Environmental Health Quiz 1

Strength, consistency, specificity, temporality, biological gradient, plausibility, coherence

Hill's criteria for causality

The Ecological Model

Proposes that the determinants of health interact and are interlinked over the life course of individuals

Risk assessent

Provides a qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences

environment

World Health Organization defines this as it relates to health, as all physical, chemical and biological factors external to a person, an all the related behaviors

ecosystem

a dynamic complex of plant, animal, and microorganism communities and the nonliving environment interacting as a functional unit

environmental policy

a statement by an organization of its intentions and principles in relation to its overall environmental performance

exposure duration

acute (usually a single exposure for less than 24 hours), subacute (one month or less), subchronic (1-3 months), chronic (more than 3 months)

point prevalence

all cases of or deaths from a disease or health condition that exist at a particular point in time relative to a specific population from which the cases are derived; Number of persons ill divided by total number in the group at a point in time

prevalence

number of existing cases of or deaths from a disease or health condition in a population at some designated time

Healthy Worker Effect

observation that employed populations tend to have a lower mortality experience than the general population

incidence

occurrence of a new disease or mortality within a defined period of observation in a specified population; number of new cases over a time period divided by average population at risk during the same period

potentiation

one chemical that is not toxic causes another chemical to become more toxic

two types of dose-response curves

one for the responses of an individual to a chemical; one for a population

National Environmental Policy Act of 1969

one of the first laws ever written that establishes the broad national framework for protecting our environment; NEPA's basic policy is to ensure that all branches of government consider the environment before undertaking major federal action that significantly affects the environment

Paracelsus

one of the founders of modern toxicology; contributed to the concept of the dose-response relationship and notion of target organ specificity of chemicals; opium for pain; mercury for syphilis

epidemiological transition

shift in the pattern of morbidity and mortality; before the shift the causes are primarily infectious and communicable diseases; after the shift the causes are associated with chronic, degenerative diseases

antagonism

two chemicals administered together interfere with each other's actions or one interferes with the action of the other

Descriptive and analytic

two classes of epidemiological studies

ecologic study

units of analysis are populations or groups of people rather than individuals

toxin

usually refers to a toxic substance made by living organisms

basic assumption of toxicology

all substances are poisons; there is none that is not a poison. the right dose differentiates a poison from a remedy

does

amount of a substance administered at one time

poison

any agent capable of producing a deleterious response in a biological system

toxicity

degree to which something is poisonous

cohort study

classifies subjects according to their exposure to a factor of interest and then observes them over time to document occurrence of new cases of disease or other health-related events

Paris Agreement

climate conference 12/15; global temp rise during present century to be kept below 2 degrees Celsius above pre-industrial levels; periodic progress reports; US withdrew in 2017 and rejoined in 2021

additive

combination of two chemicals produces an effect equal to their individual effects added together

synergism

combined effect of exposures to two or more chemicals is greater than the sum of their individual effects

Clean Air Act of 1970

comprehensive federal law; regulates air emissions from stationary and mobile sources; authorizes EPA to establish national ambient air quality standards to protect public health and public welfare and to regulate emissions of hazardous air pollutants

local effects, systematic effects, target organ effects

direct adverse effects of exposure to chemicals

confounding

distortion of a measure of the effect of an exposure on an outcome due to the association of the exposure with other factors that influence the occurrence of the outcome

Safe Drinking Water Act of 1974

established to protect the quality of drinking water in the US; authorizes EPA to establish minimum standards to protect tap water; requires all owners or operators of public water systems to comply with these primary standards

environmental toxicology

examines how environmental exposures to chemical pollutants may present risks to biological organisms

cross-section study

examines relationship b/w disease/other variables as they exist in a define population at one particular time

route of entry into the body, received dose, duration of exposure, interactions that transpire among multiple chemicals, individual sensitivity

factors that affect the concentration and toxicity of a chemical

National Institute for Occupational Safety and Health

federal agency; responsible for conducting research and making recommendations for the prevention of work-related injury and illness

Blood (sanguine), yellow bile (aggression), black bile (melancholy), phlegm (apathetic)

four humors according to hippocrates

25%

global percentage of all deaths and total disease burden that can be attributed to environmental factors

occupational health

increased recognition of the contribution of occupationally related exposures to adverse health conditions

population growth

increasing at an exponential rate, threatens to overwhelm available resources, may cause periodic food scarcity and famine in some areas of the world

Environmental Protection Agency

wants to protect human health and the environment; established by the white house and congress in july in 1970 in response to growing public demand for cleaner water, air, and land

Mathieu Orfila

wrote Trait des poisons in 1813; described various types of poisons and their bodily effects

risk assessment is a subset of risk management

yuh

Ancient Romans

Developed first infrastructure for maintaining public health

Careers in Environmental Health

-Industrial Hygienist -Toxicologist -Environmental Health Inspector -Occupational Health Physician/Occupational Health Nurse -Environmental Lawyer

Principles of environmental policy development

-The precautionary principle (preventive, anticipatory measures should be taken when an activity raises threats of harm) -Environmental justice (denotes the equal treatment of all people in a society irrespective of their racial background, country of origin, and socioeconomic status) -Environmental sustainability (adheres to philosophical viewpoint that a strong, just, and wealthy society can be consistent w/ a clean environment, healthy ecosystems, and beautiful plant" -The polluter-pays principle (polluter bears expenses)

Demographic Stage 1

Mostly young population; high fertility and high mortality; small population

policy cycle

1. policy definition 2. agenda setting 3. policy establishment 4. policy implementation 5. policy assessment

European Environment Agency

Arm of European Union, prioritizes climate change, nature and biodiversity, environment and health, and natural resources and waste

Environmental Health

Consists of preventing or controlling disease, injury, and disability related to the interactions between people and the environment

Demographic Stage 3

Decreasing fertility rates; more even distribution of population according to sex and age

Demographic Stage 2

Decreasing mortality rates; high fertility; rapid increase in population

Clean Water Act

Federal Water Pollution Control Act in 1948; first major US law to address water pollution; amended in 1973 and 1977 to become the Clean Water Act; established basic structure for regulating pollutants discharged into US waters

Provisioning, Regulating, Supporting, Cultural

Four categories of ecosystem services

Hippocrates

Greek philosopher; 460-370 BC; "father of medicine"; emphasized influence of the environment on people's health

Poverty

Linked to population growth; one of the well-recognized determinants of adverse health outcomes

Percival Pott

London surgeon; thought to be the first individual to describe environmental cause of cancer (linked chimney soot to dick cancer)

World Health Organization

Major international agency; responsible for environmental health at global level; provides leadership in minimizing adverse environmental health outcomes associated with pollution, industrial development, and related issues; concerned about impact of environmental hazards on human health since 1989 (focuses include air pollution, children's environmental health, environmental health impact assessment, climate change and human health, environmental health in emergencies, water, sanitation, and health)

Case Fatality Rate

Measure of the lethality of a disease; number of deaths due to disease "X" divided by number of cases of diseases "X"

Total Fertility Rate

Number of children a woman has given birth to by the end of childbearing; US rate is about 2 births per woman

randomized clinical trials

Phase 1: new drug is tested in a small group for first time to evaluate safety, determine safe dosage, identify side effects Phase 2: drug is given to larger group of people for efficacy and further safety evaluation Phase 3: drug is given to large groups to confirm effectiveness, monitor side effects, and compare to common treatments Phase 4: studies done after marketing to gather info on drug's effect in various populations and any side effects associated with long-term use

Pollution, Population, and Poverty

Principal Determinants of Health Worldwide (the three p's)

Relative Risk

Ratio of the incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a non-exposed group; RR>1 means the risk of disease is greater in the exposed group in the non-exposed group; RR<1 indicates possible protective effect

1. Hazard identification 2. dose-response assessment 3. exposure assessment (includes magnitude, frequency, and duration) 4. risk characterization (develops estimates of the number of excess unwarranted health events expected at different time intervals at each level of exposure) 5. Risk management (specific actions taken to control exposures to toxic chemicals in the environment)

Risk assessment process

Increases in fertility, reductions in mortality, migration

causes of population growth

Xenobiotics

chemical substance foreign to the biologic system (antibiotics, dioxin, PCBs)

John Snow

english anesthesiologist; linked cholera outbreak in London to contaminated water from Thames River in mid-1800s

Odds Ratio

measure of association between exposure and outcome; used in case-control studies: OR = (a/c)/(b/d)= ad/bc; OR>1 means statistically significant and suggests a positive association between exposure and disease

Health Impact Assessment

method for describing and estimating the effects that a proposed project or policy may have on the health of a population

California cap and trade

policy implementation with incentives; market based trading scheme; pollution limits;companies fall below pollution limits then credits can be earned; these credits can be banked or re-sold to companies that exceed limits; revenue generated supports other projects

Carrying capacity

population that can be supported without undergoing environmental deterioration; tends to limit population size

Environmental impact assessment

process that reviews the potential impact of anthropogenic activities with respect to their general environmental consequences

Role of policy and environmental challenges

protection from environmentally associated health hazards, regarded as a fundamental human right

threshold

refers to the lowest dose at which a particular response may occur

environmental epidemiology

study of diseases and health conditions linked to environmental factors (exposure is involuntary); includes air pollution, chemicals, climate change, and water pollution; uses observational data; studies the entire population

Toxicology

study of the adverse effects of chemicals on living organisms

Case Control study

subjects defined on basis of presence/absence of outcome of interest

Definition bias

systematic deviation of results or interference from the truth. processes leading to such deviation. an error in the conception and design of a study or in the collection, analysis, interpretation, reporting, publication, or review of data leading to results or conclusions that are systematically different from the truth

Thalidomide Case Study

thalidomide was never approved in US, potent teratogen responsible for birth defects in over 10,000 children in Europe, Japans, Canada, and Australia in 1950s

lethal dose 50

the dosage causing death in 50 percent of exposed animals

host, agent, environment

three points of the epidemiologic triangle; used to describe causality of infectious diseases; provides framework for organizing the causality of other types of environmental problems

latency

time period between initial exposure and a measurable response

toxicants

toxic substances that are human-made or result from human activity

CERCLA 1980

•Comprehensive Environmental Response, Compensation, and Liability Act •Provides federal "Superfund" to clean up waste -Uncontrolled or abandoned hazardous waste sites -Accidents, spills, and other emergency releases of pollutants and contaminants into the environment EPA was given power to seek out those parties responsible for any release and ensure their cooperation in the cleanup

Resource Conservation and Recovery Act of 1976

•EPA controls hazardous waste from the "cradle-to-grave." -Includes the generation, transportation, treatment, storage, and disposal of hazardous waste •Enabled EPA to address environmental problems that could result from underground storage tanks •Focuses on waste minimization and phasing out land disposal of hazardous waste as well as corrective action for releases

Agency for Toxic Substances and Disease Registry

•Prevent and mitigate harmful exposures to toxic substances and related disease. •First organized in 1985, was created by Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of 1980; Superfund law. •Love Canal 1970; Bhopal, India 1984 •Represent issues at core of ATSDR's congressional mandate. .

Toxic Substances of Control Act of 1976

•Provides EPA with authority to require reporting, record-keeping, and testing requirements, and restrictions relating to chemical substances and/or mixtures •Various sections of TSCA provide authority to maintain the TSCA Inventory, under Section 8, which contains more than 83,000 chemicals

Endangered Species Act of 1973

•Provides a program for the conservation of threatened and endangered plants and animals and the habitats in which they are found •The U.S. Fish and Wildlife Service (FWS) maintains a worldwide list of endangered species -Birds, insects, fish, reptiles, mammals, crustaceans, flowers, grasses, and trees

Federal Insecticide, Fungicide, and Rodenticide Act of 1996

•Provides for federal regulation of pesticide distribution, sale, and use -All pesticides distributed or sold in the U.S. must be registered (licensed) by EPA. -Before EPA registers a pesticide under FIFRA, the applicant must show that using the pesticide according to specifications "will not generally cause unreasonable adverse effects on the environment."

ATSDR

•Under its CERCLA mandate, ATSDR has four functions: •Protecting public from toxic exposures. •Increasing knowledge about toxic substances. •Delivering health education about toxic chemicals. •Maintaining health registries.