Little Things Matter

Blog #7
·  How does your community/area/country identify, manage, and pay for the cost of environmentally-related conditions?

o   Currently in Monterey CA

o   How can you, as a health care provider, help to alleviate those costs? 

§  This is a challenging question; I truly wouldn’t know where to start to reduce cost. As tax payers a portion of that money goes to managing our environmental conditions, but how it is divided would be my first step. There may be some wiggle room on moving funds from one allocation to another. I also believe that foundations are a modern way to allow extra funds to be raised and allocated to a specific cause without having to be split between multiple areas. At this time, I would as a provider, to alleviate these cost, would encourage patients and family to reach out to foundations for assistance; I could not only educate and provide information, but also could provide support during this process.

·      Were you already aware of the potential links between environmental health exposures and neurodevelopmental disorders?

o   I am; we learned about this and issue during my Pediatric rotation. What did surprise me was how little of an exposure it takes to cause such significant damage. In the video my Dr. Lamphears, I was shocked to learn about the drops in IQ by as a many as 6 points due to exposure. This is heartbreaking and something I feel no one really knows about; including myself.

o   How will this change your practice? 

§  At this time, I currently encourage my patients to eat healthy, make better decisions when discharging home and to avoid hazard transmission in regards to Oncology. To change my practice for environmental hazard is more challenging; I wouldn’t know where to begin to change mattresses and chemicals in the home to avoid. By educating myself, I will be a better provider, but still feel that I will struggle with changing my patients way of life.

·      If you are engaged in maternal and child health services, does your practice already incorporate the recommendations from the international group of obstetricians?

o   I am not currently engaged with Maternal and Child Health Services.

·      The relationship between environmental health exposures and reproductive effects can be extremely complex. How can you incorporate what you've learned from the UCSF video into your practice?

o   I had the same question that Dr. Woodruff proposed. Why in the world are we still using chemicals/toxins that have been proven to cause harm and such damage to people and our environment? I guess I would question that for all chemicals that have been known to cause such damage. I think to encourage mothers-to-be, that this period of pregnancy is a vulnerable time not only for mom, but for baby and choices (within their control) are vital to their health.  Something I would incorporate is the increase of ADHD and Autism- as the battle rages against vaccines; to educate parents that environmental hazards have been linked to increases of these conditions. It seems to be a very fine line between educating and terrifying future parents.

·      Considering Dr. Lamphear's short video, how will you educate pregnant women on newborn care?

o   I found this video to be so enlightening. To learn about IQ drops as levels of Lead and Mercury increase in a child system. A 5-6 point drop in IQ equates to 9.4-11 million children that fall into the “challenged” category depending on the level and number of exposures.

o   As Dr. Lamphear’s recommends, I would education my moms’ to eat more fresh or frozen fruits and vegetables, organic if available. Stay away from processed and as many canned food as possible. If fish is consumed, limit eating fish that is low in Mercury. And finally to limit pesticides in the home and to clean floors and surfaces regularly to clear lead, dust and flame retardants. Education is not a one time passing, but continuing throughout the pregnancy and being there to support mothers and families as they will have questions as the pregnancy progresses.

In The News:
      In keeping with our theme of poising and the cost associated, I found an interesting article that hopes to approve new rules aimed at identifying and triggering earlier interventions for children susceptible to lead poisoning. Illinois lawmakers have approved new rules aimed at identifying children at risk.  The state received $10 million dollars to fund nurses and inspectors to enter at risk homes and perform in-home-tests in children that tested positive for lead. Early reports are very promising, but state officials estimate that it will take another $5million each fiscal year to maintain.  
      Compared with other states, Illinois reports higher lead poisoning in children when compared to other states. The southern part of the state are particularly vulnerable as most of the homes were built before 1978.  
     As a part of the staff a nurse case manager provides education to parents on how to reduce potential exposure to lead such as: concealing chipping paint, or replacing it, and cleaning dust that could contain lead-pain flakes. Investigators are also deployed to detect potential lead sources such as paint or water.