midterm Flashcards
Which of the following is
NOT route of toxicological
exposure?
A. Inhalation
B. Ingestion
C. Dermal
D. All the above actually are
toxicological exposure
routes
D. All the above actually are
toxicological exposure
routes
True or False? r-selected
species generally are
slower-growing than K-
selected species
false
True or false? Consumerism,
but not population growth,
impact sustainability
false
List the five modern
advancements of
environmental health:
- Identification of Chemical
Hazards - Environmental Psychology
- Ecohealth
- Expansion of health care
services related to
environmental exposures - Development of
Environmental Health Policies
What is the difference between disease genes and environmental response genes?
Disease genes cause diseases regardless of environmental exposures, whereas ERGs require a specific exposure to be activated
subcategory of public health
Environmental health
environmental health
field of public health that addresses
physical, chemical, biological, social, and psychosocial
factors in the environment.
Goal/ aim of environmental health
- control and prevent environmental hazards
- promote health and well-being through environmental strategies
Industrialization brought
* Urban crowding/ cramped housing
* Lack of functioning, proper sewers & water treatment
* Feces on the streets
which then caused…
Sanitation became important in as cities grew in the age of
industrialization
Workplace conditions, especially in factories, was terrible
*No safety protocols
* Pollution
* Children in factories
Charles Turner Thackrah
Occupational Health
Alice Hamilton
Occupational Health
Jon Snow
Epidemiology
Edwin Chadwick
Social Epidemiology
Rachel Carson
Recognition of Environmental Hazards
5 trends in environmental health
- Environmental Justice
- Focus on Susceptible Groups
- Scientific Advances
- Global Changes
- Moves Towards Sustainability
- environmental justice (trend)
Ethical Obligations to ensure equity and equality in context of environment
- Focus on Susceptible Groups (trend)
Generational Equity
- Scientific Advances (trend)
New fields and technologies popping up all the time!
- Global Changes (Trend)
We realize global factors of environmental health
- Moves Towards Sustainability (trend)
Renewable Energy Source
Ecology is
the science that studies the interaction of living
things in relation to their environment
Ecology tends to
-in relation to one another, both biotic and abiotic
- By definition, it looks at things holistically
biotic
relating to or resulting from living things, especially in their ecological relations.
abiotic
physical rather than biological; not derived from living organisms.
Biodiversity
the degree of variation of life in all its forms, varies also at the question of scale–it is hierarchical
Autotrophs
producers in the food chain, meaning they create their own nutrients and energy.
heterotroph
an organism that eats other plants or animals for energy and nutrients.
Detrivores
an animal which feeds on dead organic material, especially plant detritus.
Characteristics of
populations are governed
by ecologic processes
Including population size
* Birth Rate/ Reproduction Rate
* Death Rate
* Immigration
Population dynamics
The relationships between organisms affects population size
carrying capacity
maximum population that can be sustained indefinitely
Life Span Short
R species
Quick to reach maturity
r species
number of offspring- many
r species
size of offspring small
r species
energy spent raising offspring little/ none
r species
population growth- fast
r species
Population size variability Unpredictable, unstable
r species
Population size Below Carrying Capacity
r species
Sustainable practices are necessary to
maintain our environment
We require energy
to live and, especially, to thrive
describe our existence and impact on the environment in historical terms
Anthropocene
Sustainable energy and environmental practices
key if we wish to survive
long-term as a species
affect sustainability
Consumerism and population growth
United Nations has even recognized the importance of sustainability
Brundtland Report
* Rio Declaration of Environment and Development
* Millennium Development Goals
According to the “Safe Operating Space for Humanity”, we’ve already
began to seriously damage our environment: We’ve already exceeded 3 out of 9 key planetary boundaries
Metrics are key
They need to be realistic, actionable, and appropriate to be successful
* Includes questions of time, scale, accuracy, etc.
* Metrics chosen will affect how you measure things
How to measure environmental health
- Epidemiology
- Toxicology
- Geospatial Analysis
- Industrial Hygiene
- Occupational Health
- Risk Assessment
Epidemiology
Science that assesses the distribution and determinants of health and disease among populations
Looks at exposure relationships and tries to assess causality; focuses on measures of association
Epidemiology
Causality is not easy to prove
epidemiology
Looks at events
* Morbidity and Mortality
epidemiology
Prevalence
the quantity of affected people in a specified
population at a given time
Prevalence=
number of affected people/total population
Incidence
looks at the number of newly affected individuals in
a specific population at a specific time
insidence=
newly affected people/ number of persons at risk
rule of incidence
Persons in the numerator must have the potential to be in the denominator
Mortality Rate
measure of deaths in a population at a given
time
Measures of Morbidity:
Incidence
mortality rate=
number of deaths/ number at risk
Case fatality rate:
number of deaths due to a disease among those with disease
CFR=
of deaths due to specific disease/ total # of people with that disease
Measures of association
quantify the relationship between an
exposure and an outcome
Various types of measures:
- Odds
- Risk
- Hazards
to understand the relationship
between risk factor and outcome
need to compare the exposure to non-exposure,
or disease to lack of disease
Case Report Cost
Very low
case report participant selection
medical cases
case report main measurement
none
case report is good for
describing new diseases
case report temporality
none
ecological cost
very low
ecological participant selection
populations/groups
ecological main measurement
correlation
ecological is good for
hypothesis generation
ecological temporality
snapshot
cross section cost
low
cross sectional participant selection
n/a
main measurement for cross sectional
prevalence
cross sectional is good for
exploring risk factors
cross sectional temporality
snapshot
case- control cost
medium
case control participant selection
based on disease
main measurement for case control
prevalence
case control is good for
prevalence studying rare diseases, more in depth risk factor assessment
case control temporality
generally retrospective
cohort cost
high
cohort participant selection
based on exposure
main measurement for cohort
incidence
cohort is good
for studying rare exposures, assessing incidence
cohort temporality
Retrospective
or Prospective
trail cost
very high
trail participant selection
randomization
trail main measurement
incidence
trail is good for
Assessing
causation;
researcher
control
Temporality trail
prospective
prospective
likely to happen at a future date; concerned with or applying to the future.
retrospective
looking back on or dealing with past events or situations.
Biomarkers
Measurable indicator of a biological process
Environmental epidemiology
Focuses on exposures in the environment
* Air pollution and asthma; arsenic in drinking water and bladder cancer
Occupational epidemiology
Focuses on workplace exposures and associated outcomes
* Can look at multiple types of exposures:
* Biological: animal waste (farmers)
* Chemical: heavy metals (factory workers)
* Physical: radiation (x-ray technicians), noise (construction workers)
Geospatial Analysis
-Data used in this field is often linked to place
* Georeferenced data
Geographic Information Systems (GIS)
spatial statistics
the application of statistical concepts and methods to data that have a spatial location attached to them
Toxicology is
the study of the negative effects of chemical products on biological systems
Difference between toxin and toxicant
Toxin is usually used when referring to a toxic substance produced naturally. Toxicant is usually used when referring to a toxic substance that is produced by, or a by-product of, man-made activities.
ecotoxicology
toxicity at the ecological level
“The dose makes the poison”
Paracelsus, father of toxicology
Dose-Response Curves in toxicology
Graphical representations of how bad things actually are for you
* Quantitative (exposure: outcome)
* Concentration
Toxicological Measures
Assess by Chemical class ,Exposure source, and/or Target (“Target organs” )
Regulatory
Federal Food, Drug, and Cosmetic Act (1938)
*TSCA: Toxic Substances Control Act (1976)
*Emergency Planning and Community Right-to-Know Act
(1984)
*Food Quality Protection Act (1996)
*Environmental Protection Agency (EPA):
Genetic Regulation
turns our genes off and on
Endocrine disruptors
interferes with proper genetic regulation
* Chemicals that may interfere with the body’s endocrine system and produce adverse developmental, reproductive, neurological, and immune effects in both humans and wildlife
Environmental response gene (ERGs)
dictates our response to environmental exposures. If not activated, won’t really do much
Disease genes
will be problematic regardless of environmental exposures
genetic epidemiology
specific role of genes in relation to disease (or health) in populations, most often specifically focusing on the gene-environment interactions
Molecular studies
- Multiple lab-based studies; big data making it easier, but need to be cautious
- Over-promise of GW
Are clinical trails used in epidemiology?
NOOOO
Industrial Hygiene (Occupational hygiene)
Science and practice of anticipating, recognizing, evaluating, and
controlling detrimental environmental and occupational exposures
* Hazards
Exposure Science
Field that studies human contact with various environmental agents
looking at the mechanisms and dynamics of events that prevents or
leads to disease/health
Exposure Assessment
Process that estimates/measures/ characterizes magnitude,
frequency, and duration of exposure to agent among populations
Four Steps of Industrial Hygiene
Anticipation, recognition, evaluation, control
Anticipation
Proactive estimation of health and safety concerns that are
association with certain jobs or environments
Recognition
Identification of potential and actual hazards through inspection
Evaluation
Measuring exposures through visual and/or instrumental monitoring
Control
Reduction of risk to health and safety through administrative or
engineering measures
epidemiology is about
relationships
Control
Form of primary prevention
Several approaches to control occupational and environmental
hazards:
Substitution: replacement of hazard
* Isolation: containing or limiting human access usually through engineering
* Ventilation: introduction of air or exhaust hoods
* Administrative controls: policies and procedures to reduce risk (e.g. lockout
tags, rotating workers, etc.)
* Protective devices
* Personal protective equipment:gloves, safety glasses
Exposure Science
Study of human contact with chemical, physical, and/or
biological agents in the environment
(Focuses on mechanisms and dynamics that cause or prevent health outcomes)
exposure scientists
Evaluate exposure determinants: factors and conditions that influence
exposures
exposure assessment
Quantifies exposures in both occupation and environments
* Focuses on concentration, exposure, and dose
Exposure Science
* What do we care about?
Concentration
* Exposure and Exposure Profile
(Total Exposure ,Exposure routes: Inhalation, Ingestion, Dermal)
* Dose
(Absorption factor, Absorbed Dose, Targeted Organ Dose)
* Intensity (Magnitude/ amount of contact between agent and barrier/ boundary)
* Frequency: number of exposure events
* Duration
EPA
Environmental Protection Agency
Exposure Assessment uses:
imputation (modeling exposures)
(Creation of a physical or conceptual mathematical representation of the exposure process, including events and outcomes)
* Measuring environmental exposure
* Measuring personal exposures
* Measuring biomarkers
exposure assessment can also used
Measuring environmental exposure
* Measurement can be made:
* Fixed locations (area sampling), Tends to be used for air pollution monitoring, Using individuals (personal sampling)
*Measuring personal exposure
* Placing a small device on a person
* Reference approach because it accounts for time, location, and behaviors
Duplicate diet studies:
Collects meals identical to those eaten by study subjects over a period of time to measure presence of a particular agent in food
Food diaries:
you write down everything you ate over a certain period, including size/quantity, food type, frequency, etc.
* Also used A LOT in nutritional epidemiology
Risk assessment:
stepwise process of organizing information about a particular hazard* Very much tied to exposure assessment
In risk assessment, we look at:
What can go wrong
* Likelihood
* Consequences
* How tolerable the risk actually is
Five Steps for Risk Assessment:
1.Problem Formulation
2. Hazard Identification
3. Dose-Response Assessment
4. Exposure Assessment
5. Risk Characterization
Ethics
Branch of philosophy that focuses on what is right/ wrong
*Formal approach to assessing what is right or wrong
*Can be looked at the personal level, professional level, and
even societal level
*Fundamental to public health
When we talk about ethics in the context of public health we talk about
- Bioethics
- Care ethics
what is esstential to ethics?
Transparency and objectivity are essential
Active need for ethics leads to:
Advocacy
(Fighting for what you believe)
* Activism
(Persistent advocacy)
Environmental Justice
It can be argued that we are ethically bound to understand and
combat the fundamental causes of disease
Health Disparities exist because
inequities and inequalities
Environmental Justice is the concept of
protecting all
communities from environmental hazards, while providing
equal access to all communities to environmental, social, and
economic aspects that promote health and well-being
Environmental Psychology
Multidisciplinary field within psychology
* Focuses primarily on the built environment
two main fields of environmental psychology
Conservation Psychology
* Ecopsychology
Conservation Psychology
Studies development of environmental attitudes
Ecopsychology
Studies relationship between people and the ecosystem
When people ”accept” a chronic exposure (e.g. noise, urban decay), it leads to
learned helplessness
(Belief that nothing they do can help them overcome the problem)
We can apply the concepts of environmental psychology to the real world via:
design/ design thinking
urban planning
Design
is an applied field of creative thinking with the purpose of specifically solving problems, based on the needs of the actual final user
One method used is design thinking
Five step process (empathize, define, ideate, prototype and test) that is a problem-solving equivalent to scientific method (hypotheses generation)
Urban Planning
- Multidisciplinary field that focuses on the development and design of the use of land use and infrastructure
- Uses public policies to improve the quality of life of all users of the built environment
