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Community medicine > Environmental health > Flashcards

Environmental health Flashcards

1
Q

What percentage of deaths and total disease burden globally can be attributed to environmental factors?

A

25%

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2
Q

What are the leading environmental contributors to global burden of disease?

A
  • Unimproved water and sanitation
  • Ambient air pollution
  • Indoorpollution from solid fuels
  • Lead expsoure
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3
Q

Why are preventable environmental diseases disproprtionately higher in developing countries?

A
  • Lack of modern technology
  • Weak protective environmental laws and regulations
  • A lack of awareness
  • Poverty
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4
Q

Define

Environmental health

A

The theory and practice of assessing, correcting, controlling, and preventing factors in the environment that can potentially adversely affect the health of present and future generations

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5
Q

What are the “factors in the environment” targeted by environmental health science?

A

Pollutants, toxicants, hazards in the air, water, soil, or food that human activities produce

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6
Q

How are factors in the environment transferred to humans?

A
  • Inhalation
  • Ingestion
  • Absorption (exposure)
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7
Q

What are the basic requirements for a healthy environment?

A
  • Clean air
  • Safe and sufficient water
  • Safe and adequate food
  • Safe and peaceful settlements
  • Stable global environment
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8
Q

What day of the year is designated as World Environment Day?

A

June 5

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9
Q

Define

Hazards
| (in environmental health)

A

Things in the environment that are harmful, including chemicals, disease-causing bacteria, loud noises, or stress

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10
Q

What are hazards of the environment?

A

Chemical

  • Air pollutants
  • Toxic wastes
  • Pesticides
  • Volatile organic compounds (VOCs)

Biological

  • Disease organisms present in food and water
  • Insect and animal allergens

Physical

  • Noise
  • Ionizing and non-ionizing radiation

Socioeconomic

  • Access to safe and sufficient healthcare
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11
Q

What are the routes of exposure to environmental hazards?

A
  • Air: via the lungs
  • Water: via the GI tract or the skin
  • Soil: via the GI tract or the skin
  • Food: via the GI tract
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12
Q

What are examples of manifestations of adverse effects due to environmental hazards?

A
  • Lung disease
  • Reproductive effects
  • Teratogenic effects
  • Neurologic effects
  • Immunosuprression or hypersensitivity
  • Cancer
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13
Q

Who are the vulnerable groups in environmental health?

A
  • People of a low socioeconomic status
  • Women
  • Children
  • The elderly
  • Ethnic minorities
  • People with disabilities
  • Indigenous peoples
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14
Q

What characteristics are present in vulnerable groups in environmental health?

A
  • More susceptible due to genetics, or
  • Not empowered to change their environment
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15
Q

What is the triad of disease, in which environment plays a role?

A
  • Intrinsic genetic factors
  • Environmental exposure
  • Age/time
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16
Q

What are the steps of the problem solving paradigm?

A

Risk assessment

  1. Define the problem
  2. Measure its magnitude
  3. Understand its key determinants

Risk management

  1. Develop intervention/prevention strategies
  2. Set policy/priorities
  3. Implement and evaluate
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17
Q

What are the three models of improving human health in relation to the environment?

A
  • Clinical intervention model: intervenes after the disease is established to prevent death
  • Public health intervention model: prevents the environmental factor from causing disease in those exposed
  • Environmental stewardship model: changes the human effects on the environment to prevent exposure to hazards
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18
Q

What are the characteristics of a first choice control method?

A
  • The most effective
  • Easiest to implement
  • Produces the largest benefits at the lowest cost
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19
Q

What are the 6 themes of environmental health, per Healthy People 2020?

A
  1. Outdoor air quality
  2. Surface and ground water quality
  3. Toxic substances and hazardous wastes
  4. Homes and communities
  5. Infrastructure and surveillance
  6. Global environmental health
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20
Q

Define

Environmental justice

A

The principle that everyone has the right to live in an environment that doesn’t make them sick, regardless of their race, culture, or income

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21
Q

What was the main outcome of COP26 (2021)?

A

World leaders promised to end deforestation by 2030 and reduce carbon emissions by 30% by 2030 (compared to 2020 levels)

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22
Q

Which form of pollution is the deadliest?

A

Air pollution

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23
Q

What are the four deadliest threats to human health?

A
  1. High blood pressure
  2. Dietary risks
  3. Smoking
  4. Air pollution
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24
Q

How many deaths occur per year as a result of exposure to ambient pollution?

A

4.2 million deaths

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25
Q

How many deaths occur per year as a result of household exposure to smoke from cookstoves and fuels?

A

3.8 million deaths

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26
Q

What percentage of annual global deaths can be attributed to air pollution?

A

11.6%

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27
Q

What is an illness that has been shown to be exacerbated by air pollution?

A

COVID-19

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28
Q

Which regions of the earth are most affected by air pollution?

A
  • Africa
  • Eastern Europe
  • India
  • China
  • Middle East
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29
Q

Deaths due to which illnesses have been linked to a lack of access to clean cooking fuels?

A
  • Ischemic heart disease
  • Stroke
  • COPD
  • Acute lower respiratory infections
  • Lung cancer
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30
Q

Define

Air pollution

A

What occurs when gases, dust particles, fumes, smoke, or odors are introduced into the atmosphere in a way that makes it harmful to humans, animals, and plants

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31
Q

Define

Air pollutant

A

An airborne gas, particle, or aerosol that is added to the atmosphere by natural events or human activities in concentrations that threaten the well-being of organisms or disrupt the orderly functioning of the environment

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32
Q

Define

Primary air pollutant

A

Pollutants that cause pollution when emitted directly into the atmosphere

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33
Q

Define

Secondary air pollutant

A

Pollutants that are created by chemical reactions between primary air pollutants in the atmosphere, sometimes involving sunlight or a catalyst

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34
Q

What are examples of primary air pollutants?

A
  • CO
  • CO2
  • SO2
  • NO
  • NO2
  • Most hydrocarbons
  • Most particulates
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35
Q

What are examples of secondary air pollutants?

A
  • HNO2
  • HNO3
  • H2O2
  • SO3
  • H2SO4
  • Peroxyacyl nitrates (PANs)
  • O3
  • Most salts of NO3– and SO42+
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36
Q

Which air pollutants are the most common?

A
  • Oxides of carbon
  • Volatile organic compounds (VOCs)
  • Oxides of nitrogen
  • Sulfur compounds
  • Photochemical smog
  • Suspended particulates (aerosols)
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37
Q

What are the pollutant oxides of carbon?

A
  • Carbon dioxide
  • Carbon monoxide
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38
Q

How is CO2 a pollutant?

A
  • It is an asphyxiant
  • It is a greenhouse gas (contributing to global warming)
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39
Q

How is CO2 produced?

A
  • Production from oxidation of hydrocarbons (by burning fossil fuels, solid waste, trees, etc.)
  • It is the fourth most common naturally occuring gas in the atmosphere
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40
Q

How is CO produced?

A

Incomplete combustion of fossil fuels

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41
Q

How is CO a pollutant?

A

It is toxic in low concentrations

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42
Q

What are the pollutant VOCs?

A
  • Methane
  • Benzene
  • Tetrachloroethylene
  • Gasoline
  • Formaldehyde
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43
Q

How is methane produced?

A

Natural sources

  • Marshes
  • Ruminant animals
  • Rice paddies
  • Trees

Human contribution

  • Livestock manure and agricultural practices
  • Decay of organic waste in landfills
  • Production of coal and natural gas
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44
Q

How are pollutant VOCs other than methane produced?

A

Produced by the chemical industry for use as

  • solvents,
  • paint components, and
  • cleaning agents
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45
Q

How are VOCs pollutants?

A
  • They may form secondary pollutants (photochemical smog) that can irritate the eyes and damage the respiratory system
  • Methane is a greenhouse gas
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46
Q

What are the pollutant oxides of nitrogen?

A
  • Nitric oxide (NO)
  • Nitrous oxide (N2O)
  • Nitrogen dioxide (NO2)
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47
Q

How is NO produced?

A

Soil microbes

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48
Q

How is N2O produced?

A

Natural and man-made sources (used as an anesthetic)

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49
Q

How is NO2 produced?

A
  • Formed by the combination of NO and O2 in the atmosphere
  • Formed in automobile engines and electrical generating plants
50
Q

How is NO2 a pollutant?

A
  • Contributes to heart, lung, liver, and kidney diseases at high concentration
  • Responsible for brownish haze (photochemical smog)
  • Forms nitric acid in rainwater (acid rain)
51
Q

How is N2O a pollutant?

A

It is a greenhouse gas

52
Q

What are the pollutant sulfur compounds?

A
  • Sulfur oxides (SO2, SO, SO4)
  • Hydrogen sulfide (H2S)
53
Q

How are oxides of sulfur produced?

A
  • Volcanoes
  • Sea spray
  • Combustion of fossil fuels (primarily coal)
54
Q

How are oxides of sulfur pollutants?

A
  • Irritate respiratory passages (SO2)
  • Form acidic aerosols
  • Form acid rain (SO3, SO4)
  • Damage lakes, forests, steel, and stone structures
55
Q

How is hydrogen sulfide produced?

A

Anaerobic respiration of some microorganisms

56
Q

How is hydrogen sulfide a pollutant?

A
  • Highly toxic (irritates the eyes and is an asphyxiant)
  • Extremely flammable
57
Q

How is photochemical smog produced?

A

Formed in bright sunlight from:

  • Nitrogen oxides
  • VOCs
  • Oxygen
58
Q

What is produced in photochemical smog?

A

Secondary pollutants like ozone and peroxyacyl nitrates (PANs) that are powerful oxidants

59
Q

How is photochemical smog a pollutant?

A

The secondary pollutants are responsible for eye irritation and lowering visibility

60
Q

What are the two relevant types of ozone?

A
  • Tropospheric ozone
  • Stratospheric ozone
61
Q

How is tropospheric ozone produced?

A

A secondary air pollutant made from man-made primary pollutant reactions

62
Q

Which form of ozone is a pollutant, and how is it a pollutant?

A

Tropospheric ozone; it is a component of harmful photochemical smog

63
Q

What is the role of stratospheric ozone in the atmosphere?

A
  • It screens out UV radiation in the upper atmosphere
  • Man-made pollutants (e.g. CFCs) can destroy it
64
Q

What is particulate matter?

A

Different solid or liquid particles suspended in the air, including

  • Dust
  • Fungal spores
  • Ammonia
  • Sodium chloride
  • Lead
  • Asbestos
  • Black carbon (soot)
  • Soil particles
  • Sulfuric acid droplets
65
Q

Which air pollutant is the most damaging to human health?

A

Particulate matter

66
Q

Which form of particulate matter is the most harmful?

A

Those with a diameter of 10 µm or less (≤PM10), as they can penetrate and lodge deep inside the lungs

67
Q

What are the illnesses that may result from chronic exposure to particulate matter?

A

Cardiovascular and respiratory disease (including lung cancer)

68
Q

What are the three sectors of human activity that contribute most to air pollution?

A
  • Transportation (57%)
  • Power plants
  • Other industrial activity
69
Q

What are the negative effects of global warming?

A
  • Melting of polar ice caps
  • Rise in sea levels
  • Unnatural patterns of rain (e.g. flash floods, excessive snow, desertification, drought)
  • Shift of seasons and typical weather conditions
  • Occurrence of new diseases
70
Q

How much has the earth’s surface temperature increased in the past century?

71
Q

What are the top 5 countries that contribute to CO2 emissions?

A
  • China
  • United States
  • India
  • Russian federation
  • Japan
72
Q

What are the main greenhouse gases?

A
  • Carbon dioxide
  • Methane
  • Nitrous oxide
73
Q

Which gases contribute most to acid deposition?

A
  • Sulfur dioxide
  • Nitrogen dioxide
74
Q

Define

Acid deposition

A

The phenomenon of sulfur dioxide and nitrogen dioxide emissions reacting with water vapor in the atmosphere to form acids that return to the surface as either dry or wet deposition

75
Q

What are the effects of acid deposition?

A
  • Declining aquatic animal populations
  • Damage to lakes and streams
  • Thin-shelled eggs, preventing bird reproduction
  • Damage to buildings and objects
  • Decline in forests
76
Q

What are the agricultural effects of air pollution?

A
  • Change in fertility of the soil in parts of the earth
  • Negative effects on the growth of plants
77
Q

What are common indoor air pollutants?

A
  • Tobacco smoke
  • Biological pollutants (allergens like pollen, pet hair, fungal spores, bacteria)
  • Radon (naturally emitted from the ground)
  • Carbon monoxide (from incomplete burning of gas, kerosene, coal, wood with improper ventilation)
78
Q

How can air pollution be solved?

A
  • Technological solutions: cars and factories with fever emissions; renewable energy
  • Laws and regulations on emissions
  • Raising awareness and changing human behavior
79
Q

What is the issue with the informal labor sector?

A

Employees have no social protections for seeking healthcare, and there is a lack of regulatory enforcement of occupational health and safety

80
Q

What percentage of workers in small workplaces, the informal sector, agriculture, and migrants do not have any occupational health coverage?

81
Q

What are the benefits to employers of having workplace health initiatives?

A
  • Reduced absenteeism
  • Reduced healthcare costs (resulting from injuries, etc.)
82
Q

How much of the world’s GDP is lost due to work-related illnesses and injuries?

83
Q

What chronic illnesses or conditions are associated with the workplace?

A
  • Back pain
  • Hearing loss
  • COPD
  • Asthma
  • Lung cancer
  • Injuries
  • Depression
  • Leukemia
84
Q

Which chronic illness or condition has the highest association with the workplace?

85
Q

Define

Occupational health

A

The promotion and maintenance of the highest degree of physical, mental, and social well-being of workers in all occupations by preventing departures from health, controlling risks, and the adaptation of both work to people, and people to their jobs (ILO/WHO)

86
Q

What are the disciplines included under occupational health?

A
  • Occupational medicine
  • Nursing
  • Ergonomics
  • Psychology
  • Hygiene
  • Safety
87
Q

Who gave the first written discussions of occupational health and safety?

A

Paracelsus (Swiss; “father of toxicology”)

88
Q

What was the first book on occupational medicine? Who wrote it?

A
  • De morbis artificium diatribe (Diseases of Workers)
  • Bernadino Ramazzini, an Italian physician (1700)
89
Q

Who was the leader of the occupational medicine movement in the US?

A

Alice Hamilton (early 20th century)

90
Q

Define

Hazard
| (in occupational health)

A

Something that can cause harm if not controlled

91
Q

Define

Outcome

(in occupational health)

A

The harm that results from an uncontrolled hazard

92
Q

Define

Risk
| (in occupational health)

A

A combination of the probability that an outcome will occur with the severity of the harm involved

93
Q

What are common mechanical hazards, by type of agent?

A
  • Falling down from a height
  • Confined spaces
  • Impact force
  • Slips and trips
  • Falling on a pointed object
  • Compressed air/high pressure
  • Entanglement
  • Equipment-related injury
94
Q

What are common mechanical hazards, by type of damage?

A
  • Crushing
  • Cutting
  • Friction and abrasion
  • Shearing
  • Stabbing
  • Puncture
95
Q

What are common physical hazards?

A
  • Noise
  • Vibration
  • Barotrauma (hypobaric/hyperbaric pressure)
  • Ionizing radiation
  • Electricity
  • Asphyxiation
  • Cold stress (hypothermia)
  • Heat stress (hyperthermia)
96
Q

What are common biological hazards?

A
  • Bacterial infection
  • Viral infection
  • Fungal infection
97
Q

What are common chemical hazards?

A
  • Acids
  • Bases
  • Heavy metals
  • Solvents
  • Particulates: fumes (gases/vapors); silica particles (causing pneumoconiosis)
  • Highly reactive chemicals that cause fire/explosion
98
Q

What are psychosocial hazards?

A
  • Work-related stress, including overworking
  • Violence from outside the organization (e.g. from customers)
  • Bullying, including emotional and verbal abuse, within the organization
  • Sexual harassment
  • Burnout
  • Exposure to unhealthy elements from other people, e.g. tobacco, uncontrolled alcohol
99
Q

What is pneumoconiosis?

A

Inhalation of dust causes intersitial fibrosis due to inadequate use of PPE

100
Q

What are common causes of pneumoconiosis?

A
  • Asbestos
  • Silica (rock and sand dust)
  • Coal dust
101
Q

In which industries is pneumoconiosis particularly prominent?

A
  • Mining
  • Sand blasting
  • Textile industry
  • Ship repair
102
Q

How can musculoskeletal disorders of the workplace be prevented?

A

Good ergonomic design and training

103
Q

What are the workplace hazards that affect healthcare workers especially?

A
  • Biological: TB, SARS, HIV/AIDS, COVID-19, hepatitis, change in normal flora
  • Chemical: glutaraldehyde, ethylene oxide
  • Physical: noise, radiation, slips, trips, and falls, lack of exposure to sunlight
  • Ergonomic: heavy lifting, ischemic heart disease and hypertension from sedentary lifestyle
  • Psychosocial: long shifts, violence, stress, poor work–life balance, fear of legal repercussions
  • Fire and explosions related to use of oxygen, alcohol sanitizers
  • Electrical hazards
104
Q

What is an occupational hazard that a mailman might encounter?

A

Being attacked by a dog
| (it’s stupid but it was in the video, okay)

105
Q

Define

Biological hazard (biohazard)

A

A biological substance that threatens the health of humans and other living organisms

106
Q

Define

Physical hazard

A

A factor, agent, or circumstance that can cause harm with or without contact

107
Q

How many people become sick or die from contaminated food every year?

A
  • 600 million become sick
  • 420,000 die
108
Q

What are the types of contaminants in food safety?

A
  • Biological: bacteria, viruses, parasites, fungi, biological toxins, prions
  • Chemicals: heavy metals (e.g. Pb), detergents, polychlorinated biphenyls (PCBs)
  • Physical: plastic, stones, glass
109
Q

What are the steps of the food supply chain?

A
  • Production
  • Processing
  • Distribution
  • Preparation
110
Q

Where along the food supply chain may contamination occur?

A

At any of the four steps

111
Q

How can contamination occur at the production phase of the food supply chain?

A
  • Infection of animals and their products, e.g. trichinella, salmonella
  • Contamination of water used to irrigate plants or raise animals
  • Inappropriate use of pesticides
112
Q

How can contamination occur at the processing phase of the food supply chain?

A
  • Cross contamination during slaughter of animals (e.g. from GI tract to the meat)
  • Physical, chemical, or pathogenic contaminants on unclean surfaces
  • Food adulteration to make it more appealing or make it last longer
113
Q

How can contamination occur at the distribution phase of the food supply chain?

A
  • Unclean/unsafe storage
  • Pests contaminating food
  • Poor temperature control
114
Q

How can contamination occur at the preparation phase of the food supply chain?

A
  • Poor personal hygiene
  • Cross contamination (e.g. using the same knife to cut raw chicken and to cut vegetables)
  • Poor temperature of cooking
  • Sick food handlers
115
Q

How, other than contamination, can food be unsafe?

A
  • Mislabelling: may lead to consumption of food by someone allergic to it
  • Consumption past the expiration date
116
Q

What are the effects of consuming food with biological contaminants?

A
  • Commonly: fever, abdominal pain, nausea/vomiting, diarrhea
  • Complications: kidney failure, arthritis, miscarriage
  • Toxins: paralysis, cancer
  • Prions: neurodegenerative disease
117
Q

What are the effects of consuming food with chemical contaminants?

118
Q

What are the effects of consuming food with physical contaminants?

A
  • Direct injury
  • Facilitate entry of other contaminants
119
Q

What groups of people are at higher risk of adverse effects from contaminated food?

A
  • The elderly
  • Children
  • Pregnant women
  • Immunocompromised persons
120
Q

How can the risks of unsafe food be prevented?

A
  • At global level: WHO and FAO (Food and Agriculture Organization) publish Codex alimentarius; INFOSAN
  • National: food codes and standards, surveillance and management of outbreaks
  • Business: complicance with standards, quality assurance, training, management systems
  • Individual: practicing good hygiene, separating raw and cooked food, cooking thoroughly, safe temperature, safe water

Community medicine (7 decks)

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