Exam 1 Flashcards
How is the environment related to human health
environment is intimately connected with human health, illness, and mortality
what percentage of the worlds deaths are caused by environmental factors
in the 1990s: 40%
in 2012: 1/4
list examples of today’s environmental health threats
- trash on beaches
- hazardous wastes leaching from disposal sites
- continuing air pollution
- exposure to toxic chemicals
- destruction of land/deforestation
- global warming
what are the goals of the Healthy People 2020
- improve environmental quality
- outdoor air quality
- water quality
- toxics and wastes
- healthy homes and healthy communities
- infrastructure and surveillance
- global environmental health
what is the AQI
Air Quality Index
- values 0-50: green - good air quality
- values 51-100: yellow- moderate air quality
- values 101-150: orange- unhealthy for sensitive groups
- values 151-200: red- unhealthy
- values: 201-300: purple - very unhealthy
- values: 301+: maroon- hazardous
What 5 major pollutants is AQI based on
O3, PM, CO, SO2, and NO2
who does poor environmental quality have the greatest impact to
people whose health status is already at risk
Who are vulnerable subgroups of the population
elderly people with disabilities and chronic disease, pregnant women, and children
children are vulnerable because their immune system is still developing and are not fully capable of responding to environmental toxins
What are the 3 P’s
Pollution
Population
Poverty
these are principal determinants of health worldwide (Dr. Warren Winkelstein)
how are the three P’s interrelated
population growth is associated with poverty, and both poverty and population growth are associated with pollution.
Pollution and population growth are often associated with adverse economic circumstances (poverty) and, therefore, are also closely connected with environmental health
Give an example of the impact of pollution
effects of fuel combustion (air pollution) on global environmental health
Combustion of fossil fuels –> dispersment of greenhouse gases into atmosphere –> global warming –> change in distribution of insect vectors —> impact on global environmental health
what is the threat of over population
overpopulation in developing nations could cause urban crowding, food shortage, malnutrition, and a series of health problems
- human population might exceed the carrying capacity of the planet
- world population might reach 10 billion during 21st century
why does poverty impact environmental health
- poverty is linked closely to population growth and it is one of the well recognized determinants of adverse health outcomes
- wealthy nations can provide better access to medical care and are capable to financing various pollution controls
What is the environmental risk transition
the change in environmental risks that happen as a consequence of economic development in the less-developed regions of the world
environmental health issues in developing countries
Factors: unclean air, dirty water, bad food, and poor medicine
Health Problems: diarrhea, acute respiratory disease, malaria, malnutrition, tuberculosis, etc.
Local and Immediate
environmental health issues in developed countries
Factors: long-term, long-range pollutants (ex: acid rain, ozone depleting chemicals, ultrafine particles, and greenhouse gas emissions)
Health Problems: cancer, cardiovascular diseases, diabetes, and neuropsychiatric effects
Global and Delayed
What factors contribute to population growth
- increases in fertility and reductions in mortality
- current population: 8 billion
- predicted population in 2050: 10 billlion
order of predicted most populated countries in 2050: India, China, USA
What are population dynamics
Ever-changing interrelationships among variables that influence the demographic makeup of populations and variables that influence the growth and decline of population sizes
the three key factors of population dynamics
Fertility
Mortality
Migration
Increases in fertility and reductions in mortality are the primary reasons contributing to population growth
What is the total fertility rate (TFR)
- total number of children a women has given birth to by the end of her childbearing period
what is the current US fertility rate
2.0 births per women (in 2012)
what is the estimated natural population replacement rate
2.1
Countries with TFR below the replacement rate
US, Canada, Japan, South Korea, Thailand, China, and European countries
Countries with TFR of 4.0 births per woman
South Asian, Latin American, and African Countries
What has contributed to the decrease in mortality
public health improvements, famine control, and increased availability of drugs, vaccines, and medical treatments
How is migration impacting population growth
- by 2050 US population will grow by another 100 million and about 1/3 of the growth will be from migration
- 1 billion of the worlds residents are migrants
Demographic Transition
alterations over time in a population’s fertility, mortality, and make-up
Demographic transition stage 1
high fertility rate, high mortality rate, small population (mostly young population). Chart looks like a curved triangle
- rapid population growth
Demographic transition stage 2
high fertility rate, low mortality rate, rapid increase in population.
Chart looks like strong triangle
includes US, Australia, and Canada
- slow population growth
Demographic transition stage 3
low fertility rate, low mortality rate, population growth becomes slow or stops
- zero growth
demographic transition stage 4
- negative growth
- Germany, Bulgaria, Sweden, and Taiwan
Epidemiologic transition
shift in the pattern of morbidity and mortality
- Before shift: causes of morbidity and mortality were primarily related to infectious and communicable diseases (ex: cholera, HIV, TB, etc. )
- After shift: causes are associated with chronic degenerative diseases (cardiovascular diseases, cancer, neuropsychiatric conditions)
consequences of population increase
Urbanization
Overtaxing carrying capacity
Food insecurity and Famine
Loss of biodiversity
consequences of urbanization
cause significant demands for energy, water, and air quality controls, construction materials, food, sewage processing, and solid waste disposal
consequences of overtaxing carrying capacity
available resources are exhausted due to population increase
consequences of food insecurity/famine
supplies of wholesome foods are uncertain or may have limited availability
consequences of loss of biodiversity
danger to food production due to eradication of healthful plants and insects
How is infectious disease epidemics a possible consequence of crowding
virus mutation enabling human to human transmission
what is Ecological system (ecosystem)
dynamic complex of plant, animal, and microorganism communities, adn the the nonliving environment interacting as a functional unit
what is the environment
the complex of physical, chemical, and biotic factors… that act upon an organism or an ecological community and ultimately determine its form and survival
what is environmental health
addresses all the physical, chemical, and biological factors external to the person, and all the related factors impacting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments (WHO)
Hippocrates role of environment in disease
460-370 BC
- greek philospher
- “father of medicine”
- developed the concept of the relationship between environmental factors and human health, and emphasizes influence of the environment on people’s health
- promoted doctrine of maintaining equilibrium among the bodys four humors (yellow bile, black bile, phlegm, and blood) in his work titled On Airs, Waters, and Places
Paracelsus role in environmental health
1493-1541
- swiss physician, alchemist, and philosopher
- “father of toxicology”
- “sola dosis facit venenum” - the dose makes the poison
- toxicology is the core environmental risk assessment because toxicity is the capacity of a substance/pollutant to produce serious bodily injury or death
- contributed to the concept of the dose response relationship and the notion of target organ specificity of chemicals
Significance of Rachel Carson in environmental health
Rachel Carson (1907-1964) published Silent Spring (1962)
After Silent Spring was published public concern about the effects of technology on the environment significantly increased. As a result, the 1970s are notable for the large number of important federal regulatory laws that are applicable to the environment (EPA and OSHA)
Historical background on environmental and occupational health
- occupational health is a subset of environmental health
- Environmental health: focus on the adverse health effects of hazardous substances in the environment on the general public, including vulnerable populations
- Occupational Health: focus on the adverse effects of hazardous substances in the workplace on the workers
- occupational health is called industrial hygiene in the US and occupational health professionals are called industrial hygienists
Role of a toxicologist
- specializes in the effects of toxic chemicals on the environment and living creatures
- toxicologists investigate the effects of chemicals on the human health
- knowledge in biology, physiology, and chemistry are needed
- jobs include: gov labs, academic labs, or company labs
Role of environmental health inspector
- monitors and enforces gov regulations. Includes: pollution inspector, noise inspector, and water quality inspector. Food inspector. Involved with cleanliness and safety of foods consumed by the public
- knowledge in chemistry, physics, and nutrition
Role of Vector Control specialist
enforces various public health laws, sanitary codes, and regulations related to the spread of disease by vectors. Conduct basic research on the risks associated with exposures to certain hazards and conduct statistical analyses of impact by humans.
- researcher/research analyst with knowledge of biology, ecology, and infectious disease
Role of environmental Scientist/Risk assessor
- investigate hazards in the environment. Estimate the hazard of exposure and health risks. Develop procedures for abatement of hazards or reduce exposure. Conducts health education programs
- Require specific knowledge in environmental health
Role of Environmental lawyer
- provides input to government agencies. Helps formulate policy. Involved in litigation concerning environmental health problems
- requires comprhensive knowledge in environmental health and law
Role of a Biostatistician
research
Role of occupational health specialist (industrial hygienist)
- responsible for anticipation, recognition, evaluation, and control work place hazards to protect workers health
What is epidemiology
discipline focused on studying the distribution and factors influencing health, etc. within populations
- three major ways to identify the causality between hazards and adverse health effects: epi studies, toxicological animal studies, and human studies
what is environmental epidemiology
study of diseases and health conditions linked to environmental factors
- connect certain environmental factors with cancer and other adverse health outcomes
what are the essentials of environmental epidemiology
- exposure to the environmental hazards are usually involuntary
- typically focuses on involuntary exposures among vulnerable groups
contributions of epidemiology to environmental health
- concern with population
- use of observational data
- methodology for study designs
- two classes of epidemiologic studies
epidemiology concern with population
- studies health issues in a population
- many hazardous exposures occur at the population level not individual
- population medicine
- research example: association between lung cancer mortality and population in areas with higher conc. of smokestack industries
epidemiology concern with observational data
- observational study techniques are appropriate for environmental health research with no ethical issues
- epi is primarily observational science
- takes advantage of naturally occurring situations to study the occurrence of disease
epidemiology methodology for study designs
- experimental design
- Quasi-experimental study
- Observational study design: cross sectional, ecologic, case control
what are the two classes of epidemiologic studies
Descriptive study
Analytic study:
- observational and interventional
descriptive study
- aiming to delineate the patterns and manner in which disease occurs in populations
- depicts occurrence of disease in populations according to classification by person, place, and time variables
- research examples: patterns of tobacco use among adolescents in high school, maternal mortality rate in certain population over last decade
Analytic study
- examine causal (etiologic) hypothesis regarding the association between exposures and health outcomes
- proposes and evaluates causal models that employ both exposure and outcome variables for the association between exposure and health outcomes
- research examples: association between air pollution exposure and the risk of cardiovascular disease
Exposure variables
contact route and time of toxic substance, substance toxicity, type of hazardous agent, etc
