Posts Tagged ‘EPA’

The Dose Makes the Poison

June 19th, 2012

The first thing that you learn in a Toxicology 101 class is the old saying coined by the Renaissance German scientist Paracelsus that: “All things are poison, and nothing is without poison; only the dose permits something not to be poisonous.” We’ve shortened that to: ‘the dose makes the poison”.  Anyway… a key question for public health is to figure out how much exposure (dose) to the thousands of chemicals that we’re exposed to every day is safe.  

Figuring out how toxic chemicals are and whether or not they cause cancer is really important- because without that kind of key information the international public health system can’t develop targeted interventions or inform regulatory policy makers as they develop regulations to limit human exposure. So who does the research and who decides how toxic things are and what causes cancer? 

A combination of forces do the work. Most of the primary research is done in Academia using various funding sources. Collections of researchers and experts evaluate published data to come up with consensus opinions. Internationally- the published work is evaluated by an arm of the World Health Organization International Agency for Research on Cancer (IARC). For example, this week IARC classified diesel engine exhaust as “carcinogenic to humans”. 

In the US- it’s the EPA’s job to decide how toxic things are and what causes cancer. Probably the best source of information is the EPA’s Integrated Risk Information System, which compiles and presents the data that comes out of their external peer review procedures that assess toxicity and carcinogenicity. Using these data sources, policy makers can develop better informed regulations to limit human exposure and improve health outcomes. The Agency for Toxic Substances and Disease Registry ATSDR- which is associated with the CDC- is the public health arm that works with EPA to apply toxicity information to practical matters at polluted sites etc. I started my career at ADHS in 1992 working in our ATSDR grant funded program.

Japanese Radiological Emergency

March 18th, 2011

All of us are exposed to natural radiation on a daily basis. It mostly comes from space (called cosmic rays) as well as natural radioactive materials found in the soil, water and air.  People can also be exposed to radiation from human-made sources like X-ray machines.

Radiation doses are usually measured in units called milli-Sieverts.  On average, people are exposed to approximately 3.0 milli-Sieverts per year.  Most of this (80%) is from naturally-occurring sources (i.e. cosmic radiation) with the rest coming from the medical use of radiation.  If a nuclear power plant doesn’t work properly (as is the case right now in Japan), radioactivity may be released into the surrounding area by a mixture of products generated inside the reactor (“nuclear fission products”). The main fission products are radioactive cesium and iodine.

We’re working with our federal and local partners and 3 of our state agencies to keep close tabs on the radiological situation in Northern Japan.  Most of the radiation is dissipating rapidly in the environment (because of distance and the short half-life of the elements released).  The international community and the federal government have been doing some modeling and some of the models suggest that very low levels of radiation is crossing the Pacific Ocean.  The models suggest that there could be very small increases in natural radiation in North America including Arizona in the coming days.  The levels would be very low and of no health consequence, but nevertheless measurable by the sensitive instruments that already exist and routinely test for radiation all the time.  For example, if the situation in Japan would continue as-is for several weeks, the total exposure in N. America would be comparable to the amount of radiation that you would get flying from AZ to New York (about 0.04 milli-Sieverts- or about a 1% increase from average annual background).

The EPA posted a new Japanese Nuclear Emergency website today, which includes a daily data summary.  Today’s update shows that the US’s radiation air monitors showed typical fluctuations in background radiation levels today.  As I mentioned earlier, the models suggest that there could be slight increases in the coming days.

Between the state and federal agencies monitoring the situation, we’re confident that there would be no health consequences to the people in Arizona.  But, there are stories that some folks are buying potassium iodide (which saturates your thyroid with iodide) because they’ve heard somewhere that it would provide some benefit (it doesn’t under the current circumstances).  We’re concerned that people are taking medication that they don’t need and could create problems for themselves.  That’s why we put out a notice to the folks of Arizona today suggesting that they not take potassium iodide supplements because:

  1. It’s not necessary because of what’s happening in Japan and provides no benefit;
  2. It can be dangerous to people with allergies to iodine, shellfish or who have thyroid problems; and
  3. Taken inappropriately, it can have serious side effects including abnormal heart rhythms, nausea, vomiting, electrolyte abnormalities and bleeding.

There have even been some calls to some poison control centers over the last couple of days from folks that have taken potassium iodide thinking it would be a good idea (it’s not).

For more information on the emergency in Japan, including answers to some frequently asked questions, visit the Arizona Emergency Information Network (AzEIN) website at www.azein.gov email questions to azein@azdema.gov

Palo Verde Nuclear Generating Station Full-Scale Exercise

Our preparedness team recently participated in a federally evaluated Palo Verde Nuclear Generating Station Full-Scale Exercise to test our response to a simulated radiation contamination at Palo Verde.  The exercise simulated an event whereby people, food or drinking water could become contaminated because of a release of radioactive materials into the atmosphere.  During the exercise we practiced and successfully tested our capabilities to coordinate with other agencies in responding to this type of incident.  Our focus under the response plan included the providing contamination control measures to protect the public from eating or drinking any contaminated food or water, guidance on the health effects of radiation exposure, distributing potassium iodide (there is a stockpile here in the state and nationally), coordination with the CDC, and support for local public health agencies and hospitals.  Here’s a link to our Emergency Response Plan including our Radiological Response Plan.

The Scoop on Fluoride

January 20th, 2011

This month the EPA and HHS proposed a change that would lower the recommended level of fluoride in drinking water.  A small amount of fluoride is good in drinking water because it prevents tooth decay.  The idea is to maximize the health benefits of water fluoridation by continuing to prevent tooth decay while reducing the possibility of too much fluoride exposure for children.  There are several reasons for the recent change, including new sources of fluoride, like toothpaste, mouth-rinses, prescription fluoride supplements and fluoride applied by health professionals.  Water fluoridation and fluoride toothpaste are largely responsible for the significant decline in tooth decay over the last few decades.

Water fluoridation is the single most cost-effective strategy that a community can take to improve the oral health of its residents.  Research shows that every $1 invested in water fluoridation saves $38 in unnecessary costs for dental treatment.  The national average cost of filling one cavity – $145, is more than twice the cost of providing optimally fluoridated water to an individual for a lifetime!

Fluoride at some level is naturally present in water and food. In Arizona, it is not uncommon to have naturally occurring fluoride at 0.2 to 0.5 milligrams per liter of water (mg/L), so all Arizonans get some fluoride. Fluoridation of community drinking water is the adjustment of the existing natural fluoride concentration in drinking water to a level that prevents tooth decay.  Currently, ten Arizona communities (Bisbee, Chandler, Gilbert, Glendale, Guadalupe, Mesa, Peoria, Phoenix, Tempe and Yuma) fluoridate their water supply to the optimal level.

The long recognized benefits of community water fluoridation way outweigh any risk, the only known risk is mild enamel discoloration from too much fluoride (from multiple sources).  The discoloration has no clinical significance other than that the individual is more resistant to tooth decay.

We recommend that people brush at least twice a day with fluoride toothpaste, when you get up in the morning and before going to bed.  For little kids, we recommend monitoring the amount of fluoride during tooth brushing by supervising and discouraging swallowing toothpaste and teaching kids to only place a pea-size amount of toothpaste on the toothbrush.  You can read more about community water fluoridation on the CDC’s fluoride website and on EPA’s fluoride website.

A Federal Register notice describing the rationale for the proposed change is available for review.  Comments on the proposed change will be accepted for 30 days after publication in the Federal Register, and can be sent to CWFComments@cdc.gov. The final guidance for community water fluoridation is expected by spring 2011.