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Environmental Medicine > Ways We Are Exposed > Flashcards

Ways We Are Exposed Flashcards

1
Q

what is included in EM? what does it not include?

A

includes air pollution, heavy metal exposures, toxic chemical exposures
does not include microbiology!!

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2
Q

what is ecology?

A

the study of relationships between organisms and their environments

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3
Q

what is chemical sensitivity?

A

not related to histopathological changes
are hyper-sensitive to toxins (canary in a coal mine effect)
are sensitive to one or a few identifiable chemicals

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4
Q

what is the definition of multiple chemical sensitivity?

A

an environmentally related illness which results in a toxicant-induced loss of tolerance
often no detectable triggers and pt may be allergic to everything

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5
Q

what group of people is more likely to have multiple chemical sensitivity? what comorbidities tend to go along with multiple chemical sensitivities?

A

85% of the time see in upper SES, caucasian, middle aged females
comorbidities: fibromyalgia, chronic fatigue syndrome, psychiatric/mental health conditions

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6
Q

6 criteria in order to dx someone with multiple chemical sensitivies?

A
  1. sxs are reproducible w/repeated chemical exposures
  2. condition has persisted for significant period of time
  3. low levels of exposure result in manifestations of the syndrome
  4. sx improve when triggering chemicals are removed
  5. responses often occur to multiple chemically unrelated substances
  6. sx involve multiple organ systems
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7
Q

four large ways we are exposed to toxins?

A

occupation
hobbies
home
childhood

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8
Q

main jobs that have a lot of toxin exposure for the employees?

A 
building-related illness (Sick Building Syndrome and Building Related Illness)
agriculture
air travel
chemists
clinicians
dentist
engineers
florist
hair stylists
janitors/maid
mechanics
military
miners
painters
teachers
welders
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9
Q

what hobbies pose risk for more exposure to toxins?

A

gun enthusiasts (making bullets)
stained glass (lead)
photography
pottery (lead)

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10
Q

what is sick building syndrome vs building-related illness?

A

sick building syndrome: describes a situation where people experience sxs of ill health that seem to be linked to spending time in a building where no specific cause can be identified
building related-illness: recognized diseases being caused by being in said building

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11
Q

ssxs of sick building syndrome?

A

fatigue, H/A, nausea, EENT irritation, chest tightness, asthma, concentration issues /memory loss

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12
Q

potential contributing factors to sick building syndrome?

A

chemicals like formaldehyde
mold
recirculation of air
poor ventilation

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13
Q

what toxins are agriculturists affected by?

A

pesticides
organic and inorganic dusts
noise

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14
Q

what are pilots and flight attendants exposed to in their jobs?

A

noise

radiation

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15
Q

what 2 types of chemist are at most risk for exposure?

A

esp analytical chemists who may be handling or preparing samples for analysis
maternal occupation as a chemist associated with conotruncal heart and neural tube defects

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16
Q

what are clinicians who are women especially at risk for in regards to pregnancy and their children?

A

increased risk if a nurse for the development of hydrocephalus and L ventricular outflow tract heart defects

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17
Q

what are dentists exposed to?

A

mercury- cumulative exposure shows (+) association w/decreased peripheral nerve function

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18
Q

women engineers are at risk of what birth defect with their children?

A

conotruncal defects

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19
Q

what are florists exposed to?

A

pesticides

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20
Q

what are hair stylists exposed to?

A

formaldehyde

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21
Q

what are mechanics exposed to?

A

asbestos
industrial chemicals such as heavy metals in brake fluid, degreasers, detergents, paints, fuels, solvents such as benzene, toluene, xylene, diesel exhaust, and carbon monoxide

22
Q

what are military personnel exposed to? ssxs? associated with what disorders/diseases?

A

exposed to many types of chemicals, radiation, air pollution, warfare agents such as agent orange
agent orange exposure can be associated with amyloidosis, B cell leukemia, chloracne, DM 2, hodgkin’s dz, ischemic heart disease, multiple myeloma, non-hodgkin’s lymphoma, parkinson’s dz, peripheral neuropathy, porphyria cutaea tarda, prostate CA, respiratory CAs, soft tissue sarcomas
ssxs: fatigue, H/A, joint pain, indigestion, insomnia, dizziness, respiratory d/os, memory problems

23
Q

what are miners at risk of being exposed to?

A

inorganic mercury

24
Q

what are toxins painters are exposed to? what can they contain?

A

cadmium, chromium, manganese, mercury in flake white or cremintz white, naples yellow, chrome yellow, chrome green, cobalt violent
thinners and solvents

25
Q

what birth defects might a teacher see in her child if a preschool teacher?

A

increased risk of birth defects such as cataracts and cleft lip w/w/o cleft palate

26
Q

what are welders exposed to?

A

iron dust, welding fumes (increased risk of lung CA, SCC)

manganese: fertility problems, parkinsonian sxs, neurobehavioral changes at low levels

27
Q

what in general, in the home, can cause exposure?

A 
lead
building materials (plastic)
radon gas
natural gas
air fresheners
lead pipes
compact fluorescent light bulbs
air conditioners, humidifiers, dehumidifiers
carpet
floor tiles
draperies and other window treatments
tobacco smoke
pets
windows
28
Q

what do plastic building materials emit?

A

polyvinyl chloride

pthalates

29
Q

what is radon?

A

a noble, radioactive gas that is colorless, odorless and tasteless

30
Q

what is the make-up of natural gas?

A

methane + lesser degree carbon dioxide, nitrogen and hydrogen sulfide

31
Q

what chemical can air fresheners contain?

A

benzene

32
Q

what chemicals can carpet contain?

A

VOCs
formaldehyde
biological contaminants
retention of pesticide residue

33
Q

what in the home can contain chemicals/toxins?

A 
plastic containers and plastic wrap
non-stick cookware
food
gas appliances 
cleaning products
laundry room 
bathroom items
bedroom items
living room items
basement
garage
34
Q

what can plastic containers and plastic wrap have in them?

A

bisphenol-A and pthalates

BPA is a xenoestrogen

35
Q

what is in Teflon cookware?

A

polytetrafluroethylene or PTFE

bioaccumulation is a concern

36
Q

what are the major classes of pesticides?

A

carbamates
chloroacetanilides
organophosphates (acetylcholinesterase inhibitors)
triazines

37
Q

ssxs of organophosphate poisoining?

A

fatigue, H/A, brain fog, slow response time, possible muscular weakness

38
Q

dirty bakers dozen fruits?

A 
strawberries
apples
nectarines
peaches
celery
grapes
cherries
spinach
tomatoes
sweet bell peppers
cherry tomatoes 
cucumbers
hot peppers
kale/collard greens
39
Q

clean fifteen fruits and veggies?

A 
avocados
sweet corn
pineapple
cabbage
sweet peas
onions
asparagus
mangoes
papaya
kiwi
eggplant
honeydew melon
grapefruit 
cantaloupe
cauliflower
40
Q

4 heavy metals?

A

mercury: fish
cadmium: shrimp, sunflower seeds, seaweed
arsenic: water, shellfish, fish, seaweed
lead: possibly from water, a little from fish

41
Q

what types of toxins can be in food?

A

pesticides
heavy metals (mercury, cadmium, arsenic, lead)
PCBs/OCCs (organochlorine compounds)
PFOA (perfluorooctanoic acid, microwave popcorn)
heterocyclic amines (grilling foods)
PAHs (grilling foods)

42
Q

what are you exposed to with gas appliances? how to prevent exposure?

A

carbon monoxide and nitrogen dioxide

prevent exposure by making sure proper venting, service yearly, buy equipment only with national testing agency seal

43
Q

what type of cleaning products should you avoid?

A

aerosols

44
Q

what could be toxic in the laundry room?

A 
scented detergents
fabric softeners (quaternary ammonium compounds, pthalates, synthetic musks, detrimental respiratory effects)
dry cleaned clothes brought into the home (tetrachloroethylene [PERC])
45
Q

health effects of tetrachloroethylene exposure?

A

developmental
neurological
respiratory

46
Q

toxic items in the bathroom?

A

cosmetic/personal care products: make-up (hydroquinone), hair dye, hair spray, nail polish remover, perfumes
medications
moisture, mold, mildew

47
Q

toxic items in a bedroom?

A

kerosene heaters (carbon monoxide, nitrogen dioxide)
dry cleaned goods
moth repellents
bedding

48
Q

living room exposure items?

A

fireplaces

wood or coal stove

49
Q

basement toxins?

A 
asbestos
gas appliances
furnace filters 
radon
ground/air moisture
50
Q

4 routes of exposure?

A

inhalation
skin
ingestion
injection

Environmental Medicine (9 decks)

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