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CHapter 8

by: Gabriela Saint-Louis

CHapter 8 1101

Gabriela Saint-Louis
GPA 3.04
Introduction to Public Health and Health Services
Tamara Henry

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Introduction to Public Health and Health Services
Tamara Henry
Class Notes
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This 5 page Class Notes was uploaded by Gabriela Saint-Louis on Friday March 13, 2015. The Class Notes belongs to 1101 at George Washington University taught by Tamara Henry in Spring2015. Since its upload, it has received 139 views.


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Date Created: 03/13/15
Chapter 8 Environmental Health amp Safety Defining Environment For the purpose of this topic environment will be defined to imply physical environment under which are three different categories 1 Unaltered natural in addition to oods earthquakes and volcanoes which have always been a part of the physical environment i daily exposures to communicable diseases in water and food recently i Radon increases the risk of lung cancer ii exposure to naturally occurring sunlight increases chances of skin cancer Melanoma potentially lethal skin cancer especially among lightskinned individuals 2 altered re ects impact of chemicals radiation and biological products that were introduce into the environment ranges from industrial chemicals such as pesticides benzene and chloro uorocarbons to elements mined from the earth such as mercury and lead includes radiation from nuclear energy and medical wastes Biological impacts encompass introduction of invasive species and the management of biological wastes 3 built environment relatively new concept differs by geography and stage of social and economic development includes all the impacts of the physical environment as a result of human construction i injuries and exposures in the home the transportation system and where we work and play ii factors ranging from the way we build and heat our buildings and cook our food to the way we travel from place to place iii in uences our safety through its impact on injuries and hazardous exposures iv also in uences our activity levels and our social interactions which impact our health v subtle impacts of built environment the way cities are built affects the amount of exercise we get and quantity of noise pollution we experience Burden of Disease due to Physical Environment Two important actual causes of death that represent the largest known impact of the physical environment i Motor Vehicle injuries and exposure to toxic waste combined cause 100000 deathsyr represents about 20 of preventable deaths in US and 10 of all deaths in US CDC Motor Vehicle i especially heavy impacts on the young number one cause of death in US among those 124 years of age Impact of Toxic Substances on Population Health i extends beyond acute symptoms such as skin and respiratory irritation to chronic conditions difficult to measure due to the length of time substance may take to affect the body many toxic exposures occur in occupational settings about 5000 deaths to such injuriesyr iv cannot evaluate impact of toxic exposures solely by tracing them to human deaths and disabilities Ecological impart of environmental factors can have longterm and largely irreversible consequences Once chemicals radiation and biological products are released into the environment the process cannot generally be reversed Our interaction With thsical Environment range of approaches developed in addressing issues regarding how the unaltered altered or built environment affects health i Risk Assessment formal process that aims to measure the potential impact of known hazards 0 a hazard indicates the inherent danger of an exposure While a risk assessment aims to take into account not only the inherent danger but also 0 the quantity route and timing of the exposure ex dangers of radiation came to light after high levels of cancer were detected in workers Who painted watches with radiationcontaining paint for the purpose of nighttime illumination Risk assessment attempts to evaluate the impact of environmental exposures one at a time and to measure the types and magnitudes of the impacts 0 if substantial risk is found process reviews options to protect detect and react to minimize the burden of disease to humans 0 built in margin of error designed to provide extra protection for especially vulnerable individuals or populations ii Public Health Assessment goes beyond a risk assessment by including data on actual exposure in a community Addresses not just the risks in a specific location but also the risks to large numbers of individuals and often to the population as a whole both risk assessments and public health assessments focus exclusively on the health impacts on human beings iii Ecological Assessment Broad concern about the impacts of contaminants on ecological systems ranging from chemicals to radiation to genetically altered crops has made clear the importance of ecological risk assessments Human health consequences remain an important but not necessarily direct consequence of the impacts of environmental contamination or pollution ex impacts of Mercury iv Interaction Analysis approach to environmental diseases this approach implies that to understand and control the impacts of environmental exposures it is necessary to take into account the effect of two or more exposures risk assessment approaches make the assumption that each exposure stands on its own one exposure with relative risk of 4 and second relative risk of 6 assumption of exposure to both results in a relative risk of 10 0 in situations now recognizing that there are interactions between exposures themselves so that the presence of both exposures results in an overall impact much greater than expected f 0 multiplicative reaction i examplies the multiplicative interaction between two risks ii having both exposures results in a relative risk of a bad outcome of 4 times 6 or 24 instead of 10 iii ex multiplicative interaction between radon and cigarette smoking 0 Cigarette smoking and radon exposure are multiplicative when both are present the hazard is multiple i using EPA figures when both cigarette smoking and a level of radon exposure of well over the maximum recommended level are present the relative risk of lung cancer increases over 40 times Unintentional vs Intentional Injuries In the US it is estimated one person dies every three minutes due to Violence or injury i leading cause of death among persons aged 144 yrs old Unintentional Injuries brought about on purpose that is by intention whether the injury is selfin icted or meant for others i can directly impart entire populations bioterrorist actions that lead to fear and fatalities or ii can directly impact individuals such as suicide Unintentional Injuries i encompass injuries sustained in motor vehicle collisions drowning falls fires unintentional poisonings and many other incidents current actions in place to keen population safe Outbreak investigations often Viewed as quintessential public health recent years public health agencies have been increasingly integrated into a National Incident Management System NIMS part of the Department of Homeland Security DHS i central Feature of NIMS is ICS incident command system widely used by police fire and emergency management agencies goal to integrate their approaches into ongoing operations and not solely for emergency situations ii DHS allhazards approach uses same approach to preparing for manytypes of disasters including use of surveillance systems communications systems evacuations and an organized health care response recognizes the need for basic public health infrastructure to respond not only to the dramatic crisis or emergency but to daytoday needs as well iii CDC framework used to prevent intentional and unintentional injury and diminish associated consequences identifies and monitors the injury problem conduts research to guide decision making empowers states through funding and technical assistance builds partnerships for prevention builds awareness through communication and education collaborates with partners around the globe to prevent violence and injuries globally


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