BLOG #4/ In Harm's way

I have to say that reading the article "In Harms Way" was truly an eye opener for me. As a medical provider, I thought I knew about toxins and substances that affect health such as Mercury in fish and Lead in soil. In my medical practice it is standard practice to check lead levels for children during the CHDP  physical exam. It is also very common for us to find lead toxicity in our patients. I serve a farm working community who is not only exposed to lead but also to other many pesticides and chemicals. These patients live in very poor older housing that is probably contaminated with lead. This article has further helped me to understand how serious these exposures really are. It is too sad that the poorest and most vulnerable are the most helpless to do anything to change their situation. I think the biggest problem is lack of knowledge. Most of the time the patients do not know why we are checking their blood. They believe it is only a requirement for school like immunizations. I constantly try to make sure that my patients leave with at least some understanding of the care they receive. Due to literacy problems, comprehension is still very limited. I believe that a lot more patient education needs to be done in order to address this huge environmental problem.

1. Toxicology
   • Does your new knowledge regarding toxicology have you thinking about what questions you might want to ask your patients regarding their potential exposures in their homes, schools, and workplaces? Yes, I will be more diligent in asking and educating my patients about their potential exposure to toxic harm by everyday exposure to things they may not see at harmful.
   • Will this change or add to your practice. This will both change and add to my practice
2. Fracking
   • Is there any gas or oil activity in your community? How about refineries or pipelines for gas/oil? (You'll be learning more about this in the module on Energy and Health.) There is actually a big controversy over fracking in Fresno county. There was a prior victory in 2011 in the San Jose court to halt a fracking site involving over 2700 acres (Haagenson, 2013). The biggest concern was the amount of water that would be needed to frack. There is also concern for contaminants that may seep into the water supply.
     
     
     
3. Lead
   • Do you feel comfortable educating patients about lead-based paint poisoning prevention? How about what to do if there are elevated lead levels in your community's water? Have you done any work on lead poisoning in the past? (Good resources for this are provided in the resource section) Yes, I feel comfortable educating my community regarding my community regarding lead toxicity. I worked in a rural health center and served many poor communities for over 15 years. These poorer communities have great exposure to lead toxicity due to older housing and contaminated soil. The local health department is very involved in testing the water and educating the community medical providers about lead risks in the area. I have worked as a medical provider and I have identified and treated patients wiht lead toxicity. 
   • Where is lead a problem in your community (water, soil, paint)?Yes, we have lead in the soil and old paint in older communities.
4. Asthma
   • Were you aware of the risks of adult onset asthma as a nurse?Yes, I am aware of adult onset asthma.
   • Have you known any nurses who developed asthma? Yes, I am a nurse and developed asthma as an adult.
   • What are some of the obvious potential triggers to asthma in your workplace? How could you eliminate or reduce these exposures? Some of the potential  triggers at home include, fumes form cleaning agents, fragrances worn by coworkers and dust in my office.
5. Perchlorethylene
   • Are there any dry cleaners near you that use perc? Did you know that there are non-toxic alternatives to perc? The process is sometimes called "wet cleaning". There are dry clearers near my but I am not aware of their use of Perchorethylene. no, I was not was not aware of the use of non-toxic alternatives.