With smoke from wildfires, valley air quality looks unpredictable for near future

With wildfires burning throughout the state, in addition to recent local grass fires, the San Joaquin Valley Air Pollution Control District continues to warn the public about poor air quality, including incidents of severely bad air that may occur sporadically in the coming days.

For a few hours late Saturday, the amount of fine particulate matter (PM 2.5) in the air spiked in Bakersfield and all eight counties across the San Joaquin Valley air district, to a Level 5, the highest level, where all people are advised to remain indoors.

By the next day, Bakersfield had clearer skies and air quality was back down to a moderate range. District officials said winds temporarily pushed smoke into the valley during that several hour period.

“All that pollution literally just inundated the entire San Joaquin Valley,” said Cassandra Melching, outreach and communication representative for the air district.

Because the air can be safe at one point in the day and dangerous at another, depending upon wind flows, Melching said an air quality alert is standing for all areas.

On Saturday, regions farther north in close proximity to the fire were substantially affected, Melching said, with Oakhurst in Madera County reaching a PM 2.5 concentration of 246 micrograms per cubic meter. It takes only 75 micrograms to reach level five risk. Bakersfield hit 87 micrograms that same day.

“We can’t quite say who is going to be impacted the most and when…It doesn’t mean that every single day our air quality is bad,” Melching said.

Glen Stephens, air pollution control officer of the Eastern Kern Air Pollution Control District, said the district has not released any alerts, but is tracking the smoke levels. He said there is less of a concern in eastern Kern County and mountain areas compared to valley locations like Bakersfield, but that there is still poor air quality.

“It’s generally bad. Right now it’s bad because of ozone, not because of the fire,” Stephens said.

The best way to know whether it is safe to be outdoors is by tracking your location on the Valley Air app or online at valley air.org. It is especially important for sensitive groups such as the elderly and those with asthma to remain cautious and updated.

Melching said to also be aware of the potential for ash in the air, which is most likely when temperatures cool down and is not monitored in the air quality levels.

“If you smell smoke, or if you see ash falling, you are being impacted,” Melching said.

Ways to reduce your risk of being affected by the smoke are to limit outdoor exercise, stay hydrated, change your air air filters and keep windows shut.

Article source: www.bakersfield.com/news/with-smoke-from-wildfires-valley-air-quality-looks-unpredictable-for/article_ad179f8e-99d4-11e8-88fb-ff92b41270ae.html

Asbestos exposure at West Los Angeles apartment complex leaves 15 people displaced


University High-Rise Uses Geothermal System for All Heating and Cooling

GI Energy is pleased to announce that the innovative Ground Source Heat Pump (GSHP) system they have engineered and built for The Emma and Georgina Bloomberg Center at Cornell Tech, Cornell University’s new applied tech campus on NYC’s Roosevelt Island, is now fully operational.

Highly efficient and cost-effective to run, the GSHP system delivers all the heating, cooling, and domestic hot water for The Bloomberg Center without any direct combustion of fossil fuels. The combination of the facility’s low energy design, solar photovoltaic panels and GI Energy’s GSHP system is expected to save up to 500 tons of carbon dioxide per year.

Eighty boreholes have been drilled to a depth of 400 feet, intercepting water-filled fissures in the local bedrock. The system then takes advantage of this water to increase its efficiency. It is the first time in the USA a supplemental groundwater pumping system has been applied to a closed-loop geothermal system in this way. It is designed to support The Bloomberg Center’s aspiration for radically lower energy use and minimal environmental impact.

Steve Beyers, Energy Engineer at Cornell University, notes “The Bloomberg Center’s innovative Ground Source Heat Pump system is a perfect match for Cornell’s mission of education, research, and outreach. It demonstrates respect for the environment while saving energy dollars for investment into our education mission, but it’s also a great experiment in new technology. It’s a win-win for the University.”

GI Energy’s CEO, Tom Chadwick added “this project provides a blueprint for achieving NYC’s ambitious geothermal energy plans, as set out by Mayor di Blasio. Cornell Tech and NYC are both iconic and visionary – the geothermal system we have created is in keeping with this”.

GI Energy is a leading provider of on-site energy and microgrid solutions in North America. Using world-class engineering and outstanding execution, GI Energy specializes distributed energy resources (DER) development, financing, construction and advisory services. The company helps customers, including utility companies, real estate developers and commercial building owners, leverage state-of-the-art technologies to hedge against high/volatile energy prices, improve energy reliability and reduce environmental impacts and greenhouse gas emissions thereby increasing the value of the underlying real estate assets and company value. GI Energy is headquartered in Chicago and has offices in New York, Los Angeles and San Francisco.

For additional information please contact: Amir Yanni, SVP Construction & Engineering – ayanni@gienergyus.com or visit us at http://www.gienergyus.com @gienergyus

About Cornell Tech

Cornell Tech brings together faculty, business leaders, tech entrepreneurs and students in a catalytic environment to produce visionary results grounded in significant needs that will reinvent the way we live in the digital age. The Jacobs Technion-Cornell Institute embodies the academic partnership between the Technion-Israel Institute of Technology and Cornell University on the Cornell Tech campus.

From 2012-2017, the campus was temporarily located in Google’s New York City building. In fall 2017, 30 world-class faculty and about 300 graduate students moved to the first phase of Cornell Tech’s permanent campus on Roosevelt Island, continuing to conduct groundbreaking research, collaborate extensively with tech-oriented companies and organizations and pursue their own startups. When fully completed, the campus will include two million square feet of state-of-the-art buildings, over two acres of open space, and will be home to more than 2,000 graduate students and hundreds of faculty and staff.

Article Source: https://nbherard.com/business/gi-energy-completes-geothermal-energy-system-for-cornell-tech-campus/13420

Legionella Poses Risk for Patients in Health Care Facilities

The CDC released a Morbidity and Mortality Weekly Report (MMWR)(www.cdc.gov)  and an accompanying Vital Signs report on June 6 that analyzed the prevalence of Legionnaires’ disease in the U.S. health care system and found that 76 percent of facilities studied reported health care-associated cases of the disease.

[Microscopic view of Legionella pneumophila]

Seventy-two health care facilities in 16 of the 21 U.S. jurisdictions the CDC studied reported definite health care-related cases of Legionnaires’ disease, which is known to kill one-quarter of patients who are infected.

Legionnaires disease is a severe pneumonia typically acquired through inhalation of aerosolized water containing Legionella bacteria. Legionella can grow in the complex water systems that supply many buildings, including health care facilities, when those systems are not well managed. Thus, effective water management programs could prevent the growth of Legionella in these building water systems.

Most healthy patients who are exposed to Legionella don’t develop Legionnaires’ disease. Some patients, however, are at increased risk for the disease, including those 50 or older and those who have certain risk factors, such as being a current or former smoker or having a chronic disease or weakened immune system.

  • The CDC recently released a Morbidity and Mortality Weekly Report and an accompanying Vital Signs report that analyzed the prevalence of Legionnaires’ disease in the U.S. health care system, finding that 76 percent of the facilities evaluated reported health care-associated cases of the disease.
  • Specifically, 72 health care facilities in U.S. jurisdictions the CDC studied reported definite health care-related cases of Legionnaires’ disease, which is known to kill one-quarter of patients who are infected.
  • Patients at increased risk for Legionnaire’s disease include those who are 50 or older and those who have certain risk factors, such as being a current or former smoker or having a chronic disease or weakened immune system.

Legionnaires’ disease in hospitals is widespread, deadly and preventable,” said CDC Acting Director Anne Schuchat, M.D., in a June 6 news release.(www.cdc.gov) “These data are especially important for health care facility leaders, doctors and facility managers because it reminds them to think about the risks of Legionella in their facility and to take action.

“Controlling these bacteria in water systems can be challenging, but it is essential to protect patients.”

Study Methodology

All 50 states, two large U.S. metropolitan areas and five territories report basic demographic information to the CDC’s National Notifiable Diseases Surveillance System (NNDSS) for all cases of legionellosis, which manifests as one of two distinct clinical presentations: Pontiac fever (a mild influenza-like illness) and Legionnaires’ disease. NNDSS makes no distinction between the two presentations.

In 2015, a total of 6,079 cases of legionellosis were reported to NNDSS, although the CDC noted that this estimate may be low due to underdiagnosis. The Supplemental Legionnaires’ Disease Surveillance System (SLDSS) receives additional epidemiologic information, including whether patients were exposed to health care facilities, and distinguishes Legionnaires’ disease from Pontiac fever, but reporting to SLDSS is less widespread.

The MMWR analysis aimed to define which Legionnaires’ cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

The MMWR analysis aimed to define which Legionnaires’ cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

Zoom In

Study Results

Of the more than 6,000 confirmed legionellosis cases reported to NNDSS in 2015, 3,516 (58 percent) were also reported to SLDSS, including 3,459 Legionnaires’ disease cases. Of those Legionnaires’ disease cases, 2,809 (81 percent) were reported by the 21 jurisdictions included in the MMWR analysis, including 553 (20 percent) that were health care-associated (either definite or possible).

Of the 85 Legionnaires’ disease cases that were determined to be definitely health care-associated, 80 percent were associated with long-term care facilities, 18 percent with hospitals and 2 percent with both.

Definite health care-associated Legionnaires’ disease cases were reported in 72 facilities — 15 hospitals and 57 long-term care facilities — and included one to six cases per facility. Almost 90 percent of these definite cases occurred in patients 60 or older.

Of the 468 possible health care-associated cases, 49 percent were thought to be associated with hospitals, 26 percent with clinics, 13 percent with long-term care facilities, 3 percent with other settings such as outpatient laboratories, and 9 percent with more than one setting.

Importance of Safe Water

The MMWR report’s authors said preventing the first case of Legionnaires’ disease from arising in any health care facility should be the goal, and that is best achieved by establishing and maintaining an effective water management program. To this end, the CDC and its partners have created a best practices guide(www.cdc.gov) for these facilities to use.

In general, the CDC said the principles of effective water management include maintaining water temperatures that are not conducive to Legionella growth; preventing water stagnation; ensuring adequate disinfection; and maintaining equipment to prevent scale, corrosion and biofilm growth, which provide a habitat and nutrients for Legionella.

“Safe water at a health care facility might not be on a physician’s mind, but it’s an essential element of health care quality,” said Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases, in the agency’s release. “Having a water management program that focuses on keeping facility water safe can help prevent Legionnaires’ disease.”

In related news, CMS released a survey and certification memo(www.cms.gov) on June 2 that requires health care facilities to develop and adhere to policies and procedures to reduce the risk of disseminating Legionella and other waterborne pathogens.

Family Physicians Can Help

According to the CDC, health care professionals play a critical role in preventing and responding to Legionnaires’ disease by rapidly identifying and reporting cases.

Unfortunately, Legionnaires’ disease is clinically indistinguishable from other causes of pneumonia. But failing to diagnose a health care-associated case could result in a missed opportunity to prevent subsequent cases.

Therefore, “Legionella should be considered as a cause of health care-associated pneumonia, especially for groups at increased risk, when other facility-related cases have been identified, or when changes in water parameters might lead to increased risk for Legionnaires’ disease,” the MMWR report advised.

The preferred diagnostic procedure for Legionnaires’ disease is to concurrently obtain a lower respiratory sputum sample for culture and perform a Legionella urinary antigen test.

The CDC said ideally, sputum should be obtained before antibiotics are administered and shouldn’t be rejected based on specimen quality (e.g., lack of polymorphonuclear leukocytes or contamination with other bacteria), because sputa produced by patients with Legionnaires’ disease might not be purulent, and contaminating bacteria will not negatively affect isolation of Legionella on selective media.

“This report demonstrates that Legionnaires’ disease continues to result from exposures to health care facility water systems,” said the MMWR report. “The high case fatality rate of health care-associated Legionnaires’ disease underscores the need for effective prevention and response programs.

“Implementation and maintenance of water management programs, combined with rapid case identification and investigation, could reduce the number of health care-associated Legionnaires’ disease cases.”

Article Source:http://www.aafp.org/news/health-of-the-public/20170615mmwrlegionella.html


The U.S. Department of Labor’s Occupational Safety and Health Administration announced a delay in enforcement of the crystalline silica standard that applies to the construction industry to conduct additional outreach and provide educational materials and guidance for employers.

OSHA has determined that additional guidance is necessary due to the unique nature of the requirements in the construction standard. Originally scheduled to begin June 23, 2017, enforcement will now begin Sept. 23, 2017.

However, despite the standard’s delay, OSHA expects construction employers to continue to take steps either to come into compliance with the new permissible exposure limit, or to implement specific dust controls for certain operations as provided in Table 1 of the standard.

OSHA’s final rule to protect workers from exposure to respirable crystalline silica includes these key provisions:

  • Reduces the permissible exposure limit (PEL) for respirable crystalline silica to 50 micrograms per cubic meter of air, averaged over an 8-hour shift.
  • Requires employers to: use engineering controls (such as water or ventilation) to limit worker exposure to the PEL; provide respirators when engineering controls cannot adequately limit exposure; limit worker access to high exposure areas; develop a written exposure control plan, offer medical exams to highly exposed workers, and train workers on silica risks and how to limit exposures.
  • Provides medical exams to monitor highly exposed workers and gives them information about their lung health.
  • Provides flexibility to help employers — especially small businesses — protect workers from silica exposure.

Construction employers should also continue to prepare to implement the standard’s other requirements, including exposure assessment, medical surveillance and employee training.

OSHA estimates 2 million construction workers who drill, cut, crush, or grind silica-containing materials such as concrete and stone, and 300,000 workers in general industry operations such as brick manufacturing, foundries, and hydraulic fracturing are affected by the final rule.

See also: OSHA’s Crystalline Silica website for working safely with silica and how to prevent its non-curable health effects.

Article Source: https://www.constructionequipment.com/osha-delays-silica-standard-enforcement-deadline-3-months

Invasive Mold can cause aspergillosis

inhaling mold spores and mold in my homeEarly diagnosis, effective therapy vital for treatment of deadly invasive mold

New guidelines focus on new treatments, early diagnosis of fungal infection

The updated guidelines focus on the diagnosis and treatment of the major forms of aspergillosis: allergic, chronic and invasive, the latter which kills 40 percent to 80 percent of those with widespread infection. An airborne invasive mold, aspergillus often is found in air conditioning units, compost piles and damp or flood-damaged homes or buildings. While generally harmless, it can cause an allergic reaction or chronic lung problems in some people and serious, invasive disease in vulnerable patients. Those at highest risk are people whose immune systems are suppressed, such as those undergoing stem cell and lung and other organ transplants. The infection also can affect those with severe influenza or who are on long-term steroids, or patients in the intensive care unit. “Invasive mold (aspergillosis) often is overlooked, but early diagnosis and treatment are key,” said Thomas Patterson, MD, lead author of the guidelines and chief of the Division of Infectious Disease and professor of medicine at The University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System, San Antonio. “These are complicated infections with a number of treatment options. Patients really benefit from a multidisciplinary approach, including the expertise of an infectious disease specialist.” Updating the 2008 guidelines, the new guidelines for the diagnosis and treatment of aspergillosis highlight the increased evidence for antifungal therapy recommendations as well as diagnostic tests. The improved use of diagnostic tools has enhanced the ability to identify the infection early, the guidelines note. These include blood tests, cultures and computed tomography (CT) imaging. Because some of the methods are invasive — such as taking a culture directly from the lungs — physicians often are reluctant to proceed. Because the infection is so deadly, physicians should be aggressive in diagnosing patients suspected of having the infection, Dr. Patterson notes. Additionally, new more-effective and better-tolerated antifungal medications, or versions of existing medications (e.g. extended release) have improved care, including isavuconazole and posaconazole. In some cases, combination therapy with voriconazole and an echinocandin is recommended for certain patients at highest risk. Because invasive molds like aspergillis are s so deadly, the guidelines recommend some patients at highest risk be treated with antifungals to prevent infection, including those with neutropenia and graft versus host disease (GVHD). Another prevention strategy is the use of special filtration systems for hospitalized immunosuppressed patients. Invasive aspergillosis affects about 200,000 people worldwide, Dr. Patterson said. The allergic form is most common and affects more than 4 million people worldwide, according to the Centers for Disease Control and Prevention (CDC). Those with asthma and cystic fibrosis are at highest risk of developing allergic aspergillosis. The other major form is chronic pulmonary aspergillosis, which can affect healthy people, and occurs in about 400,000 people worldwide, the CDC notes. While requiring treatment, the allergic and chronic forms of aspergillosis typically aren’t deadly. AT A GLANCEinvasive mold cause respiratory problems

  • A deadly fungal infection, invasive aspergillosis should be diagnosed early to improve care, according to new guidelines from IDSA. New and improved therapies are expanding treatment options.
  • Immunocompromised patients are at highest risk for invasive aspergillosis. The mortality rate in those patients is 40 percent or higher.
  • Aspergillus is a mold that is in the air we breathe, particularly in air conditioning units and flood-damaged areas.
  • In addition to the invasive form, aspergillus can cause chronic and allergic forms of disease.

https://www.cdc.gov/fungal/diseases/aspergillosis/ https://www.cdc.gov/fungal/diseases/aspergillosis/