Water Quality: What's in Your Drinking Water?

WATER QUALITY

Walk into the kitchen, turn on the faucet and fill up a glass of water. Go into any gas station or grocery store and in front of you may be 6-10 different brands of bottled water to choose from. Many of us can travel a few feet instead of miles to acquire water for cooking dinner or doing daily chores and personal hygiene.

These tasks in many of our daily lives are often viewed as mundane, routine, and sadly taken for granted. However, those across the world living in 2nd and 3rd world countries, the above scenarios are often scarce or even non-existent because there is no access to potable water. But before we go so quickly dismissing the notion that we in the United States or Western hemisphere are immune to poor water quality, let's take a closer look. We may very well have rational concerns right here at home. Closer than we thought.

Many factors go into measuring and analyzing the quality of our drinking water. Below are some of the key elements the Ohio Department of Health analyzes:

Turbidity- this is a measure of the cloudiness within a sample or specimen. This can range from benign particles of sediment, for example, to something more alarming as toxin-carrying bacteria or microorganisms. The standard for turbidity within public health is defined by the U.S. Environment Protection Agency. Two standards have been outlined: one for drinking water and one for public water. Drinking water is set a 1NTU (nephelolometric turbidity unit). While public water's turbidity standard must not exceed 0.3 NTU in 95% of the daily water samples taken within a month time period.

Looking further into our drinking water, some places in the world, and even in rural areas in CONUS, many individuals still acquire their drinking water from private wells. These mediums can pose other diseases and concerns from microorganisms.

Giardia- this is a diarrheal disease caused by a microscopic parasite. The parasite will reside within the intestines and the host will pass the parasite through the feces. Within the past 3 decades, Giardia has become profoundly common within the United States and can be found nationwide. The Giardia standard varies widely from state to state, as well as the federal government. The regulatory limit from the federal statute is that drinking water must achieve a 99.9% inactivation/removal of Giardia.

Cryptosporidium (Crypto)- this disease is profoundly similar to the above mentioned Giardia. Crypto is a diarrheal disease caused by a microscopic parasite. It is often transmitted through feces of an infected human or animal. Standards with Crypto are the same as Giardia (99.9% inactivation/removal) in drinking and private well water.

Radon- is a naturally occurring radioactive gas that can cause lung cancer, among other severe diseases. It is colorless, tasteless, and completely odorless. In contrast to the standards of turbidity, there is truly no safe levels of Radon. Radon, even in small amounts is a carcinogen, however there are recommendations from the federal government to help assist homeowners to reduce radon levels within their homes and communities.
The EPA has provided guidelines for radon levels, which is also known as an action level.

• 4 pCi/L= "action limit": fix your home and take action! (e.g., standard)
• 2 pCi/L= "consider taking action": consider fixing your home (e.g., standard)

One profound takeaway from the above bullets is this... Action Limit is NOT a Safety Limit! 

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COLIFORM BACTERIA 

In the environment, coliform bacteria are the collection of relatively harmless microorganisms that live in large number's in plants, soils, warm-blooded humans (intestines), and cold-blooded animals. There are 16 species found in the environment of total coliform bacteria. 

PREVENTION

• properly constructed well (underground drinking water) will have little to no contamination
• use portable or in-home water filters 
• use good hygiene and hygienic practices in public and around home to decrease risk of contamination

STANDARD

EPA mandates that no coliform bacteria be present in any public drinking water. It is recommended that low to no levels (i.e., zero is the standard) be found in private wells and underground water sources as well. Much like radon in relationship to there are no safe levels of coliform contamination in water. 

                             Glaciers and global icebergs are a large source of the earth's water.

HARMFUL ALGAL BLOOM (HAB) CYANOTOXINS

HAB's are caused by cyanobacteria which are naturally found in Ohio lakes, ponds, and slow-moving streams. Most species of cyanobacteria are not harmful however some species can harmful algal blooms. Each state has various tests and processes for testing and prevention for standards. However, similar to radon and coliform, there is no safe level of HAB's in drinking water. Therefore, the optimal standard for HAB is zero. 

Lead Poisoning: In our Children and our World

Colorless. Odorless. Tasteless. Could be found in sources that are used for human survival... (e.g., soil, water, food, air, dust). One may initially think of carbon monoxide poisoning (which also falls into some of the above mentioned categories), however, this blog will be investigating a specific heavy metal that continues to cause fatalities, yet has almost been long forgotten by many in society: lead poisoning. 

Children are the most susceptible to lead poisoning as well as the elderly. However, there is no known "safe" level of lead exposure in the human body. Lead is a toxic heavy metal and does profound damage to one's nervous system.

OHIO CASES 2014

In 2014, 153,010 children were tested for potential lead poisoning in the state of Ohio. Out of the total number of children tested, many fell within a prevalence rate between 5-10 micrograms per deciliters. 4,596 children were reported having blood lead levels greater than 5ug/dL. 1,298 children were reported having blood lead levels greater than 10 ug/dL. 

One major accomplishment from the Ohio Department of Health was through the network with the Center of Disease Control. The ODH received funds to help assess and provide surveillance for children's lead poisoning cases. Almost $400,000 was received for both 2015 and 2016. 

OHIO POPULATION TESTED

3% of Ohio's population has been tested over 2014. While that number, initially may seem low, consider the number of lead poisonings that remain under reported or not reported at all! Recall that this type of exposure is asymptomatic for a majority of people, while others can have a chronic exposure for decades without knowing what is happening within one's body. 

LEAD POISONING STATISTICS PER COUNTY

I was born and raised in northwestern Ohio within Allen County. My hometown is Lima and I lived in Allen County until I left for college and the Army. After researching the blood lead levels for Allen County, I was shocked to see that some of the highest levels were found in the very city I grew up in. After reflecting on this a while, I then realized that this is not as surprising as initially thought. Lima, OH is home of the 3rd largest oil refinery in the United States. Additionally, it is an industrial city and has many sources of lead that could be found in not only the external environment, but inside old homes as well. 

The statistics below are for Allen County and lead poisoning cases for children within the population:

• blood lead levels found in children greater than 5 micrograms per deciliter= 18.3%-27.3%
• for the following years the predicted percentage of children with blood lead levels greater than 5 micrograms per deciliter= 26.09%

Sources of Lead in the Environment

• occupational sources
• environmental (lead is naturally occurring in the earth's crust)
• water
• soil
• routes of exposure include: inhalation, ingestion

PREVENTIONS FOR LEAD POISONING EXPOSURES

One of the benefits of lead poisoning is the prevention factor of this exposure. Preventing lead poisoning is extremely simple compared to other heavy metal exposures! Different levels of prevention can be illustrated:

• Preventative medicine can be an intervention for those who are already diagnosed
• avoiding exposure to lead in the environment to avoid being poisoned (acute and chronic)
• prevention and advocacy (e.g., educational programs, outreach, macro-level) from a global level to enhance public health's effectiveness within a certain population

If you suspect you or your child may have been exposed to lead, contact your physician immediately and seek treatment.

Zika Virus: Are you safe?

The term "Zika Virus" is probably not completely foreign to you, as most have by now at least heard of this epidemic through various forms of media, news reports, or social media outlets. But past the flashy glamour of news reports and occasional google searches, what do you really know about the Zika Virus? Does it even matter or concern you? Let's take a deeper dive into what the virus is, and how, if at all, it may be of more concern than you might think.

WHAT IS ZIKA VIRUS

As defined by the Mayo Clinic's headquarters campus in Rochester Minnesota, the zika virus is: a mosquito-borne viral infection, with conflicting cases of symptomologies. Meaning, some reported cases there will be some notable symptoms, while others infected, may not even know they have the virus. 

WHERE IS ZIKA FOUND

Depending on where you reside in the world, you are more likely at risk than others. However the zika virus can be found worldwide. The greatest prevalence of the virus is located in regions such as: South and Central Americas (e.g., Argentina, Bolivia, Brazil, Ecuador), Pacific Islands, Mexico, Africa and the United States.

HOW DO WE GET IT

Individuals become infected with the Zika Virus by two main ways: 1) being in contact and through the bite of a mosquito-carrier of the virus (i.e. usually the Aedes species). 2) the other way is through sexual transmission with a Zika virus infected individual. A simple blood or urine test can confirm diagnosis. Now, as above mentioned, if some individuals show symptoms but others do not, how would one know if they have been infected with the virus?

SIGNS AND SYMPTOMS

The Zika Virus impacts individuals in a different way than most major viruses within a host body. The challenge medical professionals face with Zika virus infections is that the most severe signs and symptoms do not develop within the host, as much as a fetus. 

PREGNANCY IMPLICATIONS

For example, the mother may not display any symptoms. However, if she becomes pregnant and delivers a baby while being infected, her baby can result in severe deformities and health concerns from her transmission of the Zika virus in utero. One major example, is the link of microcephaly and Guillain-Barre syndrome. Future concerns of neurological damage is currently being addressed in the medical field. 

PREVENTIONS FOR ZIKA VIRUS

Several forms of prevention can be used to address the transmission of Zika and how to avoid it. 

• Avoid traveling to countries where Zika is actively circulating
• Apply sunscreen before applying insect repellant 
• Use condoms and dental dams if actively engaging in sexual activity
• Treat clothing with permethrin

IS THERE A CURE OR CURRENT TREATMENTS

Mild symptoms and low-grade Zika transmission often requires no treatment. Individuals infected and/or diagnosed with Zika Virus are recommended to do the following: 

• rest
• drink plenty of fluids
• treat pain and fever with common over-the-counter medication

However, if symptoms continue after attempting the above methods, seek medical treatment with a doctor. For severe cases, currently there is no vaccine for the Zika virus.

CONCLUSION

While the media or local new reports may not be as frequently reporting the Zika Virus as much as it was in late 2015, but that does not mean the risk is not existent. Zika is concerning and still very real. Utilizing preventative measures will greatly reduce your risk of getting the disease. Additionally, this will reduce the rate of transmission as well. 

AAPCC- An Overview of Poison and Toxicity within our Environment

Have you or a loved on ever checked into an ER? The answer is probably a resounding yes. We have all been in a hospital setting in some context. Toxicity and poisoning is no different. Just as bacteria and viruses can attack our immune system and be toxic towards it's host (i.e., us), poisoning has become more prevalent on our sociocultural radar.

Here's just one common example of a product that almost everyone would likely have sitting in their homes right now:

This particular product claims that it is all natural and plant-derived formula which implies it would be less toxic than other comparable surface cleaning agents.

The American Association of Poison Control Centers are enabled to help prevent and treat poison exposures. With 55 locations and open 24 hours a day, just in the past year they have received over 2.8 million phone calls. There phone number, toll-free: 1.800.222.1222, is available for anyone who may suspect they have been exposed, or even just for education on toxic awareness.

This education is conveniently provided by the AAPCC website in the form of their poison alerts. Listed below are some of these current alerts and a brief description of them:

• Hand Sanitizer- these products have become a staple within our culture over the last decade. It has been pressed within our schools, workplaces, and of course the healthcare field. The risk comes from more of our younger population. Go inside any Bath & Body Works, or retail shop, and see all the glitter filled, colorful hand sanitizer bottles and that will illustrate the marketing factor for these products. Alcohol concentrations within hand sanitizers are well over 5-6 times higher than that found in hard liquors. (e.g., 40%-95%)

• Bath Salts- Also known as synthetic cathinones, bath salts have been on the rise since 2012. The AAPCC reports, in the past year alone, they took in 2,697 calls. Out of all the calls, the highest percentile were from individuals in the 20-29 age range. Bath salts illicit hallucinogenic  symptoms as well as delusions, panic attacks, and in some cases seizures. The AAPCC warns that these substances are some of the worst and to contact the poison center if you suspect you have been exposed to these drugs.

• Opioids- Only in the past decade, this ever-growing epidemic of opioid dependency and overdoses has become a profound issue within our society. A majority of the initial exposure occurs from our hospitals and doctor-related prescriptions. The catalyst for this interest often begins from the patient's need for pain relief medication. Narcotics are a subcategory analgesics which reduce the intensity of pain signals reaching the brain. 

• Laundry Detergent Packets- The highest recorded exposures to toxic detergent packets occurred in children under the age of 5. In 2016, there were over 11,500 cases of poison exposure to single-load packets. 

• E-Cigarettes and Liquid Nicotine- Reports from AAPCC shows most exposures from liquid nicotine occur to children under the age of 6 years old. It is recommended that adults with exposure to these substances should take extra caution to protect their skin from contamination.

• Synthetic Cannabinoids- In the past 12 months, the AAPPC reported 2,695 exposures of this drug known as "synthetic marijuana". This illicit drug contains a powerful chemical called cannibimimetics. Many common symptoms to this toxic exposure substance include psychotic episodes, seizures, tremors, vomiting, and suicidal thoughts. One key factor in the rise of synthetic cannabinoids poisonings is due to the marketing. The AAPPC states these substances are created specifically for abuse. 

• Food & Mushroom Poisonings- Food poisoning may be one of the most common, taken-for-granted poisoning from the above list. As humans, we consume food on a daily basis, and often times are not mindful of every single thing we ingest. However, food-borne illnesses occur and are usually severe. The CDC reports an approximate 1 in 6 americans (48 million people) are exposed to some level of food poisoning each year. The symptoms can range from mild to lethal which include: nausea, fevers, abdominal cramps, and dehydration. Left untreated, many succumb to the infection. For more information and resources from the CDC follow the link here.

Seen below here is a common herbal tea company. One wouldn't expect that a product, which claims to be organic and natural, would have any potential toxic substances harmful to humans. 

With an ingredient list of only 2-3 components, herbal teas are one of the healthiest drinks available and often provide several medicinal benefits. But continue to the picture below, from the same box, and look closely at the statements related to the product packaging components.

When drinking our hot tea, many of us probably do not think about the staples or glue within our tea bag. Clearly stated here with Mighty Leaf, the ensure these potentially toxic substances are not used in their products. This is a profoundly encouraging step in the right direction! The more we know. 

CURRENT ANNUAL REPORT

A few highlights from AAPCC's current annual report that bares mention is the fatalities and suicide rates within the nation. In the past decade, there has been a 20% increase in suspected suicides. There is a correlation (whether directly or indirectly) to poison exposure. Other fatalities have been reported caused by various products to include: plants, cosmetics, prescription drugs, accidental overdoses, etc.

• Age & Gender- Females within the age range of 50-59.
• Chronicity- 87.2% were acute, single, repeated, or under 8 hours of exposure
• Reasons for exposure-Unintentional exposure
• Scenarios-unexpectedly took medication multiple times
• Top Substances-Pain relievers, cleaning substances, cosmetics, antipsychotics
• Route of Exposure- ingestion with the 2nd being dermal