Environmental Health

Question 1

What are the top three causes of death in the US

Answer 1

1. Heart disease
2. Cancer
3. Stroke

Chronic disease is the #1 killer in the US

7 is DM (overweight/obese and arthritis also contribute)

Question 2

what is the # 1 cause of disability in the US

Answer 2

arthritis

Question 3

what isthe #1 preventable cause of death in the US

Answer 3

tobacco use

Question 4

what are other diseases with significant burden of death/disability/poor quality of life

Answer 4

Metabolic Syndrome
Cerebrovascular disease
Neurocognitive disease
Immune dysfunction (autoimmune disease)

Question 5

what are underutilized early detection/prevention practices

Answer 5

• mammograms - 22% women 50+ havent had one in the past 2 years
• Colorectal CA screening - adults 50+ 37% have never had a colonoscopy and 83% havent had one in last 3 years

Question 6

How prevelant is lack of access to healthcare in WV

Answer 6

• About 20% of WV adults had no PCP
• About 15% could not afford medical care
• 9% of WV adults had no insurance at all

Question 7

what are some ways humans come into contact w toxic substances

Answer 7

• The food chain
• Polluted water
• Airborne exposure
• Dermal exposure

Question 8

how much does modifiable factors account for global burden of disease and deaths

Answer 8

• 24% of global burden of disease
• 23% of global deaths

Question 9

what pathways do many pollutants induce?

Answer 9

signlaing pathways that are sensitive to oxidative stress

Question 10

what are common cancer causing agents

Answer 10

• radon
• asbestos
• benzene
• coal
• soot
• smoke
• arsenic
• triclosan

cause CA by Increasing inflamm, impair immune, decrease cell repair

alter DNA and gene expression, stimulate rapid cell growth

Question 11

what chemical exposures can cause obesity, metabolic syndrome, and diabetes

Answer 11

• herbicide
• triclosan
• flame retardnats
• stain repellents
• nonstick compounds
• DDT

interfere w thyroid, mimic hormones, xenobiotic release, panreatic stres

others include arsenic and cadmium

Question 12

what exposure can contribute to vascular disease

Answer 12

toxic metals which cause oxidative stress

strong connection w develpement and progression of vascular diseases

Question 12

what exposure can cause neurocognitive impairment

Answer 12

• herbicides
• pesticides
• heavy metals
• triclosan
• teflon
• DDT

immediate SE: aggression, learning disorders, attention disorders
delayed SE → increased disposition to Parkinson’s disease, Alzheimer’s disease

Question 13

what exposure can cause endocrine disruption

Answer 13

• pesticides
• toxic metals

chemical interfere w hormone signals to various organ systems

Question 14

what is acceptable daily intake, who refulates it?

Answer 14

• daily intake of a chemical that appears to be associated with minimal to no risk over lifetime
• FDA and dept of agriculture regulated

Question 15

what is a hazard

Answer 15

ability of agent to cause injury

Question 16

what is risk

Answer 16

frequency of undesirable occureence after exposure

Question 17

what is route of exposure? give examples

Answer 17

• Industrial - inhalation, transdermal
• Atmospheric - inhalation, transdermal
• Water/Soil - inhalation, ingestion, dermal contact

Question 18

what is acute v chronic exposure

Answer 18

• acute - single or multiple over a brief period (seconds to 1-2 days)
• chronic - multiple exposures over a longer period of time

Question 19

what is bioaccumulation

Answer 19

intake of contaminant > ability to excrete or metabolize

Question 20

what is biomagnification

Answer 20

increased concentration of a given contaminant as it goes up food chain

Question 21

what is persistence

Answer 21

resist environmental, often animal metabolic breakdown

Question 22

what is toxicity

Answer 22

rating based on repeated exposures which result in human or environmental adverse outcomes

Question 23

what is CO as a pollutant

what are s/s of poisoning and tx

Answer 23

• colorless, tasteless, odorless, nonirritating pollutant that combines w O2 sites of hb
• s/s - headache, nausea, dizzy, LOC
• tx - removal from source, admin O2 within limits of O2 toxicity

Question 24

what are common sources of CO

Answer 24

Question 25

what is sulfur dioxide | what are s/s and tx

Answer 25

* colorless irritant gas that forms sulfiric acid on contact w mucous membranes * s/s - irritant to eyes, mucous membranes, skin and resp tract (eye/nasal drainage w bronchospasm) * chronic low level exposure = chronic cardiopulm disease * tx - symptomatic

Question 26

what is nitrogen dioxide | include s/s and tx

Answer 26

* brownish irritant gas * s/s - eye/nose irritation, cough, frothy sputum, dyspnea, chest pain * can cause pulm edema, subacute inflamm, chronic lung disease * tx - symptomatic, management of pulm edema and iritation

Question 27

what is ozone | include s/s and tx

Answer 27

* bluish irritant gas, occuring normally in atmosphere but in high conc w electrical equiptment, air/water purifiers and polluted urban air * s/s - irritates mucous membranes. mild - upper resp inflamm. moderate - deep lung irritation, pulm edema. severe - morphologic/functional resp tract changes * tx - symptomsatic

Question 28

what are halogenated aliphatic hydrocarbons | include s/s

Answer 28

* formerly widely used industrial solvent/cleaning agent * still used for dry cleaning * s/s - CNS depression, liver/kidney injury, cardiotoxicity, carcinogenic. * chronic - impaired memory and periphaerl neuropathy | "chlorophorm"

Question 29

what are the three aromatic hydrocarbons and each of their s/s

Answer 29

* benzene - acute is CNS depression, chronic is bone marrow disease * toulene - CNS depression, skin/eye irritant, fetotoxic * xylene - CNS depressent and skin irritant

Question 30

what are the very widely used versions of benzene

Answer 30

* combustion - volcanoes, forest fires, gasoline, tobacco smoke * common liquids - dyes, detergents, pesticides, cleaning products, paint strippers, adhesives * common solids - plastics, resins, synthetic fibers, rubber lubricants, pharmaceutical solvent

Question 31

what are organochlorines | include s/s

Answer 31

* numerous compounds including DDT (most abandoned but DDT still used for mosquito elimination in africa) * s/s - CNS stimulation, tremor, convulsions. Chronic - enhanced tumor formation.

Question 32

what are organophosphates | s/s and tx

Answer 32

* pesticides that can be used as antiparasitics * acetylcholinesterase inhibition → acetylcholine accumulation → cholinergic activity * s/s - dyspnea, lacrimation, confusion, fasciculations, progressive demyelination of longest nerves * acute - symptomatic O2, airway maintenance * no tx for delayed neurotoxicity ## Footnote some contain neuropathy target esterase

Question 33

what are bipryidyls | s/s and tx

Answer 33

Question 34

what are chlorophenoxy herbecides | s/s

Answer 34

* agent orange pesticide * large doses = coma, weakness, hypotonia * liver/kidney dysfunction * non-hodgkins lymphoma

Question 35

what is glyphosate

Answer 35

Question 36

what is the main source of lead? what are other sources? how is it acquired into the body

Answer 36

Question 37

what are s/s of lead toxicity . what are the tx | neuro, CV, renal, heme, onc, other

Answer 37

Question 38

what is mercury and where is it acquired

Answer 38

Question 39

what are s/s of mercury? what is the tx?

Answer 39

Question 40

what is arsenic and where is it acquired?

Answer 40

Question 41

what are s/s of arsenic poisoning and what is the tx

Answer 41

Question 42

what is polychlorinated biphenyls and what are the s/s

Answer 42

Question 43

what are brominated flame retardants and how do they cause harm?

Answer 43

Question 44

what are perflourinated compounds and where are they found? what are the s/s

Answer 44

Question 44

where is asbestos found? what is its effects

Answer 44

Question 45

what are the 7 potential endocrine disrupter groups

Answer 45