Lecture 2 - Overview of Occ and Env Health/Hazards/Disease

Question 1

Magnitude of Workplace injury

Answer 1

5k deaths from occupational injuries, 50k deaths from work related diseases, 5M non-fatal occ injuries adding to 90B on workers comp

these are underestimates and not good measures. A lot of problems get pushed to private insurance, symptoms but no medical attention sought

Question 2

Safety Hazards Definition

Answer 2

injury resulting from uncontrolled transfer of energy to vulnerable recipient , electrical, fire hazards, injury/fall, interpersonal safety

Question 3

Health Hazards Definition

Answer 3

chemical: heavy metals, pesticides, benzene
biological: HIV, HepB, bacteria, viruses
physical: mechanical or thermal, noise, radiation, vibration
ergonomic: heavy lifting, repetitive
psychosocial: high-stress, urban congestion

Question 4

Environmental Health Surveillance: definition, objectives

Answer 4

ongoing surveys to monitor trends in outcomes,hazards, exposures, leads to good prevention programs

objectives: characterize common injuries, identify causes and risk factors, characterize affected population and areas, estimate overall magnitude, identify new risk factors, evaluate intervention success, generate support for prevention activities

Question 5

Environmental Health Surveillance: types

Answer 5

Case based: ongoing and rapid followup, sentintel health event
Population based: collects data over time, data on all cases or representative sample, requires denominator data (# of workers at risk)
Passive: relies on reporting
Active: more aggressive case finding, more costly and labor intensive

Question 6

Major Categories of Occ Ilness

Answer 6

WRMDs, cancer, respiratory, neurologic, skin, reproductive, development, cardiovascular, hematomic, hepatic, renal and urinary

Question 7

IARC cancer classifications

Answer 7

Group 1: Carcinogenic
Group 2AB: Possibly carcinogenic
Group 3: not classifiable
Group 4: probably not

Question 8

Muskuloskeletal:

Answer 8

29% of private industry, neck, back,

Question 9

Cancer

Answer 9

1/3 of all deaths in US, most are chronic so hard to tie into legislation, IARC cancer classifications,

Question 10

Respiratory

Answer 10

silicosis, nodules form from individual response, aspestosis, asthma, COPD, hypersensitivity Pneumonitis

Soluble vs Insoluble irritants: soluble irritants have warning signs within seconds (ammonia, hydrochloric acid), insoluble irritants don’t (ozone, oxides or nitrogen) can be over exposed with no signs

Question 11

Neurologic

Answer 11

Mad hatter mercury example, the maze example

Question 12

Reproductive/Developmental

Answer 12

hazardous exposures may disrupt pregnancy, acceptable levels have decreased with increased measurement techniques

DBCP - nematocide on range of crops, associated with reproductive disruption in men (azoospermia, oligospermia, asthenospermia). banned by EPA

Question 13

Noise exposure and Hearing Disorders

Answer 13

most common work-related illness, 10M people each year (mostly in manufacturing sector)

noise-induced hearing loss develops gradually, irreversible, progression stops if removed. greatest impact on hearing at higher frequencies

other influences: age,chemical exposures, tinnitus

Question 14

Skin

Answer 14

systemic toxicity, OSD, second most common type of occupational disease, can occur in many forms (cancers, infections, injuries)

chemical agents are the main cause of occupational skin diseases and disorders (both primary and allergic rxns)
also radiation (physical agents such as extreme temperatures (hot or cold) 
biological agents (parasites)

Question 15

Cardiovascular Diseases

Answer 15

5 - 10% of CVD attributed to O and E factors including physiological strain (in jobs with high job demand, low job control) carbon monoixde, lead, organic solvents

Question 16

Environmental Disease

Answer 16

cause and effect for environmental disease is more difficult to establish for environmental exposures, many potential causes, many more people potentially exposed (subgroups (children) are of concern)

Question 17

why are children of concern?

Answer 17

undergoing rapid changes that are susceptible to minute changes, frequent hand to mouth, more contact, longer duration of concern, fetal and infant exposures

Question 18

trends?

Answer 18

cancer incidence is going up, mortality down ; hyperactivy disorder increasing, obseity increasing, autism incresing, sexual matruation happening earlier