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140 Cards in this Set
- Front
- Back
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19th Century
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growing awareness of threats to PH→unsanitary conditions (sewers to improve sanitation), hazardous work practices (Upton Sinclair’s “The Jungle”)
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20th Century
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air pollution concern (London Fog; Donora, PA); more toxic chem. awareness (Rachel Carson—Silent Spring; 1962, EPA 1970, Love Canal 1970s)
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epidemiological transition
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decrease in acute/infectious disease, increase in chronic diseases (because more resources to treat acute/infectious)
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Hippocrates (460-370 BC)
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father of medicine, identified toxicity of lead, environmental factors such as weather, season, quality of air, food, and water, and geographic location impacted human health
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Ancient Greeks/Romans
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found chems from metal production poisonous, aqueducts (transported water in, sewage out)
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Sir Percival Pott (1714-1788)
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first to describe environmental cause of cancer (chimney sweeps had high incidence of scrotal cancer)
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Alice Hamilton (1869-1970)
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documented links between toxic exposures and illness among miners, tradesmen and factory workers
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Epidemiology
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study of distribution and determinants of disease frequency in human populations
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environmental epidemiology
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focuses on diseases linked to environmental exposures/hazards (factors beyond person's control)
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environmental risk transition
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changes in environmental risk as a consequence of economic development in the less developed regions of the world
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descriptive epidemiology
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track and compare disease rates in pops across place or time; understanding risk factors (includes surveillance)
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analytical epidemiology
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document link between exposure and disease (epi research/studies)
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Vulnerable populations
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children (developmental stages, behavioral diffs, smaller-->increased exposure/body weight), elderly (decreased immune, limited mobility), disabled/chronic disease, pregnant, occupation
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prevalence
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(# existing cases) / (total # population)
used to assess variation in disease occurrence, estimate needs of med. facilities, aid in hypothesis development |
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incidence
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# new cases / # pop. at risk
used to estimate chance of developing disease during certain time period, evaluate prevention programs, demonstrate causality btwn exposure and outcome |
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experimental study
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subjects assigned to exposure or treatment, outcome observed (hard to do w. environ b/c impractical or unethical to assign to exposure)
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observational study
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exposure and outcome observed (not manipulated)
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John Snow
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father of epidemiology; linked cholera to contaminated water
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cohort study
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classify subjects based on exposure then follow and observe outcome (prospective or retrospective)
-good for multiple outcomes, not multiple exposures |
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case-control study
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group based on outcomes, then look back at exposures
-good for rare outcomes and identifying multiple exposures |
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cross-sectional study
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assess exposure and disease status at same point in time; unable to tell which came first; not good for testing hypotheses (good for generating)
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ecological study
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population level analysis of presence of disease and exposure
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case series
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collect info about people who have same disease
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epidemiologic triangle
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environment (external to human body where agents may exist)-->host (thing that allows infectious agent to survive)-->agent (causes disease)
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limitations of environmental epi
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long latency periods, low incidence and prevalence (rare diseases), recall bias, difficulty in exposure assessment (measurement)
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environmental policy goal
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reduce human risks or environmental damages resulting from pollution/environmental hazards
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precautionary principle
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take preventive measures even if cause/effect relationship not definitive (principles of environ. policy devel.)
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Principles of environmental policy development
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precautionary principle, environ. justice, environmental sustainability, polluter pays principle
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environmental justice
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fair treatment/meaningful involvement of all people regardless of race, color, national origin or income wrt environ. laws/policies
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environmental sustainability
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resources should not be depleted faster than can be regenerated AND no permanent change to natural environment
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polluter pays principle
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polluter should bear expenses of carrying out pollution prevention and control measures introduced by public authorities to ensure environment is in acceptable state
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NIEHS (institue of environmental health sciences)
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reduce burden of human illness and disability by understanding how environ. influences development and progression of human disease THROUGH research, prevention/intervention, communication strategies (training, education, comm. outreach)
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CDC
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develop/apply disease prevention/control, health promotion/education activities; identify/define preventable health problems and active surveillance of diseases (investigations, data collection, analysis, distribution--MMWR)
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NIOSH
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research and recommendations for prevention of work-related injury/illness (under CDC in DHHS)
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ATSDR
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(Agency for Toxic Substances and Disease Registry) helps prevent exposure to hazmats from waste sites, develops toxicological profiles of chemicals, responds to emerg. release of hazmats
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OSHA
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(part of Dept. Labor) develops/enforces work safety/health regulations; provides training, outreach and education
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MSHA
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(Mine Safety and Health Admin) enforces compliance with mine safety/health standards
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Dept. of Energy
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anything radioactive
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Dept. of Agric.
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animal regulation
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EPA
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protect human health and environ; develop/enforce environ. regulations; research/set standards for environ. programs
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Nuclear Regulatory Commission
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regulatory arm of DOE
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Consumer Product Safety Commission
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e.g. keep lead out of toys
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Clean Air Act (1970)
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--regulates air emisision from stationary/mobile sources
--allows EPA to set max. pollutant standards |
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Clean Water Act (1977)
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--regulates discharge of pollutants from industrial water and sewage wastes
--gave EPA authority to implement pollution control programs --funded sewage treatment plants construction |
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Safe Drinking Water Act (1974)
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--protects drinking water (comm. water supply)
--federal-state partnership --public notification system for customers in water unsafe --allows EPA to make health standards for drinking H20 contaminants |
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Toxic Substance Control Act (1976)
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EPA authoirty to track industrial chemicals produced/imported to US and ban those with unreasonable risk
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Federal Insecticide, Fungicide and Rodenticide Act (FIFRA-1996)
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requires pesticide users to register and take exam to become certified applicator; all pesticides registered to ensure proper labeling; EPA authority to study impact of usage
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Comprehensive Environmental Response, Compensation, and Liability Act (CERLA--1980)
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"Superfund"
--fed. fund to clean up hazardous waste sites/spills --EPA can hold responsible parties liable for clean-up --superfund site identification, monitoring and response through state epa or waste management agencies (not very effective) |
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Resource Conservation and Recovery Act (RCRA--1976)
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--EPA control hazardous waster from generation to disposal
--promote source reduction/recycling of haz waste --standards/permits for haz waste storage/disposal facilities --requirements for municipal landfill/waste-to-energy incincerators |
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what is the trend in chemical production in US?
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increasing
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xenobiotics
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foreign chemicals
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common xenobiotics
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pesticides, active drugs, drug additives, food additives, "other" chemicals (increasing order)
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policy cycle (book)
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1) prob def, formulation, reformulation (most crucial)
2) agenda setting (setting priorities-->when and who deal with problem?) 3) policy establishment (adoption, legislation) 4) policy implementation 5) policy assessment (use environmental objectives) |
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environmental objectives
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statements of policy intended to be assesed using info from monitoring program
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risk assessment
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process for determining health risks associated with environmental and other hazards; balancing of economic and other costs with health/societal benefits (may influence which laws are made)
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Falconer model for development of policies regarding use of pesticipdes
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hazard (chem properties)-->risk (probability of exposure)-->impacts (effects of exposure)-->social cost (society's perception of importance of harm to the environment)
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risk management
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adoption of steps to eliminate identified risks or lower them to acceptable levels
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environmental impact
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any change to environment (adverse or beneficial) in some part from org's activities, products or services
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enivorn. impact assessment
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reviews potential impact of human-related activities. looks for ways to get rid of pollution before produced
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health impact assessment
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method for estimating/describing effects that proposed project or policy may have on health of population
--stages such as, data appraisal and incorporating plan for eval and monitoring of possible adverse outcomes |
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built environment
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urban areas and structures constructed by human beings (increasing)
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National Environmental Policy Act
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one of first laws establishing national framework for environ. protection; assure all parts gov give environ. consideration before doing anything that could affect environment (requires environmental assessments and environmental impact statements--chance of impacts from alternative courses of action)
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threats to the environment?
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trash, hazardous wastes, air pollution, exposure to toxic chemicals, destruction of land through deforestation
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population growth and environ. health
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causes: poverty, urban crowding, depletion of natural resources, pollution, increase in spread of infectious diseases, overtaxing carrying capacity, loss of biodiversity, food insecurity
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$ deaths caused by environmental factors?
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40%
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total fertility rate
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how many births a woman would have by the end of her reproductive life (2.0 in US, replacement rate 2.1, rates declining in W. Europe)
--higher fertility rates in Asia, LA, Africa |
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mortality trend? why?
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declined over time b/c public health improvements, famine control, increased availability of drugs/vaccines
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migration
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causes population growth
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demographic transition
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changes in fertility, mortality, make-up of pop.
--stage 1: young pop, high fertility/mortality --stage 2: young pop, drop in mortality, high fertility --stage 3: more even age distribution, dropped fertility/mortality |
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megacity
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more than 10 million people e.g. Tokyo, NY, LA, Mumbai, Mexico City, Shanghai
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carrying capacity
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population that an area will support without undergoing environmental deterioration
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Malthusian predictions
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"positive checks" for excessive population growth rates-->epidemics, starvation, population reduction through warfare; "preventive checks"-->not allowing people to marry
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environment
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physical, chem, and biotic factors that act upon an organism or ecological community (physical environ.)
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social environment
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influences upon individ. from societal/cultural factors
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ecological model
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proposes determinants of health (environ, biolog, behav) interact/interlinked
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ecosystem
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plant, animal, microorganism communities and nonliving environ. interacting as functional unit
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case fatality rate
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(%) # death due to disease/ # cases disease x 100
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Hill's Criteria of Causality
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strength (strong associations), consistency, specificity(specific association-->given disease results from given exposure, not others), temporality (observe cause before effect), biological gradient (dose-response curve, showing linear relation btwn exposure/disease), biological plausibility, coherence (should not conflict with generally known facts)
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toxicology
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study of adverse effect of chemical, physical, or biological agents on living organisms/ecosystem, including prevention/amelioration of adverse effects
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toxin
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toxic substance made by living organism
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toxicant
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man-made toxic substance
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Paracelsus
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founder of modern toxicology: dose-response relationship (effects are related to dose size)
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Matieu Orfila
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toxicology pioneer; describes types of poisons and bodily effects
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poison/toxic agent
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any agent capable of producing harmful response in biological system
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threshold
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dose amount which has to be exceeded before see any effect (good/bad) of chemical (see in S-curved line, but not linear)
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chemical mixtures: antagonism
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decrease effect of each other
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chemical mixtures: additivity
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sum of two individual effects (each effect as expected)
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chemical mixtures: synergism
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response greater than expected
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chemical mixtures: cosynergism
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enhance toxicity of each other
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chemical mixtures: potentiation
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one non-toxic agent affects toxicity of the other
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chemical mixtures: coalitive
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2 non-toxic agents combine to cause toxic effect
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metabolism
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in order to excrete substances
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routes of exposure
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intravenous (fastest and strongest effects), ingestion, inhalation, dermal (slowest response)
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LD50
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lethal dose 50; dose at which 50% of those exposed die
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factors that affect responses to toxic chem
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route of entry, received dose, duration of exposure (acute-->chronic), interactions with other chemicals, individual sensitivity (chemical allergy-->immunologically mediated adverse reaction) (chemical idiosyncracy--extreme sensitivity to low doses or insensitivity to high doses)
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ED50
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effective dose; dose that produces desired effect in 50% population (for drug action); chose 50% b/c analytically has most power
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acute toxicity
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arises from single exposure to toxicant; poisoning, usually life-threatening effect, diagnosed an treatments or antidotes available
(uses LD50 to measure) |
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subacute/chronic toxicity
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from prolonged exposure to toxicant; no immediate effect, but could be life-threatening long term; difficult to diagnose/treat
(uses other measurement than LD50) |
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endpoints used in risk assessment: NOAEL, LOAEL
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NOAEL=no observed adverse effect level
LOAEL=lowest observed adverse effect level |
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problems with animal studies
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1) don't simulate real world
2) learn very specific things 3) does give ideas/directions for future studies 4) extrapolation to humans can be hard |
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local effects
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damage where chem. first comes into contact with body
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systematic effects
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adverse effects associated with generalized distribution of chemical throughout body via bloodstream to organs
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target organ effects
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specific organ
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latency
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period between initial exposure and measurable response
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hierarchy of protection from chemical hazards (most preffered-->least)
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elimination, chemical substitution, engineering controls, administrative controls, use of PPE
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hazard assessment
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use animal studies
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exposure assessment
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identifies populations exposed to toxicant, describes their composition and size, and examines roots, magnitudes, frequencies and durations of exposures
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risk assessment
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determining risks to health; hazard x exposure, extrapolation to humans, safety factors
1) hazard ID 2) dose-response assessment 3) exposure assessment 4) risk characterization (estimates # excess unwarranted health events expected at different tie intervals at each level of exposure) |
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risk management
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risk-benefit analysis
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pesticide
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substance/mixture intended for preventing, destroying, repelling, or mitigating any pest ALSO intended for use as plant regulator, defoliant or desicant
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insecticide
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kill insects
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herbicide
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control/destroy plants, weeds, grasses
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fungicide
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deter or destroy fungi (particularly potent bc fungi really hard to kill)
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nematocide
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destructive to nematodes (worms)
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rodenticide
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destroy rats/other rodent pests
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fumigant
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any vaporized pesticide
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pesticide classes
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organophosphates, carbamates, organochlorines, herbicides/defoliants
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carbamates
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characteristics: not generally persistent in environment, dissipate quickly from environment
**similar effects, treatment, symptoms as OP |
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organophosphates (OP)
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not persistent in environment; what: most widely chosen for agricultural purposes (inexpensive, control wide range insects)-->most common source pesticide poisoning
effect: disrupt transmission of nerve impulses symptoms: uncoordination (nerves, muscle)-->respiratory paralysis and weakness; neuro symptoms (seizures, LOC); abdominal cramping; death long-term exposure: irreversible polyneuropathy (numbness, loss of sensory abilities, weakness) examples: pet shampoos treatment: atropine |
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organochlorines
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e.g. DDT, lindane, cyclodienes, PCBs
sypmtoms: immune system suppression and cancer, reproductive effects (DDT), nervous system abnormalities persists in environmet |
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pyrethrins
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natural insecticidal extract (from chrysanthemums)
effect: paralyze/kill flying insects symptoms: paresthesia (Burning numbness of lips/hands), allergic dermatitis, nausea, headache, dizziness, neuro, rhinitis (inflammation of mucous membrane in nose) treatment: decontamination, vitamin E cream, symptomatic theraphy, remove from further exposure |
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pyrethroids
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manufactured version of pyrethrins
--use increasing --used for pet flea control, structural/agric, vector control (e.g. air craft disinfection) |
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herbicides and defoliants
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e.g. agent orange (dioxins), atrazine, paraquat
effects: estrogenic activity (atrazine) |
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fungicides
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acute effects: irritant and allergic dermatitis
chronic effects: chronic dermatitis, posible carcinogens |
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dioxins
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def: family of compounds that are unintentional byproducts of certain industrial, non-industrial and natural processes, usually involving combustion
sources: combustion, metals processing, chem. manufacturing, paper processing, volcanic eruptions characteristics: persistent-->bioaccumulate and biomagnify in food chain; fat soluble-->accumulate in fatty tissues effects: short-term to high levels-->skin lesions, altered liver function; long-term-->impaired immune, endocrine, reproductive sys and developing nervous systems; carcinogen |
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PCB (polychlorinated biphenyls)
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characteristics: organochlorine, no odor, colorles to light yellow, dioxin-like
use: insulate electrical wire, paint effects: carcinogens, immune, endocrine, and reproductive sys, child intellectual devel. |
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biomonitoring
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used to study harmful accumulation of toxic substances; may involve serial measurements to monitor accumulation in body
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methods of biomonitoring
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hair, saliva, blood (cord blood)
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consumer products containing lead
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children's jewelry, sidewalk chalk, imported crayons, lunchboxes, candy, vinyl mini-blinds, christmas lights, alphabet blocks, ceramic dinnerware, candle wicks, mobiles, children's umbrellas, cribs, toy trains, bobble head dolls, halloween buckets
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sources of lead
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paint (chips and inhalation of dust), gas, soder (water from lead pipes, jewelry), pottery/crystal/ceramic dishes, folk remidies, soil/dirt
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symptoms of low levels of lead in blood
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no symptoms
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symptoms of high levels of lead in blood
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headaches, irritability, stomachaches, tiredness, change in apetite (common symptoms to other illnesses)
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effects of lead poisoning
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impaired cog skills (decreased mem, learning disabilities, loss of IQ pts) loss if visual motor coordination (muscle weakness, impaired coordination) behavioral
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pros/cons lead capillary testing
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pros: less painful/invasive, done in pediatrician office
cons: less accurate, need follow-up testing if show elevated levels |
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pros/cons venous
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pros: more accurate, no followup testing needed
cons: more traumatic, requires lab visit |
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educating parents on lead
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wash kids hand/toys, wet clean all dusty areas, keep kids away from peeling paint, kids play on grass not dirt, give kids Fe/Ca-rich food, conduct safe home renovation, aware of occupational exposure
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hazardous waste qualities
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toxic, ignitable, reactive, corrosive
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advantages of recycling
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reduces greenhouse gas emissions, reduces water pollution, creates jobs, decreasing amount of waste in landfills
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pros of incineration
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reduces volume of solid waste to bury, requires less land, can be turned into energy
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cons of incineration
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leaves toxic ash, components can be hazard when burned, expensive to startup or shut down-->need steady trash supply,
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