Week 12: Environmental Health Injuries/Environmental Disasters Flashcards
Define injury.
Physical damage caused by excessive transfer of energy to human tissues or by the lack of essential factors for energy production or for maintenance of homeostasis; many preventable through environmental and behavior modifications
Define injury epidemiology. What are the 2 injury classifications?
Characterize distribution in
populations, quantify scope, monitor patterns and trends, evaluate countermeasures
Categorization: intentional vs. unintentional
What are 4 details about the Haddon matrix?
William Haddon applied public health triangle to injuries: interactions
among host, disease vector, and environment
Each matrix cell suggests injury prevention, control strategies
Haddon (1973) expanded concept to options analysis (using 10 general injury-control strategies to break causation chain)
1st applied to road traffic injuries (RTIs), dramatic reductions
Create a scenario using the Haddon matrix with road traffic injuries.
Pre-phase:
Alcohol; speed (host)
Tires, brakes (agent)
Signs; signals; road surface (environment)
Event:
Belt and helmet use (host)
Seat belt; airbags (agent)
Side slope; guardrails (environment)
Post-event:
Health; age (host)
Fuel system; materials (agent)
EMS response; road shoulders (environment)
What are the 10 options in Haddon’s options analysis?
- Prevent creation of hazard
- Reduce the amount of hazard
- Prevent the release of a hazard that already exists.
- Modify the rate of distribution of release of the hazard from its source.
- Separate, by time or space, the hazard from the host.
- Physically separate, by barriers, the hazard from the host.
- Modify surfaces and basic structures to minimize injury.
- Make that which is to be protected more resistant to damage.
- Mitigate damage already done.
- Stabilize, repair, and rehabilitate the injured person.
What are the 3 E’s of implementing interventions?
Education - encourage public to adopt safe behaviors voluntarily (e.g., driver education); can be less expensive than alternatives but not always effective in isolation (i.e., texting & driving may
need regulation); effect attenuation
Enforcement - if consistent, may increase compliance when vol.
acceptance low (e.g., motorcycle helmets reduce death/severe injury by ~55%; in voluntary states, half of riders wear them; in mandatory states w/enforcement, >98% do [NHTSA 2003]); expensive, some people want freedom to take risks
Engineering - design/build safety into products, environments (e.g., barriers between pedestrians and traffic); cooperation not needed; greater upstream costs, and benefits
What are 5 details about U.S. prevention and control policy?
Highways: Highway Safety Act (1970) mandated seatbelts, created National Highway Traffic Safety Administration
(NHTSA)
Consumer products: Consumer Product Safety Commission (e.g, infant cribs, crib recalls)
Voluntary industry standards:
UL, develops standards for electrical industry
ANSI, develops standards across industries and countries
both have environmental and public health safety campaigns
Others: OSHA, Nat’l Fire Protection Assoc., CDC’s Nat’l Center for Injury Prevention and Control (epi. research)
Where no standards/regulations, tort law can be used to set legal precedents on safety
What are the 3 broad categories of intentional injury (violence)? List the 3 categories of countermeasures and give examples.
Self-directed: suicide/parasuicide
Interpersonal: inflicted by another individual or small group
Collective: inflicted by larger groups (states, political groups, militia, terrorist organizations)
Countermeasures:
Enforcement (community policing, etc.);
Engineering (safety locks on guns, etc.); Environmental (improved street lighting, etc.)
What are 2 details about burns?
Burns (scald, contact burn, flame burn, electrical, chemical, radiological, UV)
Countermeasures:
Education, enforcement (e.g., building codes)
Engineering (e.g., smoke detectors)
Environment (e.g., elevated hearths)
What are the countermeasures for drowning?
Countermeasures:
Education (e.g., swimming instruction)
Enforcement (e.g., lifeguards)
Engineering (e.g., pool covers)
Environmental (e.g., fencing)
What are the countermeasures for falling?
Countermeasures:
Education (e.g., balancing exercises)
Enforcement (e.g., roof barrier laws)
Engineering (e.g., barriers in high-rise buildings)
Environment (e.g., grab bars)
What are the countermeasures for poisoning?
Countermeasures:
Education (e.g., warning labels)
Enforcement (e.g., CO alarms)
Engineering (e.g., child-resistant packaging)
Environmental (e.g., locked storage)
What is 1 detail about road traffic injuries? Give risk factors for both road users and roadway factors.
Growing global epidemic of RTIs w/rising motorization; >1 million die, 10 million permanently disabled per year
from RTIs; 2nd leading cause of death in < 44 years old
Road users: pedestrians, two-wheeled vehicle users most at risk, esp. in developing countries (Zegeer & Bushell 2012); seat belts decrease deaths and non-fatal injuries by 50%; child safety seats also reduce risk; alcohol increases probability of a crash, and death or serious injury
Roadway factors: roads used by many, not planned for safety; safe road network includes hierarchy of roads, infrastructure to protect pedestrians, cyclists; etc. vehicle design (e.g., structural cage around passenger
compartment, lights, etc.)
Define disaster. What is the Standard EM-DAT disaster definition?
Disaster: a serious disruption of the functioning of society, causing widespread human, material or
environmental losses, that exceeds the local capacity to respond, and calls for external assistance
Standard EM-DAT (Emergency Events Database) disaster definition:
At least 1 of:
≥10 killed
≥100 affected
State of emergency
Call for international assistance
What are road traffic injury countermeasures?
Education:
Pedestrian safety education
Bicyclist training schemes
Motorist education
Helmet and seat belt promotion
Enforcement:
Speed limits
Graduated driver’s licenses
Strategies for reducing alcohol-impaired driving
Helmet and seat belt use laws
Engineering:
Puncture-resistant gas tanks
Energy-absorbing interiors
Crush zones and reinforced cages around occupants
Air bags
Environmental:
Area-wide traffic calming
Bicycle paths and lanes
Energy-absorbing materials in front of bridge columns and other fixed objects
Breakaway light poles
Roadway lighting at high-frequency pedestrian crossings
What are countermeasures for playgrounds?
Countermeasures:
Education (e.g., children, parents, teachers)
Enforcement (e.g., adult supervision)
Engineering (e.g., woodchips, mulch, or pea gravel surfaces)
Environmental (e.g., separation of equipment by user age)
What are countermeasures for the home?
Countermeasures:
Education (e.g., choking response training)
Enforcement (e.g., building code enforcement)
Engineering (e.g., hot water heater temp. controls)
Environmental (e.g., fire alarms, stair gates, cupboard locks)
What are the 3 kinds of disasters? Give 2 additional details.
Classified by causative agent/hazard: Natural (incl. biological hazards/outbreaks)
Technological (man-made)
Hybrid (e.g., radiation disaster after 2010 Fukushima earthquake and tsunami)
Few purely “natural,” e.g., climate change from human activities, leading to increased natural disasters
Disaster risk: function of linked physical, social, environmental vulnerabilities (U.N. Hyogo Framework for Action, 2005); population exposure + vulnerability + capacity
What are the 2 types of natural and 3 types of technological environmental disasters? Give examples.
Natural:
Hydro-meteorological: drought, wildfires, heat waves, storms, floods
Geophysical: earthquakes, landslides, volcanic eruptions, tsunamis
Technological:
Toxic: chemical, radiological
Thermal: fires, explosions
Mechanical: transport accidents
Nuclear is all three (toxic, thermal, and mechanical)
What are 2 details about the public health impacts of disasters?
Disasters cause deaths, injuries, and illnesses
Disasters may overwhelm medical resources and health services
What are 4 details about disasters and health care infrastructure?
Disasters may destroy hospitals
Disasters may disrupt routine health services
Disasters may disrupt preventive activities
Consequence: long-term increases in morbidity and mortality
What are 3 details about disasters and the environment and population?
Disasters may increase potential for communicable diseases
Disasters may exacerbate environmental hazards
Consequences: increases in morbidity and premature death, decreased quality of life
What are 3 details about disasters and the psychological and social behavior?
Disasters may cause generalized panic or paralyzing trauma
Disasters may provoke increases in anxiety, depression and neuroses
Disasters may lead to post-traumatic stress disorder (PTSD) at epidemic levels
What are 3 details about disasters and the food supply?
Disasters may disrupt the food supply
Disasters leading to food shortages may cause specific micronutrient deficiencies
Disasters may provoke severe nutritional consequences including famine and starvation
