unit 9 Air pollution and iatrogenic disease Flashcards
What is air pollution?
Mixture of particulate matter:
- PM10
-PM2.5
-PM0.1
and gases:
- SO2
- NOx
- CO
- NH3
- VOCs
- O3
What are the varying health impacts of size of particulate matters?
PM10-2.5 do not reach alveoli - trap in mucus, cleared by cilia
PM2.5-0.1 greater hazard - reach thin respiratory membrane, larger surface area for adsorbtion
What are the biggest contributors to PM2.5?
Small combustion (residential heating
What are the biggest contributors to NOx?
Road transport
Power stations
What are the biggest contributors to SO2?
Power stations
Small combustion (residential heating)
Construction and manufacturing industry
What are the biggest contributors to ammonia?
Agriculture
What are the biggest contributors to VOCs?
Industrial processes
What effect on health does which air pollution have?
Headache and anxiety
Impact on CNS
Irritation, inflammation and infections
Asthma and reduced lung capacity
COPD
Lung cancer
Irritation of ENT
CVDs
Impacts on liver, spleen blood
Impacts on repro system
How many deaths is man-made air pollution responsible for?
28,000-36,000 deaths
Who are most at risk to air pollution?
Older people 65+
Children
Communities with poorer air quality
CVD or respiratory disease patients
What affect can air pollution have throughout life?
Low birth weight
Children:
-Asthma, slower development of lung function, development problem, wheezing and coughs, atherosclerosis
Adults:
- Asthma, CHD, stroke, lung cancer, COPD, diabetes
Elderly:
- Asthma, accelerated decline lung function, lung cancer, dementia, diabetes, heart attack/failure/stroke
What measures can be taken to clear air pollution?
Planning
Development management
Clear air zones
Reducing emissions from public transport
Smooth driving and speed reduction
Walking/cycling
Awareness rising
What measures can patients take to reduce effect of air pollution?
Car: windows closed, internal air circulation
Avoid peak traffic time
Walk the furthest from the road
More time around less busy roads
Excercising: good for cardio and resp health
Indoor air pollution: ventilation, low emission stoves, close windows
What is iatrogenic disease?
Condition or disease that has resulted from treatment and/or actions of health care professionals
What is the prevalance and severity of iatrogenic disease?
8-12% hospital admissions due to effects of medical treatment
1/3 of these result in moderate-severe disability or death
How common is misdiagnosis (US)?
10-20% cases
What are the effects of chemotherapy/radiotherapy?
Hair loss
Intestinal disturbances
Aplastic anaemia
Diabetes insipudus
Infertility
What can neutropenia be caused by?
Chemotherapy
Bone marrow disorders
Sepsis
TB
Autoimmune diseases
Hepatitis
What is neutropenia?
Decreased concentration of neutrophils in the blood
Neutrophils = WBCs
What are the symptoms of neutropenia?
Fever
Mucositis of gastrointestinal tract
Abdominal pain
What is a common complication of chemotherapy?
Febrile neutropenia (FN)
Neutropenic fever
Short term morbidity and mortality
Long term increased risk of infection
High incidence in lymphoma patients
How long is the average stay in hospital due to neutropenia?
11.5 days
What are the types of errors that lead to iatrogenic disease?
Errors in diagnosis
Improper performance
Failure to supervise/monitor
Failure t orecognise a complication of treatment
Medication errors
Where can diagnostic problems come from and result in?
Absence of and indication of disease, pre-symptomatic disease -> aggressive screening/overly aggressive pursuit of diagnostic tests -> overdiagnosis
Symptomatic disease -> delayed presentation, process errors, diagnostic testing more harmful, incorrect/delayed diagnosis
