Environmental Health: Epidemiology

Aftermath of Barriers

The following are all examples of ______________ Unmet health needs Delays in receiving appropriate care Inability to get preventive services Hospitalizations that could have been prevented

Barriers to Health Service

The following are all examples of ________________ Limited access Lack of availability High cost Lack of insurance coverage Limited language access

Psychrophilic

"cold loving" microbes

Thermophilic

"heat-loving: microbes

Odds Ratio Equation

(A/C) AD ------ = ----- (B/B) BC

Environmental Epidemiology

-The study of diseases and health conditions (occurring in the population) that are linked to environmental factors. -These exposures usually are involuntary.

Sir Percival Pott

-_______________________ was a London surgeon thought to be the first individual to describe an environmental cause of cancer -Found chimney sweeps had high incidence of scrotal cancer due to contact with soot

Odds Ratio (OR)

A measure of association for case-control studies

Relative Risk Equation

A/(A+B) --------- = C/(C+D)

Biological Factors

Age, sex, genetics (sickle cell), and inherited conditions (behavior) are all examples of?

Causality

Certain criteria need to be taken into account in the assessment of a causal association between an agent factor (A) and a disease (B).

Descriptive

Depiction of the occurrence of disease in populations according to classification by person, place, and time variables.

morbidity and mortality

Environmental epidemiology studies a population in relation to ______________ and _____________.

Analytic

Examines casual (etiologic) hypotheses regarding the association between exposures and health conditions

Host

In the epidemiologic triangle the term _______ is "a person or other living animal, including birds and arthropods, that affords subsistence or lodgment to an infectious agent under natural conditions."

Agent

In the epidemiologic triangle the term _________ refers to "A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential for the occurrence of a disease."

Environment

In the epidemiologic triangle the term ______________ is defined as the domain in which disease-causing agents may exist, survive, or originate; it consists of "All that which is external to the individual human host."

Most Important

Mesophilic microbes are the _______________ because their threat to humans

8

Microorganisms have _______ favorable conditions required for growth.

The healthy worker effect, Confounding

Name 2 types of bias in environmental epidemiologic studies

Agent, Host, Environment

Name the 3 points of the epidemiologic triangle

Postive

Note that an OR >1 (when statistically significant) suggests a ___________ association between exposure and disease or health outcome.

Formula for Incidence Rate

Number of New Cases over a time -------------------------------------- X period of Total Population at Risk time

Fromula for Point Prevalence

Number of persons ill at point in time --------------------------------------- = Total number in the group

Immunity (active or passive)

Presence of an antibody that attacks the specific microorganisms (causative agent)

Exposure-odds Ratio

Refers to "... the ratio of odds in favor of exposure among the cases [A/C] to the odds in favor of exposure among the non-cases [the controls, B/D]."

Point Prevalence

Refers to all cases of a disease, health condition, or deaths that exist at a particular point in time relative to a specific population from which the cases are derived

Prevalence

Refers to the number of existing cases of a disease, health condition, or deaths in a population at some designated time

Healthy Worker Effect

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

protective

Relative Ratio <1 indicates possible ____________ effect.

Greater

Relative Ratio >1 indicates that the risk of disease is ___________ in the exposed group than in the nonexposed group.

Fungus

Ringworm and Athletes foot are all types of what kind of biological agent?

Epidemiologic Triangle

The ________________ is used for describing the causality of infectious diseases and provides a framework for organizing the causality of other types of environmental problems

Lifestyle

The easiest determinant of health to control is?

Involuntary

The exposures to environmental factors that are linked to diseases and health conditions are usually ______________

Lifestyle Behaviors

The following are all examples of _____________ 1. diet 2. physical activity 3. alcohol, cigarette, and other drug use 4. hand washing

Social Aspects

The following are all examples of the __________________ of environment: -Availability of resources to meet daily needs (educational, job opportunities, living wages, or healthful foods) -Social norms and attitudes (discrimination) -Exposure to crime, violence, and social disorder (such as the presence of trash) -Social support and social interactions -Exposure to mass media and emerging technologies (internet or cell phones) -Socioeconomic conditions (concentrated poverty) -Quality schools -Transportation options (buses, subways, etc...) -Public safety (police involvement) -Residential segregation (renters vs. owners)

Physical Aspects

The following are all examples of the __________________ of environment: Natural environment (plants, weather, or climate) Built environment (buildings, neighborhoods) Worksites, schools, and recreational settings Housing, homes, and neighborhoods Exposure to toxic substances and other physical hazards Physical barriers, especially for people with disabilities Aesthetic elements (lighting, trees, benches, sidewalks)

Hill's Criteria of Causality

The following list is ________________: Strength Consistency Specificity Temporality Biological gradient Plausibility Coherence

the Environment

The most important determinant of health which has about an 80% impact on health status is ________________

Incidence

The occurrence of new disease or morality within a defined period of observation (e.g., week, month, year or other time period) in a specific population

Relative Risk (RR)

The 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.

Prevent Disease

The ultimate target of Environmental Health practice is to _____________________ and create health-supportive environments.

High Cost

There is a greater need for environmental health practice, public health, preventative medicine than ever before because of the _____________ of curative medicine

Study Endpoints

These are all examples of ______________: Self-reported symptom rates Physiologic or clinical examinations Mortality

Study Designs

These are all examples of ________________ Cross-sectional Ecologic Case-Control Cohort

Disease Frequency

These are all examples of measures of ________________ -prevalence -point prevalence -incidince -incidence rate -case fatality rate

Biological

These are all types of ______________ agents: -virus -bacteria -fungi -protozoa -rickettsia -parasitic worms

Limitations

This list includes the __________ of epidemiologic studies: Long latency periods Low incidence and prevalence Difficulties in exposure assessment Nonspecific effects

Mesophilic

This microorganism prefers a medium heat range

Phagocytosis

a natural cellular defense against disease

Technology and Self-help

Two main aspects of health care that affect everyone are?

Biological, Chemical, Physical

What 3 causative agents of disease?

Descriptive and Analytic

What are the 2 classes of epidemiological studies?

Physical and Social

What are the 2 major aspects of environment?

Thermophilic, Mesophilic, Psychrophilic

What are the 3 groups of microorganisms that grow in various temps?

Biological Factors (or hereditary), Medical Care, Lifestyle and Environmental

What are the 4 basic determinants of health?

Too much of, Too little of, heredity, stress, unknown

What are the 5 ways causative agents of disease can be spread?

food absence of toxins favorable temperatures moisture favorable pH favorable osmotic pressure space favorable oxygen,

What are the 8 favorable conditions required for microorganisms to grow?

Case-control Study

What kind of study design uses an odds ratio?

Experimental Case Series Cross-sectional Ecologic Case-control Cohort

Which study designs are used in environmental epidemiology?

Bias

_______ is the "Systematic deviation of results or inferences 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 (as opposed to randomly) different from the truth."

John Snow

______________ employed a "natural experiment," a methodology used currently in studies in studies of environmental health problems.

Epidemiology

______________ is primarily an observational science that takes advantage of naturally occurring situations in order to study the occurrence of disease.

Third Line of

_______________ Defense 1. Phagocytosis (a natural process) 2. Immunity (active and passive)

Confounding

_______________ Denotes "... the 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."

Second Line of

_________________ Defense 1. Proper nutrition 2. Good personal health practice 3. Bodily reflexes, chemicals, and barriers Routine health and dental check-ups 4. Application of health education

Forth Line of

_________________ Defense 1. surgery 2. administering medication and radiation 3. diagnosing by means of various lab methods 4. corrective dentistry 5. corrective therapy (speech, hearing, respiratory)

First Line of

__________________ Defense 1. Food quality management - maintaining surveillance over food from farm to consumer 2. Rodent control - removing potential harborages 3. Air pollution - reducing emissions of pollutants into the atmosphere 4. Housing hygiene - promoting housing conditions necessary for physiological and psychological well-being of inhabitants

Biological Agents

__________________ are living things that cause disease because of their effect on characteristics with life (bacteria, virus, fungi, protozoa)

Chemical Agents

___________________ are substances that cause disease because of their mass or ability to engage in chemical reactions (cleaning agents, pesticides, petroleum products)

Physical Agents

_______________________ cause damage by transferring energy to the body and damaging body cells (radiation, noise)