Case Study #2

Case Study #2Child with Recurrent Sinus Infections

www.environmentalhealthproject.org

Onset Mom and dad and 4 year old Child has been having four upper

respiratory infections in last 6 months Diagnosed with otitis and sinusitis

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History Family moved last year from Maryland

to find jobs in Pennsylvania Father has secured a job at a water

withdrawal station They live adjacent to a compressor

station

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History (continued) Mother reports that when crossing the

yard she has a funny taste in mouth Father smokes outside the home Child did not have any upper respiratory

infections prior to moving to Pennsylvania

What other pieces of information do you want to know?

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Exam Playful child Afebrile Normal growth chart Normal HEENT except some crusting nasal

discharge Occasional coarse upper respiratory sounds

Why are children not small adults?

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Children’s Susceptibility To Air Hazards Have increased respiratory rate and

breathe in more (i.e. more toxins) per body weight than adults

Play vigorously for long time periods Developmental stages predispose them

to activities and behaviors conducive to environmental exposures

Have little knowledge or awareness of environmental hazards

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Known Emissions from Compressors Compressors and motors on the drilling and

production sites, injection well disposal sites and along pipelines release combustion products and volatile organic hydrocarbons into the air and degrade the air quality

These combustion products also combine with the volatile organic chemicals in the presence of heat and sunlight to produce ground level ozone

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Ground Level Ozone Formation

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Potential for Air Pollution- VOC & PM 2.5 Ground level ozone exacerbates underlying

asthma and COPD and causes lung injury PM2.5 when inhaled lodge in the deep lung

(bronchioles and alveoli) PM2.5 carbonaecous core adsorbs PAH,

nitro-PAH and heavy metals PM2.5 invoke an inflammatory response and

contain probable lung carcinogens (IARC)

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Units at Compressor Stations & Gas Metering Stations Releasing Emissions into the Air Compressor Engines

Compressor Blowdowns

Condensate Tanks

Storage Tanks

Truck Loading Racks

Glycol Dehydration Units

Amine Units

Separators

Fugitive Emission Sources

90% of individuals reported experiencing odor events from these facilities

From survey conducted by Earthworks

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Examples of Chemicals Detected in Air Xylene

Ethane

Isobutane

Methane

Propane

Propylene

Nitrogen Oxide

Carbon Monoxide

Sulfur Dioxide

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Sample Air Test

What is elevated in this sample and what does the elevation mean?

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Important Variables with Air Testing Type of air monitor: summa canister,

H2S monitor, 24 hour personal air monitor

Direction of wind, weather pattern that day

Location sampled Beware of sample contamination

especially with summa and what each air monitor tests

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MorePotential for Air Pollution Diesel trucks traffic Flaring H2S Preexisting air quality from coal industry

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Recommendations Air filters- incoming air vents or free

standing in bedrooms Avoid ionizers

Monitor for signs of asthma Decrease second hand tobacco

exposure Father to change attire prior to coming

inside home after work

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Answer Key See Handout

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