2022 Environmental Health COPY Flashcards

Question 1

Q

What is the Grasshopper Effect?

Answer

A

Pollutants can move across vast distances from the southern hemisphere to the northern hemisphere by what is called the “grasshopper effect”. This means that they evaporate with warm air and return to earth with rain and snow in the colder areas of the globe.

Therefore, persistent organic pollutants released in one part of the world can, through a repeated (and often seasonal) process of evaporation and deposit, be transported through the atmosphere to regions far away from the original source. Over the course of several years, they approach the Arctic in a series of seasonal jumps.

https://www.unep.org/news-and-stories/story/grasshopper-effect-serves-pollutants-plates-arctic-peoples

https://www.youtube.com/watch?v=3CMlWQodtYs

Question 2

Q

Which organization is responsible for pesticide regulation in Canada?

Answer

A

Pest Management Regulatory Agency (PMRA)

https://www.canada.ca/en/health-canada/corporate/about-health-canada/branches-agencies/pest-management-regulatory-agency.html

Question 3

Q

What is Integrated Pest Management?

Answer

A

Integrated Pest Management (IPM) is a decision making process for managing pests effectively, economically, and environmentally.

Techniques range from the use of:

biological
physical
behavioural
chemical controls

It may include pesticides but does not rely on them (looks at alternative approaches first).

https://www2.gov.bc.ca/gov/content/industry/agriculture-seafood/animals-and-crops/plant-health/integrated-pest-management

Question 4

Q

List the 6 Steps of Integrated Pest Management

Answer

A

The 6 Steps of Integrated Pest Management are:

Planning and managing agricultural production systems to PREVENT insects, plant diseases and weeds from becoming pests
IDENTIFYING pests, their natural enemies and damage
MONITORING populations of pests and beneficial organisms, pest damage, and environmental conditions
THRESHOLD- Making control decisions based on potential damage, cost of control methods, value of production, impact on other pests, beneficial organisms and the environment
MANAGEMENT- Using strategies that may include a combination of behavioural, biological, chemical, cultural and mechanical methods to reduce pest populations to acceptable levels
EVALUATING the effects and efficacy of management decisions

https://www2.gov.bc.ca/gov/content/industry/agriculture-seafood/animals-and-crops/plant-health/integrated-pest-management

Question 5

Q

What is the difference between a primary and a secondary pollutant?

List one example pollutant from each category.

Answer

A

Primary Pollutants are emitted directly from the source (directly produced)

Example: Vehicle exhaust emission of CO
Other examples: Sulphur Oxides (SOx), Volatile Organic Compounds (VOCs), Particulate Matter (PM), Nitrogen Oxides (NOx)

Secondary Pollutants are formed from other precursor pollutants reacting in the atmopshere (result o chemical reaction)

Example: Ozone is formed when converted by light (https://www.epa.gov/ground-level-ozone-pollution/ground-level-ozone-basics#:~:text=Tropospheric%2C%20or%20ground%20level%20ozone,volatile%20organic%20compounds%20(VOC).)

Question 6

Q

Question 7

Q

List direct and indirect effects of climate change

Answer

A

Direct effects due to changes in temperature and precipitation, occurrence of heat waves, floods, droughts and fires
Indirect effects due to ecological disruptions (e.g., crop failures, shifting patterns of disease vectors) or social responses (e.g., displacement of populations due to prolonged drought)
Until mid-century, climate change will act mainly by exacerbating health problems that already exist and existing diseases (e.g., vector-borne infections) may extend their range into areas that are presently unaffected
Largest risks will apply in populations that are currently most affected by climate-related diseases (e.g., under-nutrition in areas that are already food insecure such as global South or country foods in Northern Canada)

Question 8

Q

You are an MOH for your provincial health authority and are part of a working group to develop a provincial climate change strategy.

A) List two major categories of actions that you would suggest to be part of the strategy and list 4 potential actions under each category

B) Identify 4 direct and 4 indirect potential health effects from climate change

C) Identify 4 different categories of geographical areas relevant to climate change effects and provide one unique consideration for climate change planning related to each location.

Answer

A

A) Two major categories of action: Mitigation & Adaptation

Mitigation

Invest in energy efficient public transportation
Change building codes to improve energy efficiency
Increase tax on motor vehicle fuels
Invest in renewable energy sources
Regulations requiring reduced vehicle emissions

Adaptation

Improve disaster preparedness and response e.g. heat response planning
Enhance environmental monitoring e.g. Air Quality Health Index
Infrastructure upgrades to reduce heat island effect
Collaboration between sectors e.g. health, animal, emergency services
Increased disease/outcome surveillance e.g. heat-related illnesses

B) List 4 Direct and Indirecct Health Effects from climate change

Direct Health Effects

Heat and cold-related illness and death
Deaths and injuries from weather disasters (floods, storms)
Psychological impacts from increased illness and deaths in families/communities
Increased skin cancers due to increased UV exposure

Indirect

Changes to vector-borne disease patterns
Increased food and water borne infections due to decreased hygiene
Malnutrition
Injuries and illness due to overcrowding/displacement
Increased asthma and allergies due to changes in air pollution/pollens/spores

C) Categories of geographical areas relevant to climate change effects and one unique consideration for climate change planning related to each location

Urban - urban heat island effect
Coastal/waterfront areas - flooding
Rural - disruption of agriculture
Northern - disruption of communities dependent on country food
Communities that neighbour forested areas - wildfires

Question 9

Q

List 4 ways that climate change may directly or indirectly affect transmission of infectious diseases

Answer

A

Increased flooding worsening water-borne outbreaks
Increased food spoilage leading to food-borne outbreaks
Longer disease transmission cycles, altering vector-borne transmission
Faster maturation cycles for pathogens, altering vector-borne transmission
Rodents may be displaced or may move due to changing climates, altering their disease transmission
Displacement of people may lead to overcrowding and increased outbreaks

Question 10

Q

Besides injury and death, list 4 ways increased extreme weather events and natural disasters due to climate change affect people’s health

Answer

A

Mental health effects
Increased infectious diseases
Food and water shortages
Disrupted health care services
Displaced populations

Question 11

Q

What is the urban heat island effect and what are three factors that contribute to this phenomenon?

Answer

A

When urban areas experience warmer temperature than nearby rural areas

Lack of vegetative cover (less shade and less cooling of air)
Lack of ventilation by tall buildings and narrow streets
Dark construction materials such as ashphalt that absorb heat
Heat generated from human activities such as driving

Question 12

Q

What are the ecological determinants of health?

Answer

A

Air, water, food, fuel and materials, protection from UV radiation, waste recycling and detoxification and a relatively stable and livable climate

Question 13

Q

What is the triple crisis?

Answer

A

Climate disruption
Biodiversity Loss
Pollution

Question 14

Q

What is planetary health and how can we promote it?

Answer

A

Planetary health describes the health of the human species and the state of the natural systems on which it depends. It is based on the understanding that human health and human civilization depend on flourishing natural systems and the wise stewardship of those natural systems.

Ideas on ways to promote planetary health:

include in the curriculum for all health sciences
promote contact with nature, parks and green cities, etc.
create planetary health officers to do this work

Question 15

Q

How can you reduce your carbon footprint? (4 categories)

Answer

A

Food is 50% of our footprint, which we can reduce it by tackling food waste and shifting to plant-rich diets.
Mobility is 25% of our footprint, and we can reduce it by finding alternatives to personal car ownership and increasing the percentage of trips by walking, cycling and public transit.
Buildings are 15% of our footprint, and we can reduce it by lowering our housing energy needs and tackling our building and construction waste.
Stuff is 10% of our footprint, which we can reduce by reusing and repurposing furnishings and appliances.

Question 16

Q

At what body temperature can hypothermia first be diganosed?

Answer

A

Hypothermia results when the core body temperature drops below 35 degrees celsius (<95 degrees F)

Hypothermia causes cardiac arrhythmias, decreased respiratory drive, and neurological changes (sensory changes, ataxia, decreased reflexes, altered mental status)

Question 17

Q

Under the Canada Labour Code, please list 3 rights and 3 duties of the employee and list the 3 duties of employers.

Answer

A

3 rights of employees:

Right to know about hazards
Right to refuse dangerous work
Right to participate in ensuring a safe workplace

3 duties of employees:

Use protective materials, equipment and devices given by employer to protect employee
Report all work-related accidents to employer
Report hazards to employer.

3 duties of employers:

Ensure workers have the needed training, information, and supervision to be safe at work.
Ensure that complaints, accidents, and injuries are thoroughly investigated
Ensure health and safety committees are formed and carry out their functions including inspections

Question 18

Q

Please list 3 interventions that can reduce radon levels in the home and other buildings such as schools

Answer

A

Adequate ventilation
Sealing cracks and holes in a building’s foundation
Sub-slab depressurization (which actively draws radon from the soil to the outside environment, bypassing the building.)

Question 19

Q

List 5 most common heavy metals of environmental public health significance

Answer

A

Lead 2. Mercury 3. Cadmium 4. Chromium 5. Arsenic

Question 20

Q

What are the health effects of cadmium?

Answer

A

Acute - headache, weakness, severe GI irritation, pneumonitis with pulmonary edema, Itai-Itai disease (in Japan)

Chronic- COPD (occupational exposure), renal tubular dysfunction, kidney stones, osteoporosis, IARC Group 1 for lung cancer

Question 21

Q

What are the 7 steps of a Hazard Analysis Critical Control Point?

Answer

A

HACCP is a systematic and preventative approach to the identification, evaluation, and control of food hazards from farm to fork.

Conduct a hazard analysis
Identify critical control points (CCP)
Establish Critical Limits
Monitor critical control points
Undertake correction action
Keep records
Verify procedures

Question 22

Q

What is the fundamental concept of waste management?

Answer

A

Containment – maintaining separation of waste from human activity

Question 23

Q

What are the primary and secondary principles of waste management?

Answer

A

Primary: DIVERT waste using the 3 R’s
1. Reduce (most effective way to reduce flow of waste to landfill)
2. Reuse
3. Recycle anything not reused
4. Composting organic wastes
5. Secondary: residual waste requiring treatment or disposal
  1. Soil (sanitary landfill, deep well injection)
  2. Air (incineration, open burning)
  3. Water (ocean disposal)

Question 24

Q

What are three human health risks of poorly managed solid waste?

Answer

A

Contamination of drinking water and soil (biological, chemical, mining wastes)
Formation of air pollutants, gas migration, and leachate discharges from landfills
Emission of air pollutants from incinerators
Contamination of food by waste chemicals that escape into the environment (chemical, pathogens)
Infectious disease from poorly managed solid waste

Question 25

Q

What proportion of all waste goes to landfills?

Question 26

Q

What are drawbacks of landfill use as waste management?

Answer

A

Groundwater contamination: leachate is a mixture of water and dissolved solids produced as water passes through waste and collects at the bottom of a landfill),
Gas emissions: methane, VOCs, greenhouse gases. Emissions from landfills account for 20% of Canadian methane emissions
Other: aesthetics, nuisance fires, infestations/scavenging

Question 27

Q

What measures are used to mitigate issues associated with landfill use?

Answer

A

Site selection: specially designated area, size, groundwater separation, soil for daily cover, population buffer, rainfall/winds, accessibility, elevation
Preparation: pre-constructed “cell” lined with impermeable layer as barrier for leachate (surface water protection), sediment/erosion controls (surface water protection), methane gas collection
Operations: waste spreading and compaction followed by 6” soil cover

Question 28

Q

What measures are used to minimize pollutants during incineration?

Answer

A

Controlled combustion processes (waste oxidized to CO2 and water) using mass burn systems, refuse-derived fuel (RDF) systems and other types of modern incinerators using pollution control devices
Maximizing complete combustion – three T’s – time, temperature, turbulence (oxidize as completely as possible)

Question 29

Q

What are concerns regarding incineration as a means of waste management?

Answer

A

Aesthetics
Atmospheric emissions of greenhouse gases, heavy metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and potential carcinogenic agents

Question 30

Q

What are the main system elements of solid waste management?

Answer

A

Waste generation
Waste handling, separation and storage at source: waste and recyclable materials are sorted, placed in containers, stored until collection, then transported to collection point.
Collection, transfer and transport: Wastes and recyclable materials collected from homes, businesses, institutions, industry etc. , then taken to materials recovery facilities (MRFs), transferred onto larger vehicles at transfer stations, or taken directly to disposal facilities.
Separation and processing: Commingled waste is separated, recyclables are recovered, and separated waste is processed further at MRFs, transfer stations, incinerators, and landfills.
Final disposal: Collected wastes are transported to landfills and incinerators and disposed of. Residual materials from MRFs and composting facilities, as well as ash from incineration are also disposed of

Question 31

Q

What are consequences of soil contamination?

Answer

A

Water body: compounds that form weak bonds with soil and organic matter are more mobile and bioavailable (e.g., phenol compounds have low tendency to absorb they are highly mobile in soil and can leach into ground or surface water)
Direct human contact: routes of exposure include ingestion, inhalation, dermal. Other than children and persons working with soil, little direct human contact. Must consider the source-pathway-receptor pathway
- Source: location from which contamination is or was derived (e.g. arsenic in surface soils)
- Pathway: mechanism by which a receptor is being or could be exposed or affected by an identified contaminant (e.g. soil ingestion)
- Receptor: which may be adversely affected by the contaminant (e.g. young children)
- Vegetation: food chain implications, (e.g. cadmium, dioxins)

Question 32

Q

List 3 steps to take when a parameter is exceeded

Answer

A

Verify information is accurate (system operator, testing laboratory)
Notify relevant authorities (public health unit, MOHLTC, Ministry of Environment
Re-sample (if appropriate)
Gather other data (turbidity, chlorine residuals)
Corrective action: increase disinfection, flush lines, equipment repair, identify cause, issue notice to public (BWA, DWA)

Immediate: E. coli or fecal coliforms

Urgent: low chlorine residuals

Investigation: chemical contaminants, especially at low levels

Question 33

Q

List the MAC for the following substances

Answer

A

Parameter

MAC

Total coliforms

None detectable/100 mL in water leaving a treatment plant and in non-disinfected groundwater leaving the well

Turbidity

Treatment limits for individual filters or units:
• Conventional and direct filtration: ≤ 0.3
• Slow sand and diatomaceous earth filtration: ≤ 1.0 NTU
• Membrane filtration: ≤ 0.1 NTU

E coli

None detectable per 100 mL

Lead

0.005 ALARA

Arsenic

0.01 ALARA

Question 34

Q

List six steps in the wastewater treatment process

Answer

A

Collection: Individual building where wastes are flushed to municipal sewer that eventually caries wastewater to treatment plant by gravity or by pumping

Screening: Large pieces of debris (“chunks” or tree limbs) are removed and disposed of in a landfill

Grit chambers: Large particles such as sand and gravel settle out

Settling (or primary clarifier): Solids settle to the bottom of a tank; supernatant is removed

Aeration: Supernatant is aerated (or filtered) to allow aerobic microorganisms to consume organic material; biomass settles out as secondary sludge

Secondary settling(or secondary clarifier): Solids settle to the bottom of the tank (again) and are sent to sludge processing

Disinfection: Aerated supernatant is disinfected (usually with chlorine or UV light) and then returned back to the water cycle (ie. to source water - lake)

Step may be combined with filtration (e.g. 10 micron polyester media) and aeration (bring up dissolved oxygen level to regulated levels)

If industrial and other sources of toxic chemicals are present, further tertiary treatment is needed

Sludge processing: Sludge from settling tank, aeration, and clarifier is digested by microorganisms

Methane from digester gas may be used to fuel a generator that supplies electricity for the plant

Digested sludge may be sent for multiple purposes (see below)

Sludge disposal: Processed sludge can be used in agriculture (fertilizer - rich in ammonia, nitrogen, phosphorus, and potassium), biofuel (nitrogen, methane), incinerated, or sent to landfill

Question 35

Q

What are 4 effects of wastewater pollution on human health or the ecosystem?

Answer

A

Releases to surface waters

Negative effect on fish and wildlife population

Oxygen depletion (e.g., decaying organic matter/debris uses up dissolved oxygen in lake –> fish and aquatic biota cannot survive)

Eutrophication of water

Beach closures

Restrictions on recreational water use

Restrictions on fish and shellfish harvesting and consumption

Metals such as mercury, arsenic, lead, cadmium

Restrictions on drinking water consumption

Releases to air

Methane, CO2, oxides of nitrogen, hydrogel sulfide, chlorine

Releases to land

Solid wastes can be applied as fertilizer/conditions, incinerated for further energy recovery, sent to landfill

Question 36

Q

Given an example of when each drinking water advisory may be issued:

Answer

A

Boil Water Advisory: Issued when the microbiological quality of drinking water is suspected or confirmed to be compromised, meaning disease-causing micro-organisms, such as bacteria, viruses or parasites, could be in the drinking water

Do not Consume: Issued when a chemical contaminant is suspected or confirmed in a drinking water supply

Boiling the water does not remove or reduce the concentration of these types of contaminants (e.g., non-volatile organic compounds such as metals, nitrates, cyanobacterial toxins and radionuclides may actually be increased with boiling)

Do not Use: Issued if boiling water is not possible (e.g. schools or public drinking water fountains)

Question 37

Q

List 3 aesthetic parameters for recreational waters

Answer

A

Parameter

Consideration

Guidelines

Turbidity

To satisfy most recreational uses

50 NTU

Clarity

Clarity should be sufficient for users to estimate depth and to see subsurface hazards

Secchi Disc visible at a depth of 1.2m

Colour

Colour should not be so intense as to impede visibility in areas used for swimming

No numerical value

Oil and Grease

Should not be present in concentrations that can be detected as a visible film, sheen, discolouration or odour; or that can form deposits on shorelines or bottom sediments that are detectable by sight or odour

No numerical value

Litter

Areas should be free from floating debris as well as materials that will settle to form objectionable deposits

No numerical value

Question 38

Q

What is the most appropriate indicator of faecal contamination in fresh recreational waters? In marine recreational waters?

Answer

A

E coli in fresh, enterococci in marine recreational

Question 39

Q

List 4 potential health hazards from wind turbines.

Answer

A

EMF exposure
Shadow flicker
Injury risk: structural failure, ice throw
Sound and vibration

Question 40

Q

How are nitrites used in food preservation?

Curing

Answer

A

nitrites, nitrate salts or both used in combination with salt and other curing aids are added to meat products to improve colour, texture and flavour and to prevent or delay undesirable microbial growth and toxin production

Question 41

Q

List 3 pathogens associated with raw milk consumption

Answer

A

Campylobacter, E. coli, Salmonella, Listeria monocytogenes, Yersinia enterocolitica, Coxiella burnetii (Q fever)

Question 42

Q

List 3 health effects of extreme heat

Answer

A

Heat edema

Heat-induced swelling frequently noticeable in the ankles, feet and hands, and most often seen in people who are not regularly exposed to heat.

Heat rash

A result of inflammation of clogged sweat glands and accompanied by tiny red spots on the skin, which may give a prickling sensation.

Heat cramps

Caused by a salt imbalance resulting from a failure to replace salt lost through excessive sweating. Symptoms are sharp muscle pains.

Heat fainting

Caused by the loss of body fluids through sweating and by lowered blood pressure due to pooling of blood in the legs. Symptoms include temporary dizziness and fainting resulting from an insufficient flow of blood to the brain while a person is standing

Heat exhaustion

Caused by excessive loss of water and salt. Symptoms may include heavy sweating, weakness, dizziness, nausea, headache, diarrhea and muscle cramps

Heat stroke

Most serious type of heat illness is a result of body heat overload. Signs of heat stroke may include a core body temperature of more than 40°C/104°F, complete or partial loss of consciousness and/or reduced mental ability

Other health effects

Increased allergies due to an extended pollen season

Increase in enteric disease due to food spoilage and inadequate food handling

Increased drownings as people seek relief from the heat

Question 43

Q

List 3 health effects of extreme cold

Answer

A

Windburn

· Occurs when cold wind removes the top layer of oil from the skin causing excessive dryness, redness, soreness, itchiness

Frostbite

· When the temperature drops below 0ºC blood vessels close to the skin constrict to protect the core body temperature

· When your body is exposed to the cold for a long period of time blood flow can be severely restricted

· The combination of poor circulation and extreme cold can lead to frostbite most commonly on the hands, feet, nose and ears

· Mild frostbite (frostnip): makes your skin look yellowish or white but it is still soft to the touch. Your skin might turn red during the warming process, but normal colour returns once the area is warmed

· Severe frostbite: can cause permanent damage to body tissue if it is not treated immediately. Nerve damage occurs and frostbitten skin becomes discoloured and turns black. After some time, nerve damage becomes so severe that you will lose feeling in the affected area and blisters will occur. If the skin is broken and becomes infected, gangrene can set in which can result in loss of limbs

Hypothermia

Stage 1: body temperature drops by 1-2ºC

· Start shivering, get goose bumps on skin, and hands become numb

· Breath can become quick and shallow, and you may feel tired and/or sick to your stomach.

· May also experience a warm sensation, which means your body is entering stage 2 of hypothermia

Stage 2: body temperature drops by 2 - 4ºC

· Muscles are uncoordinated and movements are slow and laboured.

· May suffer mild confusion, become pale, and your lips, ears, fingers, and toes may turn blue

Stage 3: body temperature drops below 32ºC

· Shivering will stop but trouble speaking, thinking, walking. Possible amnesia

· When body temperature drops below 30ºC exposed skin becomes blue and puffy, hard to move muscles and behaviour becomes irrational

· Heart may beat quickly but pulse and breathing will decrease

· High risk of mortality

Question 44

Q

List 3 key messages for the public during an extreme heat warning alert

Answer

A

“Heat illnesses are preventable”
“Take a break from the heat by spending a few hours in a cool place. It could be a tree-shaded area, swimming facility or an air-conditioned spot such as a public building, shopping mall, grocery store, place of worship or public library”
“Reschedule or plan outdoor activities during cooler parts of the day”
“Drink plenty of cool liquids, especially water, before you feel thirsty to decrease your risk of dehydration. Thirst is not a good indicator of dehydration”
“Frequently visit neighbours, friends and older family members, especially those who are chronically ill, to make sure that they are cool and hydrated”
preventable-cool/shade- hydrate- check

Question 45

Q

List 3 key messages for the public during an extreme cold warning alert

Answer

A

Dress warmly in layers and wear a wind resistant outer layer

o Stay dry and change out of wet clothing as quickly as possible

o Keep moving (especially your hands and feet) to keep your blood flowing and maintain your body heat

o If you are caught outside in extreme cold conditions, look for shelter out of the wind and keep moving to maintain your body heat

o Prepare your home by doing regular maintenance. Make sure your heating system is working efficiently and seal all cracks and drafts to keep the heat in.

o Avoid alcohol (consuming alcohol before you go out in the cold may increase your risk of hypothermia)

o Watch for signs of windburn, frostbite and hypothermia

o Seek medical attention if necessary

Question 46

Q

What are four categories of health impacts of poor air quality?

Answer

A

Premature mortality
Respiratory (asthma, allergies COVD, lung cancer)
CVD (angina, arrhythmias, MI, heart failure, HTN)
Biologic (asbestosis, legionnaire’s disease)
Reproductive (IUGR, preterm labour)
Carcinogenic (lung cancer)

Question 47

Q

What are criteria air contaminants? List five criteria air contaminants, their source, and one health effect.

CAC = Seven pollutants for which ambient air quality standards have been established. This is a set of air pollutants that cause smog, acid rain, and other health hazards

Answer

A

Pollutant -Common Sources -Health Effects

Carbon monoxide (CO)

Primary emission: Incomplete combustion (of wood, vehicles, forest fires big contributor)

Toxicity - headaches, vomiting, visual impairment, fatigue, death

asphyxiant

PM10

(largest “inhalable particle”) = coarse PM

includes EVERYTHING below 10um (2.5-10um)

Primary emission: Soil, other crustal materials (e.g., dust from unpaved roads, construction)

Irritation of eyes, nose, throat

PM2.5

less than 2.5um = fine PM

(0.1-2.5um)

Primary emission: Combustion of fossil fuels, smokestacks, wood stoves, fireplaces - >50%

Secondary formation: Reactions of SOx and NOx, VOC, NH3, soot, and acid condensates

Note: N95 - block 95% of particles 0.3 μm or larger

Respiratory symptoms, cardiac disease, eye irritant, lung cancer,

Reproductive effects (low birthweight)

Fine PM →more likely to be toxic than coarse PM because can be inhaled more deeply into the lungs)

Sulfur dioxide (SO2)

Primary emission: Fossil fuel combustion, especially power plants; smelting

Sarnia: refinery
Sudbury: smelting
Hamilton: steel
NB has very large refinery

Water soluble -> little reaches lungs. Upper airway irritation, decreased lung function, reproductive effects, acid rain

Nitrogen dioxide (NO2)

Primary emission: burning of fuel, tobacco smoke, forest fires

Secondary formation: forms from primary pollutants released by fossil fuel combustion (majority transportation, esp diesel), especially vehicles.

-Precursor for PM, O3, nitric acid (acid rain)

Eye irritation, carcinogen

Silo-filler’s disease: delayed (48h) pulmonary edema from inhalation of NO2 from fresh silage - alveolar disease

Not easily soluble

VOCs (volatile organic compounds)

-chloroform, formaldehyde, methanol

Produced by industry, vehicles, off-gassing from chemicals in the home (source of indoor air pollution, need to store properly)

Irritation to skin/mucous membranes,

-Inhaled -> headaches, carcinogen

Ammonia - NH3

Primary emission: livestock waste, fertilizer

Eye irritation

Respiratory symptoms

Ozone

Question 48

Q

. What 3 pollutants are included in the AQHI? What is the scale for the AQHI and what is the basis of the scale?

Answer

A

Pollutants: NO2, PM2.5, and O3

Scale: 1-10+

Basis for scale: Mortality risk in 12 Canadian cities

Question 49

Q

What are three limitations of the AQHI

Answer

A

Provides info on acute exposure, but doesn’t take into account long term risk/exposure
Most people spend most of their time indoors, but doesn’t monitor indoor air
Not validated for non-urban areas
AQHI was going to include SO2, but New Brunswick refused re: large refinery small province
Health risks based on mortality data, but not morbidity data

Question 50

Q

What is the difference between sick building syndrome and building-related illness?

Answer

A

Sick building syndrome:

Symptoms (headaches, dizziness, rhinitis, nausea, lethargy) that improve when individual leaves the building, but no cause can be identified
Population-related phenomenon
Groups of people in a common environment where symptoms occur higher than baseline (ex. compared to CCHS – Canadian Community Health Survey)
Symptoms > signs

Building-related illness:

Signs and symptoms that are attributable to an identifiable, building-related cause
May take long to resolve even after living the building
(e.g., Legionnaire’s disease, occupational asthma, hypersensitivity pneumonitis)
Diagnosable at individual level

Question 51

Q

Using the 6Es, provide one example for each E of how individuals can mitigate risk of poor air quality inside their homes

Answer

A

Environment:

Ensure adequate control, ventilation, and air cleaning ,Do not store paints, solvents, varnishes, gasoline, and other chemicals inside the home ,Control humidity levels ,Reduce use of candles/incense ,Vacuum carpets regularly and clean hard floors

Engineering:

Maintain fuel-burning appliances ,Building materials (VOCs) ,Wood stoves should meet Canadian Standards Association (CSA) ,Ensure interface between garage and home is properly sealed, install air filters and furnace filters

Education:

Burn dry, clean wood ,Reduce amount of wood used in woodburning stoves ,Never burn pressure-treated or chemically treated wood ,Avoid idling any gas powered equipment in the garage (e.g. car, snowblower)

Empowerment:

Install a CO detector ,Make your home smoke free ,Measure radon levels in your home

Economic:

Subsidize purchase of new wood stoves that meet standards or CO detectors , radon detectors

Enforcement

Health Canada:

Residential Indoor Air Quality Guidelines (RIAQG)

policy to restrict indoor smoking

Question 52

Q

List 4 potential health hazards of wind turbines

Answer

A

Real risks: injuries from structural failure (entire blade or blade fragments thrown); ice throw.

Potential health concerns (no evidence for causal association between exposure to WTs and adverse health effects, with the exception of annoyance):

Noise
Electromagnetic radiation
Vibrations
Shadow Flicker can cause seizures

Question 53

Q

List 2 potential routes of exposure to fracking substances

Answer

A

Drinking Water: Accidental surface spills leaching into ground water. Methane and other substances have been found in well water near fracking operations.

Air: fracking releases NOx, SOx, O3, VOCs, crystalline silica, H2S, PM, CO2 and radon.

Question 54

Q

Describe 2 potential health concerns of Giant hogweed/wild parsnip.

Answer

A

The clear watery sap of Giant hogweed contains toxins that can cause severe dermatitis.

(Sx occur within 48 hours and consist of painful blisters).

Eye contact with sap has been reported to cause temporary or permanent blindness.

Question 55

Q

List 1 benefit and 1 harm of fish consumption

Answer

A

Benefits of fish consumption

Cardiovascular disease: Omega-3 fatty acids have anti-inflammatory, antithrombotic, and antiarrhythmic effects but omega-3 fatty acid supplementation alone is not associated with decreased CVD risk

Pregnancy: positive association between fish consumption during pregnancy and neuropsychological outcomes in children. Benefits attributed to long-chain polyunsaturated fatty acids

Nutrients: Other nutrients in fish = Vit A, D, B3, B6, B12, calcium, phosphorus, selenium, iron, magnesium, potassium, iodine

Harms of fish consumption

Mercury: relatively low levels of prenatal exposure to methylmercury are associated with impairments in cognition, memory, and verbal skills of children; fish consumption is the primary mechanism of exposure

Persistent organic pollutants: PCBs result in reduced IQ, growth impairment, and motor deficits, and may result in cancers

Botulism: caused by contaminated raw or partially cooked seal meat, fermented whale blubber, smoked salmon, and fermented salmon eggs

Question 56

Q

What are 3 physical or chemical factors that would increase risk of pathogenic growth in food

Answer

A

FAT TOM:

Food: microorganisms need a constant source of nutrients to survive, esp protein. Moist, protein-rich food (raw meat, seafood, cooked rice or pasta, eggs, dairy products) are esp hazardous.

Acidity: bacteria grow best in environment that is slightly acidic or neutral (pH 4.6-7.5); they flourish in pH 6.6-7.5

Time: food should not remain in temperature danger zone (40 F to 140 F) for > 2 hours. Cool or heat.

Temperature: bacteria grow best at temperature range of 40 to 140 F – referred to as the “temperature danger zone”

Oxygen: almost all foodborne pathogens are aerobic – requiring oxygen to survive and grow.

Moisture – water is essential to bacterial growth. Microorganisms grow faster in food with high water content (meats, produce, soft cheeses

Question 57

Q

Name 3 broad categories of potential food contamination along the “farm to fork” continuum

Answer

A

Food contamination possible at any point along “farm to fork” continuum.

Production – e.g., air, water, soil, agricultural by-products – e.g., pesticides, manure, feces.

Processing and distribution – e.g. packing materials and equipment.

Preparation – e.g. food contact surfaces, food handlers, presence of rodents/insects in food preparation areas, or in direct contact with the food products.

Question 58

Q

What are 2 responsibilities that local (in ON) or regional (in other provinces) public health units have to protect food safety?

Answer

A

Routine inspections of food premises

Investigations of outbreaks

Food safety training

Question 59

Q

Name 2 Federal agencies responsible for food safety, and describe their primary responsibilities.

Answer

A

AAFC (Agriculture & Agri-food Canada): contributes to research and development of on farm food safety programs.

Health Canada: establishes food safety policy and standards. Assesses effectiveness of CFIA’s food safety activities. Conducts health risk assessments in support of food safety investigations; informs Canadians about potential risks to their health. Makes decision on recall.

CFIA (Cdn Food Inspection Agency): designs and delivers federal food inspection programs. Monitors industry’s compliance with the Acts and regulations; undertakes enforcement action as necessary; food safety investigation and food recalls.

PHAC: public health surveillance; leads foodborne illness outbreak investigations with P/T PH officials.

Question 60

Q

List six populations who are most at risk for complications from raw or undercooked shellfish that may be contaminated with Vibrio parahaemolyticus?

Answer

A

Pregnant women
Young children
Elderly
People who are immunocompromised
People with liver disease
People with low stomach acidity (including from taking antacids, H2 blockers and PPIs)

Question 61

Q

List 3 parasitic food- or waterborne illnesses and identify a different common vehicle for each agent.

Answer

A

Trichinosis – undercooked pork

Cryptosporidiosis – drinking water

Giardia – recreational water

Question 62

Q

After a weekend spent at a girl guide camp, 20 in 30 campers became sick with vomiting and diarrhea in the first 24 hours of their return home. Some campers were already sick on Sunday before departure.

What is the (1) type of study you would want to conduct in order to investigate a foodborne outbreak at this girl guide camp and (2) the measure of association you would derive?

Answer

A

List seven agents to include in your initial differential diagnosis.

Norovirus (10-50hrs)

Salmonella (6-72hrs)

E coli (1-10 days)

Shigella (1-7 days)

C. perfringens toxin (6-24 hrs)

S. aureus enterotoxin (1-6 hrs)

B. cereus enterotoxin (Diarrhea 8-16hrs; Vomiting 1-5hrs)

*Each of these agents have a shortest incubation period <=24 hours

Type of study- Case-control study

Odds ratio

Question 63

Q

List four common foods that may be contaminated with Listeria monocytogenes.

List four populations at high risk for serious illness from Listeria.

Answer

A

List four common foods that may be contaminated with Listeria monocytogenes.

raw or undercooked meat, poultry and fish;

unpasteurized (raw) milk, cheeses and other food made from unpasteurized milk, as well as pasteurized soft cheeses or mould ripened cheese, such as Brie and Camembert;

ready-to-eat meats such as hot dogs, pâté and deli meats; and

refrigerated smoked seafood and fish.

List four populations at high risk for serious illness from Listeria.

Pregnant women (and their fetuses)

Newborns

Adults 65 and over

People who are immunocompromised

Question 64

Q

List four recommendations to prevent foodborne illness from salmonella contaminating chicken.

Answer

A

Do not eat raw or undercooked products
Cook products to internal temperature of 165*F
Do not microwave products to prevent uneven heating
Wash hands with soap and water prior to and after handling products
Use separate utensils and surfaces when preparing products
Do not reuse utensils and surfaces that have come in contact with uncooked products without washing

Answer 63

A

S. aureus enterotoxin

B. cereus enterotoxin

C. perfrigens toxin

C. botulinum toxin

Answer 64

A

PHAC:

Coordinate outbreak investigations that involve >1 P/Ts (chaired by Outbreak Management Division);
conduct national surveillance for enteric illnesses;
provide consultation through the NML and CFEP;
notify the WHO if the outbreak is a PHEIC

Health Canada:

Regulate safety and nutritional quality of food, regulate pesticides, and evaluate the safety of veterinary drugs; investigate outbreaks that occur in FN communities south of 60 degrees or on cruise ships (north of 60 = territorial governments), airplanes, and trains; provide consultation on these topics as they relate to outbreaks, does health risk assessment (based on epi, lab, food safety) and decides on food recall

CFIA: Inspect food, seed, livestock feed, fertilizers, plants, and animals; trace food item through the food distribution system (traceback: what went into production of food, traceforward: where product went); food safety investigation; logistics of food recall

Traceback: Identify where food product originated

· Traceforward: Identify where the food product was distributed

Answer 65

A

Benzene

Group 1

Acute myeloid leukemia/bone marrow suppression

Chemical/fibre/plastics production,

Silica

Group 1

Silicosis/lung cancer

Construction, mining

Asbestos

Group 1

Lung cancer/mesothelioma

Asbestos

Nickel carbonyl

Group 1

Lung/nasal carcinoma

Nickel refinery

Vinyl chloride

Group 1

Hepatocellular carcinoma/liver angiosarcoma

Vinyl production

Answer 66

A

Aluminum

Refinery/foundry workers; welders, grinders, aluminum hydroxide antacids

Conjunctivitis, dermatitis, URT irritation

Neurotoxicity

Arsenic

Contaminated foods (esp seafood and rice), contaminated water; wood preservative, agriculture, cosmetics (overseas)

N/V, abdo pain, muscle cramps, parasthesias, cardiotoxicity, peripheral neuropathy

Cancer: lung, bladder, liver, SCC;

Cardiotoxicity (MI, stroke), central neuro issues, skin discolouration

Cadmium

Agricultural soil –> food; fertilizer production, smoking, batteries. Routes of exposure: ingestion, inhalation

Toxic pneumonitis

Lung cancer, renal cancer; osteoporosis (via decreased kidney function –> decreased Vit D)

Mercury

Metallic: thermometers, barometers, fluorescent lighting – inhalational, poor absorption.
Organic (methylmercury): Fish

Metallic: Delirium, hallucinations

Organic: Resp distress, non-specific dermatitis

Metallic: Behavioural changes (“mad hatter”), tremor, memory loss

Organic: tremors, ataxia, visual field constrictions, facial parasthesias; in utero: developmental delay, low birthweight.

Lead

Lead plumbing; contaminated soil and food, house paint (before 1960 interior; 1990 exterior), work and hobbies (shooting range, stain glass), imported products (pottery, Ayurvedic medicines).

Acute lead poisoning: colicky abdo pain, anemia, headache, memory loss, seizures, ataxia

Neurotoxic: intellectual deficits, behavioural problems; microcytic anemia, nephropathy –> HTN

Answer 67

A

Indigenous persons whose diets primarily comprise country foods

Children

Elderly

Females of childbearing age

Answer 68

A

Polychlorinated biphenyls (PCBs)

Industrial heat exchange fluid, additive in paint and plastic –> leaches into food

Probable carcinogen (liver and kidney); reproductive impairment (endocrine disruptor); impaired cognition, developmental delay; immunocompromise

Dioxins

Bisphenol A (BPA)

Plastics – leaching into food and drinks.

Endocrine disruptor: epi associations between BPA and obesity, endometrial hyperplasia, recurrent miscarriages, PCOS

PVCs

Endocrine disruptor

PAHs

Pthalates

Used in plastics, paints, personal care items; highly susceptible to leaching.

Endocrine disruptor – evidence of Epi associations between pthalates and waist circumference, insulin resistance, poor sperm quality.

Answer 69

A

Polychlorinated biphenyls (PCBs)

Industrial heat exchange fluid, additive in paint and plastic –> leaches into food

Probable carcinogen (liver and kidney); reproductive impairment (endocrine disruptor); impaired cognition, developmental delay; immunocompromise

Dioxins

Bisphenol A (BPA)

Plastics – leaching into food and drinks.

Endocrine disruptor: epi associations between BPA and obesity, endometrial hyperplasia, recurrent miscarriages, PCOS

PVCs

Endocrine disruptor

PAHs

Pthalates

Used in plastics, paints, personal care items; highly susceptible to leaching.

Endocrine disruptor – evidence of Epi associations between pthalates and waist circumference, insulin resistance, poor sperm quality.

Answer 70

A

WHMIS: Canada-wide system for providing information about hazardous materials in the workplace; developed jointly by labour, industry, and federal, provincial, and territorial governments; includes labelling, material safety data sheets, and worker education programs

Roles and responsibilities of suppliers:

Identify whether their products are hazardous products

Prepare labels and SDSs and provide these to purchasers of hazardous products intended for use in a workplace.

Role and responsibilities of employers:

Educate and train workers on the hazards and safe use of hazardous products in the workplace

Ensure that hazardous products are properly labelled

Prepare workplace labels and safety data sheets (as necessary)

Ensure appropriate control measures are in place to protect the health and safety of workers.

Role and responsibilities of workers:

Participate in WHMIS and chemical safety training programs

Take necessary steps to protect themselves and their co-workers

Participate in identifying and controlling hazards

Answer 71

A

Set of non-specific Set of non-specific symptoms (e.g., nausea, headache, dizziness) assumed to arise from exposure to EM-emitting sources (e.g., cellphones, wifi, high-voltage power lines, radar)

No study has confirmed that symptoms are related to exposure to or strength of EM radiation (studies use sham EM-emitting sources or vary distance to EM-emitting source).

Unlikely to cause cancer:

The studies indicate that if there is a link between long-term, low level EMF exposure and cancer, it is a very weak one. That is, the excess risk of cancer from living near power lines is at best zero, and at worst very low.”

IARC 2B – extremely low frequency (ELF) magnetic fields

IARC 3 – static and ELF electric fields

Answer 72

A

OSHA - 3 rights of workers

Right to know

Right to refuse

Right to participate in improving safety

Internal Responsibility System: Emphasizes the OHSA principle that everyone in the workplace has a responsibility to make workplaces safe and healthy

Employers: Inform workers of hazards; provide and ensure workers use PPE; support an Internal Responsibility System, do everything reasonable to make sure a workplace is safe and healthy; report occupational illness and injury to the JHSC; union (if any), and Ministry of Labour +/- MOH

Supervisors: Ensure workers use PPE; remedy hazards

Workers: Report hazards; use PPE; report injuries and illnesses; follow procedures

Note: Organizations with 20+ employees must have a Joint Health and Safety Committee with representation from management and staff

Answer 73

A

Remedial action should be implemented if average radon levels exceed 200 Bq/m3 in areas of dwelling where people spend more than 4 hours/day

200-600 Bq/m3 = fix home within 2 years

>600 Bq/m3 = fix home within 1 year

Most radon-related cancers (>90%) in Ontario are attributable to exposures below 200 Bq/m3

Environment: Radon database for monitoring/risk identification

Enforcement: Building codes to reduce radon in new construction (e.g., inclusion of passive stack)

Economic: Financial incentives for remediation and testing

Education: Awareness of risk and opportunity to mitigate risk including smoking cessation

Empowerment: Smoking cession, home monitoring

Engineering: Remediation at high levels –> active soil depressurization (most effective at 90% decrease, but expensive) vs increase ventilation (limited effectiveness at 25-50% decrease) vs. seal major entry routes (least effective at 10-15% decrease)

Answer 74

A

Acute exposure

Chronic exposure

Deterministic effects (threshold)

Acute, in utero exposure can result in mental retardation

Burns

Sterility

Acute radiation sickness (anorexia, N/V, other symptoms depending on organ) (>1,000 mSv at one time)

Death (>5,000 mSv at one time)

Cataracts

Stochastic effects (non-threshold)

None

Cancer

Hereditary effects (theoretical; never demonstrated in humans)

Answer 75

A

health status- life expectancy at birth, life expectancy at 65, perceived mental and physical health, health adjusted quality of life expectancy at birth, health adjusted quality of life at 65 years.

Social- poverty, community belonging, child poverty, food insecurity, level of education,

What is measured? poverty

This indicator refers to the percentage of people in Canada who live in poverty according to the Market Basket Measure, Canada’s Official Poverty Line. It measures poverty by comparing family disposable income to the cost of a specific basket of goods and services.

Why does it matter?

Higher income is strongly associated with better health outcomes. Income affects important social determinants of health, like safe housing, ability to buy healthy food, and access to health care

Answer 76

A

Food insecurity- percentage of households that do not have the variety or quantity of food they need due to lack of money.

Those at risk- households with lower income, education, and employment levels; households led by lone female parents; households located in very remote areas; and households with bisexual adults or Indigenous Peoples are more likely to experience food insecurity.

Answer 77

A

This indicator refers to the percentage of households that met 2 criteria: 1) occupants do not live in housing that is adequate, affordable, or suitable; and 2) occupants would need to spend 30% or more of their before-tax income to access acceptable local housing.

Households with a lone female parent, recent immigrants, refugees, or Indigenous Peoples were among the most likely to be in core housing need.

Answer 78

A

indicator refers to the percentage of people aged 12 years or older who reported excessive alcohol consumption. This means having 5 or more drinks for males, or 4 or more drinks for females, on one occasion, at least once a month in the past year.

Answer 79

A

smoking, 15 years or older who reported being a current tobacco smoker.-

vaping-15 years or older who reported vaping non-cannabis products in the past 30 days

heavy drinking-people aged 12 years or older who reported excessive alcohol consumption. This means having 5 or more drinks for males, or 4 or more drinks for females, on one occasion, at least once a month in the past year.

,opioid related deaths-,number of deaths per 100,000 people over a one-year period that were caused by poisoning where at least one substance was an opioid.

opioid related hospitalizations. - number of hospitalizations that recorded a diagnosis for opioid-related poisoning per 100,000 people over a one-year period.

cannabis use-15 years or older who reported daily or almost daily use of cannabis in the past 30 days

Answer 80

A

Bullying- This indicator refers to the percentage of students in grades 6 to 10 who experienced repeated and targeted aggression within a peer relationship in which one person has greater power than the other person.

Answer 81

A

Emergency preparedness and response to coordinate activities across the country, secure vaccine supplies, and create public health guidance and communication tools;
Health surveillance from first developing technologies to detect SARS-CoV-2 and then data systems to track the spread of the virus;
Health protection by implementing public health measures to slow the spread of the virus;
Health promotion to inform and develop policies, programs, and other interventions with communities and other sectors around mental health, food security, economic supports, etc.;
Disease prevention through vaccination and other interventions to reduce the impact of other illnesses and risk factors that exacerbate the impact of COVID-19 (e.g., mental health, substance use harms); and,
Population health assessment of the changing strengths, vulnerabilities, and needs of communities due to COVID-19 and public health measures, and rapid synthesis of research on ways to prevent infection and reduce the spread

Answer 82

A

refers to “an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity

Answer 83

A

Trustworthy

Participatory

Evidence informed and effect

Population health approach

Foundation

Strong and supported public health work force

Sufficient and stable funding

Effective governance

Tools

State of the art

medical and digital technology

Impactful and lasting policies and programs

Connected,responsive and equitable information systems

Answer 84

A

Extreme weather events: landslides, wildfires, floods, and storms;

Heat stress: rise in average temperature, extreme hot days, heat waves, and the heat island effect;

Air quality: rise in air pollutants;

Infectious diseases: changes in habitat range of vectors and animals, increasing the risk of vector-borne and zoonotic disease;

Food quality, safety, and security: crop damage from changes in temperature and precipitation, reduced quality or access to traditional foods, and damage to food distribution infrastructure;

Water quality, safety, and security: water scarcity, contamination of water sources through flooding, and changes in rainfall patterns;

and,
Slow onset climate events: drought, glacial retreat, desertification, and sea level rise.

Answer 85

A

Social, and structural determinants: economic and social policies, politics, social identity stigmas (e.g., racism, sexual stigma, gender identity stigma, ableism).

Living conditions:

Physical environment: housing, land use, transportation, exposure to toxins.
Social environment: culture, experiences of discrimination, violence
Economic and work environment: employment, income, occupational hazards.
Service environment: education, social services, health care.

Personal and life style determinates
Risk behaviors: smoking, poor nutrition, low physical activity, alcohol and other substances, violence, sexual behavior.
Disease and injury: communicable disease, chronic disease, injury (intentional and unintentional), mental health and illness.
Mortality: life expectancy, infant mortality.

Answer 86

A

Examples of upstream interventions: poverty reduction strategies, decolonizing and anti-racism policies.

Examples of midstream interventions: Culturally safe health and social services, affordable and high-quality childcare.

Examples of downstream interventions: Smoking cessation programs, sexual health education.

Answer 87

A

These pathways ultimately lead to climate sensitive health outcomes, such as:

Extreme weather events: injury, death, mental health impacts, and limited access to essential supplies and services;

Heat stress: heat stroke, dehydration, cardiovascular and respiratory impacts, mental health impacts, and pregnancy complications;

Air quality: exacerbation of respiratory conditions (e.g., asthma), cardiovascular diseases, and allergies;

Infectious diseases: Lyme disease, West Nile virus, and Hantavirus;

Food quality, safety, and security: food-borne illness, undernutrition, food insecurity, and cultural and nutritional loss of food;

Water quality, safety, and security: water-borne diseases caused by parasites or bacteria, and algal blooms;

and,
Slow onset climate events: effects on physical and mental health, increased food and water insecurity, poverty, forced migration, and conflict.

Answer 88

A

One key step towards climate change resilience will involve setting a national maximum indoor temperature standard. Once this has been set, building codes, building standards, residential tenancy laws, and purposeful urban design can be used to achieve it. At the same time, strengthening social networks and mitigating the risks of social isolation

Keeping buildings cool in a warming climate

Strategies may include localized cooling with heat pumps, as well as non-mechanical options, such as different roofing materials and exterior window shadings, both of which help to reduce the building heat

central air conditioning is one way to ensure indoor temperatures do not exceed 26°C. However, this also contributes to greenhouse gas emissions, strains power supplies during extreme heat events, and creates the potential for mass casualties during a power outage

New buildings: Indoor temperatures must be specified in building codes

Existing buildings: Evaluation and retrofitting encouraged through voluntary and regulatory means

Answer 89

A

Health protection, climate, and small drinking water systems in Canada

Source water will become more variable and difficult to treat consistently to an acceptable standard
Changes to precipitation and flooding patterns will cause periodic increases in bacterial and chemical contamination of source water, as well as increased organic matter, which can negatively affect the treatment process

Water systems infrastructure will be more at risk of contamination and damage

Addressing climate change impacts on small drinking water systems in Canada

Thawing permafrost, droughts, and flooding caused by climate change will exacerbate and compound the existing health challenges stemming from a lack of access to clean fresh water

Answer 90

A

he figure describes the health impacts of climate change across the life course.

Pregnant people: pregnant people exposed to climate change stressors such as heat, floods, air pollution and infectious agents can experience heat-related illnesses, mental health impacts, respiratory disease, infections, nutritional issues, and poverty. These dynamics can shape in utero conditions, which may lead to low birth weight, altered development, and pre-term delivery.

Infants and toddlers: limited ability to acclimatize physically and respond appropriately to stress. more sensitive to climate change stressors such as heat, allergens, infectious diseases, and food- and water-borne illnesses.

Children and youth: outdoor play increases heat-related illnesses, respiratory impacts from air pollution and allergens, and vector-borne diseases. In addition, they are at increased risk of long-term trauma, anxiety, and mental health impacts from climate change related events.

Adults: pre-existing physical and mental health conditions, living and working conditions, and socioeconomic status worsen impacts

Older adults: more sensitive to extreme heat and wildfire smoke, higher levels of social isolation or dependence, leading to difficulty preparing for and responding to extreme weather events, including associated evacuations.

Answer 91

A

These are:

Exposure (e.g., living and working conditions, structural barriers [e.g., racism, colonialism]); 
Sensitivity (e.g., pre-existing mental and physical health conditions, age); and,
Adaptive capacity (e.g., socioeconomic status, education, social norms, governance, social, health and economic policy, access to care, Indigenous and Treaty rights).

Answer 92

A

Exposure pathways (exposure): people living in neighborhoods with low socioeconomic status are generally more likely to be exposed to climate change health threats. 
Health impacts (sensitivity): people with pre-existing mental and/or physical health conditions are more likely to experience disproportionate health risks during periods of extreme heat. 
Health outcomes (adaptive capacity): people with reduced access to care and preventative services are more likely to have a severe health outcome from climate stressors.

Answer 93

A

Healthy public policy- (1) implement a range of interventions to address immediate health challenges and prevent future health risks from a changing climate;

Strengthen community action- (2) prioritize community expertise and engagement for equitable and effective climate action;

Reorient health systems- (3) advance knowledge to understand, predict, and respond to the health impacts of climate change;

Create supportive environments- (4) collaborate across sectors for transformative climate-health action and intersectoral co-benefits; and,

Develop personal skills- (5) strengthen public health leadership for climate action and public health building blocks for climate resilience.

Answer 94

A

Social, structural, and ecological determinants of health:
Economic policies to reduce income inequities and poverty;
Land and water use policies informed by One Health and health promoting approaches;
Treaty rights, self-determination, and self-governance for Indigenous Peoples;
Social policies to address racism, ageism, and other stigmas; and,
Policies to reduce extraction of oil and gas and reliance on fossil fuels and create renewable alternatives.

Living conditions and ecosystems:
Physical and built environment: housing, land use, transportation, and exposure to toxins.
Social environment: culture, experiences of discrimination, and violence.
Economic and work environment: employment, income, and occupational hazards.
Service environment: education, social services, and health care.
Climate resilient building codes (e.g., max heat, ventilation);
Equitable access to green space and tree cover canopy;
Upgraded water and wastewater systems;
Water conservation, reuse, and storage techniques;
Equitable access to nutritious and culturally appropriate foods;
Active and public modes of transportation; and,
Walkable and transit-supportive communities.

Answer 95

A

Disease vector surveillance (e.g., mosquito or tick population monitoring).
Disease incidence (e.g., Lyme disease, West Nile virus).
Syndromic surveillance (e.g., heat-related illnesses in emergency departments).
Water safety monitoring (e.g., algal blooms).
Foodborne diseases (e.g., salmonella, campylobacter).
Mental health surveillance (e.g., Positive Mental Health Surveillance Indicator Framework).
Built environment monitoring (e.g., Canadian Bikeway Comfort and Safety Classification System).

Answer 96

A

Vector control (e.g., mosquitos, ticks).
Water testing and advisories (e.g., well water testing after flooding).
Air quality monitoring and advisories (e.g., Air Quality Health Index).
Food safety and security (e.g., public awareness campaigns).
Public education programs about climate risks.

Answer 97

A

Examples of public health activities related to climate change:

Coordination with stakeholders and leadership on health-related emergency preparedness and response.
Risk assessments on potential public health impacts of natural disasters (e.g., air quality impacts from wildfires).
Provide public health advice, services, and support to stakeholders (e.g., air quality testing, heat alert and response systems, cooling centres).
Community outreach and information sharing during natural disasters.
Identifying and supporting populations that may need additional considerations during an emergency (e.g., older adults).
Shelter and other supports for populations displaced by natural disasters (e.g., evacuation of remote First Nations communities due to floods and wildfires).
Community mental health supports for populations impacted by natural disasters and emergency responders

Answer 98

A

Excess mortality: .

Sexually transmitted and blood borne infections (STBBIs):

Opioid overdose crisis:

Food insecurity:

Physical activity:

Influenza: Beginning in April 2022, as public health measures eased, confirmed influenza cases, which had been rare for most of the pandemic, sharply increased into a smaller late onset seasonal epidemic compared to pre-pandemic.

Delayed procedures:

Perceived mental health:

Stigma and discrimination:

Financial security:

Answer 99

A

. They: (1) create more equitable social and economic conditions (i.e., reduce socio-economic inequalities and provide investment in early childhood development and care); and (2) promote positive social norms, communicate risks and reduce exposure (i.e., implement policies that create the conditions for lower-risk use of substances).

The interventions at the top half of the pyramid, also called individual-level interventions with a targeted impact. They: (3) develop skills and resilience for youth and their families (i.e., deliver programs that develop social and emotional skills for youth and their families, and that support youth decision-making); and (4) intervene early for youth that need support (i.e., support individual youth at risk for problematic substance use and intervene early in their substance use pathway).

Brainscape's Knowledge GenomeTM

2022 Environmental Health COPY Flashcards

Brainscape's Knowledge Genome^TM