PBHLTH150B everything to know - human health and enviro in a changing world

population growth coincides with urbanization

55% of world population lives in cities GNI and % urban are directly proportional (positive correlation) so as countries ger richer we should expect more urbanization ** positive correlation between affluence and consumption

in general measures of association

-- OR and RR -- measures of association (direction and strength) -- RR (calculated from cohort / prospective studies) -- OR (calculated for cross-sectional studies (case-control and cross-sectional studies))

regulators have two main ways of reducing pollution

1. command and control 2. incentives

Hierarchy of Controls (for work related hazards) from most to least effective

1. elimination = physically remove the hazard 2. substitution = replace the hazard 3. engineering controls = isolate people from the hazard 4. administrative controls = change the way people work 5. PPE = protect worker with Personal Protective Equipment

three main types of chemical control laws

1. premarket testing and approval 2. premarket notification 3. postmarket

renewables portfolio standard

2008 executive order to achieve 33% renewables by 2020 2015 SB350 moved the goal to 50% by 2030 2018 SB100 moved the goal to 100% by 2045

AB 32 has led to a paradigm shift

all regulations now are evaluated re: both climate change mitigation and health co-benefits focus now on emission reduction rather than ambient air quality -- ie regulate sources rather than at the regional air quality level

secondary pollutants

another problem with air pollution is secondary pollutants which are pollutants produced from reaction between primary pollutants and natural compounds in the atmosphere atmospheric oxidation converts gases to particles (aka secondary pollutant)

hazard

ability of a substance to cause an adverse effect

potential sources

agriculture and farming, consume products, industry, healthcare, pollutant, intermediate, natural sources

fact

an estimated 10% of all irrigated land worldwide is irrigated with wastewater impacted water aka dirty water that isn't suitable to irrigate crops

pesticides

any substance or mixture of substances intended for preventing, destroying, repelling, or migrating any pest includes insecticides, herbicides, fungicides, microbicide -- also plant regulator, defoliant, or desiccant

alternative to solid fuels

clean fuels like liquified petroleum gas (LPG) which is those gas tanks and also hot plates

how cap and trade works

companies can receive credits that they can sell environmental justice concerns for people living adjacent to high GHG emitting facilities

AB 32 -- Global Warming Solutions Act

mandates to regulatory and market mechanisms to reduce GHGs

key terms in epidemiology; prevalence vs incidence

prevalence of a disease = proportion of person who have a condition at or during a particular time period -- P = (# people w disease / total # in the population) incidence of a disease = proportion or rate of persons who develop a condition during a particular time period -- I = (# of new cases over a time period / population at risk at that time) death (mortality) cure

risk assessment

process of determining hazard, exposure, and risk

estimating risk of exposure to carcinogens

risk estimate ** see lecture notes

risk factors vs causes

risk factors = potentially modifiable behaviors or activities that lead to ill-health, disease, and injury (like smoking, unsafe sex, air pollution, poor diet, etc) causes = specific causal agents of ill health / disease / death (like tuberculosis, HIV and AIDS, ischemic heart disease, etc

initial qualitative research of study in Ecuador

** antibiotics readily available for livestock and poultry lack of vet support antibiotics prescribed inappropriately 1 in 5 produces report using antibiotics very little use of extended spectrum betalactams (ie third generation cephalosporins)

noncarcinogenic risk assessment

1. ADI (acceptable daily intake) = daily chemical intake over a lifetime assumed to be without significant risk 2. RfDs (reference dose); RfCs (reference concentrations); MRLs (minimal risk levels) = estimated daily exposure assumed to be without significant adverse health effects over a certain period 3. TDI (tolerable daily intake) = chemical intakes that are not acceptable, but tolerable, because they are below levels known to cause adverse effects

common epigenetic modifications

1. DNA methylation = can be used as a molecular switch, regulates gene expression and chromatin information (influence expression and function aka health and disease) -- CpG site = C nucleotide followed by a G (CG dinonucleotide) -- CpG islands (CpGi) = regions with high density of CpG sites 2. histone modifications

effect of social inequality on the environment relate to:

1. asymmetries in political power 2. environmental intensity of consumption 3. the erosion of social cohesion and cooperation see image

two main types of receptors

1. membrane receptors -- imbedded in target cell membrane -- integral proteins / glycoproteins -- penetrate through membrane -- for protein and changed hormones (peptides or neurotransmitters) 2. nuclear receptors -- nuclear proteins that act in pairs and bind to specific HREs (hormone recognition elements = sequences on the DNA in promoter regions of target genes) -- for small, hydrophobic molecules (steroids, thyroid hormones)

sanitation ladder from worst to best (3-5 are improved sanitation facilities)

1. open defecation = in fields, forests, bodies of water, etc 2. unimproved use of pit latrines without a slab or platform, hanging or bucket latrines 3. limited = misses "safely managed" criteria, are shared with other households 4. basic = same as limited except not shared with other households 5. safely managed = not shared with other households, excreta safely disposed in-situ or transported for treatment

what determines human health the determinants of health and well-being in our neighborhoods

1. people -- age, sex, and hereditary factors) 2. lifestyle -- diet, physical activity, work life balance 3. community -- social capital, social networks 4. local economy -- wealth creation, resilient markets 5. activities -- working, shopping, moving, living, playing, learning 6. built environment -- building, places, streets, routes 7. natural environment -- natural habitats, air, water, land 8. global ecosystem -- climate stability, biodiversity

what determines whether we can move into the safe and just space of the doughnut?

1. population = more people means more resources are needed to meet everyone's basic needs 2. distribution - inequality pushes people outside the doughnut on both sides 3. aspiration = what people consider necessary for a good life is impacted by where they live 4. technology = choices made in new urban areas this decade will be critical 5. governance = need more effective forms of governance at all scales (local, regional, national, global)

community engagement in data projects promotes the 3 R's

1. rigor = good science (research design, ground truthing, interpretation, etc) 2. relevance = asking the right questions (structural causes of hazard exposure and opportunities for action, collective, and individual) 3. reach = disseminate knowledge to advance policy change

two injury mechanisms

1. sudden force = impact trauma like contusion, laceration, fracture, amputation, join subluxation, etc 2. volitional activity = overuse injury like tendonitis, tendonosis, nerve entrapment, myofascial pain, lower back pain, etc

drinking water ladder from worst to best (3-5 are improved water sources)

1. surface water - directly from river, stream, lake, pond, etc 2. unimproved water = from unprotected dug well / spring 3. limited = improved source that misses "safely managed" criteria, takes over 30 mins to collect 4. basic = same as limited but takes under 30 mins to collect 5. safely managed = located on premises, available when needed, free from contamination ** 1.5 billion people gained access to basic drinking water services from 2000 to 2015

product chemical prioritization must assess two main criteria

1. there must be potential exposures to the Candidate Chemicals in the product 2. there must be potential for the exposures to contribute to or cause significant or widespread adverse impacts

limitations of GBD is that numbers change from year to year because of two reasons

1. things are actually changing 2. more health outcomes are being included

non-sewered sanitation systems affect nutrient flows on a global scale

1.8 billion pit latrine users today 2.1 billion kg urine and 0.6 billion kg feces each day annual nutrient flow and annual US fertilizer use are of same magnitude but we are getting rid of those nutrients so we make artificial fertilizers which leads to lot of nutrient pollution and puts strains on planetary boundaries 85 - 93% of nitrogen and phosphorus from non sewered systems are released to environment without treatment all of this is why we have already exceeded planetary boundaries for these biogeochemical flows for nitrogen and phosphorus because not managing our waste properly and relying on inputs for agriculture

enterobacteriacae is serious and growing problem in the US

197,400 estimated cases in hospitalized patients in 2017 9,100 estimated deaths in 2017 $1.2 billion estimated attributable healthcare costs in 2017 ** major push for new antimicrobials (2010 - 2020) -- new legislation and funding, awards for developers

inequality is a design failure and so is environmental degradation

20th century = when it comes to inequality and income per capita, it has got to get worse before it gets better and growth will make it better 21st century = don't wait for growth to even things out because it won't, instead be distributive by design

AMR in US food animal production

27.1% of all medically important antibiotics sold in US are for pig production 27.6% sold for use in human medicine NC is second largest producer of hogs in US and they have more hogs than humans US uses average of 345 mg of antibiotics per kilogram (antibiotics / kg) of livestock, almost double that of UK

air quality -- population concentration distribution

8% of global population meets WHO 10 ug/m^3 air quality guideline 50% of world population live sin areas greater than 35 ug/m^3

calculating ADIs, RfDs, and MRLs

ADI = NOAEL / uncertainty factor(s) if NOAEL is unavailable, the LOAEL can be used (with an additional uncertainty factor) ** see lecture notes for example uncertainty (safety) factors

Developmental Origins of Health and Disease (DOHaD)

Barber's hypothesis = fetal programming of adult disease; says that low birth weight goes to disease (CHD) -- essentially someone born with low birth weight might have pretty high or higher disease risk than someone born with adequate birth weight (this was done observationally) -- epigenetics as a potential mechanism / biomarker is interface between genome and the environment

who evaluates safety of cosmetic ingredients?

CIR (Cosmetic Ingredient Review) FFDCA does not authorize US FDA to require cosmetic manufacturers to: register products or chemical ingredients in their products, substantiate product safety or their performance claims

metrics for measuring ill health

DALYs, YLLs, YLDs

DDT

DDT changed world -- heavy use during WWII, after WWII moved into agriculture in 1962, Rachel Carson's book Silent Spring published; birth of environmental movement American eagle, brown pelican, condor, etc all had eggshell thinning as result of DDT -- DDT banned in US in 1972 when banned in 1972, it was replaced by less persistent pesticides (OPs, pyrethroids, and neonicotonoids) -- lead to modern regulatory system in US

key terms for epigenetics

DNA methylation (DNAm) = covalent epigenetic modification of nucleotide cytosine (C), which ic heritable (cell division) CpG site = cytosine followed by guanine nucleotide epigenome = epigenetic information in a cell, comprising DNA methylation, post translational modifications of histones, and higher order chromatin structure EWAS = epigenome wide association study (testing all CGs across the genome) DOHaD = hypothesis that early life environment (prenatal and early childhood) can program health and disease later in life

DNA methylation (DNAm)

DNAm as a molecular switch regulates gene expression and chromatin conformation -- influence expression and function (health and disease)

greatest diesel particulate matter (DPM = diesel particulate matter) concentration drop at environmental justice monitors

DPM decreases 0.7 ug/m^3 in non environmental justice areas; decreases 2.2 ug/m^3 in environmental justice areas

key points about EDCs

EDCs are ubiquitous -- rapidly introduced with industrial revolution, many used back then are banned and we see the same cycle with emerging EDCs (new ones come out, they get banned, so new ones come out, then those get banned, etc) key interaction with receptors and / or hormone production -- agonist and antagonists, many have shared MOAs (like same receptors) different from other endpoints -- potential for synergistic interaction of mixtures, non-linear dose-response curves developmental period is highly susceptible to effects

body's endocrine glands -- female vs male

EDCs could have sex specific effects timing of exposure -- prenatal -- puberty -- reproduction -- aging route of exposure and kinetics matters -- tissue specificity mode of action -- chronic vs acute -- half life (elimination)

obesogens

EDCs that can increase adipose tissue mass by hypertrophy or hyperplasia, preadipocyte differentiation, or fate of mesenchymal stem cells to undergo adipogenic differentiation EDs have effect on endocrine function during development, especially on development of embryo and fetus hormonal actions (critical during developmental windows) can affect programming of male / female gender and phenotype; exposure to environmental EDs during this time will lead to permanent changes timing of exposure matters -- can have effects in one life stage but not the other

shared MOA (mechanism of action)

EDCs with obesogenic action activate similar receptors and pathways

what is climate change?

Earth's climate varies naturally because of cosmological and geological processes -- ecosystems and life ing eneral have evolved within narrow band of climatic environment conditions -- climate change refers to an additional and relatively rapid change induced by human actions

is chemical production driven by population growth?

NO chemical production actually growing much faster than population, increased chemical production is because of consumption GOLDEN ARROW OF CONSUMPTION FUELS DEMAND FOR CHEMICALS ** scientists say affluence needs to be addressed by reducing consumption, not just greening it

LA today

NO2 and SO2 and CO attained national standards, ozone LA peak cut over 60% and hours of exposure reduced by 90%, PM annual levels cut in half, toxics nearly 50% risk reduction

TI (therapeutic index) for pharmaceuticals

TI = (toxic dose / dose for therapeutic response) aka TI = (TD50 / ED50), toxic dose that kills half population divided by effective dose for half the population higher TI = less toxic but TI can underestimate toxicity so MOS can be better to use

who has authority to regulate chemicals used in consumer products sold in CA?

US EPA = TSCA (industrial chemicals) and FIFRA (pesiticides) and CAA (air contaminants) US FDA = FFDCA CPSC = CPSA and FHSA NHTSA = FMVSS 302 like car seats OHSA = workers' exposure legislature and courts standard-setting bodies = ANSI, UL, IEC, etc at state level, we have: CAL EPA (DTSC, DPR for pesticides, ARB for air contaminants, OEHHA prop 65, Cal Recycle), CDPH, BEARHFTI, CAL / OSHA, CA legislature and courts, municipalities and other local authorities

what is a pesticide?

a pesticide is any substance or mixture of substances intended for: -- preventing -- destroying -- repelling -- or mitigating any pest insecticides, herbicides, fungicides, microbocides plant regulator, defoliant, or desiccant

transition frameworks that attempt to describe impacts of socioeconomic development

a. demographic (population) transition -- shifts from high fertility rates and high mortality rates to period of rapid population growth as mortality rate decreases and then populations stabilizes; then fertilization decreases b. epidemiologic (mortality) transition -- shift in causes of ill health from infectious (communicable / acute) diseases to noncommunicable (chronic) diseases c. environmental risk transition -- shift in environmental risk factors that cause disease

unequal contributions, unequal impacts

about 2/3 of historic CO2 and methane emissions are attributable to 90 companies involved in the production of fossil fuels and cement the richest 10% produce 50% of total GHG emissions, but poorest 50% produce only 10% of greenhouse gas emissions future generations have a smaller allowance of carbon because carbon budget for limiting global warming to 2 degrees C will be 80% depleted by 2030

ecological sanitation

about resource, not waste cycle of containment, collection, transportation, treatment, transmission

where is Earth's water?

97.5% in oceans, 68.7% of freshwater in glaciers, 30.1% in groundwater, 0.4% in lakes and rivers 1. freshwater = 2.5% 2. other saline water = 0.9% 3. oceans = 96.5%

interaction of mixtures of chemicals

additive effects -- combined effect is equal to the sum of the individual effects synergistic effects -- combined effect is greater than sum of individual effects potentiation -- non toxic chemical causes another chemical to become more toxic antagonism -- two chemicals interfere with each other's actions

which study design is best?

depends on the study question -- gold standard is a well-designed RCT (randomized control trial) what's current knowledge on topic, how common is disease (and risk factors), how long would study take and what are costs and feasibility, ethical issues, no single study gives you final cause and effect

to reduce occupational exposure to pesticide, for field workers, CHAMACOS did what

developed method for providing warm water in the field trained crew leaders to use system crew leaders filled tanks developed and provided lightweight coverall gave gloves to crew leaders clothing and gloves reduce levels of malathion on skin and hands and workers without gloves had higher urinary pesticide levels

health gap

difference between the healthiest people and the unhealthiest people observed vs ideal health

impacts of poor sanitation

disease transmission malnutrition 432k annual deaths impaired safety, well being, and educational prospects, especially for women and girls huge financial costs

impacts of poor sanitation

disease transmission (polio, cholera, dysentery, trachoma, etc) malnutrition 432k annual deaths impaired safety and well being and educational prospects (especially women) huge financial costs

water pollution and diseases

diseases attributed to water pollution affect over 1 billion people, mostly in low / middle income countries illnesses like diarrheal diseases, parathyroid fever, typhoid fever, lower respiratory tract infections associated with unsafe water sources, inadequate sanitation, and inadequate hand washing ** Millennium Development Gaol target for safe drinking water was met -- target was halve the proportion of population without safe drinking water from 1990 to 2015; 2.6 billion people gained access to improved drinking water sources, which increased the proportion from 76% to 91%

Δ aka change in LE vs PM 2.5

each increase in PM 2.5 has a larger marginal effect of LE in cleaner countries places with higher levels of pollution tend to have higher detriments of life expectancy

OSHA (Occupational Safety and Health Administration)

encourages employers and employees to reduce number of hazards provides separate but dependent responsibilities for employers and employees authorizes formation of mandatory standards provides for research in the field, new ways to discover latent diseases, provides training programs, enforcement, and appropriate reporting procedures

paradigm shift: emissions reduction vs regional air quality

enforcement easier to implement when reduction of emissions is focus (rather than ambient level of a criteria pollutant)

epigenetic aging in blood and disease

epigenetic age acceleration in the same cohort (blood age equals about 7 years) prenatal / early life environment --> changes in epigenetic modifications of age associated methylation sites --> epigenetic age acceleration (ie epigenetic age is older than chronological age) --? increase risk of things like atopic sensitization, asthma, environmental allergen sensitization, etc

fetal epigenetic programming

epigenetic fingerprint of health and disease

epigenetics -- tissue specificity

epigenetic marks are tissue specific (same genome DOES NOT equal same epigenomes) epigenetics contributes to tissue differentiation (cell differentiation and fate) each cell type has a unique epigenetic signature

epigenetics summary

epigenetics as interface between genome and environment = exposure embodiment under the skin we study the epigenetics to understand how genetics and environment interact = physical activity, nutrition, air pollution, hazardous exposures early life exposures can program health and disease = DOHaD hype, epigenetic marks might be involved epigenetics fit within the field of toxicogenomics = ready to use in humans epigenetics help us understand exposure and disease (biological insight into mechanisms and pathways, provide biological modes of action to test) epigenetics for biomarker development (predicting disease like genomic potential, reconstructing environment exposures like biosensors) epigens to target interventions and prevention (epigenetic clock for risk prediction)

known classes of endocrine disruptors

estrogens, anti-estrogens, anti-androgens, progestogens, adrenal toxins, thyrotoxic agents, hydrocarbons, pancreatic toxins, metals, and retinoids

sanitation facts and figures

in 2015, 68% of world's pop had access to at least one basic sanitation service; increased to 74% (5.5 billion) people in 2017 45% of global population used safely managed sanitation service in 2017

how do toxic agents enter the body?

ingestion, inhalation, dermal contact, transplacental transfer, injection

lead in children's toys

like vintage toys and kids' jewelry (some stuff even recently)

zoonotic diseases

most foodborne diseases are also called zoonotic diseases and that's because the reservoir of the foodborne pathogens are actually animals, which means the animals host the pathogens that cause humans to get sick

EDCs and obesity

obesity epidemic has spread to wildlife living near humans BMI increased 2.3 kg / m^2 from 1988-2006, holding caloric intake and physical activity level constant obesity epidemic is occurring parallel ot increase in use and exposure to EDCs (correlation, but no proof of causation) natural compounds can also be EDCs

4. case control study

observational study involving individuals with (cases) and without (controls) disease / outcome fo interest -- advantages = cost and time efficient for rare outcomes (like cancer and other rare diseases), can investigate array of exposures -- disadvantages = need careful selection of cases and controls, bias **** example = outcome is ASD (Autism Spectrum Disorder) cases (control is twin without ASD), exposure is prental toxic and essential metals (deciduous teeth can measure metal at specific days, like counting tree rings)

3. cross-sectional study

observational study; exposure and outcome are collected simultaneously at one time -- advantages = cost-efficient, easy to implement, ethical (observing not intervening), good for measuring, prevalence (proportion of people with condition / exposure at one point in time) -- disadvantages = no temporal information (no cause effect info), non-response boas, prone to reverse causation (saying that air pollution causes mental health disorders and vise versa, that mental health disorders cause air pollution)

MGEs (Mobile Genetic Elements)

often contain resistance genes, certain MGEs lead to rapid spread

lead in utensils

older drinking water and coffee urns with lead, ceramics can have Pb levels, paints and glazes as a source also, lead in cosmetics

PFASs (perfluoroaklyl and polyfluoroalkyl substances)

one of the strongest chemical bonds in chemistry, which leads to environmental persistence (bond of C-H) widely used since 1940s to make things non stick, waterproof, soil / stain / oil resistant has many uses

types of endocrine disruptors

pesticides, ordinary household products, industrial chemicals, plastics, pharmaceuticals, and heavy metals

study design -- types of studies include

randomized control trial = often in clinical trials, experimental prospective cohort study = follow group track exposures and disease incidences case control study = compare people with and without disease vs with and without risk factor / exposure retrospective cohort study = defines incidence in an existing group cross-sectional study = snapshot in time that observes exposure vs prevalence ecological study = group exposure and group level prevalence / outcome disease cluster = group of similar diseases (usually cancer cluster) case series = collection of cases (subject to selection bias)

how do wastewater treatment plants work

see diagram

are EDCs responsible for current metabolic epidemics?

studies show we are creating obesogenic environment, not just nutrition but also things like flame retardant and drinking cups etc

occupational hygiene (aka industrial hygiene aka IH)

the anticipation, recognition, evaluation, control, and prevention of hazards from work that may result in injury, illness, or affect the well being of workers categories include: -- biological -- chemical -- physical / ergonomic -- psychosocial

first tenet of toxicology

the dose makes the poison -- all substances are poison, dose is what makes the difference (Paraclesus)

supra-linear relationship

when it comes to dose-response of neurodevelopment in lead it has a ____ relationship loss in IQ greater at lower than at higher blood lead concentrations -- no safe levels

epigenome

when it comes to studies in humans, epigenome is biomarkers of exposure and response to the early life environment

Occupational Safety and Health Act of 1970 (not osha)

with this, Congress created the Occupational Safety and Health Administration (OSHA) to assure safe and healthful working conditions for working people by setting and enforcing standards and by providing training, outreach, education, and assistance

the B economy

businesses compete to be best for the world, the people living in it, and the natural environment on which our quality of life depends

how thirsty is the Cloud

by 2025, 175 zetabytes (10^21 or 2^70 bytes) of data will be created and stored globally (6x more than in 2018) US data centers rely on water from stressed basins US houses about 30% of world's data center nearly half of US data centers rely on power plants located in water stressed regions

epigenetics

changes in gene expression that -- do not depend on the DNA sequence -- can be stable whether that be through cell division (mitotically stable) or transgenerational inheritance (limited evidence in humans) -- may persist even in the absence of the conditions that established them (biological memory --> biosensor)

quote by UN General Assembly (1997)

"Development is a multidimensional undertaking to achieve a higher quality of life for all people. Economic development, social development and environmental protection are interdependent and mutually reinforcing components of sustainable development."

all PFASs or their degradation, reaciton, or metabolism products are highly persistent

"The Madrid Statement on Poly- and Perfluoroalkyl Substances" documents scientific consensus on potential adverse impacts from this chemical class and proposes roadmap to prevent further harm; signed by over 230 scientists from 40 countries

the precautionary principle

"where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation" said in 1992 Rio Declaration, Principle 15

factors involved in emergence of produce-linked outbreaks

** produce is major food items leading to foodborne outbreaks -- basically produce is the leading food group thing that causes foodborne illnesses and washing it won't help -- produce (eaten raw) doesn't go through the heat / cooking step, so bacteria isn't killed -- changes in produce industry = intensification and centralization of production, wider distribution of produce over long distances -- changes in consumer habits - increased consumption of fresh fruits and vegetables and fresh fruit juices, increased popularity of salad bars -- increased at risk population (like elderly or people with compromised immune systems) -- enhanced epidemiological surveillance (FoodNet and PulseNet) -- improved methods to identify and track pathogens -- emerging pathogens with low infectious dose (like STEC)

potential health effects of informal e-waste recycling

** see lecture notes

risk assessment / management framework

** see lecture notes

Assembly Bill 617

,andates CARB to develop guidelines for community air quality monitoring requires local air districts to work with communities identified by CARB as having high cumulative exposure burden -- to develop plans for community air quality monitoring to determine local "hot spots" -- to review the results from such monitoring to develop community emission reductions programs

CA's advanced clean car standard

-- ZEV (zero emission vehicle) mandate in 1990 -- 11 other states have adopted this -- CA tailpipe CO2 standards in 2006 for fuel efficiency -- 14 other states and DC have adopted federal adoption of CA CO2 standards called CAFE standards in 2010 but repealed by Trump EPA in March 2020 --> reinstated by Biden Trump EPA moved to revoke CA's waiver to have stricter emission standards --> rescinded by Biden

critiques of risk assessment / risk management

-- data typically from homogeneous animal strains -- translating the findings to humans introduces uncertainty -- lack of data is typically equated as no risk -- cumulative impacts (mixture effects) with other chemicals are not considered -- "safe levels" might not be safe for everyone -- few chemicals have sufficient data for risk assessment

climate change affects social and environmental determinants of health

-- direct effects (heat waves, storms, etc), less direct effects (reduced water supply, worse air pollution episodes, etc), diffuse effect (conflict, migration, famine, etc) -- things expected to cause an additional around 250k deaths/year between 2030 and 2050 include: malnutrition, malaria, diarrhea, and heat stress -- weather-related natural disasters result in 60k+ deaths/year, mainly in developing countries -- direct damage costs to health estimated at 2-4 billion dollars/year by 2030

vulnerable communities to climate change

-- elderly -- infants and children -- people with heart / lung disease -- low income communitis -- people of color POC -- heat island effect -- multiple sources of pollution -- lack of air conditioning -- lack of access to health care, transportation, services

how does heat impact human health?

-- hot weather and heat extremes are associated with excess mortality, increase in ER and hospital visits, increased death from cardiorespiratory and other disease, mental health issues, adverse pregnancy and birth outcomes, increase in healthcare costs, etc -- heat related morbidity and mortality projected to increase further as climate change progresses those most at risk for heat affected health are adults over 65, people with chronic and cardiopulmonary disease, infants and young kids, etc -- other risk factors include alcohol, meds, and illegal narcotics

biological effects and transport of lead

-- lead can enter bloodstream and is distributed to body -- absorbed lead exchanged among three compartments of blood, mineralizing tissues (like bones and teeth), and soft tissue (organs, muscles, etc) -- adults typically absorbed 20% of ingested inorganic lead after a meal, 60% to 80% on empty stomach -- kids absorb 50% on full stomach, up to 100% on empty stomach

health effects of lead in children

-- lower neurodevelopment and intellectual deficits (neurological) -- at BLLs < 5 ug / dL, most common problems include attention-related behavioral problems, decreased cognitive performances, and greater incidence of problem behavior -- exposed behavior may be asymptomatic; no signs of lead toxicity until they're school age beyond IQ, lead exposure can lead to problem behaviors, self-regulation and impulsivity and aggression, lead-crime hypothesis based on ecological study prenatal lead exposure and child BMI -- see an increased risk in BMI with higher levels of prenatal lead exposure

A.B. 32 (Global Warming Solutions Act of 2006)

-- mandates regulatory and market mechanisms to reduce emissions of GHGs -- establishes GHG cap for 2020 based on 1990 levels -- means about 25% reduction from usual -- required a "scoping" plan to achieve 2020 targets (2020 compliance expected) -- SB 32 passed in 2016 mandates even more ambitious reduction (40% reduction from 1990 levels by 2030) AB 32 has led to paradigm shift -- all regulations now evaluated by both climate change mitigation and health co benefits -- focus now on emission reduction rather than ambient air quality

health estimates and double counting

-- prior to 2017, GBD double counted the household and ambient burdens -- in the current GBD, for HAP using households, total exposure = exposure HAP + exposure AAP -- fractional contribution of HAP or AAP is estimated by multiplying burden (and or PAF) by the function of exposure attributable to each source

policy needs for improving air quality / decreasing air pollution

-- sources of air pollutants that harm health are same as those that emit GHG and aerosols -- to improve air quality and mitigate climate change, we need strong policies to move our economy away from reliance on fossil fuels

we have not breached planetary boundary for freshwater use (well it depends on how you look at it)

-- we are using 2600 km^3 / year, allowed up to 4000 -- but if you consider all these different factors like deforestation and different uses of water, our total freshwater consumption is actually in the red and planetary boundary HAS been breached with revised planetary boundary, we divide water boundary into 6 subcategories of surface water, soil moisture, atmospheric water, frozen water, and ground water

foodborne disease surveillance in the US (done by the CDC)

1. FoodNet = conducts population based surveillance for foodborne infections -- collaboration between CDC and 10 states in the US for a better understanding of the epidemiology of foodborne diseases (7 bacterial pathogens and 1 parasite) -- when it comes to burden of foodborne illness in US, FoodNet confirmed in 2016 that there were 24.029k illnesses, 5.512k hospitalizations, and 98 deaths related to them 2. PulseNet = large nationwide database that connects foodborne illness cases together and identifies outbreaks -- molecular subtyping network that uses DNA fingerprinting of foodborne bacterial pathogens to detect outbreaks: PFGE, MLVA, and WGS -- PulseNet international = global lab dedicated to bacterial foodborne disease surveillance; mission is to implement standardized genotyping methods and share information in real within regional and national lab networks to support surveillance and outbreak response enabling direct comparison of interlab data irrespective of geography -- important because monitors what kind of pathogens go around globe like hotspots and variants -- WGS (who genome sequencing) = faster tech that PFGE, provides more precise and detailed information about genetic makeup of a given pathogen (13-150 DNA bands from using PFGE versus millions of nucleotides using WGS so WGS is better) -- some bacteria with different PFGE patterns are actually from the same food source -- WGS has helped solve outbreaks sooner (compared to PFGE) 3. CaliciNet (2009+) = network to quickly identify norovirus outbreaks and linking them to a common source -- also monitors circulating norovirus strains and identifies newly emerging ones

adverse effect levels for toxicity

1. NOAEL (no observed adverse effect level) -- highest dose with non-statistically significant difference from control (basically means insignificant effect) 2. LOAEL (lowest observed adverse effect level) -- lowest dose tested with statistically significant effect (basically means first significant effect)

adverse effect levels for environmental media

1. NOEC (no observable effect concentration) -- highest measured chemical concentration that doesn't yield positive effect 2. LOEC (lowest observable effect concentration) -- lowest measured concentration of the chemical that yields a biologically adverse effect

Impact of climate change on human health

1. air pollution -- asthma, cardiovascular disease 2. changes in vector ecology -- malaria, dengue, encephalitis, hantavirus, Rift Valley fever, Lyme disease, chikungunya, West Nile virus 3. increasing allergens -- respiratory allergies, asthma 4. water quality impacts -- cholera, cryptosporidiosis, campylobacter, leptospirosis, harmful algal blooms 5. water and food supply impacts -- malnutrition, diarrheal disease 6. environmental degradation -- forced migration, civil conflict, mental health impacts 7. extreme heat -- heat related illness and death, cardiovascular failure 8. severe weather -- injuries, fatalities, mental health impacts

other clues for chemical hazards

1. bioavailability -- ability of chemical to be absorbed from environment into body 2. biotransformation -- metabolic transition of environmental chemicals; defense mechanisms that can deactivate toxic compounds, but may increase toxicity of some compounds 3. bioaccumulation -- accumulation of chemical that can't be biologically transferred by organism 4. bioconcentration -- accumulation of chemical in organism above environmental levels 5. biomagnification -- increase in concentration of chemical up food chain 6. persistence -- long environmental half-life like POP (persistent organic pollutants) and PBT (persistent, bioaccumulation, and toxic substances)

The Safer Consumer Products (SCP) Process

1. candidate chemicals = universe of chemicals, basically lists they pulled together identified as being of concern we have: a. authoritative lists b. candidate chemical list 2. priority production = we have: c. three year priority products work plan (with product categories) d. proposed product . chemical combination e. rule making f. adopted regulations g. priority product notification 3. alternatives analysis = we have: h. alternative analysis process and reports i. other options (abridged AA report, alt process AA work plan, previously completed AA report, removal or replacement notification intent and confirmation) 4. regulatory responses = we have: j. possible responses (no regular responses, additional info to DTSC, product information for consumers, use restrictions / product sales prohibition, etc) **** who are the responsible entities? -- product manufacturers, importers, assemblers, and retailers

market mechanism to reduce carbon emissions (there are two)

1. cap and trade = caps carbon emissions, price of carbon fluctuates, complicated to administer -- cap limits total GHG emissions from all regulated sources -- cap declines over time and reduces emissions -- state issues GHG emissions allowances per capped facility based on emissions inventory -- participants allowed to "trade" allowances which creates flexibility, reduces costs of compliance

.

1. chemicals: candidate chemical list = we have menu of options wit 23 authoritative lists (DTSC) and exclusions = FIFRA pesticides, prescription drugs, radioactive chemicals, and natural toxins 2. product (product chemical combination): priority product = menu of options is three year priority product work plan

9 planetary boundaries (updated)

1. climate change 2. novel entities 3. stratospheric ozone depletion 4. atmospheric aerosil loading 5. ocean acidity 6. biogeochemical flows 7. freshwater use 8. land-system change 9. biosphere integrity (includes functional diversity and genetic diversity) ** genetic diversity and biogeochemical flows are very high risk

the nine planetary boundaries

1. climate change 2. ozone depletion 3. ocean acidification 4. nitrogen and phosphorus cycles 5. biodiversity loss 6. land-use change 7. freshwater use 8. aerosol loading 9. chemical pollution

cumulative impacts

1. cumulate impacts assessment 1 = disparities in exposure between racial and socioeconomic groups and significant and linked to adverse health risks; social inequality can undermine environment quality for everyone 2. cumulative impacts assessment 2 = social inequality may amplify adverse health effects of environmental hazards for vulnerable populations; regulatory science doesn't account for cumulative impacts of hazard exposures and socioeconomic inequality -- a. strategy 1 = community based participatory research; research methods in health and social sciences that seek to transform scientific enterprises by engaging communities in research process -- b. strategy 2 = community engagement in development of decision making tools; environmental justice screening method

transition frameworks attempt to describe the impacts of socioeconomic development

1. demographic or population transition -- shift from high fertility (birth rates) and high mortality (death rates) to a period of rapid population growth as mortality decreases; population then stabilizes as fertility decreases 2. epidemiologic or mortality transition -- shift in causes of ill-health from infectious, communicable, or acute diseases to noncommunicable or chronic diseases 3. environmental risk transition -- shift in the environmental risk factors that cause the disease

broad types of epidemiology include

1. descriptive epidemiology = examines distribution of a disease in a population and observes the basic features of its distribution in terms of time, place, and person -- typical study designs include observational studies (surveys, cross-sectional, case series, and some ecological studies) 2. analytic epidemiology = tests a specific hypothesis about the relationship of a disease to an assumed caused by conducting a statistical analysis that relates the exposure of interest to the disease of interest -- typical study designs include cohort, case control, RCT (randomized control study)

different types of development

1. economic development -- increase in human welfare which depends on material consumption and other factors like the environment 2. human / social development -- reduced income poverty, better access to basic services, reduced gender inequality and marginalization in other forms (like racism etc) 3. environmental protection

drivers of environmental change

1. fundamental realities -- a. economic growth -- b. population dynamics -- c. committed climate change 2. mediating factors -- d. urbanization -- e. technology these desired outcomes are equity, lifestyle, and environmental pressure and well being

international travel and the microbiome

1. gut diversity stays about the same after travel 2. E. coli increased across all subjects (p < 0.0001) 3. gut AMR genes go up temporarily after travel

Epidemiologic Triangle

1. host = person or other living animal that affords subsistence or lodgment to an infectious agent under natural conditions 2. agent = a factor (such as a microorganism, chemical substance, or form or radiation) whose presence, excessive presence, or (indeficiency diseases) relative absence is essential for the occurrence of a disease 3. environment = domain in which disease-causing agents may exist, survive, or originate

how do we assess chemical toxicity?

1. human epidemiologic studies 2. in vivo animal bioessays 3. in vitro (like AOPs) 4. in silico (like QSAR) and chip

to asses chemical toxicity we look at:

1. human studies -- clinical observations, epidemiological studies 2. in vivo animal bioessays -- traditionally used for cancer testing, based on premise that chemical that causes tumors in animals will do same to humans, generally use higher concentration that aren't environmentally relevant (death = response of individual, mortality = response of population, critical adverse effect = significant adverse biological effect that occurs at lowest exposure) 3. in vitro (or short term studies) -- fast and cheap, can give information about mechanisms of observed adverse effects 4. in silico (or chip studies) -- SAR (structural activity relationship) is based on a correlation between structural and ket parameters of a chemical and its bioactivity; explains why members of a class of chemicals tend to produce similar health impacts, can be used to assess complex mixtures of structurally related compounds

major routes of exposure to lead

1. ingestion = 20% to 70% ingested lead is absorbed into body, children absorb a higher percentage, contaminated drinking water, lead paint is major source of higher lead level exposures 2. inhalation = almost all inhaled lead absorbed into body, since phase-out from gasoline hasn't been a major pathway, tobacco / smoke lead in e-cigs 3. endogenous exposure = stored lead may be released again into the bloodstream especially in times of Ca stress (pregnancy, lactation, osteoporosis, etc just a lot of different things associated w women)

US statutes regualting chemical exposrues via media vs use

1. media specific statutes -- municipal and industrial waste (RCRA 1976) -- consumer products (CPSA 1982 and CPSIA 2000) -- work settings (OSHA 1970) -- emissions to water (Safe Drinking Water Act 1974) -- emissions to air (CAA 1972 and Toxics Release Inventory under EPCRA 1985) **** these are "subject protection" policies -- governs emissions and pollutants, establishes safety standards, issue permits, require monitoring and reporting, promote protective technologies 2. use specific statutes -- pesticides (FIFRA 1947 and amendments 1972) -- industrial chemicals (TSCA 1976 and Reform 2016) **** these are "chemical control" policies -- govern chemicals directly, collect information, require chemical testing, determine risk levels, restrict manufacture or us

society has 3 basic options for responding to climate change

1. mitigate = extent of global climate change by reducing GHG emissions or capturing from atmosphere 2. adapt = to reduce negative effects of climate change 3. suffer = suffer the consequences

main trends in GBD from 1990

1. most of the world's population lives longer and dies at lower rates (demographic transition) 2. leading causes of death shifted to non-communicable diseases (epidemiologic transition) 3. global changes in risk factors (risk transition) -- in 1990: child wasting, short gestation, and low birth weight -- in 2017: high blood pressure, smoking, and high blood sugar

main trends in GBD since 1990

1. most of world's population lives longer and dies at lower rates (bc of demographic transition) 2. leading death causes shifted from communicable to noncommunicable diseases (bc of epidemiological transition) 3. global changes in risk factors

three main types of chemical control laws

1. premarket testing and approval -- FFDCA (federal food drug and cosmetics act) authorizes US FDA to regulate food contact substances -- requires approval of food additives and colorants for pharmaceuticals but not for cosmetics -- considers all chemical food additives to be "adulterations" unless specifically proven to be safe -- FDA authorizes food contact substances via three mechanisms: ---- a. listing in title 21, Code of Federal Regulations, Section 170-189 ---- b. (GRAS) generally recognized as safe criteria ---- c. (FCN) food contact notification process which includes manufacturers must submit to FDA a safety summary and comprehensive toxicological profile including chemical, toxic, and exposure information; identity of degradation products expected to get in food from packing; when evaluating FCN, the FDA considers mixture toxicity and aggregate exposures but only from food and food packaging 2. premarket notification 3. postmarket

three main types of chemical control laws

1. premarket testing and approval 2. premarket notification 3. postmarket siloed policies at different levels of government: local, state, national, international with force of domestic law

policies to help encourage sustained, long term, and reliable supplies to eliminate barriers to usage of LPG

1. provision of two cylinders = hard to get fuel refilled in timely manner in rural areas but in cities, everyone has two cylinders 2. Ujwalla Mamta = free fuel for pregnant women, protects mother and child during vulnerable period 3. linking LPG with rural employment guarantee = fuel collection takes many hours per week; time saved from collecting fuel could be linked with a national rural employment act, helping offset the cost of fuel potentially

five categories of cumulative impact

1. proximity to hazards and sensitive land uses = point and area emissions sources, land uses associated with sensitive populations 2. health risk and exposure = state and national data sources 3. social and health vulnerability = based on epidemiological literature on social determinants of health, American Community Survey / Census data, state data sources 4. climate change vulnerability = based on climate change and health literature, heat islands and temperature and social isolation 5. drinking water - based on potential contamination exposures (N=17), technical and managerial capacity of system, domestic well

subchapter 7, group 15, article 106 (of the General Industry Safety Orders)

1. repetitive motion injury (RMI) has occurred to more than one employee a. predominantly caused by repetitive job / process. operation b. employees performing a job process or operation of identical work activity c. MSD objectively identified and diagnosed d. reported by employees to employer in last 12 months 2. program to minimized RMIs shall include worksite evaluation, control of exposures which has caused RMIs, and training of employees

Central Dogma of Molecular Biology -- three main processes

1. replication = DNA to DNA 2. transcription = DNA to RNA 3. translation = RNA to protein

how does the body respond to heat stress

1. vasodilation -- redistributes blood flow towards the skin to help transfer heat from muscles to environment -- increases cardiovascular strain 2. sweating -- removes body heat -- can lead to dehydration, which can exacerbate cardiovascular strain

chemicals in consumer products pose four main challenges

1. widespread exposures = can reach large population in short period of time 2. frequent and chronic exposures = consumers can encounter these chemicals daily 3. poorly reversible exposures = very difficult to take chemicals w known adverse impacts off the makret 4. varying risk levels = depends on how chemical is used and how consumers interact w product

inequities in drinking water access persist

1.5 billion people gained access to basic drinking water services from 2000 to 2015 but women still spend 16 million hours per day collecting water in 25 sub-Saharan countries -- men = 6 million hours -- children = 4 million hours

what is the counterfactual exposure level

2.4 - 5.9 ug/m^3

CA Green Chemistry Intitiative

2004 - the CA senate on Environmental Quality and the Assembly Committee on Environmental Safety and Toxic Materials commission the UC Chemicals Policy report 2006 - CA Policy Research Center of the UC Office of the President releases draft report to the Committees 2008 - DTSC finalizes California Green Chem Initiative report; Gov Schwarzenegger signs AB 1879 and SB 509 which became the CA Green Chem Law 2012 - the Green Chem Hazard Traits regulations become effective 2013 - the Safer Consumer Product (SCP) regulations become effective (CCR)

Renewables Portfolio Standard

2008 executive order to achieve 33% renewables by 2020, 2015 SB 350 moved goal to 50% by 2030, 2018 SB 100 moved goal to 100% by 2045

were these OP exposures (DAPS) related to child health and development?

CHAMACOS study found that length of gestation shorter for infants of women with higher OP metabolites; for every 10 fold increase in DAPS in later half of pregnancy, there was half a week decrease in gestation also prenatal OP metabolites related to abnormal reflexes in neonates when looking at prenatal OP metabolites and Bayley mental development, exposure led to decrease in IQ and negative slope just kept getting more negative 6, 12, and 24 month check in mothers' OP metabolite levels also related to child's IQ at age 7; prenatal OP metabolites related to CBCL attention at 5 years and more exposure lead to higher behavior score (ADHD)

air quality regulation in US

California Air Resources Boards (1967), Clean Air Act and US EPA (1970), National Ambient Air Quality Standards for criteria pollutants three levels of air quality control include: 1. US EPA = sets and enforces national air quality standards; regulates interstate transportation 2. California Air Resources Board = regulated mobile sources of air pollution, GHGs, and consumer products 3. local air districts = regulates stationary and local sources of air pollution

metrics for measuring ill-health

Disability Adjusted Life Years (DALYs) are the years of healthy life lost, calculated by adding the: 1. Years of Life Lost (YLLs) due to premature mortality -- for a population: the number of deaths in a population (N) times the standard life expectancy at the age at which death occurs (L) 2. Years Lost to Disability (YLD) due to injury or illness (the difference between life expectancy and healthy life expectancy) -- For a population: the number of incident cases (I) times the average duration of the disease until remission or death (L) times a weight factor reflecting the disease severity (DW) [from 0 (perfect health) to 1 (dead)] DALY = YLL + YLD = N x L + I x DW x L

approaches to control / reduce contamination of produce

GAPs (good agriculture practices) and HACCP (hazard analysis critical control point) risk assessment models to predict risk of contamination increased and improved testing development of sanitizers based on knowledge of bacterial physiology and behavior on/in plants microbial community management -- keep good ones (good competitors to keep human pathogen numbers low), get rid of bad ones (those that promote human pathogens) plant genetics hurdle technologies

YLD

I = number of incident cases L = average duration of disease until remission or death DW = disability weight factor reflecting disease severity from 0 (perfect health) to 1 (dead) YLD = I x L x DW

how to tell type of toxic effects

Key Characteristics (KCs) -- properties of a chemical that make it a toxicant to that system (like neurotoxicant, endocrine disruption, etc) Adverse Outcome Pathways (AOPs) -- new approach to evaluating changes in normal cellular pathways to due xenobiotic exposure Mode of Action (MoA) -- functional or anatomical change at cellular levels(whenMoAequalsone,thereisnoassociation) Mechanism of Action (MOA) -- change at molecular level

LPG (liquified petroleum gas) and climate change

LPG emits less CO2 and its climate credentials are significantly enhanced by emerging evidence regarding role of black carbon

MOS (margin of safety) for pharmaceuticals

MOS = (TD01 / ED99), toxic dose that kills 1 percent of population divided by effective dose for 99 percent of pop

A.B. 32 (Global Warming Solutions Act of 2006)

Mandates regulatory and market mechanisms to reduce emissions of greenhouse gases (GHG) Establishes GHG cap for 2020 based on 1990 levels Means a roughly 25% reduction from business as usual Required a "scoping plan" to achieve 2020 targets 2020 compliance expected SB 32 passed in 2016 mandates even more ambitious reductions - a 40% reduction from 1990 levels by 2030

lead in US

National Toxicology Program concluded that there's sufficient evidence for adverse health effects in kids and adults at BLL < 5 ug / dL median decrease of 95% in BLL for BLL, results greater than or equal to reference value must be confirmed within 1-3 months

what's the problem with OSHA

OSHA estimates that WRMSDs (work related musculoskeleto disorders) account for over 600k injuries and illnesses (34% of all lost workdays reported to BLS) WRMSDs account for $1 out of every $3 spent on worker compensation employers will spend an estimated $20 bil a year on direct costs for WRMSDs and up to 5x that for indirect costs (hiring, training, etc) unquantifiable toll of employees who become disabled about 65% of a company's work related injuries are strain / sprain

BoD (burden of disease) calculations

P = population I = baseline disease rates PAF = population attributable fraction RR = relative risks at each level of exposure AB = P x I x PAF PAF = (RR - 1) / R

air pollution exposure inequality

POC and low socioeconomic status have greater exposures to outdoor air pollution, disproportionate proximity to polluting land uses and toxic emissions

types of epidemiological studies (total of 8)

Randomized control trial = often in clinical trials, experimental Prospective cohort study = follow group track exposures and disease incidence Case control study = compare people with and without disease vs with and without risk factor aka exposure Retrospective cohort study = defines incidence in an existing group Cross sectional study = snapshot in time that views exposure vs prevalence Ecological study = group exposure and group level prevalence / outcome Disease cluster = group of similar diseases (usually cancer cluster) Case series = collection of cases (subject to selection bias)

California Safer Consumer Products (SCP) Regulations

SCP identifies specific products that contain potentially harmful chemicals and asks manufacturers to answer: 1. is this chemical necessary? 2. is it worth it? 3. is there a safer alternative?

cancer slope factor

a plausible upper-bound estimate of the probability that an individual will develop cancer if exposed to a chemical over a lifetime of 70 years expressed in mg/kg/day ** see lecture notes

solid fuels and biomass

about 3 billion people use solid fuels for cooking; while proportion of population using these fuels is decreasing, absolute number has remained relatively constant over past 30 yrs millions of deaths yearly from exposure to PM 2.5 arising from combustion of solid fuels -- biomass combustion results in release of many pollutants into the indoor and outdoor environments; most studied pollutants are PM 2.5 and carbon monoxide

lead in drinking water

about 7% of US homes are connected to a lead service home (about 15 to 22 million Americans nationally are served by lead lines) corrosion inside galvanized pipes can create potential for lead to accumulate over time (acidic water can contribute to leaching of lead from pipes into drinking water supply like in Flint, Michigan) boiling water will not eliminate lead for most of US pop, Pb in water isn't a problem but for some communities it can be a major exposure route

lead inside homes

about 83% - 86% of all homes built before 1978 that are in use have lead-based paint in them lead-based paint still present in 1/3 of the nation's dwellings homes built before 1986 more likely to have lead pipes, fixtures, etc

duration of exposure levels

acute -- single exposure for less than 24 hrs subacute -- one month or less subchronic -- one to three months chronic -- three or more months

UN Sustainable Development Goals

adopted by world leaders from 198 countries in September 2015 came into force January 1 2016 non binding all countries expected to take ownership and establish national frameworks to achieve the 17 goals and their 169 targets implementation costs estimated $3 trillion / year

how much water does agriculture use?

ag accounts for 70% of global water use and by 2050, 19% more water will be needed for ag -- one walnut = 4.9 gallons of water, one pistachio = 0.75, one almond = 1 gal -- foods with more protein typically need more water (protein content and water necessary are directly proportional)

agonist vs antagonist

agonist = ligand that binds to a specific receptor and triggers a response in cell -- it mimics action of endogenous ligand (aka hormone) that binds to same receptor antagonist = no apparent effects in absence of endogenous ligand, but they block effect of agonist through competitive binding to same binding site in nuclear receptors **** in recent years, there has been increasing evidence of disruption of endocrine function in wildlife population ---- abnormal thyroid function, diminished fertility, eggshell thinning (DDT remember from APES)

brief history of pesticides

agriculture began about 10,000 years ago (Mesopotamia) current loss to pests is about 35-40%, big incentive to reduce loss to pests there's financial incentive to use pesticides because every $1 spent on pesticides results in about $4 worth of crops saved

ambient PM 2.5 reduces global and regional life expectancy

air pollution cases premature death; life-expectancy (LE) adds an intuitive and policy relevant context to existing stats on mortality the gap is that systematic assessment of how global PM 2.5 affects LE at birth if air pollution were removed as a risk factor for death, how much longer would people live?

environmental risks lead to human suffering

air quality is largest environmental risk and chronic diseases dominate

chemicals in consumer products pose four main challenges

already have a flashcard on this

presumptions embedded in all statutes

already have a flashcard on this

ambient air / water pollution as wealth

ambient air / water pollution gets worse as wealth increases and then maybe it gets better but modern risk does not get better

dose

amount of substance taken or administered at one time 1. absorbed / internal dose -- amount of substances that enter the body and are taken up by organs or tissues 2. administered dose -- amount administered orally or by injection 3. total dose -- usually expressed as mg/kg/day (ex: 10 mg/kg for a person that is 70 kg results in 700 mg/day)

toxic agents

anything that can produce an adverse biological effect 1. toxins -- poisons or venoms of biological origin (usually peptides or proteins) 2. toxicants -- chemicals or physical agents (like radiation) that produce adverse effects -- a. systemic toxicants (affect entire body or multiple organs) -- b. organ toxicants (affect specific organs or tissues)

toxicogenomics

application of genomic technologies to study the adverse effects of environmental and pharmaceutical chemicals on human health and the environment -- combines toxicology with information dense genomic technologies to integrate toxicant specific alterations in gene, protein, and metabolite expression pattern with phenotypic responses of cells, tissues, and organisms -- can provide insight into gene environment interactions and the response of biologic pathways and networks to perturbations -- combines genetics, epigenetics, transcriptomics, preteomics, metabolomics, and bioinformatics with conventional toxicology to understand role of gene-environment interactions in disease systems toxicology = description of all the toxicological interactions within a living system

Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)

aspects date to 1910 (Federal Insecticide Act) FIFRA passed in 1947 (more environmental / health protections) major revision in 1972 (Federal Environmental Pesticide Control Act aka FEPCA) pesticide now registered by US EPA; with FIFRA registration package addresses toxicity, exposure, risk, food tolerance, and often proprietary

secondary particulate matter

atmospheric oxidation converts gases to particules formed by the interaction of primary particulates with the atmosphere (such as nitrates formed from nitric oxides) sulfates and nitrates

how large was avoided pollution related mortality during COVID?

basically less people died of COVID during first couple months of COVID than would have died of air pollution -- people staying inside and spending less time outdoors and breathing outside air means less exposure to this air pollution so less people died of it estimated avoided mortality attributable to improved NO2 and PM 2/5 using short term concentration response functions; avoided poll related mortality may have exceeded reported COVID mortality (basically, less people died of COVID during this time than would have died of air pollution)

EDCs (endocrine disrupting chemicals)

can build up in environments and effect how hormones are perceived Endocrine Society: "an exogenous (non natural) chemical, or mixture of chemicals, that interferes with any aspect of hormone action. Hormones are natural chemicals produced in cells within endocrine glands, which are located throughout the body." WHO: "an ED is an exogenous substance or mixture that alters the function(s) of teh endocrine system and consequently causes adverse effects in an intact organism, or its progeny, or (sub)populations."

epigenetics in risk assessment

can use epigenetic marks as early biomarkers of risk and outcomes 1. hazard identification = are there associations between epigenetic alterations and adverse health effects? 2. dose response = are epigenetic alterations dose response with adverse health outcomes or mechanisms of action? 3. exposure assessment - do epigenetic alterations affect route of exposure (or absorption, metabolism, and excretion)? 4. risk characterization - do epigenetic alterations in initial assessments inform final risk?

Quito, Ecuador

capital city in an upper middle income country, rapid population growth, less than ten percent of wastewater is treated in Ecuador extended beta lactamase producing E. coli isolated from irrigation waters and produce in Ecuador

known toxicological traits of longer-chain PFASs

carcinogenicity, cardiovascular toxicity, endocrine toxicity, immunotoxicity, reproductive toxicity environmental hazard traits = phylotoxicity, wildlife development and reproduction and survival impairment

what is epigenetics

changes in gene expression due to modification of DNA at the molecular level. this includes methylation, acetylation, etc changes in gene expression that 1. do not depend on the DNA sequence 2. can be stable (through our division aka mitotically stable, transgenerational inheritance but limited evidence in humans) may persist even in the absence of the conditions that established them (biological memory --> biosensor)

Food Quality Protection Act of 1996

charged US EPA to determine safe levels of pesticide residues in food -- must consider specific vulnerabilities of children -- first time children were considered (regulation)

Food Quality Protection Act (1996)

charged US EPA to determine safe levels of pesticide residues in food; must consider specific vulnerabilities in children

the climate gap

climate change and mitigation strategies have disproportionate and unequal implications for POC and poor -- higher mortality and health impacts, price increase for necessities, reduced economic opportunities, greater infrastructure damage according to Climate Action Tracker, we should see 2.7 - 3.1 degrees F increase in temperature by 2021 if no climate policies are implemented

climate change delays clean air progress

climate change could overwhelm existing ozone emission reduction efforts CARB (CA Air Resources Board) and UC researches estimate up to 30 more days of unhealthy ozone annually by 2050 -- CARB estimates 8 billion dollars additional annual cost of zone controls in 2050

CHAMACOS study

community-based participatory research project studying impact of environmental chemicals on farmworker families ----> four main activities 1. a study to examine = growth (fetal and child), neurobehavioral development, respiratory disease, and pubertal onset 2. pesticide exposure studies 3. mechanistic studies 4. community outreach and translation activities for CHAMACOS, chemical exposures of interest include -- pesticides (organophosphates aka OPs, pyrethroids, fumigants, fungicides containing manganese -- flame retardants (PBEs and OPFRs) -- chemicals in plastics (like BPA) and phthalates CHAMACOS found OP pesticides in house dust and biological samples (urine) --> CHAMACOS's mothers' OP metabolite levels are higher than US averages; so are their children's metabolite levels; children who eat more fruits and vegetables have higher elvels of DMs -- juice appears to be major source of OP pesticide metabolites also food is major source of DAPS --> pesticide levels decrease after switching to an organic diet

what can be done about water shortages

conserve water manage water resources more effectively diverse water resources (like tower that pulls drinking water out of thin air)

Donrolla Meadows's 12 leverage points from less effective and easier to more effective and harder

constants and parameters and numbers buffer size stocks and flow structures delays relative to change rates balancing feedback loops reinforcing feedback loops info flow structure system rules system structure / self organization the system goal paradigm used to design the system power to shift paradigm to deal with new challenges

ecological sanitation: resource, not waste

containment to collection to transport to treatment to transformation back to containment

presumptions embedded in all statutes

drugs, food additives, colorants (FFDCA), and pesticides (FIFRA) = presumed hazardous, require pre-market approval, safety and efficacy must be established cosmetic ingredients (FFDCA) = presumed safe unless FDA proves otherwise consumer products (CPSA) = generally presumed safe, pending an incident industrial chemicals (TSCA of 1976) = chemicals existing as of 1976 presumed safe, new chemicals require no hazard info industrial chemicals ("new" TSCA of 2016) = adds a prioritization and review process for existing chemicals, adds dat requirements for new chemicals CHEMICALS ARE INNOCENT UNTIL PROVEN GUILTY

circular economy

economy model in which resources remain in use for as long as possible, from which maximum value is extracted while in use, and the products and materials are recovered and regenerated at the end of the product life cycle we need a circular economy, but that requires less OR non hazardous ingredients

timing of exposure matters

effects in one life stage might be absent in another

environmental epidemiology

environmental epidemiology -- comparison with toxicology and role in regulation -- the epidemiologic transition -- prevalence / incidence data -- confounding -- effect modification -- mediator / mediation types of study designs -- descriptive vs analytical epidemiology -- case series / case report -- ecological study ---- ecological fallacy

epigenetics -- tissue specificity

epigenetic marks are TISSUE SPECIFIC --same genome DOES NOT MEAN same epigenomes epigenetics contributes to tissue differentiation -- cell differentiation and fate each cell type has a UNIQUE EPIGENETIC SIGNATURE

SCP regulations aim to protect the most vulnerable

especially young children, fetuses, pregnant women, workers, endangered and threatened species and environments, etc these are all more sensitive to impacts of chemicals

IARC (International Agency for Research on Cancer)

established in 1965 by the WHO. Its mission is to coordinate and conduct research on the causes of cancer and develop cancer control strategies human data is critical, need for high quality data (quality of epidemiological studies), high quality exposure assessment (biomarkers of chronic exposure), biological possibility (mechanistic data, toxicological studies)

climate change affects the social and environmental determinants of health

expected to cause an additional ~250,000 deaths/year between 2030 and 2050 from: --malnutrition -- malaria -- diarrhea -- heat stress weather related natural disasters result in over 60k deaths per year, mainly in developing countries the direct damage costs to health estimated at $2-4 billion per year by 2030

6. randomized control trial (RCT)

experimental study where patients / participants are randomized to receive one of several comparison treatments -- advantages = gold standard from a statistical point of view, minimizes bias and confoudning -- disadvantages = expensive, requires monitoring, inclusion criteria can limit generalizability; usually unethical for environmental exposures, not always feasible, long-latency of cancer makes it almost impossible **** example = randomized participants eat fresh vs canned soup -- measures BPA in urine; ethical?

for general view of quality of studies from lowest to highest quality

expert opinion case studies and case reports observational studies with comparison groups non-randomized controlled trials randomized control trials systematic reviews ** not a rule, but in general for the pyramid, RCTs (randomized control studies) can be bad and case reports can be very useful

terms for data

explanatory variable (independent variable) = may explain or may cause differences in an outcome which is known as a response variable (dependent variable) confounding variable = affects response variable (Y) and is related to explanatory variable (X) effect modifier = an exposure (X) has a different effect on the response (Y) depending on a third variable radiator = effect of the exposure (X) on the response (Y) if partially or fully explained by an intermediate variable on the path (M)

Agouti mouse model

exposure to BPA in utero and DNA methylation in the agouti mouse model pregnant mouse is exposed to BPA and controls are BPA diet and control diet found that animals exposed to BPA were having greater litters and lighter colored offspring (more BPA exposure = lighter colored babies) yellow mice tend to be more prone to insulin resistance and much larger than regular mice BPA now known as EDC

agouti mouse model

exposure to BPA in utero and DNAm in the agouti mouse model

foodborne disease and climate change

extreme weather events (heat spells, prolonged droughts, heavy rains, high winds) may affect: 1. contamination sources (animals, soil, manure, water, etc) 2. contamination pathways (irrigation, splash, flooding, contact with feces, wind carried aerosols, etc) 3. behavior of human pathogens in their host and environmental habitats

epigenetic clock determinants

extrinsic epigenetic age clock slowed down by fish, exercise, fruits and vegetables, moderate alcohol, education and income, etc ---- there are all GOOD for epigenetic age clock intrinsic epigenetic age clock slowed down by poultry consumption -- good bad for both: insulin and glucose, C-reactive ration, BMI, triglycerides, systolic blood pressure will raise them good for both: HDL cholesterol will lower them -- extrinsic epigenetic age = dependent on white blood cell shifts (immune system aging) -- intrinsic epigenetic age = independent of white blood count changes (cell intrinsic aging)

5 WEAll needs

fairness, nature, participation, connection, dignity

Residential Lead-Based Paint Hazard Reduction Act

federal law that requires sellers and landlords to disclose known lead paint hazards for homes built before 1978 buyers must be informed of any known lead testing, providing a 10-day window for buyers to do inspection, include in the contract or lease a lead warning statement in 1978, federal government banned consumer use of lead-containing paint and commonly found in areas with lots of wear and tear (like windows and window sills, doors and door frames, etc)

the early years of chemical pest control

first generation pesticides (inorganic) -- first attempt at chemical technology -- sulfur first known pesticide -- metals including arsenic, lead, mercury problems -- toxic to humans and crops -- pests developed resistance

early years of chemical pest control

first generation pesticides were inorganic first attempt at chemical technology, sulfur was first known pesticide, metals like Ar and Pb and Hg problems = toxic to humans and crops, pests developed resistance

CARB (CA Air Resources Board) regulatory paradigm shift

focus on emissions reduction drives tech and innovation that provides economic stimulation (jobs) to counter the anti-regulatory (job killer) rhetoric typical two way battle between industry and environment health advocacy groups at federal level now occurs less often in CA and focus on emission reductions has empowered clean tech companies to support many air quality control policies

risk characterization in practice

for carcinogens -- the lifetime cancer risk is estimated by multiplying the cancer slope factor for the substance by the chronic, 70 year average daily intake for noncarcinogenic effects -- the exposure level is compared with an ADI, RfD, or MRL derived for similar exposure periods

integrated exposure response functions

for estimating the global BOD attributable to ambient fine particulate matter exposure it was found that RRs (relative risks) rise rapidly then flatten -- included disease are lower respiratory infections, COPD, lung cancer, ischemic heart disease, and stroke when it comes to risk transition, communicable has decreased and chronic has increased; fastest changes are happening in the developing world

what is the Global Burden of Disease?

for trying to quantify the health of populations, there are two parts 1. GBD = what is the total impact of disease and injury on the population? 2. CRA = how do we compare different risk factors and interventions that affect different populations

evaluating / quantifying exposure TLV = threshold limit value

force = N, number, kg, percent of time spent above TLV repetition = reps / min contact stress = N / cm^2 awkward posture = degrees, percent of total range, percent of time spent above TLV environment (vibration) = m / s^2, hz environment (temperature) = degrees F, degrees C

physical risk factors

force, repetition, awkward postures, mechanical or contact pressure, environmental factors (vibration and cold temperatures and excess light or sound) personal and work psychosocial factors also increase risk for MSDs

xenobiotics

foreign substances taken into the body (could be either beneficial or toxic)

many factors influence toxicity

form and innate chemical activity dosage route of entry into the body (including ingestion, inhalation, dermal contact, transplacental transfer aka pregnancy, injection) duration of exposure interactions between multiple chemicals individual sensitivity or susceptibility

funding incentive for environmental health

funding incentives for environmental health scientists to conduct community-engaged research changes how scientists think and understand disease causation researchers and regulators pushed by environmental justice advocates to address cumulative impacts consider social inequalities and links to environmental degradation and health disaparities -- multiple hazards where communities live, work, and play -- vulnerability due to chronic social stressors like poverty, malnutrition, discrimination, and chronic health problems

GBD 2019 key findings

global life expectancy at birth increased from 67.2 (2000) to 73.5 (2019) healthy life expectancy has increased in almost all countries estimated number of deaths in kids under five years old has decreased from 9.6 mil (2000) to 5 mil (2019) decrease in DALYs since 1990 have been largest for communicable, maternal, neonatal, and nutritional diseases

risk assessment (in depth)

goal is to characterize likelihood of harm in a format that assists decision makers who must act to tolerate, mitigate, or eliminate potential harm; has four components of a. hazard identification = does agent cause adverse effects (structure activity analysis, in vitro tests, animal bioessays, epidemiology) -- determines whether a particular chemical causes a particular health effect -- includes how ot assess chemical toxicity (human epidemiological studies, in vivo animal bioessays, in vitro, in silico chip) -- challenge is: chemicals may target multiple tissues, hazards may differ by dose, chemical toxicity may occur, hazards can differ by life stage b. dose response assessment = what is relationship between dose and response (susceptibility which is based on age and gene environment) -- "dose makes the poison" -- carcinogenic risk assessment = usually no threshold for carcinogenicity -- cancer risk assessment = has two steps: a. evaluate all available studies to determine if substance is definite, probable, or possible human carcinogen based on weight of evidence; b. for substances classified as definite or probably, use math models to get from exposure doses to typical environmental doses -- cancer slope factor = plausible upper-bound estimate of probability taht individual will develop cancer if exposed to chemical over lifetime of 70 yrs ( expressed in mg/kg/day (so risk estimate = 70 kg x (20 m^2 / day) or 70 kg x (2 L / day) -- non carcinogenic risk assessment -- ADI (acceptable daily intake) over lifetime assumed to be without significant risk; RFDs (reference dose), RFCs, MRCs (minimum risk level, etc all estimate daily exposure assured to be w out significant health effects over certain period -- TDI (tolerable daily intake) chemical intakes that are tolerable but not acceptable because below levels are known to cause adverse effects -- ADI = (NOAEL / uncertainty factors); but if NOAEL unabailable, use LOAEL and add an uncertainty factor RFD = (x mg/kg/day) / 10 x 10 etc depending on how many uncertainty factors there are -- BMD (benchmark dose) produces predetermined change in response rate of an adverse effect, less affected by exposure conditions than the NOAEL and LOAEL c. exposure assessment = what types, levels, and duration of exposures are experienced or anticipated -- standard exposure equation: potential dose = C x IR x CF x ED x F -- C = contaminant concentration, IR = intake rate, CF = conversion factor, ED = exposure duration, F = frequency of exposure, AT = average time, BW = body weight -- challenge is multiple sources and exposure routs -- aggregate exposure is exposure form multiple source and routes for the same substance -- cumulative exposure is exposure to various chemicals and routes that have similar effects -- challenge is exposures differ by life stage (higher in early life because lower metabolic enzyme function, immature brain/blood barrier, kids consume more per pound than adults, increased absorption and decreased elimination) d. risk characterization = describe nature and magnitude of human risk including uncertainty -- for carcinogens = lifetime cancer risk estimated by multiplying cancer slope factor for substance by the chronic 70 year average daily intake -- for non carcinogenic effects = exposure level compared with ADI, RfD, or MRL derived for similar exposure periods -- cancer risk characterization estime = (cancer slope factor / 70 kg x 20 m^2 per day or x 2 L per day) and 70 kg is weight of average man so that is why it is in the equation -- non cancer risk characterization: RfD = (NOAEL, LOAEL, or BD) / (uncertainty factors) -- REL (reference exposure level) recommended guidelines for upper exposure limits to environmental contaminants -- HQ (hazard quotients) = (actual exposure dose or concentration) / (RfD or REL); and if HQ > 1, then adverse effect possible; HQ < 1, adverse effect unlikely -- models don't reflect population variability and vulnerability well -- outcome might differ by study finding source

Senate Bill 375 = Smart Growth

goal to reduce GHG emissions through "smart growth" so people will drive less metropolitan planning organizations are given targets for reducing MMTs CO2 --> targets attained through "Sustainable Community Strategies" that reduce VMTs

sustainable economic recovery

governments all around the world are preparing huge economic stimulus packages to enable recovery from COVID slow down some of this stimulus money should be used to support transition to cleaner power and transportation solutions

by 2025

half fo world population will be living in water stressed areas and 1.8 billion will live with absolute water scarcity water vocab: 1. water stress - less than or equal to 1700 m^3 / person / year 2. water scarcity = less than or equal to 1000 m^3 / person / year 3. absolute water scarcity = less than or equal to 500 m^3 / person / year -- regions most impacted seem to be in Africa; it is economic water scarcity meaning regardless of amount of water available there, they do not have the physical infrastructure to bring water to people

children have higher risk to exposure to Pb because of their behavior and physiology

hand to mount behaviors, higher breathing rate so greater volume of air per pound, more likely to breathe lead contaminated dust because they're shorter, percentage of Pb absorbed in the gut estimated to be 5-10x higher in infants and kids than in adults

LPG vs biomass

hard to compare because it depends on what pollutants we are cooking and the time horizon -- for wood fuel, depends on whether harvested renewably or non renewably, about 30% of carbon harvested renewably -- depends on efficiency of combustion, which is typically low for traditional biomass stoves -- in general and despite uncertainty, net impacts of LPG transitions seem small compare to other large sources; currently 1.6 billion people using renewable wood -- assuming those using non renewable biomass / coal result in net beenfits if transitioned to LPG ** IMPORTANT: if all 1.6 billion switched completely to LPG, an additional 0.2 billion tons of CO2 a year would be emitted context: -- global fuel combustion contributes to about 30 billion tons/year with 2% growth rate -- 7.5 billion tons from transport sector (0.78 from commercial aircrafts) -- 0.23 billion from transport in India -- growing 7% / year

air pollution reduces elderly survival

has large impact on survival for those who are age 80+ in polluted countries where few people survive to such old ages

What is lead (Pb) pollution?

heavy metal, dense, soft, malleable, and highly resistant to corrosion; historically used due to unique properties and ease of mining lead was added to paint and gasoline to improve performance

children are more exposed and vulnerable to toxicants

higher exposures -- frequent contact with the ground or floor -- hand to mouth activity -- less varied diet -- eat, drink, and breathe more per kg -- spend most of their time indoors exposure routes 1. ingestion 2. inhalation 3. dermal 4. across the placenta (basically while still in the womb)

children are more exposed / vulnerable to toxicants

higher exposures (frequent contact with ground and floor, hand-to-mouth activity, less varied diet, eat and drink and breathe more per kg, spend most of their time indoors exposure routes include ingestion, inhalation, dermal, and across the placenta metabolic pathways undeveloped in terms of metabolism developmentally immature (neural architecture not yet in place)

climate change and energy demand

higher temperatures due to climate change will increase demand for energy (air conditioning needs will grow) --> higher increases expected in inland areas, low income areas, minority communities, and communities not currently reliant on air conditioning vulnerable communities include elderly, infants and children, people with heart and lung disease, POC, and low incomes communities

lead in gasoline

historical use of lead in gas produced widespread contamination (soil, air, inner city neighborhoods, and housing near roadways) Clean Air Act banned sale of leaded fuel for use in on-road vehicles (leaded gas still available, off-road vehicles and boats and cars, small planes and helicopters) -- CAA reduced Pb in air by over 95% -- in 1970s, EPA began lead phase-out effort by proposing to limit Pb in gas -- in 1996, leaded gas was finally banned by CAA

what's a hormone receptor?

hormone receptors = cellular proteins that bind with high affinity to hormones and are altered in shape and function by binding; exist in limited numbers binding to hormone is non covalent and reversible (specific but transient) ---- similar to lock and key (if the key fits the door will open)

foodborne disease (food poisoning)

human illness caused by ingestion of food that is contaminated with a pathogenic microbe or with a toxic chemical -- most are infections caused by various bacteria, viruses, and parasites and there are multiple symptoms -- pathogens invade via gastrointestinal tract and cause symptoms like nausea, vomiting, abdominal cramps, and diarrhea; at times, chronic arthritis, paralysis, organ failure, and death

emergence of environment justice advocacy -- Warren County, NC

in 1978, waste hauler illegally dumped over 30k gallons of waste transformer oil contaminated with PCBs on roadways in 14 counties in NC US EPA designates roadsides as Superfund site in order to trigger clean up process 60k tons of PCB contaminated soil is scraped up from 210 miles of roadside shoulders in NC

impact of EDCs - EU vs US

in US, we were exposed to a chemial that leads to IQ loss much more than the EU was exposed to it the chemical being PBDEs aka flame retardants the use of them were hazed out and PBDEs were replaced with decabromodiphrenyl ether and decabromodiphrenyl ethane; concerns include persistence, bioaccumulation, and toxicity, so it is another regrettable substitution

climate change and mitigation policy -- what is the greenhouse effect

in the last century, human activities such as burning fossil fuels and deforestation have caused a jump int eh concentration fo GHGs in the atmosphere -- result has been extra trapped heat and higher global temperatures

getting LPG in India: the OLD paradigm

in the past, pay connection costs up front -- refills of LPG at set price (around 450 INR) with the government of India covering the difference between international and Indian prices

results of endocrine disruptions

inability to maintain homeostasis, altered growth and development, altered responses to external stimuli, altered behavior, suppressed gameotogensis, elevated gestational losses, embryonic malfunction, induced neoplasia or carcinogenesis

products of incomplete combustion

include many known health changing pollutants, such as NOx, SOx (non wood), hydrocarbons, oxygenated organics, free radicals, etc -- ex: wood (1000 g), 454 carbon --> CO2, PIC (products of incomplete combustion), char and ash

TOR (threshold of regulation) exemption

includes chemical w estimated human exposure below 1.5 ug/person/day, unless alert for mutagenicity

exposures in environmental epidemiology

includes contaminant chemicals in air water food, disease-causing microorganisms in food and water, ionizing and non-ionizing radiation, noise and heat and odor, hazardous wastes, occupational exposures, climatic factors

health effects of lead in adults

includes neuropathy, reduced sperm count, hypertension, kidney damage, ischemic coronary heart disease, cerebrovascular accidents

potential sources of microbial contamination of crop plants

includes untreated manure, animal and human feces, fungi and protozoa and nematodes as vectors, bioaerosol, birds, contaminated seeds, contaminated irrigation, etc

implications of environmental justice

inequality can amplify environmental hazard / health outcome relationships -- science still playing catch up to community wisdom regulatory science does not account for the cumulative impacts of hazard exposures and socioeconomic inequality underlying science to achieve this will take a while communities don't necessarily want to wait until the scientists sort it all out administrative data can be used to develop decision making tools that advance environmental justice -- even as the science evolves

why surveillance and outbreak investigations?

information --> policies and guidelines --> Food Safety Modernization Act (new rules to ensure food safety, new focus on prevention) ex of surveillance failure: Listeriosis from bologna in South Africa from 2017 to 2018

mechanisms of sex hormone ED (endocrine disruptor)

interference with hormone synthesis, disruption of hormone transport, effects on receptor binding / function

what are some strategies used by special interests to avoid regulation or deceive the public?

intimidation, manipulation, confusion (like denying science or bringing in experts to counter the scientific evidence), manufactured doubt (saying animal studies not valid bc they are not identical to humans, saying this is not reliable, etc)

Environmental Kuznets Curve

inverted U-shaped curve illustrating that as gross domestic product rises in emerging economies pollution goes through stages of rapid increase, leveling off, and decline

AA process seeks to avoid regrettable substitutions by answering key questions

is it necessary (consume or engineered demand) is there safer alternative (adverse enviro impacts, adverse public health impacts, waste and end of life effects, physical chemical hazards, physiochemical properties) what are tradeoffs (enviro fate, materials and resource consumption, associated exposure pathways and life cycle segments, product function and performance, economic impacts) ** scope of alternatives = redesign product, eliminate or reduce the chemical, reduce exposures, reduce the adverse impacts

we need Alternatives Analyses

is this the right problem to solve? is this the right solution to the problem? what are the tradeoffs?

water is a risk multiplier

it is integrating impacts of population growth (agricultural, economic, development, urbanization, climate change, etc) so in addition to being a public good it is now becoming a risk multiplier for health and people and planet

e-waste

items of electrical and electronic equipment and their parts that have been discarded by the owner as waste without intention of re use US is biggest e-waste producer, only 15% of our e-waste is recycled Asian and African countries handle most of the world's e-waste

lead in agriculture

lead arsenate used in 1892 as insecticide in apple orchards; popular among farmers because it was cheap, effective, easy to use, and persistent mostly ghost of our past, but soil in some orchards contain high levels of As and Pb, neither of which degrade or biotransform easily -- for lead in US soil, widely detected areas across country but higher concentration in urban areas; EPA standard for Pb in soil is play area = 400 mg / kg and non play area = 1200 mg / kg

essential points of lead and human health

lead poisoning is a completely preventable disease no safe BLL threshold for children lead may cause irreversible neurological, renal, cardiovascular, and reproductive damage (supra-linear dose-response curve) prenatal and early childhood exposure is a susceptible period historical use still affects us today -- and policy works

case study -- lead (Pb)

lead poisoning is a completely preventable disease no safe blood lead level (BLL) threshold for children lead may cause irreversible neurological, renal, cardiovascular, and reproductive damage -- supra linear dose response curve prenatal and early childhood exposure is a susceptible period historical use still haunts us to date -- policy works ** see lecture notes for sources

dose estimates of toxic effects

lethal dose (LD50, LD10, LD0, etc) -- statistic derived max dose at which x% of exposed organisms die lethal concentration (LCx) -- concentration in environmental media (air or water) at which x% of exposed organisms die effective dose (EDx) -- dose that produces desired effect for x% of exposed population toxic dose (TDx) -- dose that causes adverse toxic effects to x% of exposed population

general view of quality of studies

levels of evidence are appropriately represented by a pyramid each level from bottom to top reflects the "quality" of research designs (increasing) and quantity (decreasing) of each study design in the body of published literature not a rule but in general the pyramid of evidence applies -- RCTs can be bad -- case reports can be extremely useful

transgenerational epigenetic inheritance

life experiences can change parts of DNA that switch individual genes on and off alterations can be passed to future generations we can't generalize and say that this applies to humans as well; more research needed

lead detected in multiple traditional / folk remedies

like Mexican and Middle Eastern remedies and cosmetics and some Asian etc

limitation of epidemiological studies

long latency periods low incidence and prevalence difficulties in exposure assessment nonspecific effects

environmental determinants of epigenetic age

long term exposure to air pollution (0.97 ug / m^3 INCREASE in ambient PM 2.5 associated with increase of 0.32 - 0.35 years (age acceleration)) organochloride pesticides (DOUBLING in exposure associated with increase of 0.44 - 0.66 years (age acceleration))

what are endocrine systems for?

maintain and regulate endocrine functions maintain internal homeostasis support cell growth and proliferation coordinate development coordinate reproduction facilitate responses to external stimuli

fresh spinach recall after E. coli outbreak

major CA grower linked to virulent strain of bacteria that killed 1 and sickened 94 people across 20 states food source = bagged baby spinach

Assembly Bill 617

mandates CA Air Resources Board (CARB) to develop guidelines for community air quality monitoring -- requires local air districts to work with communities identified by CARB as having high cumulative exposure burden (to develop plans for community air quality, monitoring to determine local "hot spots", to review results from such monitoring to develop community emission reductions programs here is how plan is supposed to work: -- community emissions reduction programs -- accelerated retrofit of pollution controls on industrial facilities -- community level air quality monitoring -- enhanced emissions reporting -- increased penalty provisions -- grants to local community groups

exposure factors in the SCP regulations

market presence of the product occurrence, or potential occurrence, of exposures to the Candidate Chemicals in the product household or workplace presence of products containing the Candidate Chemical potential exposures to candidate chemical(s) in the product during product's life cycle -- adverse impact factors considered hazard traits and toxicological endpoints, hazard traits of the degradation and reaction metabolism products, aggregate and cumulative effects, adverse waste and end of life effects, physiochemical properties and environmental, similarity to known hazardous compounds **** all these hazard traits are given equal consideration

DALY (disability adjusted life years)

measure of burden of disease, one DALY equals one year of healthy life lost due to premature death and time lived with illness, disease or injury DALY = YLL + YLD DALY = N x L + I x DW x L

YLL (years of life lost)

measure of how many years of expected life are lost due to premature death N = number of deaths in a population L = standard life expectancy at age of death YLL = N x L

GBD (global burden of disease)

measures health gap

sustainable development

meets needs of present without compromising ability of future generations to meet their own needs economic development, social development and environment protection are interdependent and mutually reinforcing components of sustainable development

main type of receptors

membrane receptors = imbedded in target cell membrane; integral proteins / glycoproteins; penetrate through membrane -- for protein and charged hormones (peptides or neurotransmitters) nuclear receptors = nuclear proteins that act in pairs and bind to specific HREs (hormone recognition elements) which are sequences on the DNA in the promoter regions of target genes -- for small, hydrophobic molecules (steroids, thyroid hormones)

ADME (absorption, metabolism, distribution, excretion)

metabolism -- does detoxification (converts to less toxic form) and bioactivation (converts xenobiotic to more toxic form)

CA Environment Protection Agency (Cal EPA)

mission is to restore, protect, and embrace the environment, to ensure public health, environmental quality, and economic vitality -- consists of 6 boards, departments, and offices (BDDs) 1. CARB (CA Air Resources Board) = works to reduce air pollution and diesel exhaust so all Californians can breathe cleaner air and leads nation in fighting climate change / integrated programs to cut GHG under AB32 2. DPR (CA Department of Pesticide Reuglation) = protects workers and consumers by ensuring the safe use of pesticides through registration, permitting, and training 3. Cal Recycle = helps the state achieve the highest waste reduction, recycling, and reuse goals in the nation through programs that improve each vitality and environmental sustainability 4. DTSC (Department of Toxic Substances Control) = cleans up hazardous waste sites to put tem back into productive use and reduce blight and contamination to the neighborhoods and surrounding environments 5. OEHHA (Office of Environmental Health Hazard Assessment) = serves as the scientific foundation for CalEPA's environmental regulations and provides valuable information to consumers, policy makers, and manufacturers on the safety of chemicals in our environment 6. SWRCB (CA State Water Resources Control Board) = ensures that quality of drinking water and our water ways is safe and that we balance its use to meet the needs of all Californians

Epigenetics and the Environment

moderator between genes and environment short term adaptation to conditions environment exposures influencing epigenome (heavy metal exposure like Pb and As and Hg and Cd, prenatal and adult smoking, air pollution, stress and trauma, nutritional factors like folate and vitamins, etc) still ongoing research in multiple areas

commonly observed health effects of endocrine disruptors

most EDCs have multiple effects some include -- reproductive / endocrine = breast / prostate cancer, endometriosis, infertility, diabetes / metabolic syndrome, early puberty, obesity -- immune / autoimmune = susceptibility to infections, autoimmune disease -- cardiopulmonary = asthma, heart disease / hypertension, stroke -- brain / nervous system = Alzheimer's, Parkinson's, learning disabilities

ergonomics

multidisciplinary science that applies principles based on physical and psychological capabilities of people to the design or modification of jobs, equipment, products, and workplaces goals to decrease risk of injuries and illnesses to improve worker performance decrease worker discomfort, and improve quality of work life

types of musculoskeletal (MSD) disorders

muscle disorders = like upper neck tension syndrome tendon disorders = -- in shoulder = supraspinatus tendonitis and bicipital tendonitis -- in elbow = lateral epicondylitis and medial -- wrist = six extensor compartments and intersection syndrome and three flexor sites -- finger = stenosing tenosynovitis entrapment neuropathies -- cervical radiculopathy, brachial plexus neuropathy, radial tunnel syndrome, pronator syndrome, carpal tunnel, curbital tunnel, and Guyon's canal compression lumbar spine disorders -- degenerated disc, bulging disc, herniated disc, thinning disc, disc degeneration with osteophyte formation

lots of different types of resistance

mycobacterium tuberculosis = bacterium that causes tuberculosis (TB) neisseria gonorrhea = bacterium that causes gonorrhea (STI) MRSA = methicillin resistant staphylococcus aureus VRE = vanomycin resistant enterococci C. difficile = clostridium difficile insecticide resistance in insect vectors enterobacterales = an order of bacteria (like E. coli) that commonly causes infections in healthcare settings

recent policy contributions in pesticides

new CA rules on pesticide use near schools and childcare heavily influenced by CHAMACOS studies Monterey and Santa Cruz County agriculture commissioners pioneered local pesticide notification program CHAMACOS studies heavily cited in CA chlorpyrifos air toxics risk assessment

17 UN sustainable development goals

no poverty zero hunger good health and well being quality education gender equality clean water and sanitation affordable and clean energy doesn't work and economic growth industry and innovation and infrastricture reduced inequalities sustainable cities and communities responsible consumption and production climate action life below water life on land peace and justice and strong institutions partnership for the goals

conjugative plasmids are the driving force behind the emergence resistance to last-line antibiotics

non carbapenemase producing E. coli ST131 isolate acquired a cointegrate version fo teh plasmids of the E. clocae clone

does the dose make the poison?

not necessarily -- observed mixture can have very high connected absorbance even if dose is low -- "something from nothing"

major foodborne pathogens in the US

number of illness cases = norovirus, salmonella, clostridium, campylobacter, staphylococcus number of hospitalizations = salmonella, norovirus, campylobacter, E. coli 0157, cyclospora number of deaths = salmonella, listeria, norovirus, campylobacter

5. cohort study

observational study involving a group (cohort) of individuals who meet inclusion criteria followed prospectively in tiem for risk factor and outcome info (include persons exposure and not exposed to risk factor at outset) -- advantages = can assess temporal relationships (exposure before disease onset); exposure assessment is at start of study and or continuous monitoring -- disadvantages = need large numbers for rare outcomes, confounding **** example = is there association between PFAs and diabeteres incidences?; select a cohort all free of diabetes at enrollment, measure chemical PFAs (exposure) at enrollment (everyone is exposed), correlate new baseline exposrue to diabetes incidence (new cases)

what happens to our e-waste

only 15% of global e-waste is fully recycled China and a few other Asian and African countries handle most of the world's e-waste "informal" e-waste recycling provides local employment, but poses severe health threats, especially to children from water and air and soil and dust and food pollution

stats about air pollution

only 8% of global population meets the WHO ug / m^3 air quality guideline; 50% lives in areas of > 35 ug / m^3 update from 2010 is where only 40% of deaths were in areas greater than 35 North America = we have 8% of the world population, but make up 4% of deaths a year from air pollution Asia = 51% of world population, makes up 68% of air pollution deaths a year

planetary boundary for climate change was breached in May 1987 (at 350 ppm)

outer boundary beyond zone of uncertainty is at 450 ppm CO2 in 1987; currently, we are at 416 ppm after a certain point there is a fairly linear increase of CO2 emissions with GDP (after like $5000 per capita)

FDA has authorized several subclasses of PFASs since 1960s

paper and paperboard (grease proofing) durable products (nonstick coating) plastic products (extrusion agents) PFASs are ubiquitous, they are in environmental media (air and water), plants and animals, food for human consumption, drinking water, humans, etc extremely strong C-F bonds leads to extreme persistence

are there some who are more susceptible to OPs?

paraoxonase enzyme detoxifies OPs in body amount of efficiency of these enzymes depend on genes called PON1 found that PON1 levels less in newborns than adults so they have low level of enzyme so may be at higher risk mom's OP metabolites related to poorer children's IQ (especially in moms with lower PON enzyme)

smoking-placenta DNA methylation

placental DNAm mediates association of smoking and birth weight (informative of underlying biology) PBX1 gene involved in: regulation of osteogenesis, skeletal patterning and programming during development, PBX1 DNAm in cord blood associated with birth weight there is evidence of impact on placenta and birth weight

what causes of death are associated with particulate air pollution exposure?

pneumonia, heart disease, type 2 diabetes mellitus, lung cancer, birthweight and short gestation, etc

different types of pollution

point source pollution - comes from a single source nonpoint source pollution = includes many sources transboundary pollution = contaminated water from one country spilling into waters of another

terminology to know

poisons = agents capable of producing an adverse response in a biological system toxins = toxic substances produced by living organisms toxicants = toxic substances that are man-made or result from human activity toxic substances = materials that have toxic properties xenobiotics = chemical substances that are foreign to the biological system

in the last 6 years, revolutionary set of policies relying on social engagement, sophisticated marketing, and digital India have transformed the household energy landscape

policies included: 1. PAHAL = paid fuel subsidies directly into bank accounts and all LPG sold at market rates, reducing diversion of fuel intended for households into other sectors 2. Give It Up = encouraged middle and upper class households to give up their subsidy, which was targeted one to one to the poor; 10.5 million households have given up their subsidy to date 3. PMUY (aka Ujjwala) provides reduced cost connections to 50 million poor households by 2019; as of early 2017, had reached over 22 million already

one part per ____

ppm = one part per million ( 10 ^ -6) ppb = one part per billion (10 ^ -9) ppt = one part per trillion (10 ^ -12) ppq = one part per quadrillion (10 ^ -15)

prenatal maternal smoking (in context of epigenetics)

prenatal smoking --> placenta DNAm (more than 550k sites) --> lower offspring birth weight maternal smoking affects DNAm of placenta leading to lower birth weight

load carrying (in women) as a culturally significant activity

previous research suggests that heavy load carrying results in negative MS health impacts (especially for women and girls) and possible association with pelvic organ prolapse in Nepali women few studies looking at these relationships have been carried out in Africa -- mostly speculative or anecdotal, causal pathways remain unclear goal of this exploratory cross sectional pilot study was to assess the relationship between heavy load carrying and adverse health impacts in women in Shinyanga Region, Tanzania results: 82 participants, 5 sites (Ikonongo, Samuye, Nyasamba, Usanda), average age of 31.8 years (range from 18 to 64), primary occupation of farmer / farmworker, number in house of 7.5 people

Ecuador research project

primary goal was to find the role of these domestic animals in spreading organisms that causes diarrhea in children (because it means that they won't absorb nutrients well and therefore won't grow well) while doing this study they realized that there were lots of livestock and poultry vet shops and there were lots of antibiotics by the counter colonial relationship (CR) between child and chicken; so if you had baby and chicken in that household, they would more likely be sharing these drug resistant organisms -- but overall this resistance sharing occurs all over community and over pretty long resistances -- studies like these bring up household risk factors

risk

probability taht hazard will occur under specific exposure conditions risk = f (hazard, exposure)

community engagement in decision making tools

process = EYSM development and grounding truthing enhances scientific validity of data ensures metric and ranking choices are transparent builds stakeholder trust in EYSM for regulatory, policy, land use planning, and community purposes

risk management (in depth)

process of selecting policy actions to control hazards identified during risk assessment has limitations, like data usually from homogeneous animal strains, translating findings to humans creates uncertainty, lack of data seen as no risk, mixture effects with other chemicals not considered, "safe" might not actually be safe, few chemicals have enough data for risk assessment, most information is proprietary aka CBI (confidential business information)

risk management

process of weighing policy alternatives and selecting most appropriate based on results of risk assessment and social, economic, and political concerns

EPA's role in protecting public health

products = TSCA, FIFRA air emissions = CAA (Clean Air Act) water discharges = CWA (Clean Water Act), ODA (Ocean Dumping Act) underground injection = SDWA (Safe Drinking Water Act) land disposal = CERCLA, RCRA waste transfers = RCRA (Resource Conservation and Recovery Act)

kinds of hormones / hormonal classes

proteins and peptides lipids -- steroids, eicosanoids amino acid derived -- thyronine, neurotransmitters gases -- nitric oxide (NO), carbon monoxide (CO)

there has been an increased role of environment in disease

reduction of infectious disease (pre-COVID) -- increase sanitation and infection control, vaccine development increase in human lifespan -- greater exposure-time / diverse environments, improve neonatal survival increase in chronic diseases -- epidemiological transition

increase in importance of environmental epidemiology

reduction of infectious diseases increase in human lifespan increase in chronic diseases (epidemiologic transition) about 80 - 90 % of cancers are due to "environmental factors" understanding of cancer latency reduction / elimination of animal testing increase in analytical capability of chemists

to fix the issue of Global Burden of Disease (GBD) we need to:

reframe the conversation = nota. subsidy, but a social investment, like vaccines or maternal care focus on usage, like the health sector = bednets, condoms, salt reduction, helmets, etc critical evaluation of issues of cost (upfront recurring) and supply (reliability and ease of access) **** don't stop subsidies for the poor (below poverty line aka BPL and near BPL) but think of them as long term social investments in health and a clean environment

exposure response curves

relate exposure to PM 2.5 with various health outcomes -- since 2010, relied on "integrated exposure response functions" -- multiple sources (ambient, household, secondhand smoke, active tobacco smoking, etc) -- anchored by ATS -- assumes equivalent toxicity of particles from all sources; assumes a log linear shape in 2019, a few things changed: -- exclude ATS because data from higher exposure settings now available -- use splines; 3 knots (2 internal, 1 at right most edge) INSTEAD of a power like f(x) -- counterfactual not built into model fitting, but rather utilized during the risk estimation procedure; allows settings of other counterfactuals

dose-response

relationship between exposures and change sin body functions and health; helps establish: 1. causality -- whether chemical induces observed effects 2. threshold -- lowest dose that induces effects 3. slope -- rate at which effects increase with dose increases

measures of association

relative risk (RR) vs odds ratio (OR) OR = (A/C) / (B/D) = odds that case was exposed / odds that a control was exposed = AD / BC exposure | disease | yes (cases) - no (controls) yes | A B no. | C D -------------------------------------------------------------- RR = (A / (A+B)) / (C + (C+D)) = incidence among exposed / incidence among unexposed exposure | disease at X time | yes - no yes | A B no. | C D -------------------------------------------------------------- RR or RR = 1; risk is same in exposed and unexposed, so no association RR or OR > 1; risk is higher in exposed than unexposed, so it is a risk factor RR or OR < 1; risk is lower in exposed than unexposed, so ti is a protective factor

integrated exposure response function

relative risks rise rapidly, then flatten

renewable vs nonrenewable water resources

renewable = surface water and groundwater generated through the hydrological cycle nonrenewable = groundwater (deep aquifers) that recharge very slowly compared to human timescale

beyond replication ----> triangulation

replication is very important; about 40% of publications can be replicated reliably triangulation = we need at least three different lines of evidence in order for something to be considered reliable information when it comes to making inferences, association doesn't equal causation and correlation doesn't equal causation

Assembly Bill 1550

requires that 35% of cap and trade revenue is: 1. spent on projects that benefit disadvantaged communities 2. at least 25% spent on projects located in disadvantaged communities

Assembly Bill 1550

requires that 35% of cap-and-trade revenue -- is spent on projects that benefit disadvantaged communities -- at least 25% is spent on projects located in disadvantaged communities Cal Enviroscreen identifies disadvantaged communities

in last century, human activities have caused jump in concentration of GHGs in atmosphere

result = extra trapped heat and higher global temperatures heat radiated back into space as infrared light

Greenhouse Gas Reduction Fund

revenue from regulation of industrial GHG emissions targeted for investment in projects that: -- reduce pollution and GHG emissions in disadvantaged communities -- enhance co-benefits of GHG reductions (35% of funds to benefit vulnerable groups, 20% directly invested in vulnerable neighborhoods)

what causes ill health and death

risk transition -- decrease in communicable, increase in chronic fastest changes are in the developing world diseases of poverty are diseases of plenty

instructional pathway for conceptualizing environmental harms

rough structure of conceptualizing enviro harms includes basic structure of source --> emissions --> concentration --> exposure --> dose --> health effects

elemnts of an endocrine system include

sender -- sending cell signal -- hormone nondestructive medium -- serum and hormone binders selective receiver -- receptor protein transducer -- transducer proteins and two degree messengers amplifier -- transducer / effector enzymes effector -- effector proteins response -- cellular response (two degree hormones)

US federal chemical policies focus on

single chemicals rather than mixtures the most dangerous substances (most are just presumed safe) limiting adverse exposures rather than addressing inherent hazards restrictions for chemical uses and releases and exposures rather than encouraging safer and more sustainable alternatives

risk transition illustrated

slide 42 in review2_nov30.pdf

triple jeopardy -- political economy of "riskscapes"

social context = social inequality, segregation, discriminatory policy, and regulation demographics = race and ethnicity, education, country of origin, income, wealth, geography the triple jeopardy: 1. disparities in exposure = hazardous occupations, poor ambient air quality, high traffic density, water contamination 2. social vulnerability (extrinsic factors) = poverty, food insecurity, psychosocial stressors, less healthcare access, race and racism, gender roles 3. biological susceptibility (intrinsic factors) = age, underlying disease, malnutrition, genetics, sex ** these all go to interaction / additive effects and then: HEALTH DISPARITIES (mortality and morbidity)

risk overlap

some communities may experience significant traditional AND modern risks (like diseases caused by lack of sanitation and noncommunicable diseases) due to: a. risk genesis -- creating new type sof risk (ex: remerging infectious diseases due to globalized food production and anti-microbial resistance); or new diseases due to technology (like carpal tunnel from using phone too much) b. risk transfer -- trying to decrease one risk increases another (ex: pesticide use against malaria, but DDT has its own effects) c. risk synergism -- one type of risk changes sensitivity to other risks (ex: HIV and drug resistant tuberculosis)

how often to epigenetics mark change

some undergo rapid changes (like fight or flight response / infections) some are "in ink" so they are hard to change orchestral analogy: music notes are DNA, dynamics are epigenetics, conductor is phenotype

sources

sources can be things like sewage system to chemical treatment facility, emissions into atmosphere, runoff, etc think of APES point sources

doughnut

space between social foundation and ecological ceiling; practical way for humans to live without going overboard and doing further damage basically

every time we introduce a new drug or new class of antibiotics, shortly after that introduction we will see antiobiotic resistance develop

staphylococcus aureus infections, penicillin introduced in 1940s to fight staph infection; penicillin resistance by 1955 methicillin introduced 1959, by 1972 there was resistance that appeared in several countries vanomycin introduced 1972, by late 1980s there was resistance

Bradford Hill Criteria for Causality

strength -- strong associations less likely to be correlational (however many weak associations are causal) consistency -- replicating across populations, settings, and circumstances specificity -- one exposure leading to a specific disease (however, most diseases are multi-factorial) temporality -- exposure / cause occurs before the effect (no reverse causation) biological gradient -- dose / response plausibility -- biologically plausible (molecular biology) coherence -- doesn't conflict with current knowledge

Bradford-Hill's Criteria of Causality

strength = strong associations are less likely to be correlational (however, many weak associations are causal) consistency = replicating across populations, settings, and circumstances specificity = one exposure leading to a specific disease (but most diseases are multi-factorial) temporality = exposure / cause occurs before the effect (no reverse causation) biological gradient = dose / response plausibility = biologically plausible (molecular biology) coherence = doesn't conflict with current knowledge

types of epidemiological studies include: 1. case series study

study in which information about individual patients who share a disease in common is gathered over time; type of observational study -- two types are: a. case report -- detailed report of specific features of one case (n=1) b. case series -- systematic review of common features of a small number of cases ** usually doesn't involve controls (patients who are disease-free); simplest design because it is just description of interesting observations in a small number of individuals -- example: case series about e-cigs found that they need to target younger age group for prevention, THC e-cigs might be involved, timely will never be able to do RCT for this; limitations are hypothesis generating without estimate of correlation, etc

toxicology

study of adverse effects of chemical, physical, or biological agents on living organisms and the ecosystem, including prevention and amelioration of such

environmental epidemiology

study of disease and health conditions linked to environmental factors (like air, water, food, location like built environments, planetary health like climate change and ocean acidification and deforestation) important as we have seen an increasing role of the environment in disease; infectious diseases have gone down, increase in human lifespan has gone up, chronic diseases ----> epidemiologic transition

epidemiology

study of distribution and determinants of health and diseases, morbidity, injuries, disability, and mortality in populations

EDCs (endocrine disrupting chemicals)

substances or mixtures that interfere with hormones about 1000 among thousands of man-made chemicals ahve endocrine acting properties; global production of plastic was 50 million tons (1970s) but today it is 348 million tons EDCs have sex specific effects -- timing of exposure (prenatal, puberty, reproduction, aging) -- route of exposure and kinetics matter (tissue specificity, mode of action, chronic vs acute, half-life for elimination)

what is a "safe" chemical?

supposedly non toxic, nonr eactive, and non bioavailable however -- CFCs fit that description but since they were so stable and persistent in the environment, they'd last in atmosphere for so long that they could make it to stratosphere -- caused hole in ozone layer so then CFCs were replaced w greenhouse gases like HFCs, PFCs, and SF6 -- these are all a form of regrettable substitution

indoor air quality

tend to focus on PM 2.5 commonly measured pollutant most strongly associated with adverse health effects

sustainable development -- the 17 UN SDGs (Sustainable Development Goals)

the UN SDGs assume infinite economic growth

other

the UN sustainable development goals assume infinite economic growth -- economic growth is necessary Earth is "shrinking" -- trying to economically grow within planetary boundaries which are getting smaller and smaller so eventually our economy is going to exceed them

toxicogenomics

the application of genomic technologies to study the adverse effects of environmental and pharmaceutical chemicals on human health and the environment toxicogenomics can provide insight into gene environment interactions and the response of biologic pathways and networks to perturbations

Senate Bill 375 = Smart Growth

the goal of SB 375 is to reduce GHG emissions through "Smart Growth" so people will drive less metropolitan planning organizations are given targets for reducing MMTs CO2 targets are attained through "Sustainable Community Strategies" that reduce VMTs

dose-response relationship

the relationship between: EXPOSURES and CHANGES IN BODY FUNCTIONS AND HEALTH helps establish: 1. CAUSALITY - whether the chemical induces the observed effects 2. THRESHOLD - the lowest dose that induced effects 3. SLOPE - the rate at which effects increase with dose increases

what's the big deal about resistance in enterobacterales?

third generation cephalosporin resistance (1990s) Carbapenem resistance (2000s) Colistin resistance (2015) = last resort for multi drug resistance salmonella infections; decades of col use in livestock and poultry

dose response curve and important points on them

threshold = the dose at which biological effects are first seen NOAEL (no observed adverse effect level) = the highest dose with non statistically significant difference from control LOAEL (lowest observed adverse effect level) = the lowest dose tested with a statistically significant effect ** see lecture notes

what are the main challenges in riska assessment of food contact materials?

tiered testing requirements based on magnitude exposure most chemicals (about 73%) not tested for reproduction or development toxicity no testing for endocrine disruption some unknown non intentionally added substances (NIAS) lack of analytical standards for some chemicals only dietary exposures considered when calculating safe exposure levels mixture effects rarely considered CBI (confidential business information)

epigenetic clock (DNAm age)

to keep track of age: age based on calendar days --> organs and tissues don't age at same rate (like smokers' lungs are "older") -- depends on lifestyle like smoking, alc consumption, exercise and diet, stress, etc to keep track of DNAm age with a biological calendar, we use a biological clock (Horvath) which is highly correlated with biological age (using DNA methylation of many genes)

world needs more toilets but not ones that flush

toilets pollute water and even though we can treat the water it takes a lot of energy to do so flush toilets increase volume of waste by almost 30 fold over 80% of wastewater worldwide goes back into environment untreated wastewater treatment plants (where available) use lots of electricity (3% of national electricity load in US), produce methane, release nitrogen GHG and remove phosphorus instead of returning these nutrients to soils

core disciplines of environmental health science (EHS)

toxicology exposure assessment risk assessment microbial ecology epidemiology epigenetics etc

core disciplines of EHS (environmental health science)

toxicology, exposure assessment, risk assessment, microbial ecology epidemiology, epigenetics

toxicology vs epidemiology

toxicology: -mostly experimental -variables controlled by the investigator -all variables known -replication possible -results valid for tests cells or species -meaning of results for humans uncertain -little need for complex statistical analysis of data -highly equipment intensive EPI: -mostly observational -variables controlled by nature -some variables unknown -replication difficult; exact replication impossible -results often uncertain -meaning of results for humans clear -statistical control often very important -highly labor intensive

how best to assess the nexus between equity and environment quality?

traditional epidemiological methods are limited by lack of statistical power, small geographic scope of primary data collection, time and resources, need for "data judo" large secondary admin data sets can answer questions that primary data can not

what is the greenhouse effect?

trapping of sun's warmth, process by which radiation from planet's atmosphere warms surface to temperature above what it would be without this atmosphere

Flint, Michigan (water crisis)

treated water supply switched to Flint river which is more acidic and thus more corrosive to lead pipes -- high levels of lead end up in drinking water -- lead contamination has severe health effects on elderly and children including rashes, infections and impairments to the development of brain and nervous system switched water supply to save money by drawing water from a river instead; Flint water had high chloride and no corrosion inhibitor -- elevated blood Pb level by over 5 ug / dL -- in Flint, 4 in 10 families live below the poverty line, unemployment is high, majority of population is black, disadvantaged kids have higher exposure -- children continue to test positive for Pb and will be affected forever -- small scale test should be done before any changes to a water distribution system are made -- even if lead service lines are replaced but the household plumbing stays as galvanized iron pipes, there can still be exposure -- POU (point of use) filters are effective ways for reducing exposure

proposes priority products

treatments with PFAss for use on converted textiles or leathers, nail products with toluene or MMA, paint strippers and graffiti removers with NMP, laundry detergents with NPEs, motor vehicle tires with zinc and GPPD also under consideration are personal care and cleaning products with 1,4-dioxane, chemicals in hair straightening products

precision environmental health

tries to predict DNAm age to see when you will die to prevent people from dying: slow epigenetic clock ticking rate, reduce harmful exposures, optimize prenatal / childhood development, give children their best chance

underlying mortality and attributable mortality

underlying mortality = hypothetical mortality rate if pollution = 0 attributable mortality = proportion of deaths that are attributable to an exposure (in this case, air pollution)

LA 50 years ago

unhealthy levels of Pb, NO2, SO2, CO, ozone, PM (particulate matter), and air toxics in LA, over 100 air pollution alerts annually, over 200 days with unhealthy air annually, 49 one hour ozone peaks up to five times the allowable level

2. ecological study

unit of analyses are usually populations rather than individuals; measure exposure at class / town / city / county / country level, measure perevalence of disease / outcome at population / country level, test for correlation between exposure and outcome (X and Y; remember the variables) -- advantages = easy to gather aggregate data (city, county, etc level), inexpensive -- disadvantages = limitations include no cause and effect (only correlation), ecological fallacy by performing group level comparison, sensitive to multiple sources of confounding (lots of confounding variables) example: air pollution and mortality and exposure measured at city level, six cities, strong association with ?? can't read what my handwriting says

DNA

universal code of life nucleotides (GCAT) form base pairs to form the double helix one cell has about 2 meters of DNA (6.6 feet), nucleus is about 2 - 10 nanometers

perfluoroalkyl and polyfluoralkyl (PFASs)

universally detectable across population (greater than 95 to 98 percent of US pop), no stick and waterproof and oil resistant and stain resistant chemicals PFASs are long carbon-chain backbones with fluorine, stable and highly persistent in environment, half-life in humans is 3-8 years, major route of exposure is diet and water people with elevated level sof PFASs have increased risk of obesity

challenges in environmental epidemiology

usually contaminants are at very low levels and difficult to detect and measure many are in complex mixtures and correlated with each other (like metal contaminants, air pollution, cigarette smoke, etc) often exposure levels don't differ much among individuals within areas (need a gradient to test for dose-response / effects) multiple routes of exposure; timing (need biomarker reflecting total body burden over time) relative risks can be very low (< 1.5), but exposed populations may be very large (like in air pollution

there are some limitations of pesticide biomarkers (such as DAPS) available

variable not pesticide specific (DAPS) can't tell if it is related to diet or occupation non persistent pesticide exposure assessment is messy complex web of factors needs to be considered -- larger environment = violence, discrimination, poverty, acculturation -- immediate environment = enrichment, home environment, pesticides, housing quality, family relationships -- other host factors = health, nutrition -- genes

how does the body respond to heat stress?

vasodilation = redistributes blood flow towards skin to help transfer heat from muscles to environment, increases cardiovascular strain sweating = removes body heat, can lead to dehydration which can make cardiovascular strain worse

washing produce? does this help prevent foodborne illnesses?

washing produce DOES NOT HELP MUCH AT ALL it gets rid of chemical residue, but the microbes will stay (microbes are under the natural waxy layer which means it is very difficult to get water in these small crevices where microbes are -- on other hand, cooking gets rid of bacterial cells (the high temperatures kill the bacteria and therefore cooking produce rather than eating it raw is safer)

reuse our wastewater

wastewater = used water like from sinks, showers, toilets, commercial and industrial and agriculture activities, stormwater off, etc blackwater = toilet water and other wastewater rich in organics (effluent from garbage disposal systems) graywater = bath and shower water, etc

goal is to identify modifiable risk factors

wastewater irrigation is expected to grow need to identify context specific risk management decisions many low and middle income countries have developed safer wastewater irrigation through phased planning

air inequality in air pollution

we don't all breathe the same air -- some parts of the world are much more polluted than others -- thousands of studies done on the impact of air quality in high-income countries, but very few done for low-income countries

4/9 planetary boundaries

we have already breached four out of the nine planetary boundaries climate change, biosphere integrity but only the genetic diversity part of it, land system change, and biogeochemical flows

why do we have endocrine disruptors?

we have endocrine disruptors for variety of reasons such as they are: -- synthesized commercially for specific purposes (phthalates, DDT, PFAS) -- produced as byproduct of manufacturing processes (dioxin, PCBs, PFAs) -- naturally occurring substances found in plants (clover, soybeans, legumes in general, flaxseed, phytoestrogens in general)

have we reached planetary boundary for chemical pollution?

we haven't been able to quantify it yet no clear tipping point or threshold for aggregated chemical pollution

in vitro studies show binding to PPARs (peroxisome proliferator-activated receptors)

weakly activated PPARs, PRRs = metabolism of sex steroids, induce adipocyte differentiation

gap in urban PM between low and high income countries

when it comes to rising air inequality, there is growing gap in urban PM between low and high income countries incredibly rapid progress in Chinese cities (improvement) -- rapid increase in urban PM in South Asia WHO PM 2.5 guidelines in 2005 were less than 10 ug/m^3, but now it is 5 ug/m^3

regrettable substitution

when one chemical is banned, only to be replaced with another chemical just as harmful, or potentially worse examples: pesticides, flame-retardant furniture, non-stick pans, and nail polish

the pollutome

zone 1 -- well characterized health effects of pollutants, data included in GBD estimates and in this report (currently 9.0 million in this category) zone 2 -- emerging (still unquantified) health effects of known pollutants and data not included in report of GBD estimates zone 3 -- inadequately characterized health effects of emerging pollutant; data not included in report of GBD estimates