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114 Cards in this Set
- Front
- Back
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WHO defines environmental health as comprising aspects of human health that are determined by ______ factors in your environment
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physical
chemical biological social psychosocial |
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emergence of the major categories of population health hazards during human cultural evolution (timeline)
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homo sapiens appear
advent of towns and cities industrial revolution modern affluence global ecological disruption |
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traditional hazards
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disease vectors
infectious agents inadequate housing and shelter poor-quality drinking water and sanitation indoor air pollution from cooking dietary deficiencies hazards of child birth wildlife and domestic animals injury hazards in agriculture |
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modern hazards
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tobacco smoking
transport hazards pollution from sewage and industry outdoor air pollution from industry and motorcars overuse or misuse of chemicals industrial machinery unbalanced diet |
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epidemiological transition in the u.s.
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decrease in major infectious conditions
increase in accidents |
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environmental risk transition
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changes in environmental risks that happen as a consequence of economic development in less developed regions of the world
(before transition occurs: poor air, food, and water quality) |
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examples of epidemiologic transition
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chronic, degenerative diseases include cardiovascular diseases, cancer, neuro-psychiatric conditions, and injuries
becoming the major causes of disability and premature death in many nations |
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health
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condition of being sound in body, mind, or spirit
a flourishing condition or well being; not just absence of disease WHO definition - a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity |
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contemporary definitions of "health"
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multidimensional
domains of life quality can include: phsyical status and functional ability, psychological status and well being, social interactions, economic and vocational factors, religious and spiritual status) EMERGING CONSENSUS: integrates mortality with multiple dimensions of life quality |
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health status
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mortality
morbidity life expectancy functional status and capacity quality of life |
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cdc consensus set of health status indicators
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race/ethnicity-specific infant mortality rate
motor vehicle crash death rate work-related injury rate suicide rate lung cancer death rate breast cancer death rate cardiovascular disease death rate homicide rate all-cause mortality rate AIDS incidence measles incidence TB incidence syphilis incidence low birth weight incidence births to adolescents prenatal care childhood poverty proportion of people living in counties exceeding EPA air quality standards |
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basic requirements for environmental health
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clean air
safe and sufficient water safe and adequate food supply safe and peaceful settlements stable global environments |
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environment
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the circumstances, objects, or conditions by which one is surrounded
the complex of climatic, edaphic (soil-based), and biotic factors that act upon an organism or an ecologic community |
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public health definition of "the environment"
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all that which is external to the individual host. it can be divided into physical, biological, social, and cultural factors, any or all of which can influence health status in populations
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disease
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trouble or a condition of the living animal or plant body or one of its parts that impairs the performance of a vital function; morbidity
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determinants of health
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SEE SLIDE
(model) |
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contributers to the environment
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chemical - air pollutants, toxic wastes, pesticides, volatile organic compounds (VOCs)
biologic - disease organisms present in food and water and insect and animal allergens physical - noise, ionizing and non-ionizing radiation social-cultural - SES and ethnicity built - urbanization, suburbanization, and rural natural - does having nature around us impact our health |
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built environment and health
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physical inactivity ( associated health effects)
driving --> traffic --> air pollution --> lung disease (asthma) heat stress climate change motor vehicle and pedestrian injuries water quality mental health social capital disparate impacts (justice, equality) |
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the social environment
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the groups to which we belong
the neighborhoods in which we live (more than the sum of individuals living there, features can alter social support and ties, social capital, patterns of social integration and cohesion. due to such features as SES, public services, behavior, and culture) the organization of our work places the policies we create to order our lives (can have influence on the individual level and population (contextual) level) |
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natural environment
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exposure to nature enhances physical and psychological health across one's lifespan
(next slide has graph showing mortality rates going down as exposure to green goes up) |
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facets of environmental public health
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environmental epidemiology
environmental toxicology environmental engineering preventative medicine environmental law health disparities |
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environmental epidemiology
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study of patterns of illness among human populations and among factors that might be responsible for influencing these patterns
associations between EXPOSURE to environmental agents and subsequent development of DISEASE |
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environmental toxicology
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casual MECHANISMS between exposure and subsequent development of disease
understanding the TOXICOKINETICS and TOXICODYNAMICS of environmental chemicals (toxicants and toxins) |
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environmental engineering
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factors that govern and reduce exposure; understanding EXPOSURE ASSESSMENT scenarios
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environmental law
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development of appropriate legislation and regulations to protect public health
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health disparities
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it is well documented that there are disparities in the occurrence of chronic diseases between members of racial and ethnic minorities and more advantaged populations
race and SES are associated with: increased exposures to environmental hazards, increased rates of asthma, high blood pressure, elevated blood lead levels, dementia, and other diseases |
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health disparities are often associated with environmental injustice
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there are major environmental disparities between white communities and minority communities (e.g. hazardous waste sites are often located in communities that have high percentages of poor, elderly, young, and minority residents)
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what is environmental justice?
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EQUAL PROTECTION from environmental and public health hazards for all people regardless of race, income, culture, and social class
EQUAL ACCESS to socioeconomic resources so that all people can provide for their livelihood and health FAIR TREATMENT AND MEANINGFUL INVOLVEMENT of all people with the respect to the development, implementation, and enforcement of environmental laws (so that no group should bear a disproportionate share of the negative environmental consequences resulting from industrial, municipal, and commercial operations, etc.) |
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executive order 12898 (1994)
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federal action to address environmental justice in minorty populations and low-income populations
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stress-exposure disease framework for environmental health disparities
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community level vulnerability and individual level vulnerability
(see slide for picture) |
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contributors to psychosocial stress in communities
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crowding
poor quality housing inadequate access to healthy food and recreational opportunities family turmoil and violence |
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wagner's point
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The City of Baltimore operated its Patapsco Waste Water Treatment Plant on the former Martin Wagner site until the late 1990s, when the plant was closed and a nearby residential community was relocated due to environmental concerns. Houses of the former residents were demolished after the city's buyout of the properties
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top ranked environmental hazards in the epa's comparative risk assessment study
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criteria air pollutants
hazardous/toxic air pollutants other pollutants radon-indoor indoor air pollution other than radon radiation from sources other than indoor radiation substances suspected of depleting the stratospheric ozone layer CO2 and global warming point-surface discharges to surface waters |
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why ehs matter...
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acute environmental catastropihes (high-level exposures)
chronic (low-level exposures) indirect effects of global environmental changes |
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some "wake up calls" (environmental catastrophes)
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minamata disease (1945-1961) - methyl mercury poisoning
sevesto, italy - leak of toxic gas (TCDD) bhopal (1984) - 16.5 tons of toxic pesticide released (2,352 official deaths, 10,000 unofficial) chernobyl (1986) - nuclear reactor accident milwaukee incident (1993) - cryptosporidium in drinking water gulf oil spill (2010) - ecological, psychosocial |
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major air pollution episodes
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london 1882
belgium 1930 donora, pa 1948 london 1952 NYC 1983 Japan 1962 NYC 1963 |
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improvements in ph achieved in the 20th century
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water, food, and milk sanitation
reduced physical crowding improved nutrition central heating and cleaner fuels chlorination of water (graph of decrease of typhoid cases after filtration and chlorination come into practice) WOLMAN - chlorination removal of lead from gasoline |
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public health interventions (lead paint)
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banned in the U.S. (1977)
lead paint still exists on interior walls of children's homes (38 million living units in the US) air pollution control (fuel restriction) regulations 1996 |
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restriction of sulfur in fuel
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air pollutant concentrations went down in hong kong
reductions in deaths (cardiovascular, respiratory, etc.) |
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major categories in goal 8 of health people 20120 proposed to promote human health through healthy environment
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outdoor air quality
water quality toxic and waste healthy homes and communities infrastructure and surveillance global environmental health |
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chemicals in the environment
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increased production of synthetic organic chemicals (dyes, plastics, solvents, etc.) --> from less than .15 billion kilograms (1935) to more than 150 billion kilograms (1995)
roughly 100,000 different synthetic chemicals are on the global market; many others are emitted as by-products of their production, use or disposal testing for toxicity is very expensive we have to meet european standards for toxicity to have US products sold there |
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arsenic in groundwater
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arsenic exposure associated with skin lesions, and lung, liver, and bladder cancers
over 112 million in bangledesh and west bengal, india reside in areas where groundwater concentrations exceed who maximum permissible level over 90% of residents of this area use groundwater for drinking and cooking one quarter of 11,000 villagers surveyed in bangladesh suffered skin lesions |
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environmental exposure paradigm
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sources (natural: biological, physical, chemical and manmade: chemical, physical) -->
transport and fate (vectors: air, water, food, soil) --> exposure (inhalation, ingestion, absorption through skin) --> health effect (dose to target, susceptibility, effect continuum) |
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routes of exposure through gaseous, liquid, and solid media
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air (lungs)
food (gi tract) water (gi tract) soil (gi tract and skin) |
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agents
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chemical, biological, and physical
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vectors
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water, air, soil, food
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routes of entry for agents and vectors
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inhalation, ingestion, and skin absorbtion
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health effects
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a multistage "toxicological process" describes the sequence from exposure to disease
disease may take many forms in environmental health studies |
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toxicology
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toxicokinetics - what the body does to the agent (absorption, distribution, metabolism, excretion, storage)
toxicodynamics - what the agent does to the body; the molecular, biochemical, cellular and organ changes that result in an advance effect |
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health effects
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adverse vs. beneficial
acute vs. delayed onset clinical vs. subclinical manifestations transient (reversible) vs. chronic (irreversible) local vs. systemic effects |
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examples of adverse health outcomes
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lung disease
developmental effects reproductive effects teratogenic effects neurologic effects immunosuppression and hypersensitivity cancer |
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what leads to human health/disease
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intrinsic/genetic
environmental exposure age/time |
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factors associated with human disease
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host characteristics (age, gender, customs, genes)
agents (biologic: bacteria, viruses, chemical: poison, alcohol, smoke, physical: trauma and radiation) environmental factors (temperature, humidity, altitude, crowding) |
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vulnerable groups
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low SES
women children elderly ethnic minorities disabled indigenous people because of GENETICS and lack of EMPOWERMENT to change their environment |
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selecting priorities (risk assessment and risk management)
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risk assessment - the determination of the possibility that an adverse effect will result form a defined exposure
e.g. hazard identification, exposure assessment, dose-response assessment, risk characterization (science judgements) risk management - the process of weighing policy alternatives and selecting the most appropriate regulatory actions based on the results of risk assessment and social, economic, and political concern (science and value judgements) |
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three models for improving the state of human health and the environment
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clinical intervention model (intervene between disease and death)
treats symptoms, doesn't cure disease public health model (intervene between environment and public before disease) try to intervene in an environmental situation modifies the actions of individuals environmental stewardship model (intervene between public and environment) wants to help the environment |
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environmental sustainability
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adherence to a philosophical viewpoint "that a strong, just, and wealthy society can be consistent with a clean environment, healthy ecosystems, and a beautiful planet"
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environmental impact on health
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humans are impacting their environment
the impacted environment subsequently impacts human health the world is an environmental risk transition (thus we are in environmental health transition) |
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population and environment: the 3 p's
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pollution
population poverty PRINCIPLE DETERMINANTS OF HEALTH WORLDWIDE |
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environmental impact (a model)
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I = P x A x T
growth in environmental impact = growth in population x growth in affluence x growth in technology AxT = consumption |
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the earth as a fishbowl
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solar energy is the only thing that goes in
when it began we got: 1. natural resources 2. energy resources 3. environmental services heat is the only thing that exits (CO2 blocks the heat from exiting --> global warming) |
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depletion of resources
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if society has a small population and little technology --> low impact on the environment
large population and increased technology --> great impact on the environment were depleting fast and polluting more |
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fracing
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pump benzine and water underground to release natural gasses
PROBLEM; pollutes the drinking water nearby |
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forces underlying why we pollute the environment
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needs vs. wants (human behavior)
driven by: population, technology, economic and political social values mitigated by: environmental laws, market adjustments, informal social regulation |
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# of people on the planet
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7 billion
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people are moving to _____
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mega cities
cities need infrastructure eg. tokyo, nyc, sao paulo, mumbai, mexico city |
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increased food demand
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due to surging population (we consume more food than farmers can produce)
35% of world grain is used to produce livestock feed (it takes a lot of grain to feed a beef cow) we don't re-fertilize soil making it unsustainable |
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amount of fertile land is ______
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decreasing
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only ___% of water on this planet is freshwater (useable)
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2.5%
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societal needs and wants
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needs --> wants --> wants --> environment
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cars
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we are engineering cars to have less emission but are also increasing the number manufactured
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coal
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coal burning is our primary source of generating power
clean coal vs. dirty coal (we still mine dirty coal, but sell it to whoever wants it) we have tremendous coal reserves in the US but most of it is dirty so we are now searching for ways to "clean" it sulfur and nitrogen emissions are growing with an increase in fossil fuel burning burning coal generates ash |
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coal ash
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coal combustion residuals (byproducts of the combustion of coal at power plants and are disposed of in liquid form at large surface impoundments and in solid form at landfills
contain contaminants like mercury, cadmium, and arsenic (can migrate to drinking water sources --> terrible health effects) |
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gold
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mostly used for jewelry production
gold covered in mercury needs to be heated and evaporated, thus causing workers to inhale mercury |
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the industrial process and the environment
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inputs: chemical (raw materials), power (gas, oil, coal), other inputs (water)
INDUSTRY outputs: the product itself, air pollution, water pollution, toxic waste |
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types of waste
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municipal solid waste, industrial waste, medical waste, hazardous waste, radioactive waste
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uranium mill tailing hazards
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radon-exhalation
gamma-radiation dust blowing (radium, arsenic, etc.) dam failure (earthquake, erosion, flood, etc.) --> seepage into ground water |
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black hills national forest, south dakota
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abandoned uranium mine
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causes for increased waste generation
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demographic changes
degree of urbanization consumer preference demand for convenience ahead of the environment little economic incentive for americans to reduce waste |
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category with largest generated waste
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industrial
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regulation of waste
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1934 - US supreme court banned dumping of municipal wastes at sea
1950s - PH service regulations prohibit feeding of raw garbage to hogs 1972 - marine protection, research and sanctuaries act banned ocean dumping of waste 1976 - federal ban on open dumping of municipal waste |
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municipal solid was has ____ over the years
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increased
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sources of msw
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residential - paper, plastic, glass, food, etc.
institutional (eg. schools hospitals prisons) - paper towels from restrooms, food, etc. commercial (eg. restaurants, office buildings, etc.) - food and paper products industrial - packing and administrative wastes |
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how msw is managed in the us
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landfills 67%
recycling 17% incineration 16% |
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largest material component of msw by weight
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paper
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fresh kills landfill, staten island
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largest human made entity in the world
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unlined landfill leads to ____
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groundwater contamination
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sanitary landfill
federal legislation provisions |
may not be sited on floodplains, wetlands, earthquake zones, unstable land or airports (birds at site are hazard to aircraft)
must have liners must have leachate collections system operators must monitor for many specified toxic chemicals operators must meet financial assurance criteria that monitoring continues for 30 years after closure of the landfill |
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does msw degrade in a landfill
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minimal
designed to prevent generation of leache (liquid containing dissolved solids and toxics that result from precipitation percolating down through the waste and contaminating groundwater) oxygen, critical for degradation, has been eliminated by compaction "biodegradable" advertised products |
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a _____ can last 1,000,000 years in a landfill
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bottle
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potential health impacts of msw
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toxicity - hazardous waste, leachate
groundwater contamination (46% of MSW landfills are located uphill from and within 1 mile of drinking water wells) |
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why are landfill sites not being established?
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public opposition
NIMBY - not in my backyard LULU - locally unwanted land use NIMEY - not in my election year NIMTOO - not in my term of office BANANA - build absolutely nothing anywhere near anyone NOPE - not on planet earth rising costs EPA regulations |
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incineration
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reduces waste to solid residues, gases, and water vapor
process reduced waste volume by 80-90% emissions have to be closely monitored and controlled economic considerations ($125,000/ton daily waste capacity, typical plant capacity ~1000 tons daily) |
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industrial and hazardous waste
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legal designation for certain wastes that require special handling because they present a serious threat to human health and the environment if mismanaged
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genovique specialties corp
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deals with hazardous waste
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hazardous waste
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hazardous waste is waste that is dangerous or potentially harmful to our health or the environment
can be liquids, solids, gases, or sludges, discarded commercial products |
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how much hazardous waste is generated in the U.S. each year?
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EPA estimates 300-700 million tons
90% (by weight) is wastewater (contaminated from industrial processes) 10% - inorganic solids, organic liquids, sludges |
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largest hazardous waste source
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chemical industry
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characteristics of hazardous waste
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flammable gas
oxidizer explosive poision ignitability - catch fire with a flash point of 140 degrees or less corrosivity - substances that corrode storage tanks reactivity - substances that are chemically unstable and may explode or generate poisonous gases (cyanide and sulfide) toxicity - substances that are injurious to health when ingested |
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the "toxic soup" of hazardous waste
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what: heavy metals, solvents, organic chemicals, municipal waste, inorganic waste, pesticides, sludes, paints and oil wastes
how much: between 300-700 tons/year, 90% is wastewater which is dilute, but contains enough regulated materials |
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environmental contamination
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precipitation
surface runoff |
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toxic waste concerns
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assuring safe drinking water and cleaning up the messes already created
regulating the handling and disposing of wastes currently being produced so as to protect public and environmental health looking toward future solutions |
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emergence of the hazardous waste site problem (wake up calls)
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love canal (1976)
valley of the drums times beach, missouri (spreading of oil containing dioxins) libby, montana |
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love canal
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was the site for disposal of toxic wastes
later used for residential construction became identified with hazardous chemical exposures and their possible harmful influences on human health lead to the creation of the superfund |
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RCRA
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research conservation and recovery act (1976)
defines which wastes are hazardous instituted a "manifest system" for tracking set standards for hazardous waste facilities and issues operating licenses |
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CERCLA
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("superfund") comprehensive environmental response, compensation and liability act
established a national priority list for expenditure of superfund cleanup dollars |
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persons at potential risk because of npl sites
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EPA - ~73 million live within a 4-mile radii of npl sites
ATSDR (agency for toxic substances and disease registry) - ~11 million live within one-mile borders of npl sites (1.3 children under 6 years live within 1 mile) |
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brownfields
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land previously used for industrial purposes or certain commercial uses
the land may be contaminated by low concentration of hazardous waste or pollution on locations with abandoned factories or commercial buildings |
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ship recycling
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the dismantling of ships, so that their steel and other materials can be sold as scrap (often done on or near beaches in poor countries)
hong kong international convention for the safe and environmentally sound recycling of ships was adopted in 2009 |
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concentrated animal feeding operations (CAFOs)
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changes in food animal production since 1930
factory farms--integrated production model concentrated, high volume housing and processing highly intensive localization broad integration of food production and distribution |
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which livestock produces the most waste
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cattle (non-dairy)
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comparison between municipal and hog farm waste treatment regulations
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municipalities are subject to strict waste control technologies (hog farms are not)
municipalities must monitor thier environmental performance (hog farms have no obligation and are inspected by state officials only 2 times/year) |
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environmental impacts of hog farming
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nutrient pollution of soil, rivers, and shorelines (nitrogen and phosphorus stimulate algal growth leading to low dissolved oxygen levels)
air pollution (nitrogen) contaminated groundwater and drinking wells odor pollution (ammonia) |
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hog farming
potential threats to public health |
list of recognized toxicants
list of suspected toxicants pathogens antibiotic resistance greenhouse gases |
