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Case Study #1

www.environmentalhealthproject.org. Case Study #1. Rash After Showering. 724.260.5504. Onset. Family of 5 who have been living on a farm since 1980’s Parents and three children ages 11, 14, 18

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Case Study #1

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  1. www.environmentalhealthproject.org Case Study #1 Rash After Showering

  2. 724.260.5504 Onset • Family of 5 who have been living on a farm since 1980’s • Parents and three children ages 11, 14, 18 • Mother reports that sometimes when some of the family members takes showers, they notice their skin gets red and itchy

  3. 724.260.5504 History • Use well water since moved into this home • Two wells drilled in the last 8 months • One fracked and producing • One drilled only • Noticed oily residue after the second gas well was drilled

  4. 724.260.5504 History (continued) • Also developed GI symptoms and stopped drinking water • continue to shower and wash dishes in well water • Middle child has mild anemia on CBC and mild thrombocytosis • Mother has Lyme disease What other pieces of information do you want to know?

  5. 724.260.5504 Exam • All five family members have normal abdominal exams • Middle child has white comedons on chest and back • What are the health effects of water contaminants?

  6. 724.260.5504 Health Effects of Exposure to Water Contaminants • Type of contaminant • Bacterial contamination- Gastrointestinal • Inorganic • Organic • Radioactive • proprietary • Acute vs Chronic • Dizziness vs kidney damage • Organ system • Neurological, respiratory, dermal

  7. 724.260.5504 Water Test Results for the Family • What are key components of a water test? • What does this water result tell us?

  8. 724.260.5504 About Water Tests • EPA’s website defines MCL and secondary MCL • If have basic changes such as TDS, further testing is recommended

  9. 724.260.5504 Water Testing • Professional testing and citizen monitoring (Total dissolved solids) • Location of samples taken (water well, creek, spigot) • Sample contamination from metal containers used to collect the samples

  10. 724.260.5504 Potential contaminants of Well Water • Volatile Organic Chemicals-Benzene, Ethyl Benzene, Toluene, Xylene • Semi-volatile Organic Chemicals-Phenol and Pyridine • Heavy Metals-Arsenic, Barium, Cadmium, Chromium, Lead, Mercury and Vanadium • Sulfur containing compounds • NORM-Radioactive Radium 226, Radium 228 and Uranium 238 • Salt Water Minerals • Additives

  11. 724.260.5504 Endocrine disruptors • Don’t follow typical dose response • Vulnerable populations women and children • Reproductive organ systems • 47% of contaminants in flow back considered EDC’s

  12. 724.260.5504 Determining Biomonitoring from Environmental Monitoring

  13. 724.260.5504 Recommendations for Patients • Pre-drilling testing • Routinely monitor TDS, PH, coliform bacteria and nitrates, conductivity • Avoid cooking and drinking until there is a better understanding • Methane alarm • Shorter showers • Ventilation

  14. 724.260.5504 Recommendations for Health Care Professionals • Urine testing for salts and heavy metals are generally more appropriate • Use the correct test • At the right time • within hours of ingestion if possible for blood tests • within days for urine testing • hair analysis does not have validated reference ranges and is controversial • In the right tube- whole blood vs serum, preservative free urine vials, … • With the right recommendations

  15. 724.260.5504 Answer Key • See Handout

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