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2025 PHPM Royal College Study - based on AN Summary Notes > EPH - DW cont'd, indoor air, radon > Flashcards

EPH - DW cont'd, indoor air, radon Flashcards

1
Q

what are small drinking water systems (1)

A

1- water not supplied from municipal source (e.g. private well or cistern)

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2
Q

what percentage of Canadian homes have small drinking water systems (1)

A

1- 14%

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3
Q

what percentage of Canadian homes that have small drinking water systems get their water regularly tested (1)

A

1- <30%

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4
Q

what are some barriers to routine sampling of small drinking water systems (3)

A

1- inconvenience
2- cost
3- lack of time

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5
Q

what are factors that affect well water quality

‘well factors’ - DHQD
‘local environment’ - ALMNS

(9)

A

1- Depth of well (dug versus drilled well)
2- Amount of new water flowing into the area
3- Local land use activities (e.g., livestock,
pesticides, gasoline storage tanks)
4- Meteorological factors (e.g., heavy rains)
5- Natural quality of surrounding soil
6- Surface water infiltration
7- Well and local hydrogeology
8- Quality of the well-head construction
9- Distance from sources of contamination

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6
Q

how can you mitigate risk of contamination of small drinking water systems (e.g. well) - PMMT (4)

A

1- Protect source
2- Maintenance
3- Monitor
4- Treat

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7
Q

re: mitigating risk of contamination of small drinking water systems, what does ‘protect source’ entail (1)

A

1- Protect source: minimum distances between wells and possible sources of contaminants (e.g.
livestock, fertilizer storage)

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8
Q

re: mitigating risk of contamination of small drinking water systems, what does ‘maintain’ entail (1)

A

1- Maintain: regular maintenance schedule, keep
up-to-date records

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9
Q

re: mitigating risk of contamination of small drinking water systems, what does ‘monitor’ entail - what is the timeline - BM (2)

A

1- Monitor: regular testing for bacteria q4 months
2- testing for minerals q2 years

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10
Q

re: mitigating risk of contamination of small drinking water systems, what does ‘treat’ entail (1)

A

1- Treat: treat water with a disinfection system if
lab results show unacceptable levels

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11
Q

what is community water fluoridation (CWF) (1)

A

1- monitoring fluoride level in drinking water to optimal level for dental caries prevention

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12
Q

re: CWF, what are health benefits of fluoridation - PDR (3)

A

1- de-min - inhibits tooth demineralization
2- re-min - enhances re-mineralization
3- plaque - inhibits enzyme activity
of plaque bacteria

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13
Q

re: CWF, what are potential harms of fluoridation - DSI (3)

A

1- dental fluorosis
2- skeletal fluorosis
3- IARC Group 3 (not classifiable as to its carcinogenicity to humans)

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14
Q

re: CWF, what is the maximum acceptable concentration (MAC) of fluoride (1)

A

1- MAC of 1.5
mg/L, based on prevention of moderate dental fluorosis (which is re: cosmetic effect, not health impact)

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15
Q

what are ethical principles supporting CWF - no specific framework - HES (3)

A

1- Harm: public health benefit outweighs individual harms of excess fluoride exposure
2- Equity: benefits for low income children
3- Solidarity: considering the needs of the greater community over individual interest

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16
Q

what are ethical principles against CWF - no specific framework - AL (2)

A

1- Autonomy: removes individual choice
2- Least restrictive means: fluoride available in
other forms (benefit is best topically than systemically absorbed)

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17
Q

re: CWF, what are risk mitigation measures that can be taken for fluoride harms - TSW (3)

A

1- Do not use fluoridated toothpaste in children
2- Do not use fluoride supplements
3- Do not use fluoridated water with baby formula

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18
Q

what are sources of indoor air contaminants - simple/general answer (2)

A

1- outdoor pollutants
2- indoor pollutants

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19
Q

how do outdoor air pollutants enter indoor air supply (2)

A

1- enter through infiltration
2- natural or mechanical ventilation from outside

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20
Q

where does most exposure to outdoor pollutants happen (1)

A

1- Most exposure to ‘outdoor’ pollutants occurs indoors given duration of time spent inside

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21
Q

how do indoor air pollutants enter indoor air supply (1)

A

1- through indoor combustion of fuel or product residue

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22
Q

IAQ: what are sources of particulate matter - I (1)

A

1- Indoor combustion of solid fuels

23
Q

what are sources of NOx and CO - ZHCG (4)

A

1- Combustion equipment in ice arenas (Zambonis)
2- Heating - gas or wood fireplaces, stoves, furnaces
3- Cooking - electric or gas stove
4- Attached garage

24
Q

what are sources of VOCs - CFCAS (5)

A

1- Copy machines
2- Furniture and cabinets
3- Cleaning products, carpets
4- Adhesives
5- Solvents and paints

25
Q

what are sources of ground-level ozone - PEE (3)

A

1- Photocopiers
2- Electric motors
3- Electrostatic air cleaners

26
Q

what are sources of formaldehyde - CFP (3)

A

1- Furnishings
2- Carpets
3- Plywood/particle board

27
Q

what are sources of dust mites - CF (2)

A

1- Carpets
2- Foam chair cushions

28
Q

what are sources of mould - CW (2)

A

1- Condensation due to excessive humidity (think damp places like showers or basements)
2- Water leakage

29
Q

what are common symptoms of indoor air issues - DHF-DNS-CHS (9)

A

1- Dryness and irritation of eyes/nose/throat/skin
2- Headache
3- fatigue
4- dizziness
5- nausea
6- Shortness of breath
7- coughing and sneezing
8- Hypersensitivity and allergies
9- sinus congestion

30
Q

what is legislation regarding residential indoor air quality (1)

A

1- no specific legislation given the high variability between homes and difficulty that would ensue with numerical compliance of a single standard - however Guidelines are available

31
Q

who sets legislation regarding workplace indoor air quality (1)

A

1- Ministry of Labour sets industrial workplace targets for worker exposure

32
Q

what is indoor air quality (IAQ) (2)

A

1- air in which there are no known contaminants at harmful concentrations as
determined by cognizant authorities
2- air that a substantial majority (80% or more) of the people exposed do not express dissatisfaction

33
Q

what are strategies to improve IAQ - using the 6Es - economic (1)

A

1- Subsidize purchase of
home equipment that meet
standards

34
Q

what are strategies to improve IAQ - using the 6Es - engineering - FMB (3)

A

1- Filter the air (air cleaner,
HEPA filter, electrostatic
precipitator)
2- Maintain fuel-burning
appliances
3- Building materials (VOCs)

35
Q

what are strategies to improve IAQ - using the 6Es - education - BN (2)

A

1- burn dry, clean wood
2- never burn pressure-treated or chemically treated wood

36
Q

what are strategies to improve IAQ - using the 6Es - environment - VDC (3)

A

1- Ventilation (leave doors and
windows open)
2- Do not store paints,
solvents or varnishes inside
the home
3- Control humidity levels

37
Q

what are strategies to improve IAQ - using the 6Es - enforcement - I (1)

A

1- Industrial workplace targets for worker exposure

38
Q

what are strategies to improve IAQ - using the 6Es - empowerment/engagement - CM (2)

A

1- CO detector
2- make your home smoke-free

39
Q

what is sick building syndrome (1a) and what is the timeline of symptoms (1b)

A

1a- occupants experience acute but non-specific health-related effects
1b- symptoms resolve right after leaving building

40
Q

what are some symptoms of sick building syndrome - HDFM (4)

A

1- headache
2- dizziness
3- fatigue
4- mucous membrane irritation

41
Q

what is the etiology of sick building syndrome (1)

A

1- unknown, range of potential causes

42
Q

what is building-related sickness (1a) and what is the timeline of symptoms (1b)

A

1a- occupants experience acute and specific health-related effects
1b- symptoms may require prolonged recovery time after leaving the building

43
Q

what are some symptoms of building-related sickness CSCP (4)

A

1- cough
2- shortness of breath
3- chest pain
4- pregnancy problems

44
Q

what is the etiology of building-related sickness - F-LACH (5)

A

1- Legionnaires’
2- allergic reaction
3- CO poisoning
4- fibre rash
5- humidifier fever

45
Q

what is radon (1)

A

1- colourless, odourless, radioactive, and naturally occurring gas produced by
the breakdown of uranium in soils and rocks

46
Q

what percentage of Canadian homes contain radon levels > 200 Bq/m³ (i.e. greater than recommended levels) (1)

A

1- 18%, as of 2024 (nearly double the 7% level in 2012)

47
Q

what is the guideline for radon levels in homes (1)

A

1- undertake remedial measures when average annual concentration > 200 Bq/m³ in the normal occupancy area

48
Q

what is the health impact of radon (2)

A

1- IARC group 1 for lung cancer (small cell carcinoma, adenocarcinoma, and
squamous cell carcinoma)
2- smokers at higher risk for lung cancer after exposure to radon

49
Q

what is risk mitigation for radon via 6Es - economic - F (1)

A

1- Financial incentives for
testing and remediation

50
Q

what is risk mitigation for radon via 6Es - engineering - VS (2)

A

1- (Increase) mechanical Ventilation to allow an exchange of air
2- Seal all cracks and openings in foundation, walls, floors, and pipes

51
Q

what is risk mitigation for radon via 6Es - education - R (1)

A

1- raise awareness of radon health effects

52
Q

what is risk mitigation for radon via 6Es - environment - R (1)

A

1- (Develop) Radon registry and mapping to prioritize high risk communities

53
Q

what is risk mitigation for radon via 6Es - enforcement - MC (2)

A

1- Mandatory building codes
2- Consider protection of
renters

54
Q

what is risk mitigation for radon via 6Es - engagement/empowerment - S (1)

A

1- smoking cessation

2025 PHPM Royal College Study - based on AN Summary Notes (30 decks)

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