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MPH 6010 > MPH 6010 Exam 1 > Flashcards

MPH 6010 Exam 1 Flashcards

1
Q

Environmental health

A

Prevention of illness, disability, and premature death from interactions between people and the environment- addresses all the physical, chemical, & biological factors external to a person, & all the related factors impacting behaviors. It encompasses the assessment & control of those environmental factors that can potentially affect health

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2
Q

Risk

A

Probability of an unwanted occurrence and uncertainty about when/where Hazard might occur

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3
Q

Public health

A

The art and science of protecting and improving the health of a community through an organized and systematic effort that includes education, assurance of provisions of health services and protection of the public from exposures that may cause harm

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4
Q

What other sciences does environmental health “borrow” from?

A

*Epi
*Toxicology
*Chem & physics
*Micro
*Engineering
*Climatology

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5
Q

Name some reasons that health has improved in the US because of environmental health

A

*Basic sanitation
*Water treatment
*Waste treatment
*Food quality protection & nutrition

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6
Q

Environmental media

A

Areas in which pollutants or other substances may appear

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7
Q

Examples of environmental media

A

*Air
*Water
*Soil
*Sediment
*Biota

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8
Q

Physical environment

A

Environment made up of those parts of nature which would exist regardless of human activity

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9
Q

Social environment

A

Enterprises initiated by humans that generate the pollutants and microbes that potentially affect human health

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10
Q

Examples of the social environment

A

*Housing
*Transportation
*Urban development
*Land use
*Industry
*Ag

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11
Q

Principal determinants of health worldwide (3 ps)

A

*Pollution
*Poverty
*Population

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12
Q

Environmental epidemiology

A

The study of diseases and health conditions (occurring in the population) that are linked to environmental factors- think the study of the distribution & determinants of health & diseases, morbidity, injuries, disability & mortality in populations

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13
Q

Sir Percival Pott

A

A London surgeon thought to be the first individual to describe an environmental cause of cancer. THINK Chimney sweeps had high incidence of scrotal cancer due to contact with soot.

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14
Q

John Snow

A

An English anesthesiologist who linked a cholera outbreak in London to contaminated water from the Thames River in the mid-1800s.
Snow employed a “natural experiment,” a methodology used currently in studies of environmental health problems.

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15
Q

Examples of epidemiology’s contributions to environmental health

A

*Concern with populations
*Use of observational data
*Methodology for study designs
*Descriptive and analytic studies

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16
Q

Environmentally associated morbidity

A

Acute and chronic conditions, allergic responses, & disability

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17
Q

Environmentally hazardous agents

A

Microbes, toxic chemicals & metals, pesticides, and ionizing radiation

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18
Q

Most vulnerable subgroups to environmental hazards

A

The elderly, persons with disabilities & chronic diseases, pregnant women, & children

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19
Q

Environmental risk transition

A

Used to characterize changes in environmental risks that happen as a consequence of economic development in the less-developed regions of the world

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20
Q

What factors characterize the environmental risk transition

A

*Poor food
*Poor air
*Poor water
*Diarrhea due to poor sanitation and hygiene
*Acute respiratory diseases due to poor housing and indoor air pollution from poor quality household fuels
*Malaria due to poor housing quality
*Long -range pollutants such as acid rain precursors, ozone-depleting chemicals, & greenhouse gasses

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21
Q

Urbanization

A

Linked to numerous adverse implications for the health of populations including high rates of morbidity & mortality, environmental changes, scarcities of food, water & other resources, energy consumption, and production of large quantities of toxic wastes

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22
Q

Population dynamics

A

Ever-changing interrelationships among the set of variables that influence the demographic makeup of populations as well as the variables that influence the growth & decline of population sizes

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23
Q

Factors that relate to the size, age & sex composition of populations

A

Fertility, death rates, & migration

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24
Q

Completed fertility rate (total fertility rate)

A

Number of children a woman has given birth to when she completes childbearing

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25
Q

Burden of disease

A

The impact of disease in a population - an approach to the analysis of health problems, including loss of healthy years of life- think DALYs

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26
Q

Life expectancy (expectation of life)

A

Average number of years an individual is expected to live if current mortality rates continue to apply

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27
Q

Life expectancy at birth-

A

Average number of years a newborn baby can be expected to live if current mortality trends continue

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28
Q

Disability-adjusted life years (DALYs)

A

Adjustment of life expectancy to allow for long-term disability as estimated from official statistics- a DALY lost is a measure of the burden of disease on a population

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29
Q

Forced migration

A

Forcible displacement of persons- a means of escaping from persecution for religious & political reasons & to obtain relief from unstable conditions in one’s home country

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30
Q

Demographic transition

A

Alteration over time in a population’s fertility, mortality & makeup- Does NOT include the effects of migration upon the age & sex composition of a population

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31
Q

Demographic transition stage 1

A

Most of the population is young and fertility & mortality rates are high- small population

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32
Q

Demographic transition stage 2

A

Drop in the mortality rates with high fertility & rapid increase in the population

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33
Q

Demographic transition stage 3

A

Dropping fertility rates that cause a more even distribution of the population according to sex & age

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34
Q

Epidemiologic transition

A

Shift in the pattern of morbidity & mortality from causes related primarily to infectious & communicable diseases to causes associated with chronic, degenerative diseases. Accompanies the demographic transition.

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35
Q

Effects of rapid growth in the world’s population

A

*Urbanization
*Overtaxing carrying capacity
*Food insecurity
*Loss of biodiversity

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36
Q

Factors that lead to urbanization

A

*Industrialization
*Availability of food
*Employment opportunities
*Lifestyle considerations
*Escape from political conflict

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37
Q

Hazards associated with the urban environment

A

*Biological pathogens or pollutants within the human environment that impair human health-Think pathogenic agents & their vectors & reservoirs
*Chemical pollutants within the human environment
*Availability, cost & quality of natural resources on which human health depends- think food, water, fuel
*Physical hazards
*Aspects of the built environment with negative consequences on physical or psychosocial health
*Overcrowding
*Natural resource degradation
*National/global environmental degradation

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38
Q

Carrying capacity

A

The maximum number of individuals that can be supported sustainably by a given environment

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39
Q

Thomas Malthus

A

First essay on population- said population would outstrip available resources, and positive checks for excessive population growth rates were epidemics of disease, starvation, & population reduction through warfare. Also said the growth of the population could be constrained through “preventive checks”- think not allowing people to marry

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40
Q

Food insecurity

A

Supplies of wholesome foods are uncertain or may have limited availability
Food insecurity & famine may occur when the carrying capacity in a particular geographic area is exceeded

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41
Q

Biodiversity

A

The different types & variability of animal & plant species & ecosystems in which they live- involves diversity in the genes of a population, diversity in the number of species, and diversity in habitats & is an essential dimension of human health

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42
Q

Environment

A

Complex of physical, chemical, & biotic factors that act upon an organism or an ecological community & ultimately determine its form & survival

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43
Q

Ecological model

A

Determinants of health (environmental, biological, & behavioral) interact & are interlinked over the life course of individuals

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44
Q

Ecosystem

A

Dynamic complex of plant, animal & microorganism communities and the nonliving environment interacting as a functional unit- Health of ecosystem is associated with the health of human beings, animals, & wildlife

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45
Q

Hippocrates

A

Noted the role of environment as an influence on disease

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46
Q

3 eras of environmental health

A

*First wave- hazardous working conditions & unsanitary conditions
*Second wave- environmental issues at forefront, air pollution, toxic chemical awareness, EPA founded
*Third wave- high population growth, industrialization, & urbanization with focus on greenhouse gasses & global warming

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47
Q

What does environmental epidemiology do

A

Studies a population in relation to morbidity and mortality- uses OBSERVATIONAL DATA

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48
Q

List study designs common in environmental epidemiology

A

*Cohort
*Cross-sectional
*Case-Control
*Case series
*Ecologic
*Experimental

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49
Q

Descriptive epidemiologic studies

A

Depiction of the occurrence of disease in populations according to classification by person, place, and time variables
*Regarded as a fundamental approach to delineate the patterns & manner in which disease occurs in populations
*Think disease clustering

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50
Q

Analytic epidemiologic studies

A

Examines causal (etiologic) hypotheses regarding the association between exposures and health conditions

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51
Q

Epidemiologic triangle

A

Used for describing the causality of infectious diseases- provides a framework for organizing the causality of other types of environmental problems

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52
Q

3 parts of the epidemiologic triangle

A

Host, Agent, Environment

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53
Q

Environment in the epi triangle

A

The domain in which disease-causing agents may exist, survive, or originate; it consists of “All that which is external to the individual human host”

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54
Q

Host in the epi triangle

A

A person or other living animal, including birds and arthropods, that affords subsistence or lodgment to an infectious agent under natural conditions

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55
Q

Agent in the epi triangle

A

A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential for the occurrence of a disease

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56
Q

List Hill’s criteria of causality

A

*Strength
*Consistency
*Specificity
*Temporality
*Biological gradient
*Plausibility
*Coherence

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57
Q

Bias

A

Systematic deviation of results or inferences from the truth. Processes leading to such deviation. An error in the conception and design of a study—or in the collection, analysis, interpretation, reporting, publication, or review of data—leading to results or conclusions that are systematically (as opposed to randomly) different from the truth

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58
Q

What bias does the healthy worker effect introduce

A

Selection bias (in occupational mortality studies)

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59
Q

Healthy worker effect

A

Refers to the observation that employed populations tend to have a lower mortality experience than the general population

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60
Q

Confounding

A

The distortion of a measure of the effect of an exposure on an outcome due to the association of the exposure with other factors that influence the occurrence of the outcome

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61
Q

Limitations of epidemiologic studies

A

*Long latency periods
*Low incidence and prevalence
*Difficulties in exposure assessment
*Nonspecific effects
*Uncertainty with pathways of exposure

62
Q

Prevalence

A

Refers to the number of existing cases of a disease, health condition, or deaths in a population at some designated time

63
Q

Point prevalence

A

Refers to all cases of a disease, health condition, or deaths that exist at a particular point in time relative to a specific population from which the cases are derived

64
Q

Equation for point prevalence

A

Number of persons ill/
Total number in group
* At a point in time

65
Q

Incidence

A

The occurrence of new disease or mortality within a defined period of observation (e.g., week, month, year, or other time period) in a specific population

66
Q

Equation for incidence rate

A

Number of new cases over a time period/
Total population at risk
*Times a specific multiplier

67
Q

Case fatality rate

A

Provides a measure of the lethality of a disease

68
Q

Equation for case fatality rate

A

Number of deaths due to disease/
number of cases of disease
*Times 100 during a time period

69
Q

Odds ratio

A

The ratio of odds in favor of exposure among the cases [A/C] to the odds in favor of exposure among the non-cases [the controls, B/D]
*Think case-control study

70
Q

Relative risk

A

The ratio of the incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a non-exposed group (A/A=B)/(C/C+D)

71
Q

RR > 1

A

Indicates that the risk of disease is greater in the exposed group than in the nonexposed group

72
Q

RR < 1

A

Indicates possible protective effect

73
Q

Examples of study endpoints

A

*Self-reported symptom rates
*Physiologic or clinical examinations
*Mortality

74
Q

List some environmental epidemiology activities

A

*Identification of previously unrecognized exposures to known hazardous agents & the quantification of such risks
*Estimation of the amount of exposures that individuals have to environmental hazards
*Assessments of risks associated with exposures
*Evaluation of procedures to prevent exposure

75
Q

For an environmentally associated health outcome to be considered a topic of environmental epidemiology…

A

Exposure factors must lie outside the individual’s immediate control- traditionally focuses on the air we breathe, the water we drink, & the food we eat

76
Q

Goals of epidemiologic research

A

*Description of exposure-response gradients
*Discovery of how occupational hazards may cause harmful effects
*Characterization of vulnerable workers
*Input into programs for the prevention of occupationally related diseases

77
Q

Epidemiology is important to environmental health because…

A

*Many exposures & health effects associated with the environment occur at the population level
*The epidemiologic methods of natural experiments & observational techniques are appropriate
*The study designs used in epidemiologic research can be applied directly to the study of environmental health issues
*Epidemiology aids in the development of hypotheses & the study of causal relationships

78
Q

Epidemiology aids environmental health through…

A

Concerns with populations
Use of observational data
Methodology for study designs

OVERALL- epidemiologic input to environmental risk assessment involves the interpretation of epidemiological studies & their application to estimating the potential health risks to populations from known or estimated environmental exposures

79
Q

Disease clustering

A

Aggregation of relatively uncommon events or diseases that may suggest common exposure to an environmental hazard

80
Q

Natural experiments

A

Naturally occurring circumstances in which subsets of the population have different levels of exposure to a hypothesized causal factor in a situation resembling an actual experiment

81
Q

Prevalence measures uses

A

Describe the scope & distribution of health outcomes in the population & assist with assessing variations in the occurrence of disease & development of etiologic hypotheses

82
Q

Standardized mortality ratio-

A

Ratio of the number of deaths observed in the study group/population to the number that would be expected if the study population had the same specific rates as the standard population

83
Q

3 requirements for the successful epidemiologic investigation of environmental exposures

A

*Direct & accurate estimates of the exposures
*Direct & accurate determination of the disease status of study population
*Appropriate statistical summarization & analysis of data pertaining to disease & exposure

84
Q

Latency period

A

Time interval between initial exposure to a disease-causing agent & the appearance of a disease or symptoms

85
Q

Advantages of enriovnmental epidemiology

A

*Engages the real world
*Shows a unique perspective on disease/health
*Basis for action despite ignorance of mechanism

86
Q

Toxicology

A

The study/science of poisons- the study of the adverse effects of chemicals on living organisms (multidisciplinary art)
Think- toxicology studying dose-response relationships & mechanisms of action to understand adverse health effects linked to chemicals

87
Q

399 BC Death of Socrates by Hemlock

A

Socrates was charged with religious heresy and corrupting the morals of local youth. The active chemical used was the alkaloid Coniine which, when ingested causes paralysis, convulsion and potentially death

88
Q

Paracelsus

A

Said all substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy

89
Q

Toxicant

A

A toxic substance that is man-made or results from human (anthropogenic) activity- has the ability to cause harm to organs or biochemical processes in areas beyond the site of exposure

90
Q

Toxin

A

A toxic substance produced by a living organism- e.g., snake venom, bacterial toxins

91
Q

Poison

A

A chemical/compound that produces adverse effects (illness, disability, death) at a low dose

92
Q

Hazard

A

Anything that has potential to cause harm to human health and properties

93
Q

Toxicity

A

Degree to which a substance is able to damage an exposed organism (is poisonous)- related to the physical & chemical properties

94
Q

Characteristics of toxicants (5)

A

*Must be in the environment
*Must be bioavailable and bioaccumulated
*Must interact at a molecular site
*Must cause metabolic dysfunction
*Must decrease the fitness of an individual organism

95
Q

Risk equation

A

hazard x exposure

96
Q

Importance of toxicology

A

Safeguarding public health by identifying what the effects of these chemicals are & at what levels of exposure they may become hazardous to humans (understanding their toxicology)

97
Q

Exposure

A

Proximity & or contact with a source of a disease agent in such a manner that effective transmission of the agent or harmful effects of the agent may occur

98
Q

Toxicologist

A

Scientist who has received extensive training in order to investigate in living organisms “the adverse effects of chemicals (including their cellular, biochemical & molecular mechanisms of action) and assess the probability of their occurrence”

99
Q

Environmental toxicology

A

The study of the impacts of pollutants upon the structure & function of ecological systems- examines how environmental exposures to chemical pollutants may present risks to biological organisms

100
Q

Ecotoxicology

A

Studies the effects of pollutants on ecosystems & investigates dispersion of pollutants into the physical environment, their impact upon biological chains, such as food chains, & their toxic effects within ecosystems

101
Q

Developmental toxicology

A

Researches the effects of natural & man-made chemicals on prenatal development

102
Q

Teratogens

A

Substances that cause birth defects

103
Q

Xenobiotics

A

Chemicals that are foreign to the biological system that can produce developmental toxicity

104
Q

Poison

A

An agent that produces immediate effects such as lethality or sickness even when present in small doses- any agent capable of producing a deleterious response in a biological system

105
Q

Toxic agent

A

Material or factor that can be harmful to biological systems
*Physical energy (heat, radiation)
*Substances derived from biological sources (venom)
*Almost all chemicals

106
Q

Systemic toxins

A

Those that affect the entire body or multiple organ systems

107
Q

Target organ toxins

A

Affect specific parts of the body

108
Q

Dose

A

The amount of a substance administered at one time

109
Q

Exposure dose

A

The amount of a xenobiotic encountered in the environment

110
Q

External dose

A

A dose that results from contact with environmental sources, e.g., environmental contamination

111
Q

Absorbed dose

A

The actual amount of the exposed dose that enters the body (AKA internal dose)

112
Q

Administered dose

A

Indicates the effectiveness of a substance. Normally, effective dose refers to a beneficial effect such as relief of pain. It may also stand for a harmful effect such as paralysis

113
Q

Dose-response curve

A

graph that is used to describe the effect of exposure to a chemical or toxic substance upon an organism
*X-axis- dose
*Y-axis- response

114
Q

Dose-response relationship

A

The relationship of observed responses or outcomes in a population to varying levels of a beneficial or harmful agent- type of correlative relationship between the characteristics of exposure to a chemical & the spectrum of effects caused by the chemical

115
Q

Uses of dose-response relationship

A

*Causal association between toxin & biological effects
*Minimum dosages needed to produce a biological effect
*Rate of accumulation of harmful effects

116
Q

LD50 (lethal dose)

A

dosage (mg/kg body weight) causing death in 50% of exposed animals- can also be LD10 or LD90

117
Q

Nature of toxic effects depends on…

A

*Innate toxicity of the chemical
*Whether it is in sufficient concentration
*How it impinges upon a somatic location as a consequence of the route & site of exposure
*Exposure needs to take place for sufficient time duration & frequency
*One’s ability to metabolize the chemical

118
Q

Concentration & toxicity of chemicals affected by…

A

*Route of entry into the body
*Received dose of the chemical
**Duration of exposure
**Interactions among multiple chemicals
**Individual sensitivity

119
Q

Most frequent sites of exposure to environmental chemicals

A

GI tract
Respiratory tract
Skin

120
Q

Acute exposure

A

Usually a single exposure for less than 24 hours

121
Q

Subacute exposure

A

Repeated exposure for 1 month or less

122
Q

Subchronic exposure

A

Repeated exposure for 1-3 months

123
Q

Chronic exposure

A

Repeated exposure for more than 3 months

124
Q

Additive

A

The combination of 2 chemicals produces an effect that is equal to their individual effects added together

125
Q

Synergism

A

The combined effect of exposures to 2 or more chemicals is greater than the sum of their individual effects

126
Q

Potentiation

A

One chemical that is not toxic causes another chemical to become more toxic

127
Q

Coalitive interaction

A

Several agents that have no known toxic effects interact to produce a toxic effect

128
Q

Antagonism

A

2 chemicals administered together interfere with each other’s actions or one interferes with the action of the other

129
Q

Chemical allergy

A

An immunologically mediated adverse reaction to a chemical resulting from previous sensitization to that chemical or to a structurally similar one

130
Q

Chemical idiosyncrasy

A

When someone has either extreme sensitivity to low doses or insensitivity to high doses of a chemical

131
Q

Direct effect

A

Denotes an immediate impact upon the cells & tissues of the body or upon specific target organs

132
Q

Local effects

A

Damage at the site where a chemical first comes into contact with the body (think skin redness)

133
Q

Systemic effects

A

Adverse effects associated with generalized distribution of the chemical throughout the body by the bloodstream to internal organs

134
Q

Indirect effect

A

Change in the function of the body’s biochemical processes

135
Q

Risk assessment

A

A process for identifying adverse consequences and their associated probability - the process of determining risks to health attributable to environmental or other hazards- provides an estimation of the likelihood of adverse effects

136
Q

4 steps of a risk assessment

A

*Hazard identification
*Dose-response assessment
*Exposure assessment
*Risk characterization

137
Q

Hazard identification

A

Examines the evidence that associates exposure to an agent with its toxicity & produces a qualitative judgment about the strength of that evidence, whether it is derived from human epidemiology or extrapolated from lab animal data

138
Q

Dose-response assessment

A

The measurement of the relationship between the amount of exposure & the occurrence of the unwanted health effects

139
Q

Exposure assessment

A

The procedure that identifies populations exposed to the toxicant, describes their composition & size, & examines the roots, magnitudes, frequencies & duration of such exposures
*Characterize the point of exposure setting & scenario
*ID exposure pathways
*Quantify the exposure

140
Q

Exposure pathways

A

How does the agent move from its source to the individual- the processes for movement of substances from their sources to the people who are exposed

141
Q

Exposure routes

A

Modes of entry into the body

142
Q

Risk characterization

A

Estimates of the number of excess unwarranted health events expected at different time intervals at each level of exposure- yields a synthesis & summary of information about a hazard that addresses the needs & interests of decision makers & of interested & affected parties

143
Q

Risk management

A

Actions taken to control exposures to toxic chemicals in the environment

144
Q

List factors that influence exposure

A

*Exposure pathways
*Intensity/concentration
*Duration
*Frequency (think # of times and time in between)
*Intake variables

145
Q

Examples of intake variables

A

Types of food, nutrition, starvation, etc.

146
Q

Factors influencing toxicity

A

*Intake variables
*Physiological differences
*Genetic variability
*Chemical effects
*Environmental effects

147
Q

Bioaccumulation

A

The process by which organism accumulates chemicals both directly from abiotic environment (water, soil, air) and dietary sources (trophic transfer)

148
Q

Bioaccumulation factor

A

Toxicant concentration in organism /
Toxicant concentration in the media (think water, soil, etc.)

149
Q

Bioconcentration factor

A

The ratio of the toxicant concentration in organism tissue to its equilibrium concentration in water expressed in equivalent units

150
Q

Bioconcentration factor equation

A

Toxicant concentration in tissue/
Toxicant concentration in water

151
Q

Biomagnification

A

The process whereby toxicants are passed from one trophic level to another & exhibit increased concentrations with the increase in trophic levels

MPH 6010 (2 decks)

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