The Data of the Flint Water Crisis

After the city of Flint, Michigan changed its water source from Lake Huron to the Flint River in April 2014, the quality of water concerned residents. Some reports showed that the percentage of children with elevated levels of lead in their blood was doubled. Figure 1 shows children�s blood lead levels change from 2013 to 2015 in nine districts of Flint. Lead is a neurotoxin, which has no �safe level of exposure�. Newer research asserts that it may �increases the incidence of attention deficit hyperactivity disorder, learning disabilities and potentially violent behavior.� And lead can also affect DNA, carrying damage to children of this generation and the next.

 

Figure 1

The Michigan Department of Environmental Quality conducted a study to show the public that the water was safe. However, months later, under the insistence of local residents, Marc Edwards, who is a national expert on corrosion control and had solved the water crisis in D.C., was engaged in the study. He with his team, �Flint Water Study� finally confirmed that the government had underestimated the problem. The water had toxic waste, which contained a high concentration of lead. Further, the government didn�t use the federally required corrosion control to prevent the lead from leaching out of the old pipes.

The City had trouble collecting the samples, so they dropped the requirements and collected only 60 of 100 samples from all districts of Flint. Additionally, the city asked residents to clean the system the night before and test the water six hours after it had been sitting. They also used bottles with small necks to collect the water sample, all of which may lower the concentration of lead. Following these standards, the Michigan Department of Environmental Quality concluded that the water was safe.

However, Marc Edwards, with his team, did a more comprehensive test, which included 271 samples in each of the city�s ZIP codes. They tested the water three times in different conditions in order to increase the reliability of the study. The results showed that 20% of the water had lead levels higher than 15 ppb, which based on the federal law, should "trigger public warning."

In Figure 2, we can evaluate the different representations of samplings carried out by the Department of Environmental Quality and the Flint Water Study�s Analysis. In the first case the sample was small, considering only two out of the ten wards in the city, while in the second map we can see that the sample reached almost all of Flint.  

Figure 2

Further Reading:

http://fivethirtyeight.com/features/what-went-wrong-in-flint-water-crisis-michigan/

http://www.michigandnr.com/PUBLICATIONS/PDFS/ifr/ifrlibra/Special/Reports/sr27.pdf

http://flintwaterstudy.org/2015/09/commentary-mdeq-mistakes-deception-flint-water-crisis/

http://www.mlive.com/news/flint/index.ssf/2014/04/questions_abound_on_water_rate.html

Residency Hours: How do long hours and exhaustion play into medical training?

http://shortwhitecoats.com/2013/which-residents-work-the-hardest

How does the length of resident shift impact patients? How does it impact prospective doctors? These are important questions that have been at the forefront of public health dialogue in recent months.

According to a recent study in the New England Journal of Medicine, when doctors training to be surgeons are able to work longer shifts patients suffer no additional harm. For the study, 58 surgical residency programs loosened their rules regarding shifts while 59 residency programs did not. Patient outcomes for both program groups were tracked, and the study found that patients do not die or suffer complications any more often when the rules were loosened versus when they were not.

This research comes amidst critiques of the current resident requirements, which forbid residents from working extremely long shifts or back-to-back shifts. The criticism is that these rules often force interns to leave while they are treating a patient or performing surgery. The president of the Resident and Associate Society of the American College of Surgeons and current neurological surgery resident, Dr. Maya Babu, said she felt encouraged by the new findings. �We feel very strongly that flexibility is important to provide opportunities to learn and to have patient ownership, to see patients from the time they're admitted through surgery the next day.�

Others interpret the data differently. In the New York Times, Professor Aaron E. Carroll argued that working shorter shifts also does not cause any additional harm to patients. Thus, the better option is what is better for the residents, which he believes to be shorter shift requirements. Resident health is, after all, also a concern lately: another recent study shows that almost a third of residents exhibit signs of depression and almost 10 percent of fourth-year medical students have admitted to having recent suicidal thoughts.