Environmental Health Exam 1

Identify the historical figure who was among the first to expound on the role of environmental factors in causing diseases

Hippocrates

What type of interaction among several agents that have no known toxic effects produces a toxic effect?

Coalitive

Which of the following observational designs is used for hypothesis testing?

Cohort studies

MACT standards pertain to

Control of hazardous air pollutants

The Texas Sharpshooter Effect illustrates A new insect pest that is invading the southwest B. A description of disease according to person variables C. A description of disease according to etiologic factors D. One cause of spurious or chance clustering E. None of the above

D. One cause of spurious or chance clustering

Which of the following aspects is not included in the built environment?

Undeveloped land

Subacute exposures are those that last for

one month for less

Which of the following is not likely to characterize the approach of toxicology

Studies of disease occurrence in populations according to person variables

A national survey of asthma conducted on May 1, 2012 obtained the following results for the state of Oklahoma: • X--The number of residents with asthma • Y--The population of the state on June 30, 2012; all members of the population were considered at risk. • Z—The number of new cases of asthma diagnosed during 2012 Reference: Case study 1 The incidence rate of asthma during 2012 (per 100,000) would be expressed as

(Z/Y) × 100,000

A national survey of asthma conducted on May 1, 2012 obtained the following results for the state of Oklahoma: • X--The number of residents with asthma • Y--The population of the state on June 30, 2012; all members of the population were considered at risk. • Z—The number of new cases of asthma diagnosed during 2012 Reference: Case study 1 The incidence rate of asthma during 2012 (per 100,000) would be expressed as A. (X/Y) × 100,000 B. (Z/X) × 100,000 C. (Z/Y) × 100,000 D. (X/Z) × 100,000 E. None of the above

(Z/Y) × 100,000

Hill's criteria of causality include A. Strength B. Consistency C. Temporality D. Biological gradient E. All of the above

E. All of the above

The author of On Airs, Waters, and Places was

HIPOCCRATES

Environmental health comprises those aspects of human health that are determined by

All of the above

The Superfund was provided for by which of the following acts

CERCLA

In comparison with the general population, workers may receive exposures to toxic chemicals that are

. At higher concentrations for much longer time periods

The epidemiologic risk transition is characterized by a

. Growing burden of chronic, degenerative diseases

Match the agency with the function. 1. NIOSH 2. NIEHS 3. EEA 4. EPA 5. ATSDR A. Develop and enforce regulations that implement environmental laws enacted by Congress B. Conduct research to reduce work-related injuries and illnesses C. Serve as the principal federal public agency involved with hazardous waste issues D. Reduce the burden of human illness and dysfunction due to environmental causes E. Monitor the state of the environment in Europe

1. B 2. D 3. E 4 A 5. C

Match the agency with the function. 1. NIOSH 2. NIEHS 3. EEA 4. EPA 5. ATSDR A. Develop and enforce regulations that implement environmental laws enacted by Congress B. Conduct research to reduce work-related injuries and illnesses C. Serve as the principal federal public agency involved with hazardous waste issues D. Reduce the burden of human illness and dysfunction due to environmental causes E. Monitor the state of the environment in Europe

1.B, 2.D, 3.E, 4.A, 5.C

The natural population replacement fertility rate in the U.S. is estimated to be

2.1 per woman

The estimated global burden of disease (percent) linked to environmental sources is

25% to 33%

During April, 2009, a Texas community reported 87 cases of H1N1 associated influenza. Ultimately, 9 fatal cases of H1N1 occurred during this same month. There were 4 other fatalities. The CFR associated with H1N1 during April was:

9/87 × 100

Prevalence measures aid in A. Assessing variations in disease occurrence B. The development of hypotheses C. Determining the risk of disease D. Describing the scope of health problems

A B D

The polluter-pays principle states that

A polluter should bear the expense of carrying out pollution prevention and control measures.

The principle of environmental sustainability states that

A strong, just, and wealthy society can be consistent with a clean environment.

Risk characterization refers to the question o

B. What is the relationship between dose and occurrence of health effects in humans (or animals)?

What type of combination of two chemicals produces an effect that is equal to their individual effects taken together?

ADDITIVE

Which of the following is not covered under the Endangered Species Act? A. Mammals B. Crustaceans C. Insects D. Trees

ALL ARE COVERED

Hill's criteria of causality include A. Strength B. Consistency C. Temporality D. Biological gradient E. All of the above

ALL OF THE ABOVE

Specific examples of xenobiotics are A. Antibiotics B. Therapeutic drugs C. Dioxins D. PCBs E. All of the above

ALL OF THE ABOVE

The concentration and toxicity of a chemical in the body are affected by A. Route of entry into the body B. Received dose of the chemical C. Duration of exposure D. Individual sensitivity tE. All of the above

ALL OF THE ABOVE

The contributions of epidemiology to environmental health include A. Subjects are classified according to their exposure. B. They are a type of longitudinal design. C. They may be either prospective or retrospective. D. The measure of association is called relative risk. E. All of the above

ALL OF THE ABOVE

The effects of rapid growth of the world's population include

ALL OF THE ABOVE

The environment plays a role in human health through associations with

ALL OF THE ABOVE

The limitations of environmental epidemiology include the fact that A. Accurate assessment of exposure is difficult. B. Environmentally associated diseases often have low incidence and prevalence. C. Long latency periods often occur between initial exposures and disease outcomes. D. The effects of exposures are often non-specific. E. All of the above.

ALL OF THE ABOVE

Which of the following is not covered under the Endangered Species Act? A. Insects B. Mammals C. Trees D. All are covered E. Crustaceans

All are covered

The existence of a dose-response relationship may be used to establish the following kinds of information A. Causal association between a toxin and biological effects B. Minimum dosages needed to produce a biological effect C. Rate of accumulation of harmful effects D. All of the above E. A & B only

All of The ABOVE

Lemuel Shattuck's proposals set forth in the Report of the Sanitary Conditions of Massachusetts

All of the above

The concept of environmental justice specifies that

All people must receive fair treatment in the enforcement of environmental laws.

The existence of a dose-response relationship may be used to establish the following kinds of information A. Causal association between a toxin and biological effects B. Minimum dosages needed to produce a biological effect C. Rate of accumulation of harmful effects D. All of the above E. A & B only

All the Above

In comparison with the general population, workers may receive exposures to toxic chemicals that are

At higher concentrations for much longer time periods

How can the built environment encourage healthy lifestyles? A. By causing greater use of private automobiles B. By encouraging people to walk more C. By encouraging the use of public transportation D. By co-locating businesses and residences E. B through D

B through D

Which of the following activities characterizes the epidemiologic approach (as opposed to the clinical approach)? A. Description of a single individual's symptoms B. Study of cancer occurrence in populations C. Treatment of a patient with lung cancer D. Diagnosis of a disease in a single individual E. A, C, D

B. Study of cancer occurrence in populations

Which of the following statements is untrue about case-control studies? A. Exposure to a factor is determined retrospectively. B. They are a type of longitudinal design. C. Exposure levels may be difficult to quantify precisely. D. The measure of association is the odds ratio. E. They can examine many potential exposures.

B. They are a type of longitudinal design.

A national survey of asthma conducted on May 1, 2012 obtained the following results for the state of Oklahoma: • X--The number of residents with asthma • Y--The population of the state on June 30, 2012; all members of the population were considered at risk. • Z—The number of new cases of asthma diagnosed during 2012 Reference: Case study 1 The point prevalence of asthma (proportion) on May 1, 2012, would be expressed as

B. X/Y

According to Healthy People 2010, the social environment includes

C and D

Cohort study is to risk ratio as A. Hippocrates is to scrotal cancer. B. Genetics is to environment. C. Case-control study is to odds ratio. D. Sir Percival Pott is to John Snow. E. None of the above

C. Case-control study is to odds ratio.

Those members of the population who are capable of developing a disease or condition are known as A. Incident cases B. Prevalent cases C. The population at risk D. The immune fraction E. None of the above

C. The population at risk

An example of in vitro testing for toxicology is

Experiments with cells derived from human sources

What type of interaction among several agents that have no known toxic effects produces a toxic effect?

COALITIVE

Stage 2 of the demographic transition demonstrates

Drop in mortality rates; high fertility rates

Specific examples of xenobiotics are A. Antibiotics B. Therapeutic drugs C. Dioxins D. PCBs E. All of the above

E. All of the above

The contributions of epidemiology to environmental health include A. Concern with populations B. Use of observational data C. Methodology for study designs D. Descriptive and analytic studies E. All of the above

E. All of the above

Which of the following statements is true about cohort studies? A. Subjects are classified according to their exposure. B. They are a type of longitudinal design. C. They may be either prospective or retrospective. D. The measure of association is called relative risk. E. All of the above

E. All of the above

Environmental health science is concerned with agent, host, and environmental factors in disease (the epidemiologic triangle). What statement below is true about the triangle? Agent factors can include particles, toxic chemicals, and pesticides. B. The environment is the domain in which disease-causing agents may exist. C. The host is the person who affords lodgment of an infectious agent. D. Disease causality includes three major factors: agent, host, and environment. E. All of the above are true

E. All of the above are true

Risk management refers to the question of A. What are the health effects that this agent can cause? B. What is the relationship between dose and occurrence of health effects in humans? C. What exposures are currently experienced or anticipated under different conditions? D. What is the estimated occurrence of the adverse effect in a given population? E. None of the above.

E. None of the above

On Airs, Waters, and Places was significant because it

Emphasized the role of the environment in people's health

Examples of purely observational epidemiologic studies do not usually include

Experimental studies

True or False? A relative risk of less than 1 means that there is no association between exposure and outcome

FALSE

True or False? A relative risk of less than 1 means that there is no association between exposure and outcome.

FALSE

True or False? The fatal 1930 incident in Muese Valley, Belgium, was associated with leakage of toxic chemicals from a former dump site.

FALSE

True or False? The legal profession has virtually no relevance to the environmental health field.

FALSE

True or False? Van Leeuwenhoek identified the yellow fever virus during the early 1900s.

FALSE

Identify the historical figure who was among the first to expound on the role of environmental factors in causing disease

HIPPOCRATES

Which of the following statements is untrue about ecosystems?

Human beings are not considered to be a part of ecosystems.

Direct adverse effects of xenobiotics do not include

INTERFERENCE WITH NUTRITION

Of the following routes of exposure, which one has the most rapid effect?

INTRAVENOUS

The risk of acquiring a given disease during a time period is best determined by

The incidence rate for that disease in a given period of time

What problem may be encountered in the policy establishment stage?

Inability to coordinate and assess research information

Reasons for the potential spread of avian influenza include

Intensive animal husbandry practices

Which of the following abbreviations is used to describe toxic effects of chemicals?

LD50

What problem may be encountered in the policy implementation stage?

Lack of government suppor

What problem(s) may be encountered in the agenda setting stage?

Lack of information on risk; lack of coordination

What problem may be encountered in the assessment/evaluation stage?

Lack of sound scientific data

Risk management refers to the question o A. What are the health effects that this agent can cause? B. What is the relationship between dose and occurrence of health effects in humans? C. What exposures are currently experienced or anticipated under different conditions? D. What is the estimated occurrence of the adverse effect in a given population? E. None of the above.

NONE OF THE ABOVE

Subacute exposures are those that last for

ONE MONTH OR LESS

The Texas Sharpshooter Effect illustrates

One cause of spurious or chance clustering

One of the founders of toxicology was

PARCELSUS

What type of interaction between two chemicals causes one chemical that is not toxic to become more toxic?

POTENTIATIVE

Which of the following outcomes is not usually associated with world population growth?

PROSPERITY

One of the founders of toxicology was A. Claudius B. Paracelsus C. Socrates D. Da Vinci E. Theophrastus

Paracelsus

What problem may be encountered in the problem definition stage?

Poorly defined problems

What type of interaction between two chemicals causes one chemical that is not toxic to become more toxic?

Potentative

The precautionary principle states that

Preventive measures should be taken when an activity raises threats of harm to the environment.

Which of the following activities characterizes the epidemiologic approach (as opposed to the clinical approach)?

Study of cancer occurrence in populations

Why do children in comparison with adults represent a group that is especially vulnerable to environmental hazards? Choose the incorrect answer.

THEY SPEND MORE TIME INDOORS

5 out of 5 points The poisonous substance in Amanita phalloides ("death cap" mushroom) is an example of a

TOXIN

The poisonous substance in Amanita phalloides ("death cap" mushroom) is an example of a

TOXIN

True or False? Affluent Romans may have suffered from chronic lead poisoning from lead pipes used to carry the water supply.

TRUE

True or False? An ecologic study is one that examines a group as the unit of analysis.

TRUE

True or False? Cross-sectional studies may be used to formulate hypotheses that can be followed up in analytic studies

TRUE

True or False? Cross-sectional studies may be used to formulate hypotheses that can be followed up in analytic studies.

TRUE

True or False? In a case-control study, cases are those who have the outcome of interest and the controls are those who do not

TRUE

True or False? Used in cohort studies, the relative risk is a measure of the strength of association between a possible risk factor and a disease

TRUE

True or False? Used in cohort studies, the relative risk is a measure of the strength of association between a possible risk factor and a disease.

TRUE

An internal dose refers to

The portion of a substance that becomes internalized in the body

Which of the following statements is untrue about case-control studies?

They are a type of longitudinal design.

Sir Percival Pott, who wrote Chirurgical Observations Relative to

Was a London surgeon who identified an environmental cause of cancer

John Snow, in Snow on Cholera

Was an English anesthesiologist who used natural experiments

Chose the incorrect statement below. Thalidomide is an example of a drug that

Was associated with heart problems among adults

Indentify the incorrect statement: The 2009 swine flu outbreak

Was caused by the H5N1 virus

Hazard identification refers to the question of

What are the health effects that this agent can cause?

Exposure assessment refers to the question of

What exposures are currently experienced or anticipated under different conditions?

Risk characterization refers to the question of A. What are the health effects that this agent can cause? B. What is the relationship between dose and occurrence of health effects in humans? C. What exposures are currently experienced or anticipated under different conditions? D. What is the estimated occurrence of the adverse effect in a given population? E. None of the above.

What is the estimated occurrence of the adverse effect in a given population?

Dose-response assessment refers to the question of

What is the relationship between dose and occurrence of health effects in humans (or animals)?

A national survey of asthma conducted on May 1, 2012 obtained the following results for the state of Oklahoma: • X--The number of residents with asthma • Y--The population of the state on June 30, 2012; all members of the population were considered at risk. • Z—The number of new cases of asthma diagnosed during 2012 Reference: Case study 1 The point prevalence of asthma (proportion) on May 1, 2012, would be expressed as A. Z/X B. X/Y C. Y/X D. None of the above

X/Y