Waterborne diseases

I am still irritated by the one sided New York Times article on people who think “raw water” is better than treated water. I wrote previously about the various microorganisms and chemicals that can be found naturally in groundwater, but I wanted to expand a bit on water borne diseases and why we treat water. Not all water borne diseases are a result of microorganisms.

High nitrates in water can lead to blue-baby syndrome, more properly known as infant methemoglobinemia. Nitrates is associated with human-related water contamination, especially agriculture.

Arsenic occurs naturally in many groundwater sources. The United States Geological Survey (USGS) has mapped arsenic in groundwater based on a great deal of sampling. Arsenic in groundwater is particularly problematic in southeast Asia. Arsenic can cause cancer, cardiovascular disease, and skin lesions, among other issues.

Other naturally occurring metals and radioactive elements can be found in groundwater that can cause long term health problems. Groundwater and surface can also become contaminated from human activities with volatile organic compounds, pesticides, and other chemicals that you don’t generally want to ingest.

Then there are all the illnesses caused by microorganisms in water. According to the Centers for Disease Control and Prevention (CDC), the most common waterborne disease outbreak for 2013-2014 was Legionella, which I admit surprised me. Legionella causes respiratory illness due to inhalation of it, which is why it is normally associated with people inhaling the mist of cooling towers and air conditioning systems. [This is how it was first discovered and named when members of the American Legion got sick at a convention in Philadelphia hotel with unsterilized water in a cooling system.]

Most waterborne microorganism caused illness cause gastrointestinal illness though. Most people have heard of Giardia lamblia, which can cause diarrhea. There is Shigella which causes diarrhea, fever, and stomach cramps. E. coli is another common microorganism that can cause gastrointestinal illness found in both food and water. Cryptosporidium is a nasty microorganism that can cause illness. The reason I call it nasty though is because the parasite is protected by a shell that makes it particularly difficult to kill with disinfectants.

While luckily not a problem in the U.S., cholera, another waterborne disease, has killed many people throughout history. Yemen is currently in the midst of a horrible outbreak that has killed thousands and infected a million people. The cholera outbreak in London in 1854 is considered by most to be when the field of epidemiology started when John Snow, a physician, removed the Broad Street pump handle to show that that pump was the cause of most of the cases.

Point of all this is, be thankful for modern water treatment. There are very few waterborne illnesses in the U.S. It is rather rare for a person to get sick from water that comes from a public water supply, and when they do, most often because something has gone wrong at the water treatment plant. There are other issues of course, such as old water systems with lead in the pipes or solder. The source water can also become contaminated with something that the water treatment plant was not designed to treat. On the whole though, you are much more likely to become ill from untreated water then from treated water.

Raw Water

The New York Times ran an article about people who like to drink “raw water.” Evidently there are people who do not like tap water and like to drink unfiltered, untreated, unsterilized water. According to the article, some people like the taste. Fair enough. Most of the time when people object to the taste of tap water, what they are objecting to is the taste of chlorine or chloramines that are added to kill bacteria that can make you sick. Using a filter at the tap or simply putting the water in a container and letting it sit in the refrigerator overnight will solve the taste issue. One of the parts of this almost completely one-sided article that I find the most telling and amusing is this paragraph.

“He said “real water” should expire after a few months. His does. “It stays most fresh within one lunar cycle of delivery,” he said. “If it sits around too long, it’ll turn green. People don’t even realize that because all their water’s dead, so they never see it turn green.””

Water does not turn green unless there is something growing in it. The person quoted understands that there are microorganisms (algae most likely because it turns green) growing in the water but thinks that is good thing. There is a reason why water purveyors are required to disinfect water. Bacteria and other microorganisms can cause illness. Not all microorganisms call illness, and some can have beneficial effects (i.e. probiotics). Groundwater does normally have less microorganisms than surface water, but it is not sterile. Further, hot springs does not mean sterile. Scientists have been studying the microorganisms in hot springs like the geysers at Yellowstone National Park for years. Those microorganisms are often called extremophiles because they are so different from the “normal” microorganisms we normally find in less extreme settings.

Some people are concerned about the fluoride that is added to water to help dental health, and a person quoted in this articles believes it is a mind-control drug. Fluoride does help dental health, and it is not a mind-control drug. I really don’t even know where to go with the claim that fluoride is a mind-control drug, so I have decided not to address it right now. Also fluoride can be naturally occurring in groundwater.

However, here, I would like to address the issues with not treating or filtering water and all the other contaminants that can be in water, including but not limited to the microorganisms. The Environmental Protection Agency (EPA) sets limits on microorganisms, disinfectants, disinfectant byproducts, inorganic, organics, and radionuclides. Bottled water is regulated by the Food and Drug Administration (FDA), not the EPA, and the regulations and testing requirements are different. Tap water is tested more frequently and has more monitoring requirements.

Just because water comes from the ground does not mean that it is pure or clean. Bacteria naturally grows in groundwater. Groundwater normally has ions including metals in it, and not all of those metals are good for people. The only way to know if it is free of contaminants is to test it. The United States Geological Survey (USGS) studies and samples groundwater and surface water across the United States. I randomly pulled several reports by searching on water quality and groundwater at USGS’s website. This report of sampling from 2014 found heavy metals in almost all groundwater samples, as well as pesticides and volatile organic compounds (VOCs). “Groundwater Quality in the Yuba River and Bear River Watersheds, Sierra Nevada, California” indicates that while the groundwater is mostly clean, a few samples had high concentrations of four elements (arsenic, barium, molybdenum, and strontium), a few samples had high radioactivity, and coliforms were detected in over 20% of wells. This report on groundwater quality in Lycoming County, Pennsylvania shows 52% of the samples exceed the EPA standard for total coliform, 12% of the wells exceeded the Maximum Contaminant Level (MCL) for arsenic, 67% exceeded the MCL for Radon-222, and a few exceeded the reporting limit for various VOCs.”Groundwater Quality in the Northern Atlantic Coastal Plain Aquifer System, Eastern United States” found fluoride, arsenic, and manganese in high concentrations in some of the samples. [Note this is naturally occurring fluoride.] Radioactive constituents were present at high levels in about 1% of the samples and at moderate levels in about 12%.

This is the reason why water treatment plants are not one size fits all. All water treatment plants have to disinfect the water. They can’t test for all microorganisms, but they test for indicator microorganisms like total coliform to determine how much disinfect is needed. They also have to test for VOCs, radionuclides, and numerous other indicators. They also test for smell and taste. Common processes at water treatment plants include flocculation and filtration to remove dissolved and suspended particles (this includes microorganisms). The source water will dictate what processes are used and the amount of treatment. The point of the treatment is to clean the water, make sure it meets the requirements set by the EPA and whatever respective state the plant is in, and prevent the people from drinking it from getting sick because of the water. The people of the United States can thank water treatment for better health. Drinking “raw water” means returning to the taking chances on acquiring an illness that people of the past were happy to do away with when water treatment plants became standard and laws like the Safe Drinking Water Act were passed. Edited to add: The EPA sets National Primary Drinking Water Regulations (NPDWR), which are legally enforceable primary standards and treatment techniques that apply to public water systems, and clicking on this embedded link will take to you a list of them along with the health problems that can occur if the water contains one of those chemicals or microorganisms above that limit.

Author’s Note: When I originally wrote this, I referred to microorganisms that live in extreme settings as xenophiles. I meant to say extremophiles. I have corrected it, and I apologize for any confusion. This is what happens when I edit my own writing. I think I had xenobiotics in my head. Xenobiotic is term generally used to describe chemicals that are foreign to body or ecosystem. In my field, I often use that term when speaking of a contaminant in the environment that needs to be cleaned up. You might find xenobiotics in raw water.

It’s Not Rocket Science

I subscribe to my county’s weekly police report just in case there might be crime in my area I want to know about. I don’t live in a high crime area, so normally the police report is a bunch of car break-ins and drunks in the bar area of town. Today though I found this interesting report.

MISSILE INTO AN OCCUPIED DWELLING, [location of incident]. On January 18 at approximately 6:51 p.m., a resident reported a known suspect threw a brick and rock into her residence, shattering two windows. [Suspect name] was arrested and charged with missile into an occupied dwelling, destruction of property, drunk in public and violation of protection order.”

What I found interesting is that legally speaking, a brick and/or a rock is considered a missile. To me this is another reason why rocket science should not be the go to science and engineering field for things that are hard. I hate the phrase “it’s not rocket science” with a passion. Rocket science is not that hard. It involves controlled combustion and trajectory. Missiles, a term which is generally used to mean a rocket that will cause destruction, is quite frankly easy. Science fields that are hard involve things that can’t be controlled near as easy as rockets, like biological systems, like fields trying to predict what stupid humans will do, like basic science where we are still trying to understand all the forces involved. You try doing an environmental and human health risk assessment on a hazardous waste site where toxicologists are unsure what level of exposure to a contaminant is acceptable, where you can’t be completely sure what humans will really be doing and for how long at a site, where people want to know they will be not be subject to undue risk for the next 70 years, and where you can’t be absolutely, completely positive just how much of each contaminant is there, but the polluters don’t want to clean up more than necessary. Then come talk to me about how hard rocket science is.

In summary, as evidenced by this police report, missiles are easy. Rockets are easy. Stop comparing things you think are hard to rocket science.

WMATA L’Enfant Plaza Fire

Today there was a fire in a WMATA subway tunnel near L’Enfant. The National Transportation Safety Board (NTSB) is now investigating, and I have confidence that they will do a thorough investigation. I have some questions about actions taken right after the smoke was reported that no one, or at least no one in the media I have seen, has asked. The station filled with smoke, and they evacuated it. WMATA stopped running green and yellow trains through L’Enfant. However they kept running blue, orange, and silver trains through, but these trains did not stop at the station, as they normally would. For those not familiar with L’Enfant Plaza Metro Station, orange, blue, and silver lines share the same track on the lower level, and yellow and green share the same track on the upper level. My question is, were they sure it was safe to keep sending the orange, blue, and silver trains through? I am not asking from the standpoint of the fire, because presumably, they traced the location of the smoke enough to know it was not in the lower tunnel. By safe, I mean because of the potential inhalation of smoke in the lower level tunnels. If the station filled with enough smoke that it needed to be evacuated, then how were they sure that smoke would not enter the trains running through it?

A couple of quick points:

  • Just because air smells bad doesn’t necessarily mean it is toxic or hazardous, but conversely, just because air smells fine doesn’t mean it is safe.
  • Particulate matter in air and/or smoke is in general not something you really want to breath, but there are different levels of toxicity associated with it. That is, some particulate matter is not more than just an irritant. However, the effect particulate matter has on a person is also affected by that person’s health. People with respiratory issues are more susceptible to any effects.
  • Exposure to hazardous or toxic materials can cause effects on different time scales. People who were trapped on the WMATA train in the tunnel, would have acute (short-term) effects from breathing the smoke, such as coughing and having trouble breathing. However, they were probably also exposed to chemicals whose effect is not immediate, such as carcinogens.

The questions I have, that I have not heard anyone ask include:

  • What is the air exchange rate between the subway trains and the surrounding air? Can the ventilation be turned off manually, so that there was no air exchange between the train and the surrounding air while the trains were near L’Enfant?
  • Were there any measurements taken of the air in L’Enfant, particularly on the lower level where the orange, blue, and silver trains were still running through? If so, what were the measurements of? Just measuring particulate matter will not indicate almost nothing about organic compounds or other chemicals in the air.
  • How far did the smoke spread?
  • Assuming air measurements were taken, did anyone calculate the amount of contaminants that people in the trains would be exposed to while running through the station based on time and air exchange rate?

My educated guess is that no air measurements were taken. There are probably some sensors in place to measure smoke, but depending on how that measurement is taken, it will tell you information about the particulate matter and that is it. I seriously doubt there was initially any sensors that measured organic compounds or any other type of compounds in the air. I have my doubts that any portable system was put in place during the response. The priority would have been evacuating people (as it should have been). It is possible that WMATA had some qualitative data that there was not much smoke on the lower level. That is, someone may have looked at a video screen and decided the air didn’t look bad. However, unless they had actual quantitative data of what was in the air, then visual assessment of air is a really bad way to make assessments on the quality of the air.

The early statements by WMATA and all other sources, like the fire departments involved, was that they did not know the source of the fire, location or cause. Thus they could not have possibly known what was burning and what would be in the air. For example, if wood is burning, you can expect certain chemicals in the air. If rubber is burning, you can expect different chemicals in the air. WMATA probably decided that the air on the lower level didn’t look that bad, and the trains would go through the station quickly enough that very little exposure would occur. They very well may be right, but with no data and no statements about any calculations, they have no way to prove that. Also, did they inform their passengers of this? If I was on a train, and I knew that the train was going to go through, but not stop, at a station that was filling with smoke, I would get off the train. I don’t feel the need to expose myself unnecessarily to hazardous substances, even if in small amounts. I do not like standing near people who are smoking. The second hand smoke may only minimally increase my risk of disease, but I still don’t see the need for that tiny increase. Thus, was WMATA considering passengers’ exposures at all? Furthermore, did they communicate the possibility of exposure to their passengers on the orange/blue/silver lines to allow their passengers to make their own educated decision about staying on the train? My guess is the answer to both those questions is no, and that is another thing to which WMATA should be made to respond.

Run the Chesapeake Bay Bridge 10K

View of the Chesapeake Bay Bridge near the start of the race

View of the Chesapeake Bay Bridge near the start of the race

On November 9, 2014, I ran the inaugural Across the Bay 10k Chesapeake Bay Bridge Run. The point to point course includes 4.35 miles across the bridge, which reaches 186 feet at its peak. The run across the bridge provided amazing views of Chesapeake Bay. As an engineer, I really loved being able to examine the bridge up close at a slower pace than when driving across it. I wore a GoPro Hero 3+ on my head during the race to make a video of the run. I have edited the video to only include the start, bridge portion of the run, and the finish, and I have also sped up the video. My official run time was 1:16:24, and nobody wants to watch a video that long of me running across the bridge. I removed the sound due to a weird noise that was created when I sped up the video. Also, I took a few photos with my iPhone and made a few photos from freeze frames from the GoPro video.

View of the bay from the bridge

View of the bay from the bridge

View of both bridges

View of both bridges

In the truss section of the Chesapeake Bay Bridge

In the truss section of the Chesapeake Bay Bridge

They also gave us a pretty cool medal for completing the race.

Completion medal

Completion medal

HAZWOPER Training

Last week I attended 40 hour HAZWOPER training. HAZWOPER, an acronym for Hazardous Waste Operations and Emergency Response Standard, is OSHA mandated training for employees who may potentially be exposed to hazardous substances and who are engaged in cleanup operations or other certain other activities involving hazardous waste. Normally I work in an office, and the closest I come to hazardous materials or waste is sitting at a computer and analyzing data from hazardous waste sites. However, there is a possibility that I may sometimes be asked to go to a site where HAZWOPER training would be necessary, and I had an opportunity to take the training, so I did.

HAZWOPER training includes topics such as basic chemistry, toxicology, biology, radiation, environmental science, analytical sampling, and law and regulations. Truthfully, I could have taught a good portion of the training. It also includes hands on training with some of the sampling methods and instruments that are used in the field. Personally, I think playing with instruments and sampling materials is fun. As part of the training, you are required to get dressed in various personal protective equipment (PPE) that would be required under various circumstances at sites. In general, you look rather ridiculous in the PPE, but of course PPE is not supposed to be fashionable or make you look good, it is supposed to protect you from hazardous materials that could kill you or cause injury or illness. What PPE does not do, is keep you cool. It was in the 90’s °F when we were dressing in the PPE. While the suits protect you from most hazards, ironically they can cause potential health hazards if you over heat. There are different levels of PPE that are used depending on what the potential hazards are. The most protective is Level A, which is a fully encapsulating chemical-protective suit with positive pressure, full face-piece self-contained breathing apparatus (SCBA), inner and out gloves, and boots.

Me in Level A PPE

Me in Level A PPE

The next level, Level B PPE, is slightly less protective and includes chemical-resistant coveralls instead of the fully encapsulating suit, as well as SCBA, inner and outer gloves, and boots.

Me in Level B PPE

Me in Level B PPE

The next level, Level C PPE, is less protective still. It includes an air purifying respirator instead of SCBA, but other than that is fairly similar to Level B.

Me in Level C PPE

Me in Level C PPE

There is one final level, which is Level D PPE, which is minimal protection from physical hazards but does not include respiratory protection. This may sound strange, but if it is hot, Level A is actually easier to wear than B or C. The fully encapsulating suit is roomier, and the compressed air is continually blowing through your mask and then through the suit itself before it exits an exhaust vent. This air flow helps to cool you. In the chemical resistant suit for Level B and C, I just felt like a turkey that had been baked in a cooking bag. Side note, the SCBA tanks we used were made of a composite material and weighed  about a third of the weight of the metal SCUBA tanks I have worn before. Also, for as cumbersome as it was to get dressed out in all the PPE, I think it was easier to dress in and walk around in the PPE compared to the SCUBA drysuit I was wearing a month beforehand while SCUBA diving Silfra. Obviously once underwater, the tank weight is negligible, and the drysuit becomes less cumbersome, but above water, they are really difficult to get into and move.

For HAZWOPER training, you don’t just have to get dressed in the different levels, you need to get used to actually moving and doing various tasks in them. Hence, when we first wore them, our tasks were to play with balls, as one would normally do at a hazardous waste site.

Playing ball in Level A PPE

Playing ball in Level A PPE

Playing ball in Level C PPE

Playing ball in Level C PPE

Note in the above photo, the person in the center is wearing proper head protection in the form of a straw cowboy hat. No, he actually just being fashionable. Wearing hazardous material PPE is no reason to not be fashionable.

We also did a few exercises to practice tasks at a hazardous materials site, including decontamination. There are set steps and tasks to make sure decontamination is done properly. The first pair of people wash the worker, the second pair wash the worker again, the third set inspect the cleaning, and the fourth set help the worker out of the PPE. Notice the use of walkers for the worker to hold onto while the decontamination team washes the boots. There is no dignity in any of this.

Decontamination practice

Decontamination practice

We also practiced emergency decontamination of an incapacitated worker. We actually did not finish this task. This was due to the fact that after they started decontaminating him, someone loudly said, maybe we will have to do mouth to mouth. At that point, the incapacitated worker suddenly regained conscienness and took off running.

Emergency decontamination of an incapacitated worker

Emergency decontamination of an incapacitated worker

Since this was practice and not a real situation, we did a few things you can’t do on a real site. For example, the decontamination team stayed inside when not needed outside and did various things to stay cool. One thing that we did was lay on the concrete floor because the concrete was cooler than the air, and it absorbed some of your body heat. Sure, we looked like casualties at a hazardous waste site, but it worked and helped keep us cooler.

Cooling off by laying on the concrete floor

Cooling off by laying on the concrete floor

We also took “hits” of the compressed air from the SCBA. The full face masks we wore were interchangeable for either air purifying filters or for the hose from SCBA. In between tasks, we didn’t wear either. However, we would attach the SCBA for short periods of time because the compressed air blowing into your mask helps to cool you.

Cooling off by attaching the SCBA to the mask

Cooling off by attaching the SCBA to the mask

Another thing that should never be done at a real site was drinking water through the mask via a straw. Actually it might be acceptable to do this, assuming someone with clean hands put the straw in the bottle and then into your mask. It is not acceptable if you are doing this with your gloves.

Drinking water through the mask

Drinking water through the mask

For as hot as I was while in some of the PPE, I still had fun. I was out of the office, and that in itself was fun. Also, I learned a bit, and that is always fun.

For My Safety

Like probably many health insurers, my health insurance company encourages me to use a mail order pharmacy for my maintenance drugs. As encouragement to use it, with the mail order pharmacy, I can order a 90 day supply, but only pay a co-pay for 60 days. Most of my maintenance drugs are actually generic, and I get generic drugs for free, so the only real advantage to me using the mail order pharmacy is laziness. I admit it is kind of nice just to log onto the website, hit refill, and have the drugs sent to me. At the beginning of the year, my insurance company switched to a different mail order pharmacy, so for most of my prescriptions, I have had to submit requests to my doctors for new prescriptions. Annoying, but no big deal, until I started getting them filled. I have rosacea, and I take one oral medication for it as well as using two face creams and one face wash, all prescriptions for it. I had my dermatologist call in a new prescription for the oral medication, and when it came from the mail order pharmacy, they only sent 34 pills with a note saying they had reduced the amount for my safety. The pill (Oracea) is designed and approved by the FDA as a maintenance drug for rosacea. It is supposed to be taken everyday. It is a low dose antibiotic taken for its anti-inflammatory properties. I don’t know of any way to get high off of it, not that I have tried. After a long conversation with the pharmacy trying to ascertain why they deemed this not safe enough to send me more than 34 pills, even though I have been taking this pill for well over a year, or for that matter why they sent me the strange amount of 34 pills, as opposed to 30, the pharmacy stated it was my insurer who decided this was not a maintenance drug. A call to my insurer resulted in me being told I would essentially need to petition them to recognize what the FDA calls a maintenance drug, as a maintenance drug. They also said I could go to my retail pharmacy and get the same deal they offer through the mail order pharmacy of a 90 day supply for the cost of 60. Why they offer this deal through the retail and thus what is the point of trying to get me to use the mail order pharmacy is not something I could understand, and if I continued to try to talk to them, I was going to need a drink. I gave up.

Now, however, my health insurer’s and the mail order pharmacy’s concern for my safety has gone to comical levels. As I said above, I also use a prescription face wash for my rosacea. It is a cleanser with sodium sulfacetamide and sulfur in it. It is an old formula and has been used by rosacea sufferers and people with other skin issues for decades. I have used it for at least two years, and I think it helps a bit. Because it is such an old formula, there are of course generics, to which my insurer automatically switches my prescription. I don’t care, and I get the face wash for free because it is generic. I had my dermatologist send in a new prescription to the mail order pharmacy, and it arrived today. Just in case you can’t guess, enclosed with the 12 oz bottle of face wash, was a note that reads as follows.

“Enclosed is a reduced quantity of your prescription drug. Your prescription drug coverage has quantity limits for certain drugs. This is a type of drug coverage review that limits how many doses you can receive. The goal is to make sure you get a safe amount of your drug.”

That’s right, they sent me a reduced quantity of my sulfur face wash for my safety. Thank goodness because otherwise I might wash my face too many times. It’s true. Washing your face with sulfur can get quite addictive. I love the smell of sulfur. (It actually does have a slight smell of sulfur but nothing repulsive.) I get in the shower and just keep washing my face knowing that the wash is free. Of course, it bears pointing out that they sent me a 12 oz bottle. The earliest I can refill it according to the label is in three weeks. This 12 oz bottle will probably last me three months or more. I don’t really count. I just reorder when I need it. I really don’t know what my pharmacy and insurer thinks I do with this stuff. Maybe they think I have a really dirty face. I have no idea. I can’t fantom how someone misuses sulfur face wash. I don’t think I want to know. Maybe they are afraid I am going to drink the stuff. All I know is that if my health insurer and mail order pharmacy think they have to protect me from too large an order of sulfur face wash then there probably is no hope for humanity. As an engineer, I have stated on many occasions, I have to design for the stupid. Not even I thought people were this stupid. I guess I overestimate people.

Book Review: “The Immortal Life of Henrietta Lacks”

I finished reading The Immortal Life of Henrietta Lacks by Rebecca Skloot today. In 1951 when Henrietta Lacks was 30, she developed extremely aggressive cervical cancer. When she went in for surgery for cancer treatment, the doctor took a sample of the tumor. The cells from the tumor were cultured in a lab that had been trying unsuccessfully to find a way to keep human cells alive in culture. Ms. Lacks’s tumor cells, named HeLa by the lab, were the first cells they were able to keep alive in culture. Because they were able to keep them alive and growing, the cells would later become a vital tool for medical science. The scientist who first kept HeLa alive in culture gave the cells away for free to numerous other scientists who used them for various research. The cells helped in part to develop drugs for herpes, leukemia, influenza, hemophilia, and Parkinson’s. They helped develop the polio vaccine and in gene research, including most fittingly genes that cause and suppress cancer. Companies were created to use and produce the cells. Ms. Lacks’s family, however, did not know that the cells had been taken nor that they were being used for so much research. They did not know they existed until 20 years later and received no benefit from all this research. Sadly and ironically, they were so poor they couldn’t afford health insurance, and most were not educated enough to really understand how part of Ms. Lacks could still be alive or what it meant. To make matters worse, shortly after learning about the research on her cells, researchers asked family members to give a sample of their blood to them to aid them in their research. The researchers didn’t explain to the family what the samples would be used for, or at least they did not explain it in a way that the family members could understand.

Anyone who does research involving humans should read this book. Actually, everyone should read this book. It is incredibly interesting and well written. I loved learning some science from it, but it was also nice to learn about the people involved, both the Lacks family and the scientists involved with HaLa. The book gives recognition and a voice to Ms. Lacks and her family who for far too long had none. It is simply horrible how they had been treated in the past, and it is an important lesson to researchers on how not to treat research subjects and their loved ones. The book discusses a little bit of the history of human medical research and the ethics and techniques involved. The introduction of informed consent in medical research is discussed to a great degree. The concept of when a person loses ownership of their own tissue or fluid once the tissue or fluid is no longer a part of their body is discussed.

I, personally, am conflicted about the issue of ownership of body tissue once it it removed from the body. For my dissertation I did research that involved humans. Our research plan was reviewed by an Institutional Review Board as all human research studies are now. Our subjects gave informed consent. They willingly participated, allowed themselves to be outfitted with an air sampling device and to have medical tape placed on and then removed from their skin, and gave urine and blood samples. They knew the risks of participating, which really was only a possible reaction to the medical tape (which none had) and the prick of a needle if they gave blood. We explained what we were doing and why and hopefully they all understood in general what we were doing, even if they did not fully understand the details of the research. We took various steps to protect their identity and information. We made no money off of the research, but my advisor applied for grants based on it, and several of us obtained Master’s and Doctorate’s based on it.

Years ago I had two dental implants put in my mouth. The dentist who implanted them was a professor at the local school of dentistry, and because of certain characteristics of my dental history, I made an interesting case for her to operate on and later teach about. I was awake the whole time, and the surgery took much longer than it needed to because every 15 minutes or, she stopped what she was doing to take photos of the current status of my mouth. I get amused thinking about her students sitting in class viewing photos of my mouth while she discusses my case. However, I am confident my identity is protected, and furthermore I gave informed consent. I was awake. I knew full well she was taking photos and planning to use me as a case study, and I am rather pleased that I might be able to help some dentist and their dental patient in the future.

However as someone, who like the vast majority of people, who has ever given a sample of my body fluids analyzed for medical reasons, the idea that I don’t know what happens to the sample after it leaves me and who can run tests on it, makes me concerned. I once had an infected sebaceous cyst removed by a surgeon. I know it went to pathology to confirm the diagnosis that it was just a sebaceous cyst, but after that I have no idea. From what I have read in the book, it could have then gone on to an academic or commercial research lab. As a scientist, I certainly want scientists to have access to samples that can further science, but it bothers me a great deal that someone could potentially make money off of something found in my cells or fluids. If something unique is found in my tissue that can lead to the cure or treatment for a disease, I can support that, but the idea that a commercial research facility could use it to make money seems wrong to me. At the very least, I would like to know what ultimately happens to any of my tissue or fluid samples. Are they simply destroyed after analysis or are they stored somewhere or transferred somewhere? Who can analyze them and for what? I think that is another reason to read the book, so more people will talk about this subject.

Universal Blood Donor

cardI previously wrote how I decided to donate blood for the first time and live tweeted the hilarity of my nervousness during the event. Several weeks after that, I got my blood donor card. I was curious to see it because I wanted to know what my blood type is. When I got the card, I found out that I am O-negative (O-). I am a universal blood donor. I assume I have now been put on that blood donor hit list when the blood bank gets low. My blood donor card came complete with a photo of an infant’s foot to take home the fact that O- blood is often used to help newborns as well as trauma victims before their blood can be typed.

Why am I a universal blood donor? There are eight major blood types. The type refers to antigens present on the red blood cells. I say eight major blood types because there are actually more blood types than that based on various antigens found on the red blood cells, but when you donate blood, they type you based on ABO antigens and the Rh factor. With ABO antigens, there is O, A, B, and AB with O meaning the absence of A or B. You can only accept blood from someone who has antigens that you have on your own red blood cells or to say it another way, someone who does not have antigens that you don’t have. With Rh factor, you have that antigen or you don’t, so if you have it, you are Rh+ or Rh-. If you are +, then you can accept from people who have it or those who don’t. If you are -, then you can only accept from that who don’t have it. You can’t receive blood from someone with an antigen on their red blood cells that you don’t have or your immune system will quickly react very badly to that foreign antigen being in your body. If you still find this confusing, it works out like this.

Blood Type US Population* Can donate to: Can receive from:
O- 9% Everyone (O-, O+, A-, A+, B-, B+, AB-, AB+) O-
O+ 39% O+, A+, B+, AB+ O-, O+
A- 6% A-, A+, AB-, AB+ O-, A-
A+ 31% A+, AB+ O-, O+, A-, A+
B- 2% B-, B+, AB-, AB+ O-, B-
B+ 9% B+, AB+ O-, O+, B-, B+
AB- 1% AB-, AB+ O-, A-, B-
AB+ 3% AB+ Everyone (O-, O+, A-, A+, B-, B+, AB-, AB+)

*The population data is based on information from AABB.

Thus, as someone who is O-, I am a universal blood donor, but I only can receive blood from other O- people. AB+ people are universal blood recipients and can receive blood from anyone. All of this shows the importance of blood typing people before they know they will need blood. It also shows why on tv and the movies, whenever someone is rushed into an emergency room and needs blood, the medical staff scream for O- blood (plus it makes for drama). Until they have time to type the patient’s blood, they can safely give the patient O-. Thus the information on my O- blood donor card that informs me it is particularly important for me to donate blood for those emergency room patients and of course the babies whose feet are on my card. It’s a nice little guilt trip to get me to keep donating.

The guilt trip worked. I gave blood again yesterday. It went a little better than last time because I wasn’t quite as nervous, but I admit I was still nervous. Unfortunately it didn’t go quite as well as it could. Last time, I used my left arm, but because I use the computer mouse with my left hand but write with my right hand, I decided to have them use my right arm this time. Evidently I have better veins in my left arm. The phlebotomist poked my right arm and couldn’t get the needle in well or something. He asked if he could take it out, which I readily agreed to because it was causing me pain. I switched chairs. He poked my left arm and found a good vein. I guess I need to find out how to build better veins in my arms. I survived. I felt fine afterwards, and I saved another life. That’s what really important.

38th Marine Corp Marathon

Yesterday, I watched the Marine Corp Marathon from a couple of different spots and cheered on the runners. Absolutely everyone of them has my respect. They inspired me to increase my Sunday long run from eight to nine miles. There is no way I can run a marathon, or at least not yet, but they inspired me to up my game. Below are a few of my photos that I took. Some runners are dressed in costume. Some military members are dressed in military gear including backpack. Some carried flags. One guy jump roped. One guy ran while juggling three footballs and dressed as Robert Griffith III because evidently running is just not a challenge (check out his photo below, as the best part is the look on the face of female runner next to him). At the end of this post is all the photos that I took on the extremely off chance that someone who reads this blog post knows someone in or was in the marathon and I by chance got their photo. If so, leave me a comment, and I will be happy to send you a copy.IMG_0224 IMG_0246 IMG_0256 IMG_0270 IMG_0276 IMG_0280 IMG_0285 IMG_0289 IMG_0299 IMG_0309 IMG_0314 IMG_0315 IMG_0322 IMG_0360 IMG_0364 IMG_0393 IMG_0407 IMG_0410 IMG_0412 IMG_0417 IMG_0418 IMG_0447 IMG_0450 IMG_0452