PREVENTATIVE MEASURES Flashcards
WHO DEFINITON OF AN ENVIRONMENTAL RISK
“All the physical, chemical and biological factors external to a person, and all related behaviours, but excluding those natural environments that cannot be reasonably be modified”
- SOMETHING EXTRNAL TO THE PERSON, BUT EXCLUDING THOSE THINGS YOU CANNOT CHANGE
HOW MANY DEATHS GLOBALLY ARE ATTRIBUTABLE TO ENVIRONMENTAL FACTORS?
1/4
EXAMPLES OF ENVIRONMENTAL RISKS
Pollution: air, water, soil UV and ionising radiation Occupational risks Climate change Built environment (housing, land use, roads) Noise (Sanitation)
Examples of Diseases contributed to by the environment
Infections ← water, sanitation and hygiene (WASH
Cancers ← air pollution, tobacco, radiation, chemicals
Mental health ← occupational stress, climate change, noise
Asthma ← air pollution, tobacco, exposure to mould
Hearing loss ← noise
Road accidents ← poor road design, traffic
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - SECOND HAND TOBACCO SMOKE
Smoking is not an environmental factor (BECAUSE PEOPLE CHOOSE TO DO IT ND CAN CHOOSE TO STOP)
Second-hand smoke = tobacco smoke exposure in non-smokers
Increases risk of stillbirth and low birth weight
Increases risk of lung cancer (2% of cases)
Indoor smoke-free legislation
In Belgium, resulted in reduction in preterm deliveries
No smoking in vehicles (currently in UK with under-18s inside)
Any intervention to prevent smoking, or smoking cessation
Issue: most SHS exposure occurs in homes – difficult to regulate
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - AMBIENT AIR POLLUTION
Ambient air pollution (pollutants: PM2.5, PM10, NO2)
Increases risk of preterm birth, low birth weight and infant mortality
Increased risk of lung cancer (14% of cases), and ischaemic heart disease
Interventions: Speed limit changes Low emission zones Promote electric car use Compulsory vehicle standards Fuel taxation Industry regulation (e.g. emissions cap)
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - HOUSEHOLD AIR POLLUTION
Household air pollution (solid fuel combustion)
Risk factor for stillbirth and low birth weight
Increased risk of lung cancer (17% of cases), and IHD (18% of global burden)
Interventions
Improved cookstoves (ICS) – use biomass (paper, vegetable matter) and maximise fuel efficiency and have safer emissions
Improving kitchen ventilation (chimneys)
Promote use of “clean” fuels
Ethanol, LPG (propane, butane), solar, electricity
Ban on wood or coal burning in the home, and coal sales for domestic use
Education: move cooking outside, keep children away from cooking areas
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - IONISING RADIATION, RADON EXPOSURE
Radon exposure (colourless, odourless radioactive natural gas)
The main source of indoor radon is radon gas infiltration from soil into buildings. Rock and soil produce radon gas. Building materials, the water supply, and natural gas can all be sources of radon in the home. Basements allow more opportunity for soil gas entry than slab-on-grade foundations.
Increased risk of lung cancer (6% of cases)
Source: ground (rocks and soil), mainly in Wales and SW England
Interventions:
Under-floor ventilation
Natural → suspended ground floor with space underneath (ALLOW SPACE BETWEEN GROUND FLOOR AND THE GROUND ITSELF FOR THE RADON GAS TO ACCUMULATE AND NOT DISPERSE INTO LIVING SPACES)
Active → fan used to blow/extract air from space below a suspended floor
Radon sump (void under building that collects ground gas, piped away)
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - IONISING RADIATION, MEDICAL IMAGING
Medical imaging (X-rays, CT scans) Multiple CTs before 15yr → ↑ risk of breast / brain cancer & leukaemia
Interventions
Only image when clinical indicated (rationalise use)
Use minimum radiation dose (X-ray instead of CT) – clinical trade-off
Use non-radiation imaging (MRI, ultrasound)
Workers:
Protective clothing – lead apron, thyroid shield
Personal radiation dosimeter – to monitor radiation exposure over time
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - UV EXPOSURE
UV exposure (sunlight, indoor tanning) increases risk of:
Melanoma
Basal and squamous cell carcinoma
Public educational messaging
Risks of sun exposure, using sunscreen (high SPF, 15+), wear protective clothing, avoid midday sun
Reduce indoor tanning
Age limits, advertising bans, taxation
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - CHEMICAL EXPOSURE
Asbestos
Increased risk of mesothelioma and lung cancer
Other chemical/toxin exposures
Lymphoma/leukaemia – benzene, formaldehyde, chemical in rubber manufacture
Liver cancer – aflatoxin (from fungus Aspergillus flavus in food)
Bladder cancer – aromatic amines (plastic/dye/rubber manufacture)
- PPE
- Legislation on cancer-related chemicals
- European REACH (registration, evaluation, authorisation and restriction of chemicals); Controls on production, import and use of industrial chemicals in the EU
- Substitution of carcinogenic substances with less dangerous ones; Asbestos ban
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - OCCUPATIONAL STRESS
Occupational stress ← high demands and low control in workplace
- Exacerbated by poor social support networks, job insecurity, poor work/life balance
- Increases risk of depression and anxiety, and adverse health behaviours
Post-traumatic stress disorder (PTSD); Specific occupations at risk: police, firefighters, paramedics, military
- Support programmes at work Stress reduction (mindfulness, lifestyle advice), mentoring, regular breaks, recreational facilities, out-of-office rules, paid sick/annual leave, flexible working
PM2.5, PM 10..?
AIR POLLUTANTS
The term fine particles, or particulate matter 2.5 (PM2.5), refers to tiny particles or droplets in the air that are two and one half microns or less in width.
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - NOISE
Usually occupational, can result in hearing loss
E.g. construction workers, musicians, bar staff, runway marshallers, dentists
Methods to reduce hazard from noise exposure:
- Engineering controls (reduce noise emissions from machinery, barriers)
- Administrative controls (limiting time spent in noisy environment)
- PPE (ear guards)
- Noise monitoring and awareness training in workers
- Audiometric testing (surveillance for deafness)
DESCRIBE THE ENVIRONMENTAL RISK FACTOR - LIVING ENVIRONMENTS AND OTHERS
Policies to reduce barriers to physical activity
Increased green space / equipment for recreation
Encouraging walking and cycling to school
Traffic calming measures
Pedestrianised areas
