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A JW Env Health > Env Health Ch 1-4, 6 > Flashcards

Env Health Ch 1-4, 6 Flashcards

1
Q

What is the “three-legged stool” of sustainable development?

A

It is the idea that sustainability depends on 3 major things:

  1. Economic development
  2. Social development
  3. Environmental protection
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2
Q

Explain the DPSEEA model.

A

It is used to analyze environmental health hazards.

Driving Forces - population growth

Pressures - toxic air emissions

State of environment - accumulation of toxins in air

Exposure - breathing in the air

Effects on health - coughing

Actions - may address any of the above, but prevention (driving forces) is best

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3
Q

Define environmental health.

A

Environmental health is the field of public health that addresses physical, chemical, biological, social, and psychosocial factors in the environment.

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4
Q

Define toxin vs toxicant.

A

Toxin = a harmful chemical of natural origin.

Toxicant = any harmful chemical

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5
Q

Name the 3 different methods for classifying toxic compounds.

A
  1. By chemical class (grouped by functional group(s), presence of metallic elements, or physical properties).
  2. By source of exposure (industrial, waterborne, etc).
  3. By health effects on specific organ systems (hepatotoxins, nephrotoxins, etc).
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6
Q

Describe cross-sectional studies.

A

They measure exposure and outcome at the same time.

They are often used when the outcome is subclinical.

They are weaker than cohort and case-control studies.

Problem: It is impossible to tell whether or not the exposure actually preceded the health outcome.

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7
Q

Define primacy of the environment.

A

The idea that the environment is the most important of the 3 “legs of the stool” of sustainability. This is because humanity’s basic needs derive from healthy ecosystems.

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8
Q

Define PCBs, and name a few facts about them.

A

PCBs = Poly-chlorinated biphenyls.

They are classified as persistent organic pollutants (POPs).

Their production was banned by US federal law in 1978.

They are classified as “definite carcinogens”.

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9
Q

What is the difference between descriptive and analytical studies?

A

Descriptive = there is no comparison group, and there is no hypothesis being tested.

Analytical = there is a comparison group, and there is a hypothesis being tested.

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10
Q

Define overshoot.

A

Overshoot = when society is using more resources than what can be replenished naturally every year. Humanity has been in a state of overshoot since the 1970s.

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11
Q

Define PAHs.

What are they used for?

How are people exposed?

What are the health effects?

A

Polycyclic aromatic hydrocarbons.

They are not “used for” anything, but they are released as combustion by-products and industrial waste.

People are exposed by inhalation of contaminated air.

Primary health effect = carcinogenesis.

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12
Q

Define environmental epidemiology.

A

This area of epidemiology studies involuntary exposures to environmental agents. For example, it excludes alcohol and tobacco use, but includes second-hand smoke.

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13
Q

Explain the precautionary principle.

A

It states that when there are threats of serious or irreversible damage, lack of full scientific certainty should not be used as a reason for postponing cost-effective measures to prevent environmental degradation.

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14
Q

Describe case-control studies. What type of exposures and diseases are they good for studying?

A

They compare exposure rates in diseased vs healthy people, using an odds ratio.

They can be retrospective only, not prospective.

They are good for rare diseases and common exposures.

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15
Q

Describe meta-analyses (name 3 facts about them).

A
  1. They provide a weighted average of quantitative results across studies.
  2. They can combine results from different study designs.
  3. They do not need access to the original data from each study. The published literature is enough.
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16
Q

Define EPCRA.

A

Emergency Planning and Community Right-to-Know Act (1986). This US law was passed in response to the Union Carbide disaster in Bhopal, India, where 40 tons of methyl isocyanate gas were released.

EPCRA addresses emergency preparedness for chemical disasters, defining local-level responsibilities. It also requires the chemical industry to report on the storage, use, and releases of hazardous chemicals. It also created the TRI.

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17
Q

Describe phthalates.

What is their general structure?

What are they used for?

How are people exposed?

What are the health effects?

A

They are derived from esters of phthalic acid.

They are plasticizers, meaning that they increase the flexibility and durability of plastics. They are found in most plastic products, such as toys, clothing, food packaging, etc. Interestingly, they are found in products used in medical care, such as IV fluid bags and plastic tubing.

People are exposed via ingestion, inhalation, dermally, and intravenously (via IV bags and tubing).

The health effects are varied, but some phthalates are “probable carcinogens”.

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18
Q

Which is preferred: p values or confidence intervals?

A

Confidence intervals, because a range of plausible values is more informative than a p value.

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19
Q

Define REACH.

A

Registration, Evaluation, Authorization, and Restriction of Chemicals. EU regulation, passed in 2006.

One key feature of REACH is that it requires premarket testing of chemicals, placing the burden of proof of safety on manufacturers.

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20
Q

Describe ecological studies.

A

AKA correlational studies. They are like descriptive studies, but they use groups, not individuals.

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21
Q

Name 3 current areas of investigation in environmental epidemiology (name the environmental agent and the possible disease).

A
  1. Job stress and blood pressure.
  2. A noisy workplace and blood pressure.
  3. Shift work and breast cancer (due to altered circadian rhythm and hormones like estrogen).
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22
Q

Describe validity.

A

Validity refers to whether or not the results of the study are true and correct.

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23
Q

How are people usually exposed to BPA?

What health effects does it cause?

A

People are usually exposed via ingestion, because the BPA in food packaging can leach into the food (especially if the food is acidic or heated).

BPA exposure can cause endocrine disruption (it mimics estrogen) and reproductive and developmental toxicity. It is particularly problematic for fetuses, infants, and children.

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24
Q

Name 4 types of chemicals that may mimic estrogen.

A
  1. DDT
  2. PCBs
  3. BPA
  4. Isoflavones (naturally produced by legumes)
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25
Q

What do metabolic transformations tend to do to xenobiotics? (Specifically, what change do they usually make to the chemical?)

A

They tend to transform xenobiotics into substances that are more water-soluble and less fat-soluble. This allows the products to be excreted more easily.

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26
Q

Define TSCA.

A

Toxic Substances Control Act (1976). It is the major piece of protective legislation for non-workplace exposures to chemicals. It allows the EPA to regulate chemical substances and mixtures. Under TSCA, EPA has 3 responsibilities:

  1. Gather info on chemicals used in the USA.
  2. Gather data on chemical risks.
  3. Regulate chemicals that present an “unreasonable risk of injury to health or the environment”.
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27
Q

Describe I = PAT

A

Impact = Population x Affluence x Technology

Society’s Impact on the environment is equal to the product of Population, Affluence (per capita consumption), and Technology (Lower value = more efficient technology).

28
Q

Describe confounding.

A

Confounding occurs when the exposure-disease relationship is distorted by a third variable that is associated with both the exposure and the disease.

29
Q

How does estrogen exert its physiological actions?

A

By binding to receptors in the nucleus of target tissues, which then activates gene transcription.

30
Q

Why is it important to define sustainability metrics and track them over time?

A

This is important so that responsible parties (governments, NGOs, and the private sector) can know whether or not sustainability is actually being achieved.

31
Q

Define ecosystem services, and give 4 examples.

A

Ecosystem services = the benefits that people obtain from ecosystems.

Examples:

  1. Provisioning services (food, wood, etc)
  2. Regulating services (pollination, air quality, water quality)
  3. Cultural services (aesthetics, recreation)
  4. Supporting services (water cycling, soil formation)
32
Q

Name 4 reasons why the health care sector is a good place to encourage sustainability.

A
  1. Health facilities use a lot of energy.
  2. Reducing energy and resource use can yield substantial economic benefits.
  3. Sustainable practices are often also healthy practices.
  4. Many health care organizations strive to be leaders in their communities, and sustainability gives them an opportunity to do this.
33
Q

Define rate ratio.

A

A rate ratio is a relative difference measure that is used to compare incidence rates of 2 events.

Rate Ratio = (Incidence Rate 1) / (Incidence Rate 2)

34
Q

Describe descriptive studies.

A

They characterize a disease based on demographic factors such as age, sex, etc.

35
Q

Name 2 reasons why GDP is not a good measure of sustainability.

A
  1. It assumes that more economic activity is always better. But, there is a high correlation between GDP and energy inputs into economies.
  2. GDP calculations include economic activity that is detrimental to sustainability (such as coal mining), and the results of that activity (such as treating diseases caused by air pollution).
36
Q

Define odds ratio.

A

An odds ratio is defined as the ratio of the odds of A in the presence of B and the odds of A in the absence of B.

When the odds ratio is greater than 1, then A is considered to be associated with B.

37
Q

Describe selection bias.

A

This occurs when the relationship between disease and exposure in the study population is not representative of the true relationship in the general population, because the study population was selected in a non-representative way.

38
Q

Describe recall bias.

A

It is a bias due to differences in the accuracy or completeness of the recollections of study participants.

Example = It can occur if “cases” tend to remember more about past exposures than “controls” do.

39
Q

Define “green chemistry”.

A

This refers to the design of chemical products and processes that reduce or eliminate the use or generation of hazardous substances.

40
Q

Which are more subject to bias: cohort studies, or case-control studies? Name 2 reasons why this is true.

A

Case-control studies, because:

  1. It can be difficult to choose cases and controls who are representative of the overall diseased and non-diseased populations.
  2. It is often difficult to measure past exposure accurately. Example = recall bias.
41
Q

Name 2 examples of how the concept “the dose makes the poison” is incomplete.

A
  1. A safe dose for an adult may be dangerous for an adolescent during puberty.
  2. During fetal development, there are particular points in time when chemicals have a much stronger effect.
42
Q

Define neo-sustainability, and describe its 3 premises.

A

Neo-sustainability = the ability of an activity to sustain a system by improving its quality and operating within its limits. Three premises:

  1. There are natural limits to growth (carrying capacity).
  2. Environmental concerns must be given primacy.
  3. A systems approach must be used, because the economy, society, and environment are intertwined.
43
Q

Describe RfD.

A

RfD = Reference Dose. The RfD is an estimate of the daily oral dose of a chemical that is likely to be without appreciable risk for an individual over a lifetime of exposure. The EPA uses the NOAEL for specific chemicals to establish RfD values.

44
Q

Describe cohort studies. What type of exposures and diseases are they good for studying?

A

They compare disease rates in exposed vs unexposed people, using a rate ratio.

They can be prospective or retrospective.

They are good for rare exposures and common diseases.

45
Q

Define ecological footprint.

A

Ecological footprint = the total area of land and water ecosystems that is required to produce the resources that are consumed by a population, and to deal with the wastes that are produced as a result.

Therefore, the ecological footprint approximates the area of earth needed to sustain consumption and absorb waste of a society.

46
Q

Define cluster.

A

A cluster is an apparently elevated number of cases of disease in a limited area over a short timeframe, suggesting some common cause.

47
Q

Define enzyme induction.

A

If a person is exposed to a high concentration of a xenobiotic, the body will increase production of the enzyme that metabolizes the xenobiotic. The resulting increased amount of enzyme will help the person respond to future exposures, both to the original compound and similar compounds.

48
Q

Describe information bias.

A

This occurs when information obtained about either exposure or disease is incorrect. This is most commonly caused by mismeasurement or misclassification of exposure.

49
Q

Describe effect modification.

A

This is when a third variable modifies the effect of the exposure variable of interest. It is different from confounding.

Example = if welders who also smoke are at increased risk of lung cancer (possibly because smoking damages lung epithelia, so allows the welding fumes to cause more damage than they would to a non-smoking welder).

50
Q

Name the subtypes of analytical studies.

A
  1. Cohort studies.
  2. Case-control studies.
  3. Cross-sectional studies.
51
Q

Define ecological fallacy.

A

This is a fallacy in which the nature of individuals is incorrectly inferred from the nature of the group.

52
Q

What does BPA stand for?

What is it used for?

A

Bisphenol A.

It is used for making polycarbonate plastic, which is used in making water bottles, CDs, auto parts, toys, and other things.

53
Q

What contribution does toxicology make to environmental health studies?

A

It helps provide a sense of “biological plausibility” to association studies that find a link between exposure and disease.

54
Q

Describe generalizability.

A

Generalizability (AKA external validity) is the extent to which the conclusions of a study in one population can be applied to other populations.

55
Q

Name 2 ways to estimate a person’s exposure to an environmental agent.

A
  1. Estimate their external exposure (possibly by making a job-exposure matrix).
  2. Estimate their internal exposure by analyzing a biomarker.
56
Q

Describe the Frank R. Lautenberg Chemical Safety for the 21st Century Act

A

It passed in 2016. It updated TSCA, with the following 4 improvements:

  1. Requires EPA to evaluate existing chemicals (with clear deadlines).
  2. Requires risk-based chemical assessments.
  3. Increased public transparency for chemical information.
  4. Consistent funding source for EPA to carry out these responsibilities.
57
Q

What is the major route of excretion of toxins and their metabolites?

A

Through the kidneys.

58
Q

Name 4 types of bias.

A
  1. Recall bias
  2. Selection bias (including the healthy worker effect)
  3. Confounding
  4. Information bias
59
Q

Describe etiologic studies.

A

They are another name for analytical studies.

60
Q

What do the most “famous” endocrine disrupters do?

A

They mimic estrogen. They can bind to a receptor and elicit a response, similar to endogenous estrogen would. Or, they can block normal estrogen binding to a receptor.

61
Q

Define toxicokinetics.

A

This is the process of tracking a potentially toxic compound, from the environment, into the body, through the body, all the way to its molecular site of action.

62
Q

What is the difference between observational and experimental studies?

A

Observational = the researcher did not assign exposures

Experimental = the researcher assigned exposures

63
Q

Describe the healthy worker effect.

A

It is a type of selection bias. It occurs when workers are compared to the general population. This is a problem, because workers are healthier than the general population.

64
Q

Define Contraction and Convergence.

A

Contraction and Convergence is a proposed global framework for reducing GHG emissions. The strategy consists of reducing overall GHG emissions to a safe level (contraction), resulting from every country bringing its emissions per capita to a level which is equal for all countries (convergence).

65
Q

Name the 2 main classes of epidemiological studies, and their subtypes.

A
  1. Observational

Can be Descriptive or Analytical

  1. Experimental

Can be RCT or non-randomized controlled study

A JW Env Health (11 decks)

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