Environment and Your Health Exam 1

Environmental Policy

Precautionary Principle

Environmental justice

environmental sustainability viewpoint

The polluter should bear the expenses of carrying out the pollution prevention and control measures introduced by public authorities in member countries, to ensure that the environment is in an acceptable place.

Overnutrition

The transition from mostly infectious conditions to the three major chronic conditions (cancer, heart disease, stroke).

The condition of being sound in body, mind, or spirit. Consensus: Integrates mortality with multiple dimensions of life quality.

Mortality, morbidity, life expectancy, functional status and capacity, and quality of life.

1. clean air
2. safe and sufficient water
3. safe and adequate food supply
4. safe and peaceful settlements
5. stable global environments

The circumstances, objects, or conditions by which one is surrounded. All that which is external to the individual host. It can be divided into physical, biological, social, and cultural factors, any or all of which can influence health status in populations.

Trouble or a condition of the living animal or plant body or one of its parts that imparis the performance of a vital function; morbidity.

Policies and interventions, social environment, access to quality health care, physical environment, and individual (biology and behavior)

Chemical, biologic, physical, social-cultural, built, and natural

Physical inactivity
Driving
Heat stress
Climate change
Motor vehicle and pedestrian injuries
water quality
Mental Health
Social Capitol
Disparate impacts (justice and equality)

-Groups we belong to
-Neighborhoods we live in
-Organization of our workplace
-Policies we create

Toxin-- Man-Made
Toxicant-- Came from something living

-Increased exposures to environmental hazards
-Increased rates of asthma, high blood pressure, elevated blood lead levels, dementia, and other diseases...

Equal protection
Equal access
Fair treatment and meaningful involvement

crowding
poor quality housing
inadequate access to healthy food and recreational opportunities
family turmoil and violence

-Criteria air pollutants
-Hazardous/toxic air pollutants
-Other air pollutants
-Radon-indoor
-Indoor air pollution other than radon

-Water, food and milk sanitation
-Reduced physical crowding
-Improved nutrition
-Central heating with cleaner fuels
-Chlorination of water
-Removal of lead from gasoline

A. Outdoor air quality
B. Water quality
C. Toxics and Wastes
D. Healthy homes and communities
E. Infrastructure and Surveillance
F. Global environmental health

Sources--> Transport & Fate --> Exposure --> Health Effect

Chemical, biological, and physical

water, air, soil, and food

inhalation, ingestion, and skin absorption

what the body does to the agent

What the agent does to the body

Clinical Intervention Model
Public Health Intervention Model
Environmental Stewardship Model

-Humans are impacting their environment
-The impacted environment subsequently impacts human health
-The world is in an environmental risk transition
-As a consequence, we are in an environmental health transition

1. Clean air
2. safe and sufficient water
3. safe and adequate food suppy
4. safe and peaceful settlements
5. stable global environments

Principal Determinants of Health Worldwide:
1. pollution
2. population
3. poverty

I=PxAxT
(Environmental Impact= Population x Affluence x Technology

Growth in environmental impact=growth in population x growth in affluence x growth in technology

Sunlight comes in, heat goes out but CO2 keeps the heat in

Population, technology, economic political and social values. Human needs and wants

Environmental laws, market adjustments, informal social regulation

1. Tokyo
2. Mexico City
3. Sao Paolo
4. New York City
5. Mumbai

the surging population!
-We've been consuming more food than farmers can produce
-35% of world grain is used to produce livestock feed
-increased demand on soil--> degraded an area of land the area of US and Canada combined

0.3%

The emissions from cars has gone down, but the number of vehicles has increased.

Coal burning

Mercury

You can sell dirty coal to whoever wants it

Coal combustion residuals (coal ash) are byproducts of combustion and are disposed of in the liquid form at surface impoundments and in the solid form at landfills.
-Contaminants: mercury, cadmium and arsenic (associated with cancer)

without proper protection, it can leach into groundwater and can migrate to drinking water sources.

JEWELRY

It's covered in mercury. When heated, it evaporates. Becomes gas and is toxic. Mercury is used to separate gold from rock. Causes neurological and genetic damage. Waste mercury in liquids enters river sediments and vegetation.

exposure= intensity x frequency x duration

Continuous: breathing dust
Cyclic: ozone
Concentrated: wake up call (Chernobyl, Denora, London Fog)
Intermittant: smoking/seasons
Random: living near a factory

Short exposure to high concentration. Examples: Bhopal &

Long-term exposure to low concentrations
asbestos, mesothelioma
lung cancer--radon
carbon monoxide detection

A cluster is when a group of individuals develop the same disease in numbers that appear too large to be due to coincidence.

the study of diseases and health conditions (occuring in the population) that are linked to environmental factors.

epi is primarily an observational science that takes advantage of naturally occurring situations in order to study the occurance of the disease

Host--Environment--Agent

occurance of new disease or mortality within a defined period of observation (week, month, year, etc) in a specific population

measure of disesase frequency and refers to existing cases of disease or deaths

all cases of a disease that exist at a particular point in time relative to a specific population from which the cases are derived.

Ratio of odds in favor of exposure among the disease group (the cases) to the ratio in favor of exposure among the no-disease group (the controls).

1. strength
2. consistency--repeatedly
3. specificity--specific association
4. temporality--cause before effect
5. biological gradient
6. plausibility
7. coherence

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

1. latency-- long time between exposure and response
2. multi-factorial etiology--multiple factors influence the occurrence (and severity) of disease.
3. disease non-specificity (multiple causes besides environmental agents)
4. Individual characteristics-- susceptibility (genetic factors) and effect modifiers (diet, habit, health)
5. changes in response with changing dose
6. Mixed exposures (multiple agent exposures)

Traditional Epi: Disease--> [ ] --> exposure
Traditional Environmental Health:
Exposure--> [ ] --> Disease

Incorporation of biomarkers into analytic, epidemiologic research

Chemical, molecular, biochemical or cellular alterations that are measurable in biological media, such as human tissues, cells, or fluids.

the utilization of biomarkers in the measurement of the body burden of toxic chemical compounds, elements, or their metabolites, in biological materials.

Biomarkers of internal dose: direct measure of toxic chemicals or their metabolites in cells, tissues, or body fluids
markers of biologically-effective dose: assessment of the interaction of the active form of toxicants with their molecular targets.
Markers of early biological effect: assessment of molecular sequelae of toxicant-cell interactions
markers of altered structure and function: assessment of changes int he function or structure of cells and organs
markers of susceptibility: assessment of genotype/phenotype of individuals which predispose them to risk from chemicals

Cancer, heart disease, chronic lower respiratory diseases have all gone up, but the overall death rate has dropped 50%

Africa and Asia

1952 London Fog Episode

1. china
2. india
3. US
4. indonesia
5. brazil

1. India
2. China
3. USA
4. Nigeria
5. Indonesia

food with lots of salt, sugar and fat!

1st: intensive studies at molecular/cellular level
2nd: genome sequencing and cloning
3rd: PUBLIC HEALTH

-Municipal solid waste
-Industrial waste
-Hazardous waste
-Medical Waste
-Radioactive Waste

-little economic incentive for americans to reduce waste
-demographic changes
-degree of urbanization
-consumer preference
-demand for convenience ahead of the economy

INDUSTRIAL!

1973 Marine Protection, Research and Sanctuaries Act

1. Households
2. Institutions
3. Industrial
4. Commercial

Source reduction
Reuse
Recycling
Incineration with energy recovery
Incineration with no energy recovery
Landfill

67%-- LANDFILL

300-700 million tons/year

chemical industry

1. Ignitability
2. Corrosivity
3. Reactivity
4. Toxicity

Concentrated Animal Feeding Operations

John Snow worked with the cholera epidemic in London (showed the spread of disease was related to extracting water from the pump) and invented the central tenets of epidemiology.

Law coming out of a court case

Passed by legislators (federal). Pretty general.

state, local, federal governments. Which level do you intervene?!?

federal government has environmental law authority and delegates it to states

Enforcements
Injunction-- order issue that says you have to do something
Penalties-- if you violate the law, government asks you for money or can sue you

rules or commands enforceable by the positive power of the state
-statutes, ordinances, court rulings backed by the government
-law has enforceable power that could be used against you

Laws that protect nature and ecology; and laws that protect public health and welfare

Clean Air Act
Clean Water Act
Safe Drinking Water Act
Resource, Conservation, and Recovery Act
Superfund
Toxic Substances Control Act
National Environmental Policy Act

1. Societal needs vs. Individual wants
-Striking proper balance; constitutional issues?
2. Turf wars
-National vs. State vs. Local
-Executive vs Judicial vs Legislative
-Agencies: EPA vs CDC vs OMB vs NIOSH

Agencies!

Adjudication and Rulemaking
-Administrative Procedure Act

a decision about a particular claim by a particular entity; assess penalty and injunctive or declaratory relief

agency decisions that affect groups of people, especially the regulated community
-Informal rulemaking: notice and comment
-Formal rulemaking-- Hearing

1. Hazard Identification (wight evidence that substance causes adverse health effects; determine if relevant to 2 settings)
2. Dose/Response Assessment (extrapolate from observable to non-observable range or from animals to humans)
3. Exposure Assessment (where substance found, potential routes, how ppl exposed, who is exposed, magnitude, duration, timing)
4. Risk Characterization (risk estimates, significance of risk, assumptions and uncertainties)

1. Data on level playing field for everyone to see
2. Structured decision making process

1. Data gaps and uncertainties
2. Often hard to combine science
3. Doesn't have consistant meaning
4. RA takes a fair amount of time and sometimes incomplete. Often cannot wait that long.

35%