Final Flashcards
Lead- how?
Not naturally occurring
Comes in occupation, environment, waste, water
Kids- paints, canned food, lunch boxes, jewelry, calcium supplements
Lead “elevated” level
10ug adults and 5ug kids
Lead hx events
Roman Empire & industrialization
1940 Glasgow retardation, regulation began 16c Germany and 17c Massachusetts
Lead in FOOD
Processing, pesticides, canning.
Process- gasoline makes it airborne, got into uncovered crops
Pest- lead arsenate still worldwide (coffee Central America) switched to DDT in 1960s because of resistance.
Can- BPA in lining now instead of solder
Lead in WATER
Unnatural, r/t infrastructure. Part of EPA SDWA, issue that EPA only protects till property line. Action level first draw after 6 hours sedent, action level <15ppb and actions are:
1) public education (avoid first draw, protect children)
2) water quality parameter (WQP) monitoring
3) source water monitoring & treatment (look for acid causing leaching)
4) corrosion control treatment
DC 2000 crisis & flint 2016 crisis
Lead water crises
DC 2000- changed from chlorine to chloramine (lasts longer but not as strong, leached lead from pipes). CDC did investigation and said there was no problem, they took samples from children who had not even been drinking the water and they were covering it up and Mark Edwards blew the whistle. The CDC didn’t retract the report but then noted “limitations of methods” and then same dude was ready for:
Flint 2016- source water had lots of microorganisms (flint river bc Lake Huron too $$) no anticorrosive- leaching and not enough chlorine- biofilm, legionella
Mercury
Bioaccumulation from methyl (fish & ayurveda) methylmercury- MeHg. Coal-fires power plants is how Hg gets into wager, then benthic bacteria in water & soil convert to MeHg (sulfate dependent methylcobalamin pathway)-> fish fat. Fetus impaired motor & cognitive skills.
MeHg absorbed into GI with cysteine and this pair looks like methionine and treated as such. Transported in air currents up to Canada. DC is hotspot bc downwind of coal plants. Regulations spots- source control, water, food @ sale, consumer warnings
Arsenic
Naturally occurring but also anthropogenic (industry & farming). Colorless, tasteless, odorless, and takes decades to develop disease. Lead arsenate- still worldwide (coffee)
FDA 2016 action level= 100 ppb. Huge in rice products which is what they recommend babies to eat
Arsenic Bangladesh 1980s crisis
Switched from biocontaminated surface water to arsenic contaminated groundwater thru tube wells. Lesson here= can be naturally occurring in water unlike lead. They used to grow rice during rainy season but now during the dry season they pump it out with arsenic diesel that’s getting into the rice. Absorbs more effectively because grown in water flood
Outbreak stats
Most cases are toxins & chemicals from a HAB
respiratory has more instances but GI affects more ppl, and then out of GI the biggest is crypto
Instances of surface= ground but surface affects more ppl (more common source. Ground isn’t safe either- channels & faults)
Microcystin
Cyanobacterial toxin, algal bloom in huge Lake Erie. Regulations hadn’t been in place to protect from toxin so instead EPA published an “advisory”
Ground water rule
Oct 2006- purpose= reduce disease causing microorganisms in drinking water. If ground water systems are at risk for feces must take corrective action to reduce potential illness, but still bacteria only!
RECREATION
Untreated all bugs are equal but treated it’s all crypto. Swimming pools ppl don’t seek treatment for diarrhea they keep swimming. Crypto so danj bc low infectious dose & high titer in diarrhea= one incident can affect everyone. Diarrhea disperses w/o notice. Action- immun, toddlers, and I’ll avoid swimming (6 pleas). Operators educate. Comes from dog poop too. Can either shock chlorinate the pool or some pools are using 1 micron filters
Emerging infections program EIP- FoodNet
Owned by CDC- main part is foodnet, hears back from CDC, USDA, FDA, and has 10 sites in different states. Surveils 15% area, tracks:
1) new & emerging
2) frequency & severity
3) trends
4) specific foods
Might be 6-23 days from eating food to case confirmed. It’s active not passive meaning it reaches out to labs. Tracks all big bacteria but NOT NORO. eFORS= electronic food outb syst. If one state outbreak they may consult but let them handle it, once it’s multi state it becomes outbreak net
OutbreakNet
“The national network of public health officials coordinated by CDC that investigates enteric disease outbreaks” and coordinates among states, leads studies (ID & how) then take info to FDA/USDA and start recalling stuff. Tell public, tell docs how to treat, prevent. Can’t point fingers too soon bc it’s millions of dollars
PulseNet
“The national subtyping network for foodborne disease surveillance coordinated by CDC” outbreak detection with sero & subtyping
Pulsed-field gel electrophoresis
The fingerprint, you have to already have it to know it. It’s all approximate, this is what was historically used, but hard to actually get & harvest sample from pt
Whole genome sequencing
Uses computer algorithms & looks at whole thing so better
Peter Pan peanut butter 2006
47 states, strain Tennessee. PulseNet was like woah lots more salmonella then outbreaknet was like ok where is it coming from and it took weeks to figure out it was PB. 4000 products, 360 companies. Pigeons in plant, untrained workers, tried to resell recalled containers
Spinach 2006
O157:H7 it’s constant from California Salinas valley
Wisconsin first thought livestock at state fair but then questionnaires found it was spinach. About 10 days to confirm spinach & recall bags, 15 to find “smoking bag” sad bc a 2yo boy died. 50% hospitalized, 17% got HUS (more than usual because this type of shiga tox very virulent) came from wild pigs shitting on the lettuce. they told the industry to change and it hasn’t really changed. should be using clean water, keeping away animals, giving bathrooms to workers, decontaminating before mixing, keeping it all cold
Seed sprouts
Over 30 outbreaks of salmo & ecoli since 1995. Even 2018 is was jimmy johns. eaten raw, high moisture, penetrate inside, hard to treat in a way that doesn’t kill a sprout but could do chlorine & heat
Turkey X disease
Started with turkey X in 1961- they stop eating & growing, get lifeless, die. Interviewed ppl who made the food and learned that it was moldy. So there are spores in the soil and then mold grows on food after harvest. Aflatoxin is fluorescent, heat stable, lethal at high dose and liver Ca at low dose. Stunts growth bad in central america that’s why theyre short. peanuts, wheat, rice, corn, oats. There is a small level allowed in food because it would be too $$$ if we took it all out but Valencia brand has 0 aflatoxin.
Food testing & regulation acts
1906 Food & Drug Act
1938 Food Drug & Cosmetic act
1960 Amendment-
Dietary Supplement & Health Act of 1994 (DSHEA)
Nitrates & nitrites
Eclipse cafeteria had sodium nitrate instead of salt and 11 blue men came to the hospital. 5 other housemates did same thing with mislabeled bucket. Nitrate is a good botulism blocker. Ascorbic acid (vitamin C) blocks carcinogenic ability of nitrates. Spam has a ton of them, turns meat red.
GU poison squad
Harvey Washington Wiley fed med students common additives to see if they hurt. Candy colorings had lead in them.