Environmental Health Flashcards
Basic nursing competencies in environmental health
- Mechanisms and pathways of exposure to environmental health hazards
- Basic prevention and control strategies
- Interdisciplinary nature of effective interventions
- Role of research and advocacy
- Diagnosis, treatment and prevention of environmentally related diseases
- History taking
- Exposure assessment
- Risk communication
- Required reporting
- Advocacy
One of the primary determinants of individual and community health
Environment
Environmental health comprises…
Those aspects of human health, including quality of life, that are determined by physical, chemical, biological, and social and psychologic problems in the environment
Environmental health refers to…
The theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially adversely affect the health of present and future generations
Number of chemicals that did not exist before the 1940s that have been introduced into the environment
Tens of thousands
Publicly accessible toxicity data are not available for —– of the 3,000 high-production industrial chemicals
71%
Of the top 20 environmental pollutants that were reported to the EPA in 1997, nearly 75% were known or suspected ——-
Neurotoxins
——– pounds of pesticide products are intentionally and legally released each year in the United States
1.2 billion
More than 50% of Americans live in an area that exceeds current national ambient air quality standards for……
- Ozone
- Nitrous oxide
- Sulfuric oxide
- Particulates
Number of states that have issued one or more health advisories for mercury in their waterways
40
Number of states that have issued advisories for mercury for every lake and river within their borders
10
Number one cause of air pollution in the United States
Mobile sources (motor vehicles)
Substances found in measurable quantities in the nation’s streams
- Antibiotics
- 17-b estradiol
- Caffeine
- Acetaminophen
Number if Americans who drink water that contains contaminants which exceed one or more of the EPA safe drinking water standards
Thirty million
Common contaminants in drinking water
- Lead
- Other heavy metals
- Nitrites
- Dioxin
- Hydrocarbons
- Pesticides
- Radon
- Cyanide
Body systems in laboratory animals affected by combinations of commonly used agricultural chemicals in levels typically found in groundwater
- Immune system
- Endocrine system
- Neurological system
Thirty seven pesticides registered for use on food are…
Neurotoxic organophosphates
Radon may be responsible for 20% of ——— among non smokers
Lung cancers
Examples of endocrine disrupters
- Plasticizers
- Polychlorinated biphenyls
- Many pesticides
- Dioxins
Endocrine disrupters appear in —– of the population
95%
Dioxins mimic
Estrogens
Which diseases severity is increased by poor indoor and outdoor air quality
Asthma
Host factors that determine the relationship between environment and health
- Age
- Gender
- Genetic makeup
- Underlying diseases
- Dose-response factors
- Length of time exposed
Environmental health is based on what type of model?
Public health model with a emphasis on prevention
Preventive interventions in environmental health include:
- Pollution prevention
- Product design
- Engineering controls
- Purchasing choice
- Eduction
US environmental standards are based on health risks to…
- Healthy
- 70kg (154lb)
- White
- Male
Environmental standards may not provide sufficient protection to:
- Pregnant women and fetuses
- Young children
- Frail and elderly
- Immunocompromised
Synthetic chemicals can be found in…
- Food
- Air
- Soil
- Water
- Workplaces
- Schools
- Homes
- Communities
Synthetic chemicals can be found within ——– in measurable amounts
Human bodies
There is limited information regarding ————- associated with many of the synthetic chemicals in our environment
Human health effects
Neurotoxins account for more than ——– pounds released into air, water and land
A billion
In 1998 Consumer Reports tested leading-brand beef baby food and measured….
Dioxin levels the exceeded the EPA allowable quantities by 100 times
Several pesticides and herbicides have been linked to…..
Leukemia
Exposure to endocrine disrupters very early in life can have the potential to disrupt critical endocrine pathways with the possibility of causing adverse effects to…
- Reproductive systems
- Neurologic systems
- Immunologic systems
Risks that occur in environments where people live, work, play and learn
- Chemical
- Biologic
- Radiologic
Chemical and radiologic exposures can be…..
Cumulative
Occupational and environmental health nurses must assess a person’s —– exposure to environmental risks in order to understand and address potential health threats
Total
Very specific gestational ages can be associated with….
Exquisite vulnerability to the effects of certain toxic chemicals
Opportunities for informed decision are created by…
Information via labeling and other forms of “right to know”
Potential environmental exposures and environmentally related diseases can be assessed….
- Individually
2. Community wide basis
Individual environmental health assessments should take into account all potential exposures including….
- Home
- Workplace
- School
- Community
National Library of Medicine’s resource that provides easily accessible, peer reviewed information about the potential health hazards in our environments
ToxTown
ToxTown covers a broad range of information about health risks associated with…
- Factories
- Farms
- Homes
- Offices
- Schools
- Drinking water
- Recreational water
- Pests
- Vehicles
- Hazardous waste sites
- Airplanes
- Construction
- EMFs (electric and magnetic fields)
Within ToxTown there is a database of likely chemical exposures associated with….
An extensive list of specific job categories
Household product information found on www.household.nlm.nih.gov
- Auto products
- Landscape/yard
- Home maintenance
- Pet care
- Arts and crafts
- Personal care
- Cleaning products
———- provides high quality information regarding children’s exposures; their e-house website specifically provides information about home related environmental health risks
The Children’s Health and Environment Coalition
The EPA website provides…
A range of environmental exposure information
EnvironFacts
EPA website that provides geographically related information
EnviroMapper
EPA website provides air, water and hazardous waste site information by location/region
The Children’s Environmental Health Network
Website that has developed a health assessment tool for children
EnviRN
- University of Maryland’s website
- Has a home assessment survey that includes information about the health implications of environmental exposures
Agency of Toxic Substances and Disease Registry
- agency within the CDC
- created ToxFacts
ToxFacts
Provides excellent toxicological information on chemicals that are commonly associated with environmental health risks
Community environmental health assessments identify potential exposures in
- Water (including drinking water)
- Air (including indoor air)
- Dust (including lead based paint particles)
- Soil (including exposures from current and previous land use)
- Radiation (ionizing and nonionizing)
Environmental assessments may depend on extrapolating from…
Aggregate national, statewide, county or metropolitan exposure data
Geographic information system (GIS)
- A method for assessing community risks to environmental exposures and potential health problems
- consists of computerized mapping of graphically related data
- environmental and exposure data can be entered and evaluated for geographic relationships
- data can be presented in map form
Sources of more information on GIS
- www.gisportal.com
- Agency for Toxic Substances and Disease Registry
- Geography departments in universities
Essential competences for environmental health assessments
Knowledge of:
- Federal, state and local health and environmental statues and regulations
- Practices regarding what data are collected and how they are accessed
Principle sciences used to determine the relationship between environmental exposures and health outcomes
Epidemiology and toxicology
Environmental epidemiology
Uses epidemiologic techniques to examine environmental exposures
Study design of choice in environmental health
Analytical studies (cohort and case control)
Type of study rarely done in environmental health
Experimental
Because it is unethical to intentionally expose individuals or communities to environmental hazards
Cluster investigations are often used to…
Respond to community concerns about an excess of cancer or birth defects
Common results of cluster investigations
Negative or equivocal results
Cluster investigations are most convincing when….
The disease in question is rare and very specific for the putative etiologic exposure
Example of a disease that a cluster investigation would be useful
Asbestos causing mesothelioma
Limitations of environmental epidemiology
- Exposures often poorly defined and measured
- A very limited understanding of mixed exposures
- Relatively small number of individuals constitute the study populations
- Lack of understanding about variability in the susceptibility of segments of the populations
- Long latency between many environmental exposures and the evidence of chronic disease
Most common type of environmental exposure
Mixed exposure
Why is small study population a limitation of environmental epidemiology
Small study populations yield limited statistical power to detect an association between exposures of concern and health effects
Segments of population that could have variable susceptibility rates
- The poor
- Children
- Elderly
Why is lack of understanding about variability of susceptibility in a population a limitation of environmental epidemiology
It limits the ability to compare findings across studies
Environmental toxicology
The science that examines the toxic effects of agents in the environment
Toxicology
The science that investigates the adverse affects of chemicals on health
Toxicology is similar to…
Pharmacology
The effects of hazardous chemicals can be…
- Immediate (acute)
- Long term
- Present after a latency period
Effect of hazardous chemicals often associated with presentation after a latency period
Cancer
Host factors that must be considered when looking at hazardous chemicals
- Age
- Sex
- Genetics
- Weight
- Drugs that a person may be taking
- Pregnancy status
Host factors may affect….
The therapeutic or toxic effect of a drug or chemical
Hazardous chemical exposures are often….
Involuntary
Pharmacology
Scientific study of the origin, nature, chemistry, effects and use of drugs
Toxicology
Science that investigates the adverse effects of chemicals on health
Definition of dose in pharmacology
Refers to the amount of a drug absorbed from an administration
Definition of dose in toxicology
Refers to the amount of a chemical absorbed into the body from a chemical exposure
Definition of administration in pharmacology
A drug can be administered:
- One time
- Short term
- Long term
Definition of exposure in toxicology
The actual contact that a person has with a chemical
Can be:
- One time
- Short term
- Long term
Dose-response curve in pharmacology
Graphically represents the relationship between the dose of a drug and the response elicited
Dose-response curve in toxicology
Describes the relationship of the body’s response to different amounts of an agent such as a drug or toxin
Routes of administration in pharmacology
- Oral
- Intramuscular
- Intravenous
- Subcutaneous
- Dermal
- Topical
Routes of entry in toxicology
- Ingestion
- Inhalation
- Dermal absorption
In pharmacology with drugs there are ——- (desirable effects) and —– (undesirable effects)
Therapeutic responses
Side effects