or bad publicity

- Generated great deal of controversy called Urban areas that are having the most difficulty
“New Source Review” meeting air quality standards by requiring controls
on motor vehicles and factories must consider
Original Act was passed in 1970 regulating sources of pollution that have far been
- Set standards to new built power plants but left alone
not require changes to existing plants Los Angeles banned use of charcoal lighter fluid for
Mid-1990s barbecues and regulates exhaust of gas-powered
lawnmowers
- After years of negotiations with the industry,
Clinton administration sued seven electric
Dry-cleaner, autobody shops, furniture refinishers Smoking
also significant sources of toxic air pollutant that are
- increases levels of carbon monoxide in
regulated in Los Angeles area
indoor air and is source of benzene, which
2004 is toxic and carcinogenic
- Region announced a program through Wood-burning stoves and fireplace
which residents could turn in old gasoline
- emit significant amounts of particulate
lawnmowers in exchange of new,
matter and gases into thin air.
nonpolluting electric mowers
Gas ranges and furnaces
California
- Still struggles with pollution associated with - burn more cleanly that wood stoves, but
produce carbon monoxide and nitrogen
its ports, caused by cargo ships and trucks
oxides
that crowed dock areas to move imported
goods inland Radon
National scale - radioactive gas emitted by the decay of
- Obama administration’s 2009 program nick- radium and uranium
named “Cash for Clunkers”. - has long been known to be a major health
threat to uranium miners
o Provided rebates to people who turn
- high risk of developing lung cancer
in old vehicles for new, more fuel-
- enters home by seeping up from the soil
efficient ones, proved popular and
and rock through dirt floors, crawl spaces,
helped to reduce pollution in areas
cracks in cement floors and walls, sump
with high-emissions from motor
vehicles holes, floor drains.
- May dissolve in well water and be released
Emissions of most common pollutants have into thin air during showers or baths
decreased significantly since 1970
Other common indoor air pollutants:
Los Angeles, concentrations of ozone, most difficult
- Formaldehyde – possibly carcinogenic gas
pollutant to control, are now only one half of what
they were in the mid-1970s that irritates the respiratory system and is
contained in insulation, particleboard,
Indoor Air Quality plywood, some were common in
prefabricated and mobile homes.
1980s
- May have adverse health effects,
- Saw increased attention paid to indoor air includes:
quality. o Pesticide
- Most people spend more time indoors than o Dry-cleaning solvents
out o Paints and paint thinners
- concentrations of many pollutants trapped o Carpet glues
inside a building may exceed those o Hair spray
outdoors in all but most polluted cities. o Air fresheners
- In the extreme, lack of sufficient ventilation Most biological air pollutants are a problem
may lead to “sick building syndrome” which only for people who are allergic to them:
building occupants develop an array of
symptoms that disappear when they go - Mold
outdoors - House mites
- Animal dander
Most common indoor pollutants:
Airborne microbes can pose serious health
- Tobacco smoke
hazards: witness Legionnaire’s disease
- Other products of combustion
- Radon gas Global Effects of Air Pollution
- Consumer products that release chemicals
Air pollutants most mobile of all forms of pollution,
into thin air
ill effects may spread far beyond immediate area
- Biological pollutants
o Bacteria where they are released
o Mold Evidence of mounting that human activities are
o Dust mites actually changing the composition of the
o Animal dander atmosphere
- “Secondhand smoke” – has become
political issue Acid rain
- Many states now ban smoking in various - Produced when two common air pollutant –
public places. sulfur dioxide and nitrogen dioxide – react
Tobacco smoke with water to form sulfuric acid and nitric
acid
- most significant air pollutant and the main
source of particulate pollution for children
 - In eastern Canada resulting from US air
pollution has been a cause of diplomatic
tension between the two countries.
- Damages forests, reduces crop yields,
corrodes surfaces of building and statuary
- Turns water in lakes and rivers acidic
- Killing freshwater shrimp
- Wiping out bacteria on lake bottoms
- Interfering with fish reproduction
- Some lakes too acidic can’t support life
- Many metals are soluble in acid, the
increasing acidity of water may lead to toxic
levels of metals in drinking water supplies
o Aluminum
o Lead
o Copper
o Mercury
Depletion of ozone layer, another manifestation of
global effects of certain air pollutants
Ozone, harmful to respiratory systems at ground
level
- Natural components of upper atmosphere
that provides a layer of protection against
ultraviolet radiation
- Detection of chlorofluorocarbons (CFCs) in
the ozone “hole” which opened over
Antarctica, early 1980s convinced scientists
that these chemicals, which were used as
refrigerants and spray can propellants,
responsible for the breakdown of ozone
- Increased ultraviolet radiation that reaches
ground level is causing increased rates of
cataracts, major cause of blindness in the
world and skin cancer
After years of controversy and denial, diplomats
from 29 nations met in Montreal, Canada in 1987 to
sign an agreement aimed at reducing the
production and use of CFCs
Carbon dioxide
- Not strictly an air pollutant
o Along with nitrogen, oxygen, argon,
one of the four major components of
atmosphere
- But its increasing proportion in the air has
ominous implications for the future of earth’s
environment
Atmospheric Carbon dioxide
- Acts like glass of a greenhouse
- Allowing sunlight to enter but trapping the
heat inside
- The resulting “greenhouse effect” leads to
warmer temperatures at earth’s surface.
CHAPTER 22 The discovery of PCBs in the Hudson reverse led
CLEAN WATER: A LIMITED RESORCE to a ban on commercial fishing there because the
chemicals were so concentrated in the flesh of the
 The importance of safe drinking water to fish.
public health has been clear since John
Snow identified that polluted air as the Minnesota Incident
source of London's cholera epidemic in  Residents of Duluth, Minnesota, alarm that
1855 the reserve mining company had been
 major epidemics of cholera and waterborne dumping asbestos containing wastewater
diseases, broke out. into Lake Superior, the source of municipal
 90,000 people died of cholera in 1885 in water for more than 20 years.
Chicago, persuading officials to stop this  For a year bottled water was distributed to
discharging the city's sewage into Lake the population until a new water filtration
Michigan which was the source of water plant was completed.

647 outbreaks of waterborne diseases were Kepone Poisoning

documented by the Centers for Disease Control  James River was so badly polluted with the
and Prevention, CDC between 1971 and 1994. insecticide Kepone discharge from a
 include that the 1993 cryptosporidiosis manufacturing plant in Hopewell Virginia
outbreak in Milwaukee. between 1966 and 1975.
 There was no practical way proposed to
Each year between 1991 and 2002 CDC and the clean
Environmental Protection Agency (EPA) recorded  plant was closed because of the employees
an average of 17 outbreaks associated with suffered neurological, liver and other
contaminated drinking water. damage from Kepone poisoning.

Common water pollutants include Cuyahoga River Incident

 microbial pathogens,  In 1969, the Cuyahoga River in Ohio caught
 a wide range of chemicals that might be fire because it had so much oil floating in it
toxic to drinking water but harmful effects on surface.
fish and wildlife.
 have been discharged it into waterways as The Clean Water Act of 1972 which was amended
industrial wastes. in 1977, and the Safe Drinking Water Act of 1974
 Similar to mercury in Minamata bay and which was rewritten in 1966.
polychlorinated biphenyls (PCBs) in Hudson
River. The goals of Clean Water Act is obviously to help in
achieving the goals of the Safe Drinking Water Act.
Other sources of pollution include
 deposition from the air, as in acid rain, CLEAN WATER ACT
 run off from the land.
The Clean Water Act set national goals that lakes
Until the early 1970s individual states responsible and rivers should be fishable and swimmable, and
for the quality of their water waste, and the purity of that all pollutant discharges should be eliminated
their drinking water.
 This did not control the water pollution, Point source pollution
because the sources of pollution and the  a well defined location that discharge
communities affected by the pollution may pollutants into lakes and rivers
be under different political jurisdiction.
1972 and 1977 legislation
Example, New Orleans, draws its drinking water  strict controls on these sources provided
from the Mississippi River. It was helpless to stop billions of dollars of funding to assist
the cities upstream located in other states from municipalities in building wastewater
discharging sewage and industrial waste into the treatment facilities.
river.
The 1987 reauthorization of the Clean Water Act,
  focused on cleaning up nonpoint source treatment process rendering the plant
pollution laws governing point source ineffective
pollution set requirements for treating  plant was cleaned up for two years, cost
wastewater, so that it can be discharged millions of dollars.
into waterways without causing human  100 million gallons of untreated sewage
health problems or disrupting the aquatic were discharged into the Ohio River every
environment. day

The primary step 1981

 to remove suspended solids by screening  Cincinnati a paint factory discharge
them, and then allowing them to settle out hydrochloric acid into the CDC worse
by gravity in settling tanks. corroding the sewer pipe and causing it to
collapse, leaving a hole in the street 24 feet
The secondary stage in diameter.
 to break down the remaining organic
material using biological processes, The Clean Water Act
wastewater is mixed with bacteria and  requires pretreatment of industrial wastes
plenty of oxygen, resulting in conversion of that are discharged into sewers
the organic wastes into carbon dioxide,  standards have not yet been said many
water and minerals. smaller commercial establishments
 It is then disinfected with chlorine before including car washes and further processing
being discharged into the environment. plants hazardous chemicals, also in their
sewer systems from residences.
 Cities have inadequate sewer systems that
back up into basements or overflow and Nonpoint source pollution
dump untreated sewage into water, waste  become increasingly important threat to the
water wastes. water quality.
 This problem is due to population growth.  This come from farmland construction sites
and urban streets
According to an analysis by the EPA data by the
New York Times, sewage systems are the nation's Agriculture
most frequent violations of the Clean Water Act,  the leading source of water pollution in the
United States, with soil menor fertilizers,
EPA and the Government Accountability Office, pesticides that wash into the streams and
 estimated that $400 million in extra lakes.
spending is needed over the next decade to  This is believed to be the source of the
fix the nation's sewage infrastructure Milwaukee cryptosporidiosis outbreak
discharges from industrial sources are the
second major category of point source Construction activities
pollution regulated by the Clean Water Act,  contributes to soil runoff water together with
 EPA required to develop standards for the oil bar paint and cleaning solvents.
release of various categories of pollutants
into the environment Contaminants by urban street runoff
 include dirt road salt, oil, grease heavy
Industries metal particles pesticides and fertilizers
 they actually discharge into the nation's from lawns and animal and bird droppings.
waterways are required to obtain a permit,
specifying allowable amounts and can teach A variety of approaches must be used to minimize
you as pollutants that they may discharge pollution caused by stormwater; includes
 they must routinely monitor their discharges 1. preventing soil erosion by planting
and report regularly to the EPA. vegetation on exposed exposed soil
2. incorporating more green space into urban
1977 areas
 pesticide wastes illegally dumped into the 3. minimizing the use of chemical fertilizers
seaward of Louiseville Kentucky killed all and pesticides and controlling later.
the microbes responsible for the secondary
 Air pollution  high concentrations of dissolved calcium or
 also a source of water pollution. magnesium.
 Chemicals are just deposited into lakes,  It has objectionable taste or others due to
rivers and oceans from the air dissolve iron or gases
 includes lead asbestos, PCBs and very  additional treatments may be used.
used, pesticides,
 major portion of the PCBs in the Great Regular laboratory levels are generally done to the
Lakes come from the air, industrial final product, traditional measures are turbidity and
accidents and spills also contribute the coliform levels.
pollution of waterways.
Turbidity
Clean Water Act, the EPA  indicates the presence of suspended
 regularly collects data from the states on particles, which means there is a failure of
water quality of rivers, lakes and estuaries. separate sedimentation and filtration steps,
 suspended particles may interfere with the
From the data from 2004. We had a long way to germicidal action of chlorine.
meet the fishable and swimmable requirements  After the cryptosporidiosis outbreak, which
44% of river miles 64% of Lake, acres and 33% of was accompanied by an increase in the
Bay estuary, square miles were found to be unfit for turbidity of the Milwaukee's water.
fishing and swimming.  The National turbidity standards were
tightened
SAFE DRINKING WATER  coliform bacteria are detected, there is a
 Almost half of the drinking water in the possibility that there is a failure of this
United States comes from rivers and lakes. infection.
 The other half comes from underground  The presence of the bacteria indicates that
aquifers, which has a better quality, but more harmful microorganisms may have
increasingly susceptible to contamination by survived that treatment process.
leaching from landfills leaking oil and gas
storage tanks and other sources of
chemicals. The general approach to water treatment is
directed to bacteria diseases.
 Surface water quality, brought by clean It is not very effective in fighting viruses and
water out made the job easier for parasites cryptosporidium and giardia,
community water systems, all communities which are resistant to chlorine.
systems need to treat through water, so that It does nothing to address the problem of
all contaminants will be removed, the steps contamination with common chemical
needed to produce potable water vary, pollutants such as pesticides, herbicides,
depending on the source of the water and fertilizers, PCBs, lead, and other metals that
the type of contamination. may be harmful to health

The basic steps to most systems include Safe Drinking Water Act of 1974
1. sedimentation  required the EPA to set standards for local
2. coagulation water systems and mandated that states
3. filtration enforce the standards, uniform guidelines
4. disinfection reserved for drinking water treatment and
 incoming water is first allowed to sit quietly regular monitoring and testing were
while suspended material settles out required.
 alum is added, causing small particles to
coagulate and settle out, The 1986 reauthorization of the Safe Drinking
 Filtration through beds of sand, or similar Water Act
materials, remove the smaller particles,  specified add contaminants to be regulated
 chlorine is added to kill remaining pathogens. by the EPA,
 Fluoride is often added to protect community  set deadlines for action.
residents from tooth decay.  Ii required water systems to take measures
to prevent contamination with Crystospordia
Hard and Giardia
Maximum contaminant levels groundwater, and most of these cause
 have been set for 87 identified acute gastrointestinal illness
contaminants, including microorganisms
disinfectants disinfection by products or 1978 CDC surveillance for water,
inorganic chemicals, organic chemicals and  warring disease outbreaks expanded to
radionuclides include outbreaks associated with
recreational water such as swimming pools
Secondary standards water parks and beaches.
 have been set for 15 contaminants that do  They account more outbreaks than drinking
not cause health risks, but may affect taste water sources in 2007 to 2008
or odor or color or the onset of discoloration  134 outbreaks affecting 13,966 people and
of skin or teeth. crossing 17 deaths
 most of the diseases are gastrointestinal
1996 Congress caused by infectious agents or chemicals,
 Strengthened the Safe Water Drinking Act but most of these are poisonings, or
 Community water systems provide annual respiratory irritation caused by a chemical
Consumer Confidence Reports about the spike in the pool
source of water, water contaminants and
the health effects of this contaminants The New York Times
 Included requirements for source water  40% of the nation's community water
protection, tightened standards system violated the Safe Drinking Water
Act, at least once in just one year of the
Right-to-know study in 2008
 Expected to evoke public pressure that  23 million received substandard drinking
would result in better compliance with water violations are due to chemicals that
standards may even at low concentration cause
cancer or other chronic diseases that take
 Ongoing surveillance for waterborne years or decades to develop.
disease by CDC provides useful data for
evaluating the adequacy of existing water  Politicians resist enforcing these laws
treatment technologies and the because of economic impact, or bad
effectiveness of drinking water regulations publicity.
 Bush administration, the EPA did not push
CDC provides data every two years state or local governments to meet
 They analyzes the outbreaks by causative standards or punish industries that dump
agent type of water system type of pollutants into the lake or rivers,
deficiency in the system and source of unregulated chemicals and water supplies
water. and have revealed that some regulated
 The recent available report found 36 chemicals are harmful at low concentrations
outbreaks in the two year period from 2007 that meet current federal standards
to 2008, affecting 404,128 people and
causing three deaths, 2010
 Lisa Jackson the EPA Administrator
 31 of the outbreaks were caused by non
appointed by President Obama
infectious agents:
 announced that they develop a new drinking
- Five viruses
water strategy aimed at finding ways to
- three by parasites
strengthen public health protection from
- 21 by bacteria
contaminants
- one by both viruses and bacteria
 address contaminants as group rather than
- one by bacteria and parasites.
one at a time
 foster development of new technology,
 The outbreak was caused by a chemical
develop closer relationships with states to
and 1/3 of the outbreaks in 2007 to 2008
share data on compliance and enforcement.
were caused by Legionella bacteria, which
cause respiratory disease.
Private wells
 Half of the outbreaks are associated with
untreated or inadequately treated
  are not regulated under the Safe Drinking upgrade their sewage plants, buying
Water Act. sensitive land near their service
 The EPA issues recommendations for  making changes in the way farmers dispose
ensuring that those are safe, their manure.
 about 43 million Americans get their  The Milwaukee's Cryptosporidium those
drinking water from private wells outbreak occurred despite the fact that the
its system filters the water
study by the US Geological Survey,
 Americans choose to drink bottled water 1997 New York City
believing that it is pure and it's better than  reach an agreement with the upstate region
tap water, to implement the watershed protection plan
 study published in 1999 by the National  2007 with the EPA in the upstate counties
Natural Resources Defense Council 103 for a 10 year filtration avoidance
brands tested contain chemical or biological determination.
contaminants through,  The city buying land in the watershed the
 concentrations are enough to cause health region which can be used for recreational
problems, purposes like hunting, fishing and hiking,
 CDC in 2000 surveillance recorded a but cannot be developed.
multistate outbreak affecting 84 People  The agreement cause the city to work with
caused by salmonella in bottled water due communities to upgrade water waste
to contamination at the water source. treatment plants and septic systems
 Outbreaks associated with bottled water working with agricultural groups to develop
were also reported in 2001 2003 2004 and pollution prevention programs for broad
2007, bottled water is regulated by the Food partners.
and Drug Administration, it requires to meet  The city has built an ultraviolet disinfection
the EPA is drinking water standards. facility in Westchester County, designed to
kill cryptosporidium and Gardia
DILEMMAS IN COMPLIANCE microorganism.

New York Incident  The cost of ensuring safe drinking water is a

 New York gets most of its tap water from major obstacle for many communities, the
the six reservoirs in the Catskill Mountains, clean water and drinking water
built in the 1950s and 1960s. infrastructure gap analysis.
 The city was justly proud to the purity and  The EPA has shown the spending on water
taste of its water. and sewage system is inadequate to cope
 But these offered the 1970s and 1980s. with such problem as leaks in ageing water
 More than 100 Community sewage pipelines and failure in aging urban sewage
treatment plants discharged into the systems, another dilemma concerning
watershed area and violated the discharge drinking water is the very chemicals used to
permit standard substandard septic tanks kill microbes in water may themselves be
also contributed to the problem. harmful to help,
 New York's water frequently violated EPA  chlorine, the most common disinfectant
standards and the amount of chlorine added reacts with organic matter to form
to control bacteria increased the level that it byproducts that some evidence shows may
affected the waters tastes be carcinogenic,
 Cryptosporidium, have also been found in  another material used is bubbling ozone
the city's water. that also forms byproducts that may equally
 The EPA ordered New York to clean up the be harmful to help even double water is
pollution to build a filtration plant for the required to meet only the same standards in
water from upstate reservoir, setting a purity as tap water,
deadline of December 18 1996
 The estimated costs will reach up to $8 General steps to prevent water pollution through
million. elimination point and nonpoint sources are helpful.
 The city's proposed plan to protect the However, since cleaner water sources require less
watershed by helping communities to treatment to meet drinking water standards.
Drinking Water of trace amounts of a wide variety
of hormones pharmaceuticals and household
chemicals.
 Most of them got into the wastewater and
be are treated by humans or animals and
they're not removed by sewage treatment
systems.
 Most of the frequently can detect that
contaminants are steroids insect repellent
antibiotics and non prescription drugs,
including caffeine and metabolites of
nicotine.
 They have ecological effects on fish and
other aquatic species, female hormones
and various small concentrations have been
found to cause feminization of male fish and
there is also a concern in human feces may
similarly be affected.
CHAPTER 23 - dumps, supporting large populations of vermin
SOLID AND HAZARDOUS WASTES: WHAT TO DO WITH produce toxic lead sheets that seep through the
GARBAGE soil and contaminated groundwater,
- environmental protection laws banned these
1987 methods of waste disposal.
- spring in summer the problem of solid waste
disposal was brought to the national attention The Clean Air Act.
by the plight of garbage barge. - Most incinerators illegal,
- This barge could not find a place to unload its
cargo Clean Water Act
- it carries 3000 tons of commercial trash banned - outlawed dumping into waters or lakes
from the local landfill in Islip New York.
- returned after five months, and the trash was Marine Protection Research and Sanctuaries Act of 1972
incinerated. Americans dispose about 250 - Prohibited most ocean dumping open dumps
million tons of municipal solid waste a year were outlawed by many states and then by the
federal government in 1976.
2010
- 4.43 pounds per person per day The Resource Conservation and Recovery Act RCRA
- municipal solid waste includes durable goods (rickra)
non durable goods containers and packaging - standards for sanitary landfills.
food scraps yard trimmings and miscellaneous - Replace dumps, as the most common method
inorganic wastes from residential, commercial, of municipal waste disposal.
institutional and industrial sources.
- It does not include construction and demolition SANITARY LANDFILLS
debris is automobile bodies, municipal sludges, - Sanitary landfills require wastes to be confined
and industrial processes waste, all of which in a sealed areas
must be disposed in some ways. - A properly constructed sanitary landfill starts
with an appropriate site
 Garbage collection has been an important - The site should be dry and consists of
responsibility of local governments since the impervious soil
late 19th century, - A large hole is dug and lined with plastic
 it was recognized that rats flies and other - Refuse is spread in thin layers, compacted by
vermin attracted by garbage carry diseases such bulldozers and covered each day with a thin
as plague and typus layer of soil
 ancient Athens require that wastes be disposed - Decomposing organic matter products may
by outside the city produce liquids that dissolve metals and other
toxins and potentially explosive gases
1970 - Vents and drains are created to control these
- little attention was paid to what was done with hazards
the garbage, after it was taken away from - These are also used as alternative fuel or
residential neighborhoods. burned them to produce renewable energy in
- It is done in open dumps, the form of electricity.
- it was burned. - The landfill is covered with a 2-foot layer of soil
- It was incinerated or out in the open. - The surface can be used as a park golf course
- It was also poured in your by rivers and lakes or and other recreational activities
oceans, - The drawback is the space
- the drawbacks of this method methods became - It is also expensive to transport garbage from
obvious as the volume of garbage, crowded areas to disposal sites with plenty of
- increased garbage was returned to the beaches free space
and contaminating drinking water
- incineration emitted for others noxious fumes Tipping Fee
and black smoke - Measure of availability of landfill space
 - The cost for disposing of a ton of municipal solid  The willingness of Pennsylvania and Virginia to
waste continue accepting New York's garbage

2010 2006
- The tipping fee in the US was $43.99 per ton - The city published a comprehensive solid waste
management plan designed to address
Highest Tipping Fee environmental issues and to increase reliability
- Massachusetts with $105.40 and to reduce cost
- increase in recycling our shift from reliance on
NIMBY trucks to trains and barges for carrying trash out
-Not in my backyard of the city
-Complicating the problem for citiws - attempt to find landfill space within New York
People do not want a landfill in the neighbourhood City.

Problem on epitomized garbage crisis in New York ALTERNATIVES OF LANDFILLS

- Residents complain about the Fresh Kills landfill - 54% of municipal solid waste, as well as waste
in Staten Island from other sources dispose in land fields.

Staten Island To make land fields last longer.

- Rural borough located within city limits - To apply the three R's reduce, reuse, recycle,

Fresh Kills Reduce

- started in 1948 - prevention of a disposal problem by reducing
- 1996 it was accepting about 13,000 tons per waste materials is obviously the most efficient
day. approach,
- It never met a minimal environmental - consumer behavior holds the key to successful
standards. 1996, the EPA, ordered it to cut reducing waste
down on emissions of noxious gases, - this approach requires people to buy only the
- freshkills returned into a park. amount of a product that will be used.
- The first phase will take place on 2014 and it - Choose items without excessive packaging and
will take 30 years to be completed. to use reusable napkins towers diapers dishes
and cups rather than the disposable ones.
Department of Sanitation - popularity of yard sales is favorable trend
- propose to conduct regular tours of decide the towards achieving reduction of waste through
world's largest dump your use.
- the proposal horrified city authorities and was
promptly denied. Recycling
- technically called Resource recovery rapidly
Mayor Rudolph Guiliani growing as a method of reducing the amount of
- propose freshkills to be down. waste that must be put in land fields.
- It was closed in March, 2001. - Providing curbside collection of separated
- It was used to dispose the World Trade Center recyclables, is a way to communities
debrief after September 11 of the same year. encouraged recycling
- refundable deposits and bottles and cans is a
 Other land fields are located in Pennsylvania very effective way of encouraging recycles
and Virginia. - obstacle is the lack of a market used for glass,
 City sanitation trucks take about 12,000 tons of metal, plastic and paper.
residential wastes per day to transfer stations in - Paper is a problem.
the five boroughs in New Jersey, - It constitutes such a large proportion of trash,
 the cost of disposing of ton of trash in 2004 and - it cannot be recycled indefinitely because the
had risen to $75, the 40% more than it cost in fibers break down.
1997. - Newspapers contain a specified minimum
percentage of recycled fiber,
 - they can make a significant impact on the - samples were obtained, and it was revealed
recycled paper market. that it contained 200 different chemicals,
- Recycling will remain cost effective, as long as including benzene dioxin pesticide and a
the price of replacing trash in landfills remain number of other known carcinogens and
high. teratogens

Composting August 1978,

- is a form of recycling that allows the natural - President Carter declared Love Canal, a federal
decay process to convert yard and food wastes disaster area.
so much useful in gardening. - The families were evacuated from their home.
- It can be individual or municipal level. - The source of the problem was an abandoned
- disposal of solid waste is waste. Waste to waste industrial dump, which was used by a chemical
incineration reduces solid waste and produces company for disposal of its waste for over 10
heat and energy. years
- This minimizes the emission of air pollutants.
- They might emit toxic gases including dioxins 1952
and furans. - The Trench was declared full and covered with
- It might be obtained from burning plastics lead, soil.
cadmium and mercury vapors from batteries - They build a school on the area
mixed in with municipal wastes.
- Incineration ash must be disposed as a Missouri
hazardous waste because it frequently the - Several episodes in 1971 waste oil was sprayed
contains dangerous levels of heavy metals. on the floors of several horse arenas around the
- NIMBY Opposition tends to make funding aside state, a practice used to keep the dust down
for a waste energy intimidate or politically these affected animals and people who came in
difficult. Building an operating one is expensive contact with the dirt
because all of the safety features required. - they developed chloracne and some had to be
hospitalized with severe flu like symptoms,
HAZARDOUS WASTES - horses were affected and many died, hundreds
- Only a small percentage of solid waste is of dead birds were found in the area,
hazardous waste. - waste oil was suspected but the hauler claim,
there was nothing unusual about the oil,
Hazardous Waste
- It is toxic to human plants or animals and likely Missouri Department of Health and the Centers for
to explode corrosive and likely to burn through Disease Control and Prevention,
containers or human skin. - find nothing unusual with the soil sample.
- There are two special categories of hazardous - The same hauler had been hired to spray oil in
wastes that are regulated under separate laws, the 23 miles of dirt roads in times Beach, a
radioactive waste and infectious medical wastes community of about 2000 people near St. Louis
during the time of summer,
1978 Love Canal - 1972 scientists continue to run tests, and in
- 20 year old housing development in the town of 1974 they identify dioxin at concentrations, as
Niagara Falls, New York had been noticing some high as 31,000 parts per billion.
alarming phenomena snowfalls noxious - Oil Hauler had been hired by a chemical
chemicals had begun to bubble up the company to dispose of weights from the
backyards and seep into the basements, manufacturer of Agent Orange, the herbicide
chemical odors were prevalent. used in Vietnam War
- The children develop rashes and watery eyes. - waste oil with used crankcase oil and using it to
- Heavy rains washed away so to reveal buried spring the operations.
metal drums that were corroded and leaking. - The same measures per Love Canal were
- These cause cancer, birth defects miscarriages applied
and other health problems among the residents - The decision has been widely criticized as an
overreaction the levels of dioxin and time
 speech were much lower than those in the - The two key elements of RCRA is tracking and
horse arenas, permitting
- little was known that the time about the toxicity
and carcinogenicity of the dioxin in humans. Tracking
- The effect on animals were certainly cause of - mandates the paperwork document that
concern. progress of hazardous waste from his side of
- Love Canal residents have been carefully generation through treatment storage and
dragged for health outcomes that might be disposal,
associated with us, exposure,
Permitting
The New York State Department of Health, - any facility that thrift stores or disposes of
- interviewed 6000 former residents between hazardous waste must be issued a permit from
1978 and 1982, and 1996 began searching the EPA or the state to permit prescribed
records of births, deaths and state registries of standards for management of new ways.
cancer diagnosis and congenital malformations - Transportation of Hazardous Waste which must
for evidence of health problems, be clearly labeled is regulated by the US
- 2008, clear evidence of adverse reproductive Department of Transportation.
outcomes including low birth rate and preterm
birth among women who had lived in Love EPA
Canal. - 40 million tons of hazardous wastes are
- There were also indications of an increased risk managed annually under this RCR ad regulation.
of some forms of cancer, especially lung cancer. - Hazardous Waste is managed by practicing the
three R's reduce, reuse, recycle, reducing
RCRA the federal legislation treating it to make it less hazardous by:
- first and acted in 1976 to deal with solid waste - biological or chemical treatment by burning the
disposal, which included special regulations on waste at high temperatures
handling of waste, regulations, which were - by separating solids from wastewater to reduce
strengthened by amendments to our RCRA in the volume of waste that must be disposed
1984 and 1992
- can prevent future Love Canals and Times 1980
Beach incidents, - Congress passed the Comprehensive
- require all hazardous wastes to be accounted Environmental Response Compensation and
for from cradle to grave, Liability Act, known as Superfund
- there are criminal penalties for those who - requires the EPA to compile a priority list of
violate the law, waste sites that threaten the public health or
- legal disposal of hazardous wastes expensive environmental quality,
and no one knows how much illegal midnight - authorized $1.6 billion over a five year period
dumping may actually go on today, for emergency cleanup of the sites
- super fund was reauthorized in 1986 and 1990,
RCRA lists many specific ways that are regulated under allocating additional billions of dollars for
the law, including cleanup.
- petroleum refining, - The pace of the cleanup was been slow and
- pesticides manufacturing cause has been very high, there were 1242 sites
- some pharmaceutical products on the list. Clean up had been completed or 926
sites
- wastes are also considered hazardous if they - This is a great deal of effort has been spent on
are ignitable corrosive reactive or toxic. trying to establish who is liable.
- They are stricter in large quantity generators - Congress did not reauthorize the corporate
facilities that generate more than 2200 pounds taxes that paid into the trust fund when the tax
per month than small quantity generators expired in 1995, and the Fed had been
facilities that generate between 220 to 2200 exhausted.
pounds per month.
General Electric Company,
 - paying for the dredging of the Hudson River, 2010,
- clean up orphan sites for which their - EPA administration Lisa Jackson labeled coal ash
responsible company could not be identified, or non hazardous meaning that it will be regulated
could not be is now being paid for with taxpayer by the states.
dollars.
- The shortage of clean up options what to do
with the toxic materials removed from the site.
- Congress specified that it should permanently
and significantly reduce the volume toxicity and
mobility of hazardous substances.

The EPA brownfields initiative

- sets lower standards for sites designated for
industrial use an approach that makes clean up
easier but is less acceptable to some
communities,
- close to one quarter of the EPA his entire
budget has been allocated to the Superfund
program and additional funds are contributed
by industry.

COAL ASH
- Previously obscure category.
- Before Christmas 2008 was a dam on the banks
of Tennessee River tributary broke spilling a
billion gallons of toxic sludge across 300 acres of
East Tennessee.
- It was holding back millions of cubic yards of
wet coal ash waste from Tennessee Valley
Authority power plant that burned 14,000 tons
of coal per day, supplied enough electricity to
670000 household.
- So the spill polluted the water with thousands
of pounds of arsenic, lead and other toxic and
carcinogenic metals,
- coal ash was not regulated by the EPA
- 28 years amid controversy about whether to
consider it hazardous or non hazardous waste.
- The volume of ash produced grew from less
than 90 million tons in 1990 to 120 million tons
in 2007.
- Most of the waste is stored in more than 1300
Open dumps around the country scattered on
26 states
- Effects include decimated fissh Bird and frog
populations and contaminated drinking water
for an unknown number of people
- are used for construction landfill mine
reclamation and improvement of soil for
agricultural and golf courses.
- The Obama administration promised to propose
a new regulation and coal ash by the end of
2009
Chapter 24
Safe Food and Drugs: An Ongoing Regulatory Battle Hepatitis A
- Occurred when people ate at Chi-chi’s
The CDC estimated 48 million people contract restaurant in Pennsylvania in year 2003
foodborne diseases each year with 3000 deaths that - Traced in green onions from Mexico
declined in year 2000s. - Usually transmitted by food handlers that were
not careful about hygiene
The likelihood of contracting a foodborne disease in a - Contagious 10 to 14 days before onset of
single meal is relatively small. symptoms.

1906 2008
- The Federal Food and Drug Act and Meat - Largest food borne outbreak was attributed to
Inspection Act Salmonella contaminated Jalapeno and Serrano
- Program to supervise and control the pepper from Mexico
circumstances of manufacture, labelling and - Two farms wherein the irrigation was infected
sale of food with the bacteria
- Caused illness to 1442 people, 2 died in 43
FDA states, Districts of Columbia and Canada
- Oversee regulation of food and drugs
- Given authority over cosmetics, medical devices Fish and Shellfish
and feed and drugs for pets and farm animals. - Harbour pathogenic microbes if harvested in
waters polluted by human sewage
CAUSES OF FOODBORNE ILLNESS - Raw clams and oysters are extremely dangerous
 Contamination of foods with bacteria, viruses, since they grow in shallow coastal waters
or parasites due to breakdowns in sanitation - These shellfishes may carry cholera and related
and/or proper food handling practices. bacteria, Hepatitis A, common Norwalk Virus
which are all capable of causing disease to
Salmonella humans
- Common contaminants of poultry, meat and - Those used in Japanese sushi and sashimi as
eggs. well as South American ceviche may also be
- Infected hens may transfer the pathogen to the dangerous since they might carry parasites.
eggs as they are being formed in the ovary - Causes more outbreaks than any other food
- People at risk for salmonellosis are those who category.
prefer their meat rare or their egg yolks runny, - Fish can be affected with nonmicrobial toxins
especially if eggs are left in room temperature - Farmed salmon (Research in 2004) contain high
allowing the bacteria to flourish levels of PCBs and dioxin and several
- Common symptoms for poisoning includes organochlorine pesticide
vomiting, diarrhea, and abdominal pain.
- Can be obtained is vegetables were chopped in Scromboid toxin
the same cutting board where the raw chicken - Can contaminate the fish by poor cooling on the
were cut. boat.

Escherichia coli 0157:H7  Bacteria may cause illness by way of toxins they
- Widespread in beef produce rather than simple infections
- The way livestocks were raised and processed.  These are contaminants that are hazardous
- Can be obtained by taking in salami, raw ilk, even when the food is cooked
leuce, alfalfa sprouts and unpasteurized apple
juice Botulism
- The bacteria is common on the inesinal racs of - Caused by a deadly bacteria
cows and are secreted with their feces - Flourish in the absence of oxygen which is
greatly associated with home canned
 Fresh products is responsible for increasing vegetables that were inadequately cooked
number of foodborne diseases. before canning
 - Once the toxin is formed, it can obly be
destroyed by boiling it to 15-20 minutes.  Importing of foods can be a challenge to the
food safety system.
 Fish may also develop toxins such as Ciguatoxin  40-45% of fresh fruits and vegetables; 75% of
or Scromboid poison that are produced by seafoods are imported
bacteria or algae that fish feed on or grow on  It can be dangerous if eaten raw or prepared
them, poisoning the flesh for human poorly.
consumption  Such as:
Hepatitis A outbreak from Mexican
GOVERNMENT ACTION TO PREVENT FOODBORNE Green onions
DISEASE Salmonella outbreak from Mexican
peppers
- Variety of federal, state, and local agencies are Outbreak caused by Cuclospora in
responsible for protecting the safety of the food Guatemala because of raspberiies in
supply 1990s
- Major inconsistencies among different types of
food in the way food safety is regulated occur Modernization Act in 2011
because of patchwork legislation, division of - Rely on port of entry inspections a facility that
responsibility and lack of coordination. refuses to permit FDA inspection and it can
- The system depends too heavily on detecting detain for testing shipments of food that it has
and correcting problems after they occur rather reason to believe that it is harmful.
than preventing them.
2008
FDA and Department of Agriculture (USDA) - A story published under New York Times
- Share the primary responsibility of ensuring - Mercury had been found in the sushi made
that foods are safe, wholesome and properly from tuna in 20 Manhattan stores and
labelled restaurants
- Mercury can go into the ocean via industrial
USDA sources especially coal-burning power plants
- Responsible for meat and poultry which is absorbed by bacteria and makes it way
- Prepared products that contain 2% of cooked to the food chain to larger fish such as tuna.
meat and poultry as well as processed eggs
- Inspection of all meat and poultry processing 2006
plants daily and that an inspector must be on - Concluded that the cardiovascular benefits of
site whenever a slaughtering plant is in modest fish consumption outweights the
operation increase cancer rates in adults
- Has the power to bar importing of meat and - The authors also suggested that women should
poultry from countries with inferior food safety reduce their intake of swordfish, shark golden
systems. bass and king mackerel (6 ounces per week)

FDA HACCP (hassip)

- Responsible for all other foods including - Took effect on December 1997
seafood and produce - Hazard Analysis Critical Control Point
- 80% of federally regulated foods, 67% of - In cooperation with National Aeronotics and
reported food borne illness outbreaks Space Administration
- Can inspect food processing facilities under its - Ensured that foods prepared for the astronauts
jurisdiction only once in 10 years were safe
- Focuses on procedures, putting the
Food Safety Management Law responsibility on food businesses to analyse
- Added responsibilities for FDA their procedures and requiring government
- Expanded inspections and setting standards for inspectors to verify compliance.
safe growing, harvesting, sorting, packing and - Identifying potential sources of contamination
sorting of fresh fruits and vegetables. and devising ways to avoid them
 - Requires analysis of process of food from - strict guidelines concerning the temperature at
production, processing and production which food may be stored, cooked and kept in
- Identify each possible hazard and for each one heating today's food should be refrigerated at
or more “control points” which are practices 40 degrees Fahrenheit or below,
and procedures that will eliminate prevent or - heated thoroughly so that internal
minimize the hazard. temperatures are above 140 degrees, special
rules apply to large pieces such as roast meats
HACCP Procedures and stuff quality because then internal
1. Conduct a hazard analysis temperatures may lag behind the internal,
2. Determine the critical control points external changes in temperature, allowing
3. Establish critical limits pathogens to grow during roasting or after
4. Establish monitoring procedures refrigeration.
5. Establish corrective actions
6. Establish verification procedures Radiation
7. Establish record-keeping and documentation - potential solution to the problem of foodborne
procedures. disease
- kills microbial contaminants in food.
 Many companies were already using the - It leaves no radioactive residue and more than
HACCP, and the FDA and USDA in the late 40 years of research have shown it to be safe.
1990s, is to encourage more reliance on the - Kills pests in dried herbs, spices and tea controls
system. insects in weight and flour
 reduce the need for inspection, relying instead - kills parasites that cause trichinosis when
on frequent reviews of procedures to make sure undercooked pork
the system is being carried out - reduce contamination of chicken breasts with
 the FDA implemented the HACCP on seafoods salmonella
making it mandatory in 1998 Raw sprouts, eggs - ground beef with E-coli 0157:H7
and fresh juice were added later. But for them, - shrimp with cholera bacteria
the use of the system is voluntary. - It could increase the safety of the food supply,
approved the irradiation of red meat, poultry,
2004, pork, fruits and vegetables, seeds, herbs and
- the General Accounting Office investigative arm spices eggs and wheat
of Congress
- (2004 Government Accountability Office) 2004
- reviewed the FDA is program for the safety of - USDA began to offer irradiated ground beef as
important seafood, which accounts for 80% of part of the National School Lunch Program
the seafood Americans consume
- recommendations for improvement, including 2008
developing agreements with trading patterns - FDA approved addition of the iceberg lettuce
that they maintain comparable food safety and free, fresh spinach to help protect
systems requiring importers to ensure that consumers from salmonella and E coli.
foreign firms comply with HACCP regulations
and giving enforcement priority to violations  Epidemiologic surveillance and prompt follow-
posing the most serious risks. up of any foodborne outbreak to prevent
further spread of disease
FDA
- Issues recommendations that the state and Pulsenet
local governments can use to regulate - CDC program
establishments that deal with food, including - Consists of public health laboratories in all 50
retail stores, restaurants and institutions such states and Canada
as schools and nursing homes. - Can do DNA “fingerprinting” on foodborne
- Importance of hand washing by food service bacteria
workers and restricting sick workers from direct - Timely comparisons of pathogens that may
contact with food cause outbreaks in various parts of the country
 - Identifying common sources and enabling public - contaminants that can be detected by condition
health officials to take action to halt distribution included dirt, hairs, rodent feces and insect
of contaminated food. parts
- pesticide residues may we left and food as a
November 2008 result of crop spraying or when livestock, eat
- an unusual strain of Salmonella had been pesticide contaminated fodder
reported to 12 states - pesticide law passed by Congress in 1996
- The source of problem was identified in early requires the Environmental Protection Agency
January 2009 to the peanut butter produced by to establish tolerance levels, the maximum
Georgia company allowable residues for all pesticides used and
- The plant was deficient with rodents, a leaky food crops.
roof, demoralized workers and the previous - It requires testing of pesticides for damage to
contamination of Salmonella was not the endocrine system and for effects and
addressed. developing fetuses infants and young children,
- It was closed and the business is under criminal - the FDA and USDA are then required to monitor
investigation. foods to ensure that the stiff side residues are
within the allowed tolerance levels.
Foodnet - Only a fraction of the food supply is tested
- An active surveillance network because tests are available for only some of the
- Designed to help public health officials better pesticides and because when contaminants are
understand the epidemiology of foodborne detected, it is too late to prevent the food from
diseases in the United States being market that a problem of important foods
which may contain recent use of pesticides that
Passive surveillance are banned in the US,
- Public health agency waits for information to be - other contaminants include hormones and
reported to it by doctors, hospitals and antibiotics, antibiotics in livestock is believed to
laboratories. have led to increased antibiotic resistance and
many bacteria.
Active surveillance
- Contact laboratories to ask about every case of Diethylstillbestrol
diarrheal illness they conducted tests on - The sex hormone
- Sends survey to physicians to determine how - form of estrogen
often and under what conditions they send - used to fed to chickens to promote your
stool specimens to laboratories growth.
- Call embers of the general population to ask if - This increases human breast cancer is
they have recent diarrheal illness - banned in 1977

Vibrio 1994
- Salmonella - use of bovine growth hormone in dairy cows to
- Caused by eating contaminated seafood more increase their milk production.
than doubled
Organic
 The institute of Medicine, the President’s - foods are not proven safe, and it's used by a
Council on Food Safety and the GAO have common commercial method.
concluded that laws should be revied to give - There was no federal standard that regulated
one federal official responsibility and authority what foods could be labeled organic
to keep the nation’s food supply safe.
 The problem is the resistance by the powerful 1990
food industry - require the USDA to set standards.
- But there were so much controversy and
ADDITIVES AND CONTAMINANTS objections from the conventional food industry.
- The standards require that organic meat,
poultry, eggs and dairy products must be grown
 without antibiotics or growth hormones and to look for side effects and
organic produce must be grown without toxicities
pesticides, synthetic fertilizers or sewage phase two
sludge.  a larger number of patients for
- In early 2004 The Bush administration clarified science, that the new drug is
that the standards, weakening some of the effective
previous editions on antibiotics and pesticides. phase three
 a full scale control trial in which
Additives patients are assigned randomly
- are put into foods for a variety of reasons. One, to two groups, people in the
to prevent deficiency of diseases that used to experimental group received
cause serious public health problems. the new drug, and members of
- Example the control group received the
Iodine in the table salt for goiter placebo
Vitamin D, added to milk for rickets - cosmetics are more loosely regulated by the
niacin, a B vitamin is added to breadd to FDA. They do not need pre approval.
prevent pellagra - There is no requirement for safety testing on
folic acid, added to floor and rice to cosmetics but a warning label must be attached
prevent some birth defects. to any product that has not been tested.
- There were also a number of ingredients that
- The purpose of food additives is preservative were used in include several chlorinated
retard spoilage or prevent fats from turning compounds as well as some color additives and
rancid additives are used to improve the color most compounds containing mercury.
or to enhance flavor or texture.
- Congress passed legislation in 1958 that FOOD AND DRUG LABELING AND ADVERTISING
required FDA approval for any proposed food - The standards that inspired passage of the
additives, additives already in use were original appear Food and Drugs Act of 1936
exempted and placed on the GRAS list are says of economic fraud that were threats to the
generally regarded as safe. public health
- expensive imports such as tea, coffee and spices
DRUGS AND COSMETICS are frequently adulterated with dried leaves of
- FDA also responsible for the safety of drugs. native trees and ground native nuts and berries.
- It includes both prescription and over the
counter Labeling
- companies seeking to market new drugs are - Accurately labelling was one of the most
required by the law to conduct the tests and important provisions of the 1936,
submit the evidence to the agency. - labeling requirements have become increasingly
- There is an orderly procedures for collecting the elaborate over the years, overall dietary
evidence on new prescription drugs. behavior has far more impact on health than
One is, exchange of information between the food contamination does.
pharmaceutical company and the FDA are - The FDA has placed more emphasis on
required. empowering consumers to eat a healthy diet
requires the company to file a new drug - regulations established in 1994 require labels
application for an investigational new drug. on prepared foods to contain information on
- company is allowed to test the drug in humans fats, fiber, vitamins and other nutrients, along
in clinical trials. with recommended daily intakes for these
Phase one nutrients
 the new drug is given to a small - labels are required to list the amount of artery
number of people who are clogging saturated fat. The pile kind found in
extensively tested to measure butter whole milk, beef and pork.
absorption, distribution,
metabolism and excretion and January 2006
- foods had been required to either label the energy boosters age to ease weight loss and
amount of trans fat in a serving of the product, sexual stimulants and as a way to get high.
trans fat, which had been used in 1980s, - The CDC report that eight deaths and 500
substitute for a saturated fat found in fried adverse health effects including heart attack
foods and baked goods have learned to be at seizures psychosis.
least harmful to our duties as saturated fats - FDA could not stop their sale.
- But a 23 year old Baltimore Orioles, a pitcher
 claims of safety and efficacy are accurate and who died used ephedra to lose weight at the
communicate information about hazards directly to beginning of spring training,
the consumer. - the FDA banned the substance ephedra is not
 This is important for over the counter drugs, the only natural substance that has proven to
labeling of prescription drugs falls under the be unsafe.
authority of the FDA. - According to the American Association of
- It is the created so that the companies will not Poison Control Centers, between the passage of
create ads that are misleading over emphasizing 1994 and 2007 Poison Control Centers received
the benefits and deemphasizing their risks more than 1.6 million reports of adverse
- unfounded claims for health benefits from reactions to vitamins, minerals, essential oils,
certain foods drugs and vitamins have had a herbs and other supplements are
popular appeal in the United States 19th And - federal law was passed in 2007 requires
early 20th century patent medicines contain supplement manufacturers to report serious
alcohol and sometimes opium, which helps adverse effects to the FDA, whether the law will
patients feel better but did not cure the result in significant reporting remains to be
underlying problem. seen.

FDA POLITICS OF FDA

- can act when labels on a food or drug contain - FDA regulates products, amounting to over 25%
false or misleading claims accompanying leaflets of consumer dollars spent in the United States.
are considered labels. - One of the most frequent criticisms of the FDA
has been that it is too slow in approving new
SUPLEMENTS drugs.
- Nothing can be done to suppress the articles on
nutrient nutritional supplements. Thalidomide
- Congress in 1994 passed the dietary - a disaster that was averted in the United States
supplement health and education apps for bids may a cautious FDA official was no longer
the FDA from requiring safety testing of herbs enough to deter calls for reform.
and food supplements. - Congress in 1992 opted to speed up the
- They are sold freely and health food stores, approval process by requiring drug companies
although they may turn out to be harmful once to pay a fee for the processing of NDA’s, which
they are better understood. allow the agency to hire more reviewers but
this situation has given rise to other problems,
Melatonin as discussed below.
- promoted as a sleep aid and treatment for
jetlag is sold as a nutritional supplement despite Fen Phen
the fact that it is a hormone with unknown and - approved in 1996 had to be recalled a year later
potentially powerful effects on their brain and because it caused serious heart valve problems.
their reproductive and immune system
automates it for Seldane
- in 1997, cause cardiac arrhythmias
“Ultimate Xphoria” (herbal ecstasy)
- contained ephedra a potent natural stimulant, Rezulin
similar to amphetamines and ephedra - in 2000 caused liver problems
containing compounds were marketed as - diabetes drug
Baycol post marketing studies of drugs, already in the
- 2001, a cholesterol lowering drug cause of market,
injury to muscle tissue. - grant the agency authority to require
companies to do studies on approved drugs for
 Merck for pharmaceutical company withdrew the adverse side effects,
from the market. Vioxx, a painkiller, - requires registration for all clinical trials and
- because of the risk of heart attacks. public posting of their results,
- includes incentives for testing drugs in children
- The FDA is now accused of neglecting the safety as well as provisions designed to limit conflicts
of consumers. of interest of advisors.

1992 law
- permits, permitting pharmaceutical companies
to pay user fees to speed up drug approval. The
agency has become too cozy with the
company's post marketing surveillance relies on
the drug companies

Post marketing Surveillance

- relies on the drug companies to report adverse
effects, a system that is inadequate.
- At best, and rife with conflicts of interest on the
part of the companies drugs sold in the United
States like food are increasingly being
manufactured in from China and India. T
- he FDA has a mandate to inspect producers of
drugs chemicals used to manufacture drugs for
the American market,

 large quantities of heparin a blood thinner

commonly used to prevent clotting during
surgery or other medical procedures was
recalled because of its allergic reactions to to an
impurity introduced during manufacturing at
the plant at China.

o The FDA is difficulty in spurred review

by the Institute of Medicine that
recommended a number of reforms,
more funding for the purpose of greater
authority for the FDA to require
companies to conduct follow up clinical
studies, newly detected adverse effects,
newly approved drugs should carefully
billing, that indicates safety information
is incomplete and that direct to
consumer advertising should be banned
for the first two years after approval.

Congress passed legislation in 2007,

- which authorized the use of user fees for the
drug approval process, increase the funding of