Fetal Monitors

♥ 2 Miscarriages ♥ asked:


I am interested in buying an at home fetal monitor and was wondering how far into a pregnancy do they work and roughly how much do they cost?

Kelly

liambsden asked:


Let the fetus have its say regarding sex during pregnancy and in particular the fetal response to uterine orgasm. The contractions of delivery during birth cut off the blood supply and would suffocate the fetus if not spaced out. Uterine orgasm during pregnancy can last up to 30 minutes. The same physiology must exist as during birth with the cappillaries at the uterine-placental junction being clamped shut by the contracting uterine muscles. It is obvious the fetus survives,but what if repeated breath holding contests inutero lead to asthma etc. What if the reduced flow of cord blood leads to toxemia and anoxia as in a drowning victim? 5000 fetuses are aborted daily in America. If we can justify intruding on the fetal space with abortion, I pray the time has come that some brave researchers will use the high-tech fetal monitoring tests to let the fetus have its say. What are we so terrified of learning? Sex during pregnancy is such a common human experience, fear not I AM

Lisa

–Kelli–Kaiya’s Mommy asked:


Do you like it? I cant seem to hear anything with it. I can hear my own heartbeat, but not the babies. Any thuds I hear are from moving the monitor. I can hear an ocassional kick. Besides that it seems to be a waste of money.

Ann

buttercup8745 asked:


I am 21 weeks and really want to buy or rent my own fetal monitor. They are pretty expensive- to get the one like they have at the office. The cheap ones at stores like walmart or target have bad ratings so i dont even want to try that. Has anyone rented or bought one to just have during your pregnancy? I personally feel that having one will make me feel better when she still doesnt have definite movements and that i can check on my baby before i go to my appointments. Im on bedrest and to me it would make me feel better.

Juanita

Frederic Lampard asked:


Recurrent pregnancy loss exacts a devastating emotional toll on patients’ lives. Each miscarriage brings with it a profound sense of loss and frustration. While hormonal, uterine, immune system, and chromosomal abnormalities are widely accepted as possible causes of repeat miscarriages, the latest studies point to a new area of investigation - inherited blood clotting factors.

When a patient has a tendency to form blood clots, the condition is called thrombophilia. Thrombophilia can be a life-threatening event if the clots restrict blood flow. Thrombophilia can be an inherited disorder, but can also be caused by external events such as surgery, obesity, pregnancy, use of oral contraceptives, antiphospholipid syndrome, or long periods of immobility. Physicians may suspect thrombophilia when patients have a blocked blood vessel at a young age or have a strong family history of clotting disorders (such as stroke, pulmonary embolism, or deep vein thrombosis). However, some patients with thrombophilia do not experience any symptoms. Or if they do have symptoms, the condition often goes undiagnosed because the tendency to make clots is subtle. Recent research suggests a possible correlation between inherited thrombophilia and recurrent fetal loss. Genetic markers for these clotting factors include factor V Leiden mutation and prothrombin G20210A mutation. These two mutations are the most common causes of inherited thrombophilia. These markers, as well as several others that have also been associated with recurrent miscarriage, can be detected through simple blood tests (see recommended testing).

Recent research indicates that patients who experience recurrent miscarriage may have one or more of these markers for thrombophilia. One study found that 19% of miscarriage patients (15 of 80) carried the factor V Leiden mutation compared to 4% of controls. Other indicators of thrombophilia (prothrombin mutation, activated protein C resistance, and antithrombin III deficiency) are also more prevalent among women experiencing frequent miscarriages [1,2]. Several other recent studies have reached similar conclusions. While more research is needed, this is a promising new area of investigation.

Treatment regimens used at Georgia Reproductive Specialists to manage thrombophilia may include heparin or Lovenox (low molecular weight heparin) injections, and baby aspirin or metformin (for insulin resistant patients with elevated PAI-1). These treatments are designed to improve blood flow in the follicle, optimize egg quality, and improve pregnancy outcomes. All patients receiving treatment must be carefully monitored. Patients on heparin require monthly PTT, blood counts, and platelet levels. These patients should also consider dietary calcium supplementation.



Rick

Nikki87 asked:


So some friends and I were playing around with the fetal monitor, one of my friends already knows she is pregnant so we listened to the babies heart beat. Then shortly after we listen to my other friends stomach just playing around and she has not had a period an over 2 months and when we put the monitor in the pelvic area we heard a fast pace heart beat so we went to the store and bought a pregnancy test and it said she was not pregnant! So, why did we hear a heart beat in the pelvic area????????

Clarence

James Jonas asked:


Marfan Syndrome

History and Explanation

Marfan Syndrome is a genetic, “inherited” disorder that affects the body’s connective tissue. Connective tissue is the tough, fibrous tissue that connects one part of the body with another. It is a major component of tendons, ligaments, bones, cartilage, and the walls of large blood vessels. Marfan Syndrome affects one out of every 10,000 newborns. It is one of the most common of the more than one hundred inherited disorders of connective tissue. The disorder affects males and females from all racial and ethnic groups. It is named after Dr. Antoine Marfan, who in France, in 1896, described a five year old patient with unusually long, slender fingers, limbs and other skeletal abnormalities.

The problem in Marfan Syndrome is caused by a mutation (change) in a gene. Genes are segments of DNA that direct the body to produce proteins. In many families with inherited Marfan Syndrome, the mutation affects the FBN1 gene on chromosome 15; although a second gene on chromosome 5 may be involved in some cases. Normally the FBN1 gene enables the body to produce a protein called fibrillin which contributes to connective tissue strength and elasticity. Fibrillin, normally, is especially abundant in the aorta, in the ligaments that hold the eye lens in place, and in bones. Individuals with Marfan Syndrome have scant or faulty fibrillin in these structures which stretch abnormally because of their inability to withstand normal stress. The abnormal gene is usually inherited from one parent who has the disorder. The abnormality is a “dominant” genetic trait, so each child of a parent with the abnormal gene has a 50:50 chance of inheriting it.

For example, my father had Marfan Syndrome which he inherited from his father thus resulting in a normal FBN1 gene and an abnormal FBN1gene in his body. If my father gave me his mother’s normal gene, I would not have had Marfan’s. Since he gave me his father’s abnormal gene, it expresses itself as a dominant gene over my mother’s normal gene. I then, also, have the same opportunity to pass my father’s abnormal gene or my mother’s normal gene, resulting in a 50:50 chance of each of my children inheriting the disorder when combined with my wife’s normal FBN1 gene. As it stands now, one of my three daughters, who is 2 ½ years old, has inherited the disease. One daughter, 5 years old, does not seem to have inherited it and one daughter, 11 months old, we haven’t had tested yet.

On a side note, we have chosen to get life insurance for our children before being tested or officially diagnosed for Marfan Syndrome. My mother did this for me and since being diagnosed, I would not have been able to get life insurance and am not able to increase it. I highly recommend asking your doctor to hold off on an official diagnosis until life insurance is finalized.

In about 25% of diagnosed Marfan cases or 2,500 of Marfan newborns, a genetic accident (new mutation not inherited) occurred in the sperm or egg cell in unaffected parents, thus resulting in a Marfan child. In these cases, reoccurrence risk for related offspring (siblings) is unpredictable, but usually very low.

Features

Because of the inherited problem of producing fibrillin, people with Marfan Syndrome have many different problems related to weakness in connective tissue. These problems include, but are not limited to:

1) Reduced vision – in about 65% of Marfan patients, the lens of the eyes become dislocated because tiny eye ligaments that normally hold the lens in place are weak. This condition is called Ectopia Lentis. Marfan Syndrome also seems to increase the risk of near-sightedness, cataracts at an unusually early age (40-50 years old), glaucoma, detached retina, and crossed eyes. It is generally not recommended for Marfan patients to undergo lasik eye surgery due to tissue frailty and excessive scar tissue.

2) Skeletal abnormalities – patients with Marfan Syndrome are typically very tall, having long limbs and long, slender spider-like fingers. They also may have severe chest deformities, such as a chest that is either caved in or protrudes in front. Some patients may have scoliosis (curvature of the spine) and/or flat feet and some may display a high-arched palate in the roof of their mouth and crowded teeth. Many have very loose joints. The skeletal abnormality is frequently what people notice and question first and may be the first clue to a Marfan’s diagnosis.

3) Cardiovascular changes –

a. Weakened connective tissue affects the heart and large blood vessels of people with Marfan Syndrome. This creates the most serious problem associated with the disorder which is weakness of the aorta (the body’s largest artery). Cardiovascular changes affect most individuals with Marfan Syndrome to some degree. Blood pumped from the heart passes forcefully and directly into the aorta which branches out to carry oxygen-rich blood to the entire body. As the walls of the aorta gradually weaken (aortic dilatation), they can split in places allowing blood to leak into the chest, abdomen, or wall of the aorta itself. Sudden large splits can, and often do, result in sudden death. Recent studies have shown that cell death (necrosis) occurs at a much higher rate in Marfan patients which contributes to aortic dilatation or the weakening of the aortic walls.

b. Connective tissue weakness in the heart can also cause mitral valve prolapse (a “floppy” mitral valve or heart valve that doesn’t close properly) resulting in mitral valve regurgitation (a problem in the closing of the mitral valve that results in significant back flow of blood into the left atrium). Heart valves are pairs or trios of flaps that keep the blood flowing in one direction through the heart. Their motion during heart beats may allow brief reverse blood flow (leakage) and can cause a heart murmur.

You may have Marfan Syndrome if you exhibit at least two of these three major criteria: Ocular, Skeletal, or Cardiac. You could also have genetic testing done to determine if the FBN1 gene is abnormal.

Severity

The severity of Marfan Syndrome features varies, meaning that some people with the Syndrome have more serious effects than others. This variability can occur even within one family.

For example, my grandfather lived a very normal life without Marfan complications until an automobile accident ruptured his dilated aorta resulting in immediate death.

My father, on the other hand, was 6’5”, 135 pounds, and very unusual looking, meaning unproportionately long face, very narrow jaw, spidery arms and legs, etc. (this look is called “Marfanoid”). He had severe valve leakage as early as age nine and died a very sick man, at the early age of 40, on the operating table during open heart surgery to replace the aortic valve, mitral valve, and aortic root/ascending aorta.

I don’t look unproportionately unusual, although I am slender with long fingers and toes. I do have the cardiac abnormalities resulting in open heart surgery at the age of 26 to repair my aortic valve, mitral valve, and replace my aortic root/ascending aorta with a Dacron graft.

My older sister, who also has Marfan’s, doesn’t look proportionately unusual and, although being monitored by echocardiograms, does not present herself with the classic cardiovascular abnormalities; meaning all her cardiovascular measurements are currently within normal limits.

Diagnosis

Marfan Syndrome is sometimes difficult to diagnose because the features and severity of the disorder can differ greatly among affected individuals or family members. Also, certain other disorders, such as Ehlers-Danlos Syndrome, have features that overlap with those of Marfan Syndrome. In some cases, genetic testing of a blood sample may be recommended to help confirm the diagnosis. Genetic testing is more likely to aid in diagnosis in families with multiple affected members. Genetic testing is frequently unavailable at the average hospital and requires special expertise found at large children’s hospitals or university hospitals.

Your doctor should ask about any family history of Marfan Syndrome, as well as about any family members who are unusually tall and slender and ask if they have vision problems. Your doctor should also ask about any family history of sudden cardiac death resulting from aortic dissection (rupture), especially if this death was attributed to “heart problems”.

Your doctor may suspect Marfan Syndrome based on this family history, your personal history of Ectopia Lentis (dislocated eye lenses), and your physical appearance. The diagnosis can be confirmed if you have an aortic aneurysm (dilated aorta) visible on echocardiography, a painless test that uses sound waves to outline the structure of the heart and its major vessels. The diagnosis will be even more certain if you have other skeletal abnormalities (chest wall deformities or scoliosis) or heart murmurs due to aortic or mitral valve abnormalities.

Marfan’s in Women

Women with Marfan Syndrome who become pregnant are considered to be high-risk, whether or not they have symptoms of an enlarged aorta. They face an increased possibility of aortic splitting during pregnancy. The pregnancy causes greatly increased blood volume and pressure required to maintain normal fetal/mother circulation.

Treatment

Currently Marfan Syndrome cannot be cured or reversed but advances in treatment have greatly improved the outlook for children and adults with Marfan Syndrome. Today, the life expectancy of individuals with the disorder, who receive early, proper medical treatment, is about 70 years. It’s important to note that although knowledge about Marfan Syndrome has increased in recent years, expertise in treating the cardiac symptoms is rare. Research can be done to narrow your search for a Marfan’s expert through the National Marfan Foundation, an organization providing support to Marfan patients and their families throughout communities all over the country. Most of the problems associated with Marfan Syndrome can be managed effectively through medication as a preventative tool of the disease’s progression as long as it is diagnosed early.

The disorder is usually treated by a team of specialists overseen by a single doctor who knows all the aspects of Marfan Syndrome. The team would consist of an ophthalmologist (eye doctor), orthopedist (foot doctor), cardiologist (heart doctor), orthodontist (teeth doctor) and a spine specialist.

There is no medical treatment currently to reverse the fibrillin abnormality in people with Marfan Syndrome. Current research on a strain of mice that are born with similar fibrillin problems may lead to a successful treatment for Marfan’s in the future. One of the drugs being used is Losartan. They are beginning the first phases of human testing to experiment with medications that have actually reduced the aortic size in Marfan mice.

Preventative Therapy

Until we can shrink the aorta, doctors try to prevent or delay the aortic changes seen in Marfan patients by prescribing beta-blockers and/or Ace-Inhibitors.

a. Beta Blockers – These medications, such as Propranolol (Inderal), Metoprolol (Lopressor), and Atenolol (Tenormin) decrease the strain on the aorta’s walls by slowing the heart rate and reducing the force of heart contractions, especially during exercise. They also reduce blood pressure.

b. Ace-Inhibitors – These medications, such as Lisinopril (Prinivil), and Captopril, help to drop blood pressure by relaxing arterial tension. In addition, they have been shown to decrease accelerated cell death (necrosis) in the aorta which is common to Marfan’s. My 2 year old daughter is currently taking Enalapril, also an Ace Inhibitor, in a liquid form and loves it. This will slow the progression of cell death in her aorta as well as stop the increasing progression of the aortic dilation. As a result, they are hopeful she will never have open heart surgery and hopeful she will be able to bear children which is an amazing, and new, development for a female Marfan’s. My sister, 5 years ago, was told she could never bear children.

c. Calcium Channel Blockers – although not used as often anymore, they help to reduce force of contraction (how hard your heart squeezes) and blood pressure.

Nutrition Therapy

Nutrition is so important in the development of healthy connective tissue, particularly in growing children. We build a trillion cells a day by what we eat. It takes 19 vitamins and minerals and 9 amino acids with a perfect protein to build a perfect cell. Even if we miss only one nutrient, then we are building imperfect cells for seven days. These defective cells will promote the development of degenerative diseases among other things. We are the only ones who can do something about our nutrition.

With proper consumption, assimilation, and elimination our body has the ability to:

o Change the chemistry of the blood in seven days

o Change the composition of cells in seven weeks

o Change some major organs in seven months

And, as science knows, we have a completely new body in seven years. Physiological chemists state that there is not a blood cell in our body more than fourteen days old and that we rebuild a new heart every 30 days.

Can nutrition, alone, cure Marfan’s? Obviously not; however, my children and I need the proper building blocks available for the production of the best connective tissue we are capable of making. The cause of different severities among Marfan patients is unknown; however, I believe that a major component in lessening the severity in my family has been proper nutrition.

We lead a very busy life and it is natural that our nutrition generally suffers as a result. 99% of American adults fail to meet the USDA “Food Pyramid” dietary guidelines (Council for Responsible Nutrition, 1998). Therefore, we need supplementation, especially for our children. This is where Shaklee, a nutraceutical company, can benefit us greatly.

Shaklee was founded by a Chiropractic doctor in 1956. It is considered the number one leader in the nutritional industry. Shaklee nutritional products are recognized by the government as food rather than drugs. Shaklee has spent over $100 million on research which is more than the next six largest companies combined. They have over 150 scientists on staff whereas many nutritional companies don’t even have a research staff. Shaklee has never had to recall a single product in its 50 year history because each product goes through as many as 176 separate tests for purity, potency, and safety. All this to say that not all vitamins are created equal. Shaklee is superior in many areas. Ask your company for their clinical research.

For recommendations on where to begin with supplementation, refer back to my website by clicking here and going to the bottom of the website page.

Intervention Therapy

If you have Marfan Syndrome, your cardiologist should monitor your heart health carefully with echocardiograms (heart ultrasounds) at least annually to check for developing problems in the aorta and mitral valve. Surgery is usually recommended if the patient’s aortic root has stretched to more than 6 cm. in diameter or the thoracic aorta has widened to greater than 5 cm. in diameter. In a typical operation, the faulty aortic valve, along with a section of the aorta where it emerges from the heart, is replaced with an artificial valve attached to a synthetic tube. The mitral valve, if affected, can also be repaired or replaced at this time.

There are many different types of valves that can be used as replacements. These include:

1) Tissue valves – these include pig valves (porcine), cow valves (bovine), and human valves (homograft). The advantage of the tissue valve is that you don’t have to be on Coumadin the rest of your life. The disadvantage is that they typically last between 10-15 years.

2) Mechanical (metal) valves – these include St. Jude’s (bi-leaflet tilting discs), Bjork-Shiley (single tilting disc), and Star Edwards (ball cage valve). Of these three, St. Jude’s is the best option and is most commonly used. The advantage of mechanical valves is that they can last up to 20-30 years. The disadvantage is that you will be on Coumadin the rest of your life.

After any valve replacement surgery, the patient is given anti-clotting medication, such as Coumadin, at least temporarily. If your valve is a mechanical valve, you will be on Coumadin for life because blood tends to clot when it comes into contact with the metal.

A recent study showed that early, preventative surgery for aortic dilation is far safer than waiting until an emergency surgery is needed. With preventative surgery, the death rate was 1.5% versus 12% for patients who had surgery on an emergency basis. This is played out to be true in my family – my Dad waited to have surgery until it was an emergency and died during the operation; whereas, I had surgery early enough that I was healthy and strong and recovered very quickly.

If you have Marfan related scoliosis of 20-40 degrees, you can be treated with a brace and physical therapy. For scoliosis greater than 45 degrees, you will need surgery.

Crowded teeth can be adjusted by an orthodontist (remember to take antibiotics if you have a valve problem).

You should have an annual eye exam to look for Marfan related eye problems. If you have dislocated lenses, you may be able to be treated with special lenses called Aphakic Lenses and special eye drops to widen the pupil rather than surgery. If eye surgery is necessary, it should be done in an ophthalmology center that specializes in the treatment of Marfan Syndrome.

Precautions

The greatest danger is death from a sudden split in the aorta. Dilation may happen from the normal pumping of the blood through a weakened aorta, from extreme physical exercise (as in my case) or extreme emotional distress, both of which sends the blood rushing at higher pressures.

Children and adults with Marfan Syndrome are warned to avoid heavy exercise, contact sports, and lifting heavy objects. However, with their doctor’s guidance, most are able to participate in less vigorous activity such as walking, bike riding, and swimming. All of these activities should be non-competitive. If you have a coach pushing your performance to its maximum, it’s considered competitive.

Because of heart valve abnormalities, most people with Marfan syndrome are prone to infections in those valves. They must be treated with oral antibiotics to prevent infection of valves by bacteria in the blood stream before routine dental work, including a cleaning, as well as before any kind of surgery. Those who have had valve replacement surgery sometimes require higher doses of antibiotics which are usually given by injection.

Call your doctor if you have chest pain, shortness of breath especially during exercise, or an irregular pulse. If you know you have Marfan Syndrome, call your doctor immediately if you experience severe pain in the front or back of the chest, sudden weakness or tingling in the arms or legs, or an unexplained fever. These may be symptoms of aortic dissection (tear), a medical emergency that can lead to aortic rupture, which is fatal in 90-95% of cases.

Conclusion

In conclusion, Marfan Syndrome is a rare disease and requires close monitoring. Marfan Syndrome cannot be “caught” from another person – it is generally inherited, with the exception of very rare mutations. Support groups for Marfan families are available across the country and I strongly recommend finding an active, local group to answer questions. You can locate a group by going to the National Marfan Foundation website.

Genetic counseling should be considered for Marfan’s who are considering having children.

As Marfan’s age, it is possible for the lining around the spinal cord to stretch towards the base, the lumbar region. In Marfan’s patients this is called Dural Ectasia and is seen best by MRI. Radiologists, however, may call this abnormality a Neurofibroma (benign tumor) if they aren’t familiar with Marfan Syndrome. Dural Ectasia can cause lower back pain.

Connective tissue disorders are rare but many. You may have been diagnosed with Marfan Syndrome when in reality you have a different yet very closely related syndrome. In the same way, people may be diagnosed with a connective tissue syndrome that can more accurately be diagnosed as Marfan Syndrome.

I am an Echocardiographer by trade and welcome any questions about the heart and/or measurements, etc. Even if you just need someone to talk to, we would love to hear from you. If you have any further questions or we can be of help, please contact us at the information below.

Sources

** Information acquired from “IntelliHealth”, “March of Dimes” and “National Marfan Foundation” websites as well as years of personal experience in the field of echocardiography.

** Feel free to pass this information along to anyone who may benefit from it as long as you include the information, including website, at the bottom.

James & Titia Jonas – A Healthy Advantage

303-482-0002

1-800-228-6237

Longmont, CO

www.ahealthyadvantage.net

articles@ahealthyadvantage.net



Kim

Md. Wasim Aktar asked:


SEWAGE SLUDGE DISPOSAL – LAND APPLICATION -ENVIRONMENTAL PROBLEMS – AN OVERVIEW

Md. Wasim Aktar

Pesticide Residue Laboratory, Department of Agricultural Chemicals,

Bidhan Chandra Krishi Viswavidyalaya, Mohanpur-741252, Nadia, West Bengal, India

1. Introduction

Most wastewater treatment processes produce a sludge which has to be disposed of. Conventional secondary sewage treatment plants typically generate a primary sludge in the primary sedimentation stage of treatment and a secondary, biological, sludge in final sedimentation after the biological process. The characteristics of the secondary sludge vary with the type of biological process and, often, it is mixed with primary sludge before treatment and disposal. Approximately one half of the costs of operating secondary sewage treatment plants in Europe can be associated with sludge treatment and disposal. Land application of raw or treated sewage sludge can reduce significantly the sludge disposal cost component of sewage treatment as well as providing a large part of the nitrogen and phosphorus requirements of many crops. Very rarely do urban sewerage systems transport only domestic sewage to treatment plants; industrial effluents and storm-water runoff from roads and other paved areas are frequently discharged into sewers. Thus sewage sludge will contain, in addition to organic waste material, traces of many pollutants used in our modern society. Some of these substances can be phytotoxic and some toxic to humans and/or animals so it is necessary to control the concentrations in the soil of potentially toxic elements (PTE) and their rate of application to the soil. The risk to health of chemicals in sewage sludge applied to land has been reviewed by Dean and Suess1

Sewage sludge also contains pathogenic bacteria, viruses and protozoa along with other parasitic helminths which can give rise to potential hazards to the health of humans, animals and plants. A WHO (1981) Report on the risk to health of microbes in sewage sludge applied to land identified salmonellae and Taenia as giving rise to greatest concern. The numbers of pathogenic and parasitic organisms in sludge can be significantly reduced before application to the land by appropriate sludge treatment and the potential health risk is further reduced by the effects of climate, soil-microorganisms and time after the sludge is applied to the soil. Nevertheless, in the case of certain crops, limitations on planting, grazing and harvesting are necessary.

Apart from those components of concern, sewage sludge also contains useful concentrations of nitrogen, phosphorus and organic matter. The availability of the phosphorus content in the year of application is about 50% and is independent of any prior sludge treatment. Nitrogen availability is more dependent on sludge treatment, untreated liquid sludge and dewatered treated sludge releasing nitrogen slowly with the benefits to crops being realised over a relatively long period. Liquid anaerobically-digested sludge has high ammonia-nitrogen content which is readily available to plants and can be of particular benefit to grassland. The organic matter in sludge can improve the water retaining capacity and structure of some soils, especially when applied in the form of dewatered sludge cake.

2. What is sludge?

Residuals, biosolids, septage, sewage, wastewater byproduct, compost: there are many names for sludge and sludge products. The term “sludge” is used as most people understand it: the sometimes solid, sometimes liquid material generated by wastewater treatment plants and used as fertilizer on fields, in gravel pits, and on forestry lots throughout the state. Sludge may classified as “Class A” if it has been treated to reduce germs to background levels (levels normally found in soils) and “Class B” if it has been treated so that germs are reduced by an estimated 90%.

3. Composition of sewage sludge:

The nature of the sewage sludge depends on the waste water treatment process and on the source of the sewage. In general it contains both toxic and non-toxic organic wastes. Of the two, non-toxic compounds are most prevalent comprising all materials of plant and animal origin, including proteins, amino acids, sugar and fats. Toxic organic compound comprises Poly-nuclear aromatic hydrocarbons (PAHs), alkyl phenols, polychlorinated biphenyls (PCBs) organo-chlorine pesticides, monocyclic aromatics, chloro-benzenes, aromatic and alkyl amines, polychlorinated dioxins, phenols etc. In addition to these organic waste material sewage sludge also contains traces of many pollutants like Copper, Zinc, Nickel, Cadmium, Lead, Arsenic, Chromium, Selenium etc. Some of these substances can be phytotoxic and some toxic to humans and / or animals, so it is necessary to control the concentrations in the soil of potentially toxic elements and their rate of application to the soil. Sewage sludge also contains pathogenic bacteria, viruses & protozoa along with other parasitic helminthes which can give rise to potential hazards to the health of humans, animals and plants. Apart from those components of concern sewage sludge also contains useful concentrations of N, P and organic matter. Each component of the sludge has its own environmental impact, which must be taken into account when choosing the disposal route.

4. Processing of sludge:

Increasing urbanization and Industrialisation have resulted in a dramatic increase in the volume of waste water produced around the world. The waste water treatment step concentrates the various pollutants (upto 90%) in the waste water into sludge, normally containing between 1% and 2% by weight dry solids. The waste water treatment commonly involves the following processes to process the sludge for the production of suitable end products for utilization or disposal:

Sludge processing methods

Process Description

Sludge pasteurization Minimum of 30 minutes at 70ºC or minimum of 4 hours at 55ºC (or appropriate intermediate conditions), followed in all cases by primary mesophilic anaerobic digestion.

Mesophilic anaerobic digestion Mean retention period of at least 12 days primary digestion in temperature range 35ºC ± 3ºC or of atleast 20 days primary digestion in temperature range 25ºC ± 3ºC followed in each case by a secondary stage which provides a mean retention period of at least 14 days.

Thermophilic aerobic digestion Mean retention period of at least 7 days digestion. All sludge to be subjected to a minimum of 55ºC for a period of at least 4 hours.

Composting The compost must be maintained at 40ºC for at least 5 days and for 4 hours during this period at a minimum of 55ºC within the body of the pile followed by a period of maturation adequate to ensure that the compost reaction process is substantially complete.

Lime stabilization of liquid sludge Addition of lime to raise pH to greater than 12.0 and sufficient to ensure that the pH is not less than 12 for a minimum period of 2 hours. The sludges can then be used directly.

Liquid storage Storage of untreated liquid sludge for a minimum period of 3 months.

Dewatering and storage Conditioning of untreated sludge with lime or other coagulants followed by dewatering and storage of the cake for a minimum period of 3 months. If sludge has been subject to primary mesophilic anaerobic digestion storage to be for a minimum period of 14 days.

5. Agricultural application

The application of sewage sludge as a “ safe fertilizer “ started in earnest after the 1988 ban on dumping sewage sludge into the ocean. When the Ocean Dumping Ban Act of 1988 went into effect, the municipalities & the Govts. left with a new problem – how to get rid of the tons of sludge they generate on a daily basis. The federal Environmental Protection Agency (EPA) stepped in with a plan to “solve” this problem by promoting sludge (sometimes called ‘biosolids’, a public relations term that is used interchangeably by EPA with the technical term “sewage sludge”) as fertilizer to be spread on land – where people live, work and play. Though, the viscous, black cake adds free Organic Matter & Fertilizer to poor soils, making them productive and profitable, the main limitations arising from such factors are: pathogens, heavy metals, toxic organics. Therefore, the plan of EPA has allowed toxic chemicals into air, water, soil, crops & into us. So, to call this sludge “ fertilizer” is tantamount to call a soup “food” which, though it contains some meat & vegetables, also contains a bit of lead, a little arsenic, and perhaps hundreds or even thousands of other toxic organic and inorganic materials whose impact ranges from carcinogenic to teratogenic (birth defect inducing ). “Most people want a simple answer; is it good or is it bad. The answer is not that simple. It is not completely risk free, but it has benefits. Just like driving a car”, Sanden said.

The benefits of sewage sludge on agricultural land

• Valuable agricultural nutrients like Nitrogen, Phosphorus, Potassium and Sulphur can be returned to the land

• Soil organic matter levels have been increased to 12% – 15%

• Ground water and surface water quality are maintained

• Decrease bulk density and increase the non-capillary pore space

• Improve the aggregation of soil particles

• No significant health or nuisance problems occur

6. Problem of Sludge

Sludge contains measurable quantities of pollutants, such as heavy metals, dioxin, and other toxic chemicals. Sludge also contains pathogens–human germs, bacteria, viruses, and parasites. And sludge smells: sludge odor is more than just a nuisance; it is a public health threat, which has been linked to respiratory problems and death. The land application of sludge distributes pollutants from large towns and cities to rural areas, far from where they were originally produced. State and federal agencies of various countries regulate sludge spreading, but regulation of this waste is difficult and problematic. Many scientists agree that the current land application rules do not protect human health, agricultural productivity, or the environment. The lack of funding to provide proper regulatory oversight and the very nature of sewage allow for sludge spreading of an unknown quality to occur on our lands.

The problems with sludge include:

? Sludge contains heavy metals, toxic chemicals, and pathogens.

? The testing and regulation of sludge is inadequate and problematic.

? Sludge odors pose a public health threat and lower quality of life.

7. The trouble with sludge

7.1. How toxic sludge become fertilizer

In traditional agricultural societies, human waste was often used to enrich the soil. The Industrial Revolution caused increased urbanization and the need for cities to develop primitive sewer systems to remove human waste. Pipes and gutters were built to dump sewage directly into our lakes, rivers, and oceans. As industry increased in World, factories began using these primitive sewer systems to get rid of their waste. This practice continued well into 20th century, when industry began widely using toxic chemicals. Using the local sewer system as a dumping ground for toxic waste was an easy solution to their disposal problems and was cheaper than treating their waste on site. Sewage loaded with toxic chemicals created major public health and environmental disasters throughout the World: rivers caught fire, public drinking water supplies became polluted, and waste washed up on our beaches. Public outcry from the growing number of disasters led to the passage of the federal Clean Water Act in 1972. This act set water quality standards nationally and provided money to communities to improve sewer systems and create wastewater treatment facilities. Unfortunately, instead of addressing the root of the problem by stopping industrial use and disposal of toxic chemicals, the act instead regulated the amount of pollution large industries could release into sewer systems.

By the late 1970s, extensive sewage systems had been built across the country. Wastewater treatment plants were built to separate solid waste from water, and, following natural and chemical treatment, release water back into the environment, clean of human waste. Unfortunately, they were not built to treat toxic chemical waste. While these sewage systems and wastewater treatment plants improved public health standards and water quality, they have an ironic flaw. The treatment process creates cleaner water but also creates a toxic byproduct: sludge. In fact, the Clean Water Act rightly defines sludge as a pollutant. Like all waste, sludge must be disposed of in some way. What to do with sludge has been a source of controversy for the past three decades in the World. Through the 1970s and 80s, the federal Environmental Protection Agency (EPA) strictly regulated the land spreading of sludge, effectively prohibiting much of the waste from being used on agricultural land. Wastewater treatment facilities could only dispose of sludge in one of three ways: by sending it to a landfill, by incinerating it, or by dumping it 100 miles offshore into the ocean.2

Ocean dumping eventually created large under-sea dead areas. In response to public concern, Congress passed the Ocean Dumping Act, which banned ocean dumping of sludge in 1992.3 Sludge disposals was then largely limited to landfills and incineration that became expensive for wastewater treatment plants. Municipal treatment facilities then pressured the EPA to relax its standards for the land spreading of sludge on agricultural fields. Following a number of draft rewrites of EPA regulations, corporate sludge marketing companies and municipal wastewater treatment facilities were successful in relaxing the limits of toxins in sludge for land spreading. What was once considered hazardous waste became a fertilizer? By classifying sludge as a fertilizer, it became exempted from several waste management regulations.

7.2. Marketing of toxic sludge

Municipal water treatment facilities depend upon corporate sludge brokers to dispose of their sludge. To dispose of it, these private corporations convince farmers and landowner across the country to spread sludge on their fields as a nutrient supplement for their crops. Sludge is marketed to landowners and consumers in two different ways. The first, and most obvious, is by offering them free sludge. By convincing individual property owners that sludge is of “agronomic benefit” to their land, sludge brokers are finding extremely cheap disposal sites for sludge that would otherwise have to be shipped to landfills or incinerators at a cost of approximately $70 a ton.4

Companies then claim that everyone wins: treatment plants have a cheap disposal option for their sludge, which gives taxpayers a break, and landowners get free nutrients for their fields. As an accurate result, the sludge brokers walk away with the disposal fees from the treatment facility. The sludge brokers also escape from potential liability, which is now assumed by the farmer or property owner. The second way sludge is marketed is by composting or palletizing it. Then it can be sold or given away as compost or fertilizer. Since the weakening of sludge regulations in the late 1980s, citizens cross the World have been fighting to keep sludge from being spread on fields and farmland in their communities. Activists fighting sludge are up against formidable opponents. Water treatment facilities and sludge brokers have formed powerful trade groups, such as the New England Biosolids & Residuals Association (NEBRA). NEBRA, in turn, is part of an even larger and more powerful group: the National Biosolids Partnership, which is a coalition of groups such as the EPA and Water Environment Federation, whose primary responsibility is to change “public perception” about sludge spreading.

7.3. Toxic secrets of sludge

Land applied sludge is required laws to have toxic levels below certain limits and it is treated with lime to reduce pathogen levels. However, no sludge in World is completely free of toxic chemicals or pathogens. In fact, after it is treated, Class B sludge still contains a significant amount of pathogens5.

7.4. Toxic in sludge

A. Heavy Metals

All sludge in world contains heavy metals like arsenic, cadmium, chromium, copper, lead, mercury, molybdenum, nickel, selenium, and zinc.6 These metals are persistent—that is, they do not break down in the environment and therefore build up over time. As the Cornell Cooperative Extension states, “most heavy metals remain in the soil for long periods of time, ranging from several decades to many centuries.” The heavy metals in land spread sludge therefore become permanent additions to the total quantity in the soil. Even extremely small amounts of heavy metals in sludge, therefore, are dangerous.7 High levels of arsenic in food or water can be fatal. Cadmium, chromium, nickel, and selenium have been linked to cancer. Cadmium has also been linked to kidney problems, miscarriages, and stillbirths. Copper, nickel, and zinc are known to cause growth problems in crops. Children exposed to lead can develop behavioral and learning problems. Mercury exposure at key moments in fetal development can cause learning disabilities and neurological disorders. Molybdenum bioaccumulates in grass eating livestock; ingested in excess, it can cause anemia, diarrhea, and growth problems.8 These metals can be taken up by the plants that are grown on sludge and re-enter the human food chain via livestock feed. These metals can also leach into groundwater. Highly acidic soils, like those found in Maine, can exacerbate heavy metal leaching.9

B. Pathogens: Bacteria, Viruses, and Parasites

Sludge, by its very nature, contains human pathogens: germs such as bacteria, viruses, and parasites. Whereas exposure to heavy metals can cause problems over time, exposure to these germs is more acute and can cause health problems almost immediately. Because of the extremely large numbers of pathogens that exist in the world, it is impossible to test sludge for all types of pathogens. Some common pathogens in sludge include the bacteria E-coli and Salmonella, the virus Hepatitis A, and parasitic worms. Pathogens can cause intestinal problems, other serious illnesses, and death. Land spread sludge can be treated to nearly eliminate pathogens. By composting sludge, for example, pathogen levels can be reduced significantly. Unfortunately, federal and state laws allow “Class B” sludge, which has not been treated to the strictest pathogen reduction methods, to be spread. In other words, sludge with live pathogens is being spread throughout the state. Unfortunately for the residents and workers of Northern New England, wet and overcast climates encourage pathogen growth. Researchers have found that pathogens can survive in sludge for weeks, months, or even years after reduction treatment processes.

Humans can be exposed to sludge pathogens in a number of ways. We might consume vegetables that have pathogens on them. Children might accidentally gain access to a sludge field and become exposed to the germs. Pathogens can also be spread by pets or wildlife, such as deer, that walk through a sludge field.

C. Dioxin: “The Darth Vader of Chemicals”

Dioxin is the unwanted byproduct of chemical processes involving chlorine. According to the EPA, sludge spreading is the largest land distributor of dioxin nationally.10 Dioxin is a known carcinogen and has been linked to reproductive problems, genetic damage, and endometriosis. Scientific evidence suggests there is no safe exposure level to dioxin.11 As one well-known dioxin expert called it, dioxin is “the Darth Vader of chemicals,” because you can’t see or taste it, but it is deadly. The source of dioxin contamination in sludge is not known. It might be discharged into the sewer system by unknown industrial or residential sources. Dairy cattle grazing on sludged land may ingest dioxin and the chemical will then enter humans via milk and meat.

7.5. What We Don’t Know Can Hurt Us

The federal Environmental Protection Agency estimates that there are 70,000 synthetic (not naturally occurring) chemicals. Yet, only 2% of these chemicals have been fully tested. In fact, even the most basic toxicity testing results cannot be found in the public record for nearly 75% of the most widely used of these chemicals. The ways in which these chemicals affect human health and the ways in which they interact with one another in the environment (their “synergistic effects”) are not always known. Despite this, industry only needs to report the discharge of 1% of these chemicals into the waterways and sewers. Although industries and households release thousands of chemicals, World sludge is only regularly tested for few heavy metals and occasionally tested for dioxin and toxic pesticides.

8. Source of toxic chemicals

Sludge contains heavy metals and other pollutants because industry and households use and release far too many toxic chemicals. The sources of contaminates in sludge are many, depending upon the specific water treatment facility and the community that it serves. Sources of contamination include industrial releases, small business discharges, hospital releases, household waste, leachates from landfills and Superfund sites, including nuclear waste dumps, and municipal water and sewer systems as a whole.12Everything that is discharged into a sewer that leads to a water treatment plant could potentially become part of the sludge that the facility produces. If a worker at an industrial facility accidentally dumps toxic chemicals down the drain instead of disposing of it properly, those chemicals could end up in the sludge. Likewise, if a home gardener rinses out a bottle containing toxic pesticides in the sink, those toxic pesticides could find their way to the sludge.

8.1. Industrial Hazards

As discussed earlier, many chemicals used by industry have not been properly tested and are not regulated or reported. Additionally, even at the safest facilities, accidents happen and toxic chemicals can be released into the waste stream. World requires wastewater treatment plants to work with large industries on reducing and monitoring their waste discharge. This “pretreatment process” is required of companies that discharge a large amount of waste into the sewer system or use a large amount of chemicals that could affect the operation of the sewer system. Unfortunately, once companies release heavy metals, or other toxins, into the sewer system, there is no process to remove these chemicals from the sludge. In addition, every industry in the country can discharge 33 pounds of hazardous waste every month into wastewater treatment plants, without penalty or reporting.13

8.2. Small Business Hazards

Many small businesses are not regulated for their toxic releases. Nor are they included in the pretreatment processes. While auto garages, dentist offices, photo developers, dry cleaners, and other small businesses may not individually release a large amount of toxic chemicals, taken as a whole their contribution to chemicals in sludge could be dangerous.

8.3. Hospital Hazards

All hospitals are required to dispose of toxic chemicals and biohazards in a state approved manner. Nevertheless, accidents do happen: from a broken mercury hermometer to additional human pathogens being washed down the drain, hospitals can contaminate sludge.

8.4. Contamination from Municipal Water and Sewer Systems

Many towns and cities have water and sewer systems made with lead and copper pipes. Lead, copper, and other metals often leach into the waste stream and contaminate sludge. Contamination of sludge can also occur if a town’s reservoir is polluted with pesticides and other chemicals for which testing are not required.

8.5. Household Hazards

From pesticides (including flea shampoos), to heavy duty cleaning agents and hair coloring products, toxic chemical containing products abound. Any of these chemicals dumped down the drain could end up being spread on a farm field or in a forest.

9. Sludge regulation

It is nearly impossible to know the exact levels of toxic materials in each batch of sludge because what is released into the waste stream varies day to day. While sewage waste is treated at wastewater facilities for several days, not every batch of sludge is tested before it leaves the plant. It is more due to economics than to concerns for health protection, that sludge generators do not test the waste more frequently. For example, waste is often only tested for dioxin twice a year because of the cost of the test. A worker may accidentally spill pesticides into a sink or storm drain, or someone might illegally dump other toxic chemicals down the drain, and no matter how strict regulations are in the law books, testing could miss these sudden increases in contaminants. Regulations and testing cannot guarantee sludge safety until toxic chemicals are removed from industrial household use.

10. Sludge consequences

“Temporary odors are a necessary inconvenience in the practice of agriculture.”14 Sludge smells similar to manure and that the smell will dissipate “within several days.” Despite industry propaganda, studies have shown that sludge odors are more than just a nuisance; they are a public health threat. Harmful gases, called organic amines, can develop from chemical reactions that occur in sludge. These gases are released when the pH of sludge is raised above 10, such as when lime is added. Studies suggest that sludge odor can cause health problems in humans as far as 1600 feet from a site.15A study performed by a former EPA sludge regulator linked sludge odors to “severe irritation to mucous membranes followed by respiratory infections” in residents living near a sludge site. Irritation of the eyes, throat and skin make infection from pathogens in sludge more likely. The study was conducted following the death of a New Hampshire man suffering from respiratory distress in the vicinity of a sludge site.16 Residents near sludge sites have not been the only victims of sludge odor. Symptoms associated with organic amine poisoning frequently occur among waste treatment plant workers and drivers who haul sludge.

10.1. Deaths associated with sludges

At least two deaths have been associated with sludge spreading. In October 1994, an eleven-year-old boy, named Tony Behun, went dirt bike riding near his home in Osceola Mills, Pennsylvania. Unknowingly, the boy rode through a field covered in Class B sludge. He came home covered in dirt and grime. Two days later, he developed a sore throat, headache, and a boil on his left arm. Brenda Robertson, his mother, took him to the doctor, who prescribed flu antibiotics. The next day, Tony had trouble breathing. He died after being flown by helicopter to a hospital in Pittsburgh. The final diagnosis was that Tony had died from a bacterial infection. How her son contracted the infection remained a mystery to Brenda Robertson until five years later when she read about an investigation into her son’s death by the Pennsylvania Department of Environmental Protection. Without consulting Brenda, the state published a report concluding that Tony died of a bee sting and that Class B Sludge was not spread on property that he went riding on.

Another sludge related death occurred in Greenland, New Hampshire. In late October of 1995, the Marshall family had their otherwise quiet lives tragically disrupted. Sludge was being dumped on a field in their rural neighborhood. This was just the beginning of the residents’ problems. On Halloween, Joanne Marshall rushed home from work to take her little girl trick-or-treating. When she arrived home and jumped out of her car, she was “greeted by such a stench, it took her breath away. ”17 The Marshalls and their neighbors began suffering from nausea, vomiting, stomach cramps, migraine headaches, flu-like symptoms, slowed reflexes and respiratory problems.

10.2. Environmental Assessment and some remedy:

Recycling sewage sludge to agricultural land to gain benefit from the essential plant nutrients and organic matter it contains, would seem a reasonable and rational method of managing a material which would otherwise need disposing of by some other non-beneficial route. But sludge also contains inorganic, organic and biological contaminants and so careful, management is required to avoid the potential environmental problems. The problems are listed in following Table. Large application of sewage sludge can decrease the soil pH. This can be avoided, if the soil pH is increased by application of lime, or if sludge application rates are limited in some way.

The no. of bacteria of different genera in sludge varies. In general, a total coliform count of 10 to 10 can be found per gram of dry wt., while fecal coliform bacteria generally represent 10 to 10 per gram of dry wt. The pathogens should be reduced to levels that are unlikely to cause a threat to public health and the environment under specified use conditions processes to significantly reduce pathogens, such as digestion, drying, heating and high pH or their equivalent are the most commonly used one.

For the removal of OCs from sludge mainly two approaches ar there – physico chemical or microbiological which involves either high temperature oxidation (incineration) or reductive dechlorination (pyrolysis in an atmosphere of hydrogen). To achieve allow level of risk, presticide concentrations in the combined soil and sludge mixture must be less than 1.25 mg/kg dry wt.

Environmental impact risk and benefit assessment for sewage sludge recycling to agricultural land (B= beneficial effect, L=Low risk, P=Possible risk, NA=Not applicable.)

Environm-ental parameter PTEs Organic contaminants Pathogens Nitrogen Phosphorus Organic matter

Human health L P L B B B

Crop yields L L L B B B

Animal health L L L B B B

Ground water quality L L L P L L

Surface water quality L L L P P B

Air quality L L L P NA NA

Soil fertility P L L B B B

Natural ecosystem P P L P P B

11. Sludge regulation

Sludge, by its very nature, is difficult to regulate. Depending upon what chemicals are being released into various sewer systems minute to minute, the toxicity of the state’s sludge could vary day-to-day, minute-to-minute. Regulations of sludge do not adequately protect public health and the environment.

11.1. Regulations problems:

• Have weak pollution standards;

• Allow for the spreading of sludge containing live pathogens;

• Discourage municipalities from being precautionary and public health oriented by not allowing them to make stricter standards than the state’s; and

• Marginalize citizens’ voices in the process as the sludge industry has greater access to state regulators than the average citizen.

11.2. Heavy Metals Standards (in ppm)

Heavy Metal Denmark Sweden Finland Germany Netherlands Norway European Union

Arsenic 25 N/A N/A N/A 0.15 N/A N/A

Cadmium 0.8 2.0 1.5 5 or 10* 1.25 2.5 20

Chromium 100 100 N/A 900 75 100 N/A

Copper 1000 600 N/A 800 75 1000 1000

Lead 120 100 100 900 100 80 750

Mercury 0.8 2.5 1 8 0.75 3 16

Nickel 30 50 100 200 30 50 300

Zinc 4000 800 1500 2500 300 800 2500

*Source Harrison, et al. 1999 7

11.3. Sludge vs. Natural soil

Heavy Metal Average Sludge (ppm) Natural Soil (ppm) Times Higher than Natural Soil

Arsenic 5.6 7.4 1.3

Cadmium 2.4 0.37 6.4

Copper 388.0 23.3 16.6

Chromium 33.3 30 1.1

Lead 61.5 17 3.6

Mercury 1.2 0.003 400

Molybdenum 7.5 0.79 9.4

Nickel 22.8 18 1.2

Selenium 2.6 0.45 5.7

Zinc 468.5 68.5 6.8

11.4. Standard values for organic compounds

Compounds Concentration in sludge

PAHs 1-10 mg./Kg.

Alkyl phenols 100 – 3000 mg./Kg.

PCBs 1 - 20 mg./Kg.

Poly chlorinated dibenzo-p-dioxins Very low < µg /Kg.

OC pesticides < low mg./Kg.

Monocyclic aromatics

Patricia

New mommy to baby Alexia! asked:


Since i had decreased fetal movements I told my doctor about it today, and he hooked me up to a fetal monitor, then he came back and said the baby was fine…

Just wondering if this is the way they find out/?? (by the way my baby still moves more than `10 times an hour in her active hours, just decreased movement throughout the day)

Carlos

New mommy to baby Alexia! asked:


Do their heartbeats drop??

How low should it be so doctors begin getting worried? is it normal that the heartbeat goes up and down alot during monitoring?
im 22, 23 in February

Douglas