2F environment Flashcards
What is a: environmental hazard
-factors which have the potential to harm health (ie air pollution, extreme temperatures, radiation)
Environmental determinants of health (11)
- environmental health used to focus on short term harms of chemical, biological and physical agents
- Now generally the environment is taken to meal all external factors including housing, water diet etc
ENVIRONMENTAL DETERMINANTS OF HEALTH
1. global
- global warming and climate change
- sustainable development
2. living and working conditions
-housing and built environment
- occupational health
- water and sanitation
-transport
- air quality
-agriculture and food
3. traditional environmental hazards
- chemical agents
- physical factors (ie noise, radiation, temperature)
-biologic agents (inlc. infectious diseases)
what is environmental injustice
The phenomenon that exposure to environmental risk factors tends to be greatest for the deprived. However, the wealthy often contribute most to environmental risk factor development
Give a local and global example of environmental injustice
LOCAL
- wealthy contribute most to air pollution as drive more/bigger cars/ bigger engines
- poor are more likely to live by a main road and be exposed to air pollution
GLOBAL
- developed countries emit most CO2
- However developing countries often feel worst effects of climate change ie flooding of small island states
What is environmental risk
If this instance risk is:
the probability of an unfavourable event occurring multiplied by the consequences of the event
Risk management: what are the stages
- Risk assessment (risk is characterised)
- hazard identification
- dose response assessment
- exposure assessment - Risk management (risk is mitigated and communicated)
- risk evaluation
- risk communication
- control of exposure
- risk monitoring
Risk management: what is in the 3 stages of risk assessment
HAZARD IDENTIFICATION
- this may be a new hazard (ie identified in new epidemiological study) or a known hazard identified in a new location
HAZARD DOSE- RESPONSE ASSESSMENT
- the relationship between the amount of exposure and the occurrence on health events needs to be understood
- this may come from observational studies or experimental lab studies
EXPOSURE ASSESSMENT
- field work to understand the current degree of exposure of a population and the potential degree of exposure under different conditions
Risk management: what is in the 4 stages of risk management
RISK EVALUATION
comparison of the risk against existing standards/guidelines
RISK COMMUNCIATION
- clear and appropriate communication of the risk
CONTROL OF EXPOSURE
This may be:
- at the source (ie change hazardous substance for a less hazardous one ie unleaded petrol)
- down the pathway before it reaches population (ie remove the hazard from the environment)
- At the person (ie PPE)
- secondary preventio n; ie early treatment of health effects to prevent/reduce more serious disease
RISK MONITORING
need to monitor ongoing exposure and health effects
What is Sandmans concept of risk
- Sandman proposed an alternative concept of risk that takes into account the publics response to a hazard
Risk= hazard + outrage
Where hazard is the epidemiological technical aspects of risk (ie the probability of an exposure/event and the magnitude of the effect)
Where the outrage is the perceived negatives of the situation (not just the negatives of the outcomes)
8 things effecting outrage in Sandmans concept of risk
CONTROL
when prevention and mitigation are in the individuals hands the risk is seen as lower
FAIRNESS
outrage is increased when people feel they are being unjustly treated or exposed to more risk than their neighbours, especially if this is not random
MORALITY
Outrage is greater when there is a moral component and discussion of cost- risk trade offs are seen as callous ie childhood cancer
VOLUNTARINESS
Outrage is lower when people voluntarily take the risk ie smoking compared with air pollution
PROCESS
outrage is affected by the public’s perception of a public organization ie the government
FAMILIRATY
People are more outraged by new risks rather than familiar ones
DREAD
Certain conditions are feared more than others i.e cancer is feared more than heart failure even though heart failure prognosis is often worse
DIFFUSION IN TIME AND SPACE
people are less outraged by risks spread over time and geography ie 50 anonymous people dying yearly is often not perceived as so unacceptable as a 1 in 10 risk of a town of 500000 people being wiped out in the next century
What does Sandmans concept of risk mean for risk communication
- you need to secure an appropriate degree of public outrage when communicating risk
- you don’t want public to be unnecessarily scared but also do not want them to be apathetic
-public health professional can communicate risk more effectively by listening to the public in order to:
1. take into account things that increase risk perception
2. understand the strength of feelings and the points of view
3. use appropriate media and language to communicate relevant information appropriately
What are the main causes of anthropogenic (man made) climate change?
increased levels of greenhouse gas emissions, predominantly CO2 and methane
Global warming
Average global temperatures have risen by 1.1 degree Celsius since 1880. Most of this has occurred since 1975.
because of this more extreme weather events are occurring more frequently.
Health effects of climate change
Can be divided into direct and indirect effects
DIRECT
- heatwaves/ extreme cold–> illness/death in vulnerable
- extreme weather events can lead to flooding/fire/high winds –> trauma/mortality
INDIRECT
- changing epidemiology of infectious diseases (ie malaria, mosquito distribution changing)
- Drought/ extreme weather –> impact on farming and agriculture leading to famine
- Flooding/ extreme weather–> contaminated water/ water borne disease
-rising sea levels/drought/flooding –> economic migration and refugees
- changing pattern of respiratory illness due to changes in aeroallergens
Responding to climate change- what are the 2 main categories
- Mitigation
- Adaptation
Responding to climate change: mitigation
- Mitigation of climate change mainly focused on reducing CO2 emissions, this may be through:
- switching to non-fossil fuel/ renewable energy sources
- energy efficient measures
- behaviour changes ie active transport
Legislation an important tool to focus policy on reducing emissions. For example the Kyoto protocol and Paris agreement agreed via the United Nations Framework Consensus on Climate Change
Climate change mitigation: United Nations Framework Consensus on Climate Change (UNFCCC)
-The UNFCCC was agreed in 1992 by a group of member states. It had the primary objective of stabilising greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system
- the UNFCCC was not legally binding but allowed legally binding treaties to be negotiated
- An annual conference is held in which the UNFCCC signatories meet
THE KYOTO PROTOCOL
- active from 2005-2012
- legally binding agreement for developed countries to reduce emissions of 6 main greenhouse gases
- US rejected the treaty and canada renounced the treaty in 2011
THE PARIS AGREEMENT
- Active since 2016
- Aim to limit the global temperature rise to 2 degrees Celsius above pre-industrial levels and preferably limit the increase to 1.5 degrees
CONFERENCE OF PARTIES
- the supreme decision making body of the UNFCCC is the conference of parties (COP) which meets annually
- At COP28 (the most recent) the first global ‘stocktake’ was concluded of the world’s effort to address climate change under the Paris agreement. It showed progress was too slow across all areas.
Responding to climate change: Adaptation
Adaptation may be required in many ways:
- Infrastructure ie flood defences, shad, passive cooling buildings
- Information dissemination ie heat wave warning systems
- Vaccination against infectious diseases
- Preparation for increased migration
what is Environmental sustainability
Involves balancing the needs of the current generation with those of future generations
Requires long term consideration about how we use our resources
Give examples of current unsustainable uses of resources
- global reduction in productive soils for agriculture
- depletion in fisheries
- use of fossil fuels
what does DEFRA stand for
Department for environment, food and rural affairs
What is the mnemonic for DEFRAs 5 principles for sustainable development
Every Healthy Goose Soars Easily
- ENVIRONMENTAL LIMITS
- HEALY and JUST SOCIETY
- GOOD GOVERNANCE
- RESPONSIBLE USE OF SCIENCE
- SUSTAINABLE ECONOMY
What are DEFRA’s 5 principles for sustainable development
- These take a wide view of sustainability, taking into account environmental, social and economic developments
Every Healthy Goose Soars Easily
1.ENVIRONMENTAL LIMITS
- respect the limits of the environment, resources and biodiversity
- ensure all natural resources needed for life remain for future generations
- HEALTHY and JUST SOCIETY
- meeting the diverse needs of all people in existing and future communities
-promoting wellbeing, cohesion and inclusion and creating equal opportunity for all - GOOD GOVERNANCE
- actively promoting effective, participative governance in all levels of society by engaging peoples, creativity, energy and diversity - RESPONSIBLE USE OF SCIENCE’
- ensure policy is developed and implemented on the basis of good science
- taking into account scientific uncertainty and public attitudes and values - SUSTAINABLE ECONOMY
- building a strong, stable and sustainable economy which provides prosperity and opportunity for all
- an economy where environmental and social costs fall on those who impose them (polluter pays principle) and in which incentives are in place to promote efficient resource use
Link between housing and health
- Difficult to outline
- Individual exposures do not normally lead to specific morbidities
- People living in poor housing are often experiencing a lot of other deprivation making the effect of housing difficult to isolate
- housing can have effects on both phsyical and mental health
Give some examples of health effects of housing
1 TEMPERATURE
- poor insulation can lead to excess winter deaths, particularly in elderly
- poor ventilation in extreme heat can lead to excess deaths again particularly in the elderly
- MOULD
can trigger/ cause respiratory disease - DESIGN
Poorly designed or poorly maintained homes can be a cause of falls - CHEMICALS
CO poisoning due to faulty boiler
Lead paint leading to neurodevelopmental delay in children
Asbestos in insulation - RADITATION
Radon is a particular concern in the southwest, levels can build up in the home if poorly ventilated, assoc. with lung cancer - NOISE
Poor sound insulation can lead to mental health concerns secondary to chronic noise exposure - OVERCROWDING
- can cause psychological distress and contribute to the spread of infectious diseases
Homelessness
-includes people sleeping rough, those sofa surfing, those in shelters, hostels and squats
- strong associations between homelessness and health
- high rates of drug and alcohol abuse, mental health concerns and infectious diseases (hepatitis and TB)
What is water needed for (5)
-drinking
- cleaning
- food production
- industry
- agriculture
Who inspects the quality of water supplied to customers in the UK
The Drinking Water Inspectorate
What number of households are not on mains water and what is the issue with private water supplies
- up to 1 million households
- Private water supplies can contain high levels of arsenic
- arsenic can lead to bladder, skin and lung cancers
What tests does water undergo
PHYSICAL CHARACTERISITCS
- taste, colour and smell
CHEMICAL COMPOSITION
- levels of calcium and magnesium: markers of how hard the water is
- Concentration of chlorine
-Concentration of nitrogen (can be indicative of decomposing organic matter)
- oxygen - absence of oxygen indicates stagnate water which can have high levels if contamination
BACTERIOLOGY
-bacterial examination to detect faecal organisms
Common water pollutants
FERTILISER
- nitrates and phosphates, mainly from agricultural processes, lead to the eutrophication of waterways (ie overgrowth of algae, leading to oxygen depletion)
METALS
- aluminium can be found naturally in water but aluminium sulphate is also added to improve taste. Too much aluminium can lead to joint pain, blistering, blue/green hair discolouration and long term neurological effects
-Lead: mainly from domestic plumbing systems
-Other Heavy metals: may be naturally occurring or have leached from contaminated soil
ORGANIC WASTE
- waster from slurries, silage liquor, excess crops, industrial waste may enter the water course if poorly stored or improperly disposed of
SEWAGE
- In the UK acceptable sewage regulations are enforced by the environment agency
- storm overflows can be used to discharge rainwater and sewage after heavy rainfall
- research shows these are being frequently used
Measures to protect water supply
Industry level:
- monitor levels in rivers, reservoirs etc
- requiring water companies to produce a water resource plan
- Issue abstraction licences to ensure not too much is taken
Domestic level:
- fix dripping taps and pipes
- low flush toilets
-reuse water
- collect rain water in water butts
- hosepipe bans
- fit water meters
- showers instead of baths
How can flooding impact health
- Drowning
- Injury
- Contamination of drinking water with sewage
- Loss of electricity and water (heating, communications, cooking effected)
- Mental health impacts
-social impact of relocation and loss of possessions - infectious disease risk
- loss of transport to health services
How many people in the world do not have safe drinking water
A WHO report in 2019 highlighted that globally 1 in 3 still do not have access to safe drinking water
What can cause poor water security and sanitation in developing countries
-lack of rainfall
- lack of infrastructure
- pollution of water course
- natural disasters
In developing countries inadequate water supply can lead to a range of infectious diseases, how?
- Ingestion of faecal matter due to lack of water for washing hands/ food
-Ingestion of faecal matter due to contamination of drinking water - water microbial agents ie schistomiasis
- water related vectors ie mosquitoes carrying malaria
What is UN millennium development goal 6?
Ensure access to water and sanitation for all
What is sanitation?
Refers to facilities or services for the safe disposal of human urine, faeces and waste water
Name the 3 main types of food contamination and give examples
BIOLOGICAL
(ie food-borne diseases such as salmonella)
CHEMICAL
pollution- ie mercury from industrial waste contaminating fish
Food storage/ processing ie polychlorinated biphenyls from inside silos have been associated with immunosuppression and malignancy
RADIATION
ie following Chernobyl disaster
List the stages at which food quality can be improved
PRODUCTION
- limiting use of pesticides
PROCESSING
- reducing the risk of biological contamination by drying crops
PRESERVATION AND STORAGE
- reducing the risk of biological contamination through irradiation, canning or freezing
PREPARATION
- keep raw and cooked food separate and cook at an appropriate temperature
CONSUMPTION
- consume within use by dates
who is responsible for monitoring levels of food contamination in the UK
Food Standards Agency
