Air Pollution and Trace Metals: Health Effects and Environmental Impact

petroleum

is a complex mixture of both inorganic and organic compounds that may exist as a solid (coal), liquid (crude oil) or gas (natural gas)

petroleum hydrocarbons

Mixtures of Hydrogen and Carbon that are the dominant component of
crude oil, accounting for 50-98% of the crude oil, averaging 75% by weight. The remaining 25% is comprised of oxygen, sulfur, nitrogen and trace metals

Aliphatic Hydrocarbons (Alkanes; Branched Chain Alkanes or Paraffins)

open straight-chain molecules that are not that persistent but are acutely toxic (e.g. CH3---CH3 = Ethane)

Alicyclic Hydrocarbons (Cycloalkanes or CycloParrafins)

molecules are arranged with carbons that are arranged in a ring structure with < 6 carbons, that are more intermediate in persistent and moderately toxic [e.g. Cyclobutane (C4H8)]

Aromatic Hydrocarbons

molecules are arranged with carbons in a 6 carbon ring and are very
persistent, acutely and chronically toxic and have higher KOWs than Aliphatic or Alicyclic Compounds [Benzene (C6H6)]

Polycyclic Aromatic Hydrocarbons (PAHs)

multiple (2 or more) 6 carbon rings are termed PAHs which are chronically toxic causing cancer , highly persistent and have very high KOWs (e.g. Benzo(A)pyrene

Mousse

a mixture of petroleum than is 8 parts water and 1 part oil created by interaction with waves/wind, that may coat marine organisms and increase clean-up costs because of the increased volume of oil product.

3 billion Metric Tons per Year

Total Annual Global crude oil production in the world, with approximately half of this total transported by sea.

2-5 million Metric Tons per Year

The quantity of oil pollution entering marine waters each year from
all sources (excluding biosynthesis) is estimated to be about 0.06-0.16% of petroleum used in commerce enters as pollution/year (2-5 million mt/yr/3000 million mt/yr = 0.06-0.16%).

Drunken Jacks Marina and the Causeway to Garden City Beach

locations in Murrells Inlet, SC that have the highest levels of PAHs from marinas and roadways, respectively

Exxon Valdez Oil Spill

Major tanker accident in Alaska in 1989 that resulted in a major oil spill in Prince William Sound.

Ixtoc Oil Spill

oil drilling platform in the Gulf of Mexico which exploded in 1979, resulting the spillage of 40,000-50,000 barrels/day for 10.5 months.

Deep Water Horizon Oil Spill

oil drilling platform in the Gulf of Mexico which exploded in 2010,
resulting the spillage of 5,000-20,000 barrels/day for 1.5 months

Lightly Oil Beaches

2.2 kg of /m2 on certain critical beach locations

Moderately Oiled Beaches

= 12.0 kg of oil/m2 on certain critical beach locations

Highly Oil Beaches

20.2 kg of /m2 on certain critical beach locations

$4 billion, including $1.256 billion in criminal fines

the amount BP will pay as a result of the Trans Ocean settlement for the Deepwater Horizon Oil Spill

Tarmats

weathered oil from the Ixtoc Spill

Petroleum Hydrocarbons

contain molecules ranging in molecular weight from 16 (methane - CH4) to >20,000, comprise more than 75% by weight of most crude and refined oils.

Toxicity of Petroleum Hydrocarbons to Marine Organisms

Hydrocarbon acute toxicity tends to increase along the series from the aliphatics, alicyclics, and aromatics. Thus, aromatics are more toxic
than > Alicyclic > Aliphatics. Increased hydrogen-carbon substitution on the carbon rings or chain increases acute toxicity. PAHs are more of a chronic toxicity hazard.

Human Health Toxicity of Petroleum Hydrocarbons

(1) Acute Toxicity – 1 and 2 ring aromatics pose an acute toxicity hazard both via inhalation and dermal exposure - e.g. Benzene in gasoline; (2) Chronic Toxicity – 1 and 2 ring aromatics and PAHs pose chronic toxicity hazard by causing cancer- e.g. Benzo(A)Pyrene in cigarette smoke and charcoal broiled meats

Refining petroleum affects its toxicity

Lower boiling point compounds such as gasoline (straight run
distillates) are more acutely toxic > Middle Distillates (Kerosene, Diesel Fuel, Jet Fuel, Home Heating Oil). Heavier MW and higher boiling point compounds such as the wide cut gases (lubricants, oil used in cars) and Residual Oils are more of a chronic hazard

Petroleum Interactions with Seawater and the Marine Environment

Oil is lighter than water and Thus, it floats on top of water; (2) Petroleum will physically coat/cover and smother aquatic organism and cause death due to hypoxia, not chemical toxicity per se; (3) Oiling of birds causes the feathers to loose their waterproofing and results in drowning; (4) When physically disturbed due to wave and wind action oil will from an emulsion called Mousse than is 8 parts water and 1 part oil, thus 1 gallon of oil will produce 9 gallons of mousse that will coat/smother organism and will require increased amounts of clean-up; and (5) Heavier oil will sink and become entrained in sediments.

Annually World-Wide Inputs of petroleum as pollution are put at 2-5 million metric tons/year from:

Land Based Sources -56 %, including River Runoff (40%), Sewerage Outfalls (12%), Urban Runoff (3%) & Refinery Discharges (1%); (2) Marine/Maritime Based Sources – 25% including Shipping/Transportation Accidents (20%) and Offshore Oil Production (5%); (3) Natural Sources - 15% from Natural Oil Seeps along Tectonic Plate Margins (15%); and (4) Atmospheric Fallout - 4%.

Petroleum Pollution

While the public generally perceives tanker spills as the principal source of oil in
the environment, such episodic events actually deliver a relatively small volume of oil to the sea 0.110
mt/yr. The major source of petroleum pollution in the environment is from NPS runoff of PAHs in the
environment, primarily from automobile combustion discharges. The National Academy of Sciences
(NRC, 2002) reported that polycyclic aromatic hydrocarbon (PAHs) and other petroleum products
running off of roadways, parking lots and driveways in the U.S. cumulatively account for more than
10.9 million gallons of petroleum pollution in an 8 month period, which is the equivalent to the
volume of oil spilled in the EXXON VALDEZ Oil Spill.
Grass Shrimp Effects form Urban PAH Exposure – (1) High levels of PAHs (> 4,000 ppb in sediments) are
only acutely toxic at hot spots of PAH pollution such as near marinas, roadways and industrial
discharges/superfund sites. (2)At other locations (sediment levels < 4,000 ppb) PAHs are not acutely
toxic to grass shrimp but may be chonically toxic by adversely affecting late season reproduction in
females due to the interactions of the PAHs and ultraviolet light , which cause photo-toxicity, which
enhances the toxicity of the PAHs. This results in a 90% reduction in annual grass shrimp production
when compared to North Inlet.
Environmental Sensitivity Index (ESI) – developed at USC in the 1978 time period and is used to protect
resources at risk during an oil spill including (1) Anadramous fish spawning areas such as salmon runs,
(2) Shellfish Beds; (3) Bird Rookeries; (4) Marine Mammal Haul Out Areas; ((5) Sea Turtle Nesting Sites
and (6 ) Important Locations/Habitat for Endangered Species The ESI is based on HABER’s Law and
prioritizes different habitat sensitivity based upon their ability to concentration of oil (Dose) and for oil
to persist (Duration of exposure) within a habitat. Every mile of shoreline in the US has been mapped
with the ESI. The ESI maps contain wildlife symbols which include (1) the General Animal Type; (2)
Seasonal Occurrence/Distribution; and (3) Species Identification. The EIS contains other important
information including power plant intakes, drinking water intakes, location of marinas and boat ramps
for staging clean-up equipment and boom/skimmer locations for cleaning up the spilled oil.
Ixtoc Well Blowout, June 3, 1979 –March 25, 1980 (> 3 million barrels; 2.5 MG of dispersant Corexit
9527) - -Burned at the well site – 1%; Mechanically Removed – 5%; Evaporation into the Atmosphere –
50%; Photochemical/Biological Degradation – 12%; Mexican Beach Landfall – 6%; US Beach Landfall –
1%; Sank to bottom of the Gulf of Mexico – 25% = -71,500 barrels (11,000 m3) of oil impacted 162 miles
(260 km) of U.S. beaches as the oil was contained there and not in estuaries (lagoons).
Deep Water Horizon April 20 – July 15, 2010 (4.7 million barrels; >2MG of dispersant) –Burned at the
well site – 5%; Mechanically Removed – 3%; Direct Recovery from the Wellhead – 17%; Evaporation into
the Atmosphere or Dissolved – 25%; Chemically Dispersed – 8%; Naturally Dispersed – 16%;
Photochemical/Biological Degradation – NC (Not Calculated); Residual (includes oil water mixtures,
tarballs , & oil buried or washed ashore) - 26%; Sank to bottom of the Gulf of Mexico – NC (Not

Petroleum Pollution

The major source of petroleum pollution in the environment is from NPS runoff of PAHs in the environment, primarily from automobile combustion discharges. The National Academy of Sciences
(NRC, 2002) reported that polycyclic aromatic hydrocarbon (PAHs) and other petroleum products running off of roadways, parking lots and driveways in the U.S. cumulatively account for more than
10.9 million gallons of petroleum pollution in an 8 month period, which is the equivalent to the volume of oil spilled in the EXXON VALDEZ oil spill.

Grass Shrimp Effects form Urban PAH Exposure

High levels of PAHs (> 4,000 ppb in sediments) are
only acutely toxic at hot spots of PAH pollution such as near marinas, roadways and industrial discharges/superfund sites. (2)At other locations (sediment levels < 4,000 ppb) PAHs are not acutely toxic to grass shrimp but may be chonically toxic by adversely affecting late season reproduction in females due to the interactions of the PAHs and ultraviolet light , which cause photo-toxicity, which enhances the toxicity of the PAHs. This results in a 90% reduction in annual grass shrimp production when compared to North Inlet

Environmental Sensitivity Index (ESI)

developed at USC in the 1978 time period and is used to protect
resources at risk during an oil spill including (1) Anadramous fish spawning areas such as salmon runs, (2) Shellfish Beds; (3) Bird Rookeries; (4) Marine Mammal Haul Out Areas; ((5) Sea Turtle Nesting Sites and (6 ) Important Locations/Habitat for Endangered Species The ESI is based on HABER’s Law and prioritizes different habitat sensitivity based upon their ability to concentration of oil (Dose) and for oil to persist (Duration of exposure) within a habitat. Every mile of shoreline in the US has been mapped with the ESI. The ESI maps contain wildlife symbols which include (1) the General Animal Type; (2) Seasonal Occurrence/Distribution; and (3) Species Identification. The EIS contains other important information including power plant intakes, drinking water intakes, location of marinas and boat ramps for staging clean-up equipment and boom/skimmer locations for cleaning up the spilled oil

Ixtoc Well Blowout, June 3, 1979 –March 25, 1980 (> 3 million barrels; 2.5 MG of dispersant Corexit 9527)

Burned at the well site – 1%; Mechanically Removed – 5%; Evaporation into the Atmosphere – 50%; Photochemical/Biological Degradation – 12%; Mexican Beach Landfall – 6%; US Beach Landfall – 1%; Sank to bottom of the Gulf of Mexico – 25% = -71,500 barrels (11,000 m3) of oil impacted 162 miles (260 km) of U.S. beaches as the oil was contained there and not in estuaries (lagoons)

Deep Water Horizon April 20 – July 15, 2010 (4.7 million barrels; >2MG of dispersant)

Burned at the well site – 5%; Mechanically Removed – 3%; Direct Recovery from the Wellhead – 17%; Evaporation into the Atmosphere or Dissolved – 25%; Chemically Dispersed – 8%; Naturally Dispersed – 16%; Photochemical/Biological Degradation – NC (Not Calculated); Residual (includes oil water mixtures, tarballs , & oil buried or washed ashore) - 26%; Sank to bottom of the Gulf of Mexico – NC (Not Calculated). Know statistics about % of Fishery Samples (0%) exceeding Safe Consumption levels, yet the fisheries were closed as a precautionary measure.

Deep Water Horizon Oil Spill Offshore Impacts

Amphipod (Leptocheirus plumulosus) Bioassays of offshore sediments indicated that toxicity was only observed within a 3 sq. mile areas around the wellhead. Endpoints - mortality and growth. There was toxicity observed at two other more distant sites but levels of PAHs/Petroleum Concentrations were low and it was determined that the toxicity observed at those 2 sites was related to other factors (contaminants from drilling muds around other abandoned
wells).BP has reached a tentative settlement with the federal government for damages

Shoreline Impacts of Major Oil Spills

Deep Water Horizon - NOAA had surveyed 1,796 miles of
Louisiana coast and found 221 miles of oiled shoreline including 35 miles of shoreline to be heavily oiled, 71 miles to be moderately oiled , and 115 miles to be lightly oiled; (2) EXXON VALDEZ spill
contaminated 1,300 miles of shoreline, about 200 miles of it heavily or moderately oiled; and (3) Ixtoc – 162 miles of oiled shoreline in the U.S.

PAH exposure and ports

Environmental Justice issue as PAH exposure at ports is greater in African Americans and Hispanics than Caucasians. Similar issue with roadways. PAHs cause increased cardiovascular disease in children in heavily traveled roadways and refineries.

Dolphins and Deepwater Horizon

increased exposure in the lungs leading to increased cortisol levels
which resulted in more lung disease. Similar effects in first responders in the NIH GULF STUDY.

Interstate Shellfish Sanitation Conference

organization made of federal and state agencies and the seafood industry that regulate molluscan seafood safety in the US. Executive offices are in Columbia,SC

$4.8-23 Billion

Todd (1991 ) estimate of foodborne illnesses and health care costs in the US

$1.28 billion

Settlement Cost EXXON VALDEZ Oil Spill

$4 Billion

Settlement Cost DEEPWATER HORIZON Oil Spill

$1 Billion

CDC (2001) estimated costs of Food Borne Illnesses estimated in the US including (1) 76 million cases of food-borne illnesses/year; (2) 325,000 hospitalizations/year; (3) 5,200 deaths/year and (4) Health Care Costs

$900 Million

marine-borne pathogens in the USA have annual costs
on the order of $900 million (Ralston et al., 2011).

$350 Million

health care costs due to pathogens and marine toxins
specifically identified as causing food-borne disease in the US

76,000,000 Illnesses and > 5,200 Deaths

Meades's (1991) estimate of foodborne illness impacts in the US using CDC data

Antibiotic Resistance

propensity of bacteria to develop resistance to antibiotics making infections more difficult to treat and may often lead to death

Seafood and Fruits/Vegetable

food often consumed raw and are the highest risk foods and some of the leading causes of food borne illness

Room Temperature

incubation zone for most bacteria and viruses causing food-borne illnesses

Food Intoxification

infectious agent is consumed as a toxin produced in food that poisons the host

Food Infection

An infectious agent is consumed in food as a live agent or organism that produces disease in the host.

Facultative Anaerobe

bacteria such as Clostridium botulinum that can live in the absence of oxygen

HACCP

Hazard Analysis Critical Control Points such as temperature
used to control pathogens that may cause food-borne illnesses

Norwalk Agent

a virus that causes disease outbreaks on cruise ships,
schools and health care facilities, which is an example of a food
infection and is the leading cause of food-borne illness today

Parasites

Giardia and Cryptosporidium.

MRSA = Methicillin Resistant Staph aureus

A dangerous bacteria, known as methicillin-resistant Staphylococcus aureus, or MRSA, that has been spreading around the country causes more life-threatening infections than public health authorities had thought and is killing more people in the United States each year than the AIDS virus, federal health officials reported at the CDC. The microbe, a strain of a once innocuous staph bacterium that has become invulnerable to first-line antibiotics, is responsible for more than 94,000 serious infections and nearly 19,000 deaths each year

Low Acid Canned Foods

food preservation methods that prevent food borne illnesses

Peanuts and Grains

crops which grow mold which produces Aflatoxins

Staph. Aureus

bacterium, which is one of the leading causes of food-
borne illnesses and is the prime example of a food intoxification as it
forms toxins which make you ill

Clostridium botulinum

is a bacterium which is an obligate parasite and facultative anaerobe (can live in the absence of oxygen) that produces a spore stage when it encounters poor living conditions. Thus it may grow well inside of a can of food and may produce a deadly toxin

Clostridium perfringens

a Gram-positive, rod-shaped, anaerobic, spore-forming bacterium of the genus Clostridium. In the United Kingdom and US, C. perfringens bacteria are the third-most-common cause of food-borne illness, with poorly prepared meat and poultry the main culprits in harboring the bacterium.

Salmonella

causative agent of food infections in the US, one of the
leading causes of foodborne illness in the US

Vibrio cholera

free living marine pathogen, very common cause of illness after natural disasters such as the Earthquake in Haiti.

Vibrio parahaemolyticus

free living marine pathogen, very common in seawater and shellfish as well on the mucous of fish. Common cause of illness from Sushi Consumption. Leading cause of food borne illness in Japan

Vibrio vulnificus

free living marine pathogen which is the leading
cause of death from seafood consumption in the US

Camplylobacter jejuni

bacteria, which accounts for 4% of all cases of
gastroenteritis in the US. Most cases occur in June - Sept. time frame
(warm months) and in 18-30 year old individuals. Immuno-deficient
individuals have the more severe illnesses with bloody diarrhea

mimicking Crohn’s Disease and may have arthritis like symptoms.
Common in hamburger and clams

What are the major exposure pathways for microbes?

Air, water and food

1981

568 outbreaks involving 14,432 cases of illness (estimates of 1
million cases/year predicted based upon low rate of reporting).

Hansfield & Bryan (1983)

Salmonella: It is estimated that there is 1 case reported for every 29.5 cases that go unreported. (38,881 cases reported X 29.5
= 1,147,000 cases of Salmonella in the US)

Todd (1991) estimated in the US: reported that

1.9 million cases of Salmonella/year; (2) Total cases of all food borne illnesses range from 6-99 million cases/year; (3) Costs = estimated at $4.8-23 billion/year for all food-borne illnesses; (4) Each case of Salmonella reported costs $1,300 in health care cost/case; (5) Annual # of deaths range from 523- 7,241/year (latter is considered accurate)

CDC (2001)

Food Borne Illnesses estimated in the US: (1) 76 million
cases of food-borne illnesses/year; (2) 325,000 hospitalizations/year;
(3) 5,200 deaths/year and (4) Health Care Costs >$1 billion/year

Scallan et al. 2011

31 major pathogens acquired in the United States
annually caused: (1) 9.4 million episodes of foodborne illness (90%
credible interval [CrI] 6.6–12.7 million), (2) 55,961 hospitalizations
(90% CrI 39,534–75,741), and (3) 1,351 deaths (90% CrI 712–2,268).

Scallan et al. 2011 estimated that the leading causes of food-borne
illness cases were caused by:

Viruses - 5.5 million(59%) , Bacteria- 3.6 million(39%) and Parasites
- 0.2 million (2%); (2) Pathogens causing the most (88%) illnesses were: Norovirus -5.5 million (58%), Nontyphoidal Salmonella spp. - 1.0 million (11%), C. perfringens - 1.0 million (10%) and Campylobacter spp. 0.8 million (9%).(3) Deaths: These 31 pathogens caused 2,612 deaths (90% CrI 1,723–3,819), of which 1,351 (90% CrI712–2,268) were caused by contaminated food eaten in the United States; (4)Leading Causes of Death: Bacterial – 64%, Parasites - 25% and 12% by viruses. And (6) The leading causes (82%) of all deaths were Bacterial -Nontyphoidal Salmonella spp. (28% )& Listeria monocytogenes (19%) and Viruses - Norovirus (11%); and Parasites - Toxoplasma gondii (24%)

SC

had confirmed cases of food-borne illnesses in 2007 including 13
bacterial cases/100,000 (585 cases), 1 chemical case/100,000 (45 cases) and 2 viral cases/100,000 (90 cases) = 720 cases Total Estimated for 2007

High Risks Foods

Foods Consumed Raw – salads and shellfish such as
oysters and sushi and Imported Food (Know Examples of Top 12
Imported Foods)

The following events must occur for an illness to be included in lab-
based surveillance:

The ill person must seek medical care; (2) A specimen must be submitted for lab testing; (3) The lab must test for and ID the causative agent; & (4) The illness must be reported to public health authorities.

Factors Affecting Food Sanitation

Improper Holding Temperature; (2)Inadequate Cooking; (3)Temperature; (4)Contaminated Equipment;
(5)Infected Food Handlers; and (6)Food from Unsafe Sources

Hazard Analysis and Critical Control Point (HAACCP)

Consumer education to at risk individuals; Time-Temperature Post Harvest Control Plans; Post Harvest Pasteurization and Irradiation

Environmental Sanitation

principles of public health protection applied to remove chemical and microbial hazards in Water, Food & Air

Boore (2007)

Among the 235 outbreaks attributed to a single food
commodity the 3 most common causes of illness were: Poultry (17%),
Beef (16%), and Leafy vegetables (14%). The commodities most
commonly implicated in outbreaks were finfish (41 outbreaks), poultry
(40 outbreaks), and beef (33 outbreaks)

Staph aureus

25% of all food borne illnesses are Staph aureus.
Symptoms – diarrhea, cramps, nausea, vomiting, gastrointestinal
pain, dizziness, cold sweats, and occasional shock. Symptoms may
begin 1-2 hours after ingestion of tainted food and may persist for 24-

48 hours. Boiling will kill off the bacteria but the toxin is heat stable,
even after 20 minutes of boiling at 15 PSI in an autoclave. Common
Foods – meat and meat products such as ham, milk and milk products,
and cream-filled bakery goods. Incubation Zone 42-1300 F; hence that
is why refridgerators keep food at < 380 F. Studies on TV dinners and
left-overs indicate excessive reheating of food

Clostridium bottulinum

a bacterium which is an obligate parasite and facultative anaerobe (can live in the absence of oxygen) that produces a spore stage when it encounters poor living conditions. Thus it may grow well inside of a can of food and may produce a deadly toxin. Always report canned goods where the end of the can is bowed out to authorities as there has obviously been gas production due to bacterial growth inside the can. Toxins: 7 different types including alpha, beta, C-gamma, C- beta, D, E and F strains. Lethal dose in a 70 kg human is 0.2 ug. The fatality rate has been as high as 65% but with better and earlier diagnosis and better anti-toxin treatments the fatality rate is < 10%. Symptoms: 1)
Impairment of peripheral nerves; 2) Vision alterations; 3) Difficulty in
swallowing; 4)Constipation & 5) Respiratory Failure which may lead
to death. Symptoms appear within 12 hours-10 days post ingestion and
depend on the amount of toxin ingested, body weight of host, and
strain of the toxin. The toxin is heat sensitive and sensitive to pH.
Clostridium botulinum cannot grow in pH < 4.5; thus almost all canned
foods use foods additives such as ascorbic acid to lower the pH = This is termed Low Acid Canned Foods, which is the standard for most of the
canned food industry.

Aflatoxins

Aspergillus flavus produces a Fungal or Mold Toxins (Myco
toxins) termed Aflatoxins, which severely damage the liver and may
lead to liver cancer in humans. Toxin is heat stable and thus may be
passed along in processed foods. The toxin resembles coumarin and
induces hemorhaging. Toxin risk is a chronic not an acute hazard. There are 4 different Toxins produced: Beta 1; Beta 2; Gamma 1 and Gamma 2 (Don’t have to know the four different toxins). High Risks Foods: foods with a high carbohydrate level such as grains (corn and wheat) and nuts (peanuts and peanut butter). Particular care of stored grains to keep low humidity and temperature to prevent mold growth.
Exposure Pathways: Transmission Mode: Grain (High Temp &
Humidity) → Contaminated Grain → Chickens/Beef. Terrestrial
Pathway: Processed Foods -> Man and Milk ->Man. Aquatic
Pathway: Chicken/ Beef Waste -> Water -> Trout (Usually there are
deaths in chickens, cows or trout & the disease is detected thus
preventing human exposure).

Salmonella

Food serves as the vehicle of infection. Salmonella
bacteria: 10 different types. Symptoms: Fever, nausea, stomach
cramps, diarrhea, headache, dizziness, and vomiting. Symptoms
appear 4-24 hours or longer after ingestion of contaminated food. Not
usually fatal, but debilitating. Infectious dose: 105 –109 density of cells
required to cause symptoms and disease. Toxic factor is a
lippopolysaccharide in the cell wall of the bacteria that affects the
intestine and GI tract. High Risk Foods: Poultry, egg products, baked

Vibrios

include V. cholera, parahaemolyticus, and vulnificus.
Vibrio infection rates have increased 41% over the last decade and the
rate of antibiotic resistance in Vibrios has increased by 31% during the
same time period

Vibrio cholera

is a free living marine bacterium that lives in
marine and brackish waters - Common illness after environmental
disasters which lead to poor sanitation and crowded living conditions.
There have been 7 world-wide outbreaks since 1817, with the last
occurring during the 1990’s in South America. Over 150,000 Americans
died in the during the1832 and 1849 outbreaks. 50,000 Americans
died in the 1866 outbreak. In 1911, the 6th outbreak cases were
reported in MA and NY. All Vibrios are gram negative and rod shaped
bacterium. - 3 major biotypes of V. cholera - (1) V.cholerae 01
Toxigenic or Ogawa (most toxic form= Classical Cholerae) ; (2) V.
cholerae 01 El Tor or Inaba (rarely fatal but makes you wish you were
dead) ; and (3) V. cholerae non01 (rarely fatal but causes mild to severe
gastro-intestinal illness).

Vibrios – Vibrio parahaemolyticus:

free living marine pathogen, very common in seawater and shellfish as well on the mucous of fish. First reported in 1950’s, primarily a gastrointestinal pathogen, cases of ear and wound infection have also been reported. A total of 10 outbreaks in the US, the most recent being in Washington State (1997) and Texas (1998) which were caused by introduction of a Pakistani strain of TDH postive V. parahaeomolyticus from ballast water, which closed the shellfish industry in each state for 3-6 months.

Vibrios – Vibrio vulnificus:

First identified in 1979 in the US, this Vibrio is responsible for more deaths than any other Vibrios, causing approximately 22-25 deaths per year (leading cause of death from seafood consumption in the US), mostly stemming from consumption of raw shellfish from the Gulf of Mexico during the summer months by at risk individuals (immuno-compromised, AIDS, underlying liver disease, cancer survivors).

Campylobacter

Accounts for 4% of all cases of gastroenteritis in
the US. First reported in 1975, as primarily associated with Veterinarian
pathogen. Most cases occur in June - Sept. time frame (warm months)
and occurs mostly in 18-30 year old individuals. Most cases are self
limiting producing abdominal pains and diarrhea for 2-3 days.

Immuno-deficient individuals have the more severe illnesses with
bloody diarrhea mimicking Crohn’s Disease and may have arthritis like
symptoms. Camplylobacter jejuni is the most common species and are
small flaggeallated, endotoxin (produced by the cell wall) producing
gram negative, rod shape bacterium, whose normal hosts are animals.
High Risk Foods: Unpasteurized or inadequately pasteurized milk, raw
clams, and raw-rare hamburger and poultry

Viruses (Norwalk and Hepatitis)

very
common in sewerage and implicated in shellfish transmission.
Sewerage contains enteric viruses at levels ranging from 100-10,000
viruses/liter. Uptake: Shellfish remove 10% of viruses present in
seawater (dose 104 cfu HAV for 6 hours). Depuration: oysters only
depurated < 50% of the virus after 48hours. Thus oysters may
represent a significant source of vial exposure. (2) Norwalk Agent Virus
- Symptoms: nausea, vomiting, diarrhea, and abdominal cramps
(24-72 hours post exposure). Raw shellfish and other uncooked foods
are high risk foods. The 1982 Outbreak in New York: Between May1-
Dec 31, 1982 there 103 outbreaks involving 1017 cases of illness
associated with the consumption of raw/steamed clams (80% of the
cases) and oysters (20% of the cases). The overall attack rate was 56%
in those consuming raw and steamed clams, 26% in those eating
steamed clams to 3% in those not consuming clams. Cruise ship
industry - was hard hit in 2003 with Norwalk-like outbreaks most likely
resulting from infected food handlers. Feb.- March, 2010, cruise ship
MERCURY from Charleston has>1200 Norwalk illnesses on 3 cruises.
The State Ports Authority (SPA) in Charleston has signed agreements
with cruise lines for 69 ships in 2010 up from 33 ships in 2009. The SPA
has said they feel 104 ships are possible in the future, or two per week.

Raw Molluscan Shellfish - New England Journal of Medicine Editorial

Consumption of Raw Shellfish – Is the Risk Now Unacceptable?
Published after this outbreak in New York questions the high risk of raw
molluscan shellfish consumption. This editorial states “ Consumption of
raw molluscan shellfish such as clams is unsafe and that Public Health
educators and academic leaders will have failed as medical educators if
people continue to eat uncooked shellfish without understanding the
health risks they are taking”. This was followed by a National Academy
of Science study on Seafood Safety which re-iterated

Leading Known Cause of Illnesses in Drinking Water Historical
Perspective

1920-1960 - Typhoid Fever 70% of all cases; (2) 1960 -
1970 –Hepatitis A Virus ; (3) 1970-1990 – Giardia ( a parasite); 1990-
2001 - Chemical Poisonings

Food -Total Cases in US 2011 -

9.4 million episodes of foodborne
illness /year.Pathogens causing the most (88%) illnesses were:
Norovirus -5.5 million (58%); Nontyphoidal Salmonella spp. - 1.0
million (11%) , C. perfringens - 1.0 million (10%) and Campylobacter
spp. 0.8 million (9%). Leading Cause of Deaths: Salmonella, Listeria
&Toxoplasma which account for > 75% of all deaths

Drinking Water—Total Cases, US, 1920–2002

10,646 cases/year;
Etiology of Disease Outbreaks, 1991-2001 in Drinking Water: Acute
Gastroenteritis Infection (AGI) Unknown Origin 38%; Chemical
Poisonings 16%; Giardiasis 12% ; Cryptosporidiosis 7%; Norovirus 6%;
E. coli 0157:H7 5%; Shigellosis 4%; Legionella 3% and
Campylobacterosis 3%

Surface Water

Contact Recreation -Total Cases US in 2004 –2,968
cases/year; Leading Causes of Illnesses in US: Bacteria (21% of all
cases)-Pseudomonas sp.; Legionella; Shigella; E. coli & MRSA; Parasites (53%) - Cryptosporidium and Giardia; Viruses (13%) – Norovirus; and (4) Chemical Toxins (1%)-Mycrosytin (toxin from blue-green algae)

Genetically Modified (GM) Foods

Genetically Modified (GM) Foods – foods produced from Genetically Modified Organisms (GMO) that have had their DNA altered through Genetic Engineering

Most Common GM Foods:

soybeans, corn, canola and cotton

First GM Food

Flavr Savr Tomato produced by the California Bio-Tech
Company Calgene in 1994. The genetic traits were added that
prevented rot in the tomato. Consumers readily accepted this product
paying 2-5 times the price of conventional tomatoes. Patent rights
passed on to Astro-Zeneca.

Other Common GM Foods Today

Soybeans – resistant to herbicides;
Corn –resistant to herbicides and produces insecticides (e.g. Bt corn);
Cotton - resistant to herbicides and produces insecticides; Sugar Cane -
resistant to herbicides; and Rice – developed to contain higher levels of
Vitamin A (e.g. Golden Rice)

Other GM Food Traits being Developed

Pesticide Resistance – Bt Corn; Herbicide Tolerance – Round-up Ready Corn; Disease Resistance – Flavr Savr Tomato; Cold Tolerance – anitfreeze gene from polar fish put into tobacco and potatoes; Drought/ Salinity Tolerance; Nutritional – Golden Rice (increased Vit.A); Pharmaceuticals/Medicines; and Phytoremediation – clean up of hazardous waste site

Prevalence of GM Crops

995 – 17,000km2 (4.2 million acres) versus
2005 - 900,000km2 (222 million acres) = a 50 fold increase world-wide;
13 countries grow GM crops world-wide today versus and 6 Countries
that Grow 99% of all global transgenic crops: US 63%; Argentina 21%;
Canada 6%; Brazil 4%;-China 4%; and South Africa 1%. The other 1% -
Germany, France, Mexico, Romania, Uruguay, Bulgaria, and Australia.
Soybeans and corn are the top GM crops, followed by cotton, rap seed
(canola) and potatoes

Genetic traits Most Commonly Used in GM Food

74% Herbicide
Tolerance; 19% Pesticide Resistance; 7% Both Herbicide Resistance and Pesticide Tolerance.

Prevalence of GM Crops in the Foods We Eat in the US

Grocery Manufacturers of America – 75% of all processed food in America contains a GM ingredient. US in 2006, GM crops made up: 89% of total soybean production (herbicide tolerance); 83% of total cotton production (herbicide tolerance and insecticide Bt production); and 61% of all corn/maize production (herbicide tolerance and insecticide Bt production

Environmental Issues with GM Crops

Herbicide Tolerance Genes
– increased used of herbicides at higher application rates and passing of

herbicide resistance genes to weeds to produce “Super Weeds”. Also
microbes acquiring the gene. (2) Pesticide Tolerance Gene – Bt is toxin
produced by bacteria Bacillus thuringiensis. Concern over other
microbes picking up this gene. (e.g. Bt corn is planted 50% conventional corn and 20% BT corn to prevent development of resistance= “Checker Board Square” Protection Strategy??). (3) Allergies – new genes may produce new food allergens (e.g. Bt causes asthma in farm workers); and (4) Genetically Resistant Microbes – unknown hazard