Answer 5 of 7 questions. In answering questions please be specific and refer back to class readings or presentations as needed. Long essays are not needed but specific detail or examples would help support your arguments. i will attach the class slides for your reading.
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Final Exam
Introduction to Environmental Health 19.506
Fall 2018, Due in Class on Dec 13
Answer 5 of 7 questions (20 points each). In answering questions please be specific and refer back to
class readings or presentations as needed. Long essays are not needed but specific detail or examples
would help support your arguments.
1. We have studied a wide range of environmental health challenges in class during the semester.
What is the most important environmental health issue we face and why? Provide data to
support your argument.
2. You are the Mayor of San Francisco and want to establish a zero waste policy that addresses
household solid waste as well as hazardous waste and waste from restaurants and offices.
Importantly, because it is San Francisco, citizens are concerned about what happens to their old
electronics. Describe four key elements of this strategy and why they would be important to
achieving this zero waste goal. Provide data to back up your points.
3. You are a worksite health and safety manager designing a health and safety program for a
company that makes microwave popcorn. What are the main worker health hazards one might
expect? What elements would your health and safety plan have to address these hazards and
why (use each level of the industrial hygiene hierarchy of controls).
4. You are the president of a sub Saharan African country and are building program for sustainable
water resources. What are the major water quality concerns you have and why? What are the
core aspects/elements of the plan to ensure safe, clean and accessible water.
5. You are the director of a national taskforce on sustainable food systems tasked with significantly
reducing the impact of food production on environment and health while reducing the incidence
of foodborne illness. What principles should guide the vision for the taskforce and what are the
core elements of its plan and why?
6. You are the mayor of a New England small city. Outline the core elements of an emergency
response plan to address a natural disaster. What are the key challenges you might face in
responding to such a disaster and how would you overcome them?
7. You are president of a major retailer that is being pressured by consumers/advocates to
eliminate the use of methyl paraben in the products it sells (handsoap, paint, cosmetics)? What
are the potential health impacts of methyl paraben (use the TURI chemical hazard evaluation
template to the extent feasible). What process steps would you undergo to examine
alternatives and what considerations might be important in thinking about those alternatives so
as to avoid risk trade-offs?
Chemical Hazard Evaluation (template)
Chemical Name:
Endpoint [Source]
Environmental
Persistence in Water (days) [European Chemicals Agency – REACH
Registration Database (ECHA-RR)]
Persistence in Soil (days) [ECHA-RR]
Persistence in Sediment (days) [ECHA-RR]
Persistence in Air (days) [ECHA-RR]
Bioconcentration Factor (BCF) [ECHA-RR] or log Kow [Hazardous
Substances Data Bank (HSDB); ECHA-RR]
Acute Aquatic Toxicity LC50 or EC50 [HSDB; ECHA-RR]
Chronic Fish Toxicity (ChV) (mg/l) [HSDB; ECHA-RR]
Environmental Fate [HSDB; ECHA-RR]
Health
Carcinogenicity [International Agency for Research on Cancer (IARC);
California Office of Environmental Health Hazard Assessment
Proposition 65 List of chemicals known to the State of CA to cause
cancer or birth defects or other reproductive harm (Prop 65); National
Institute for Occupational Safety and Health Pocket Guide (NIOSH-PG);
ECHA-RR; National Toxicology Program (NTP); HSDB]
Mutagenicity/Genotoxicity [Chemical Carcinogenesis Research
Information System (CCRIS); Genetic Toxicology Data Bank (GENE-TOX);
Registry of Toxic Effects of Chemical Substances (RTECS-ToxPlanet);
ECHA-RR]
Reproductive/Developmental Toxicity (e.g. include
neurodevelopmental) [Prop 65; Developmental and Reproductive
Toxicology Database (DART); RTECS-ToxPlanet; Haz-Map; ECHA-RR]
Asthmagen [Association of Occupational and Environmental Clinics
(AOEC); ECHA-RR]
Sensitizer (Skin, Respiratory) [AOEC; Haz-Map; ECHA-RR]
Irritant (Eye, Skin, Respiratory) [Haz-Map; HSDB; MSDS; ECHA-RR]
Neurotoxicity [Haz-Map; Grandjean & Landrigan]
Acute Mammalian Toxicity LD50 (Oral, Dermal) [ChemIDPlus;
HSDB; RTECS-ToxPlanet; ECHA-RR]
Acute Mammalian Toxicity LC50 (Inhalation) [ChemIDPlus; HSDB;
RTECS-ToxPlanet; ECHA-RR]
Endocrine Disruption [The Endocrine Disruption Exchange List of
Potential Endocrine Disruptors (TEDX); European Commission Endocrine Disruptors]
Target Organs [NIOSH-PG; Haz-Map]
CAS #:
Data
Chemical Hazard Evaluation (template)
Chemical Name:
Endpoint [Source]
Breakdown Products
Metabolism Information [HSDB; ECHA-RR]
Byproducts [HSDB]
Combustion Byproducts [HSDB]
Exposure Indicators/Relative Measures of Toxicity
OSHA PEL (Occupational Safety and Health Administration
Permissible Exposure Limit) [NIOSH-PG; HSDB; RTECS-ToxPlanet]
NIOSH REL (NIOSH Recommended Exposure Limit) [NIOSH-PG;
HSDB; RTECS-ToxPlanet]
NIOSH IDLH (NIOSH Immediately Dangerous to Life and Health)
[NIOSH-PG; HSDB]
ACGIH TLV-TWA (American Conference of Governmental
Industrial Hygienists (Threshold Limit Value – Time Weighted
Average) [RTECS-ToxPlanet]
RfD (Reference Dose) [US EPA Integrated Risk Information System
(IRIS)]
RfC (Reference Concentration) [IRIS]
GHS Phrases [Sigma-Aldrich SDS; Registration, Evaluation,
Authorisation and Restriction of Chemicals (REACH)]
Safety
Flash Point [NIOSH-PG; HSDB; ECHA-RR; SDS]
Flammability [HSDB; ECHA-RR; SDS]
Vapor Density [HSDB; SDS]
Vapor Pressure [NIOSH-PG; HSDB; ECHA-RR; SDS]
Lower Explosive Limit (LEL) [NIOSH-PG; HSDB; SDS]
Upper Explosive Limit (UEL) [NIOSH-PG; HSDB; SDS]
Reactivity [NIOSH-PG; HSDB; ECHA-RR; SDS]
Boiling Point [NIOSH-PG; HSDB; ECHA-RR; SDS]
Regulatory – Domestic
Massachusetts Toxics Use Reduction Act List [MA-TURA]
US EPA High Production Volume Chemical [HPV]
Regulatory – International
Canadian Domestic Substances List [DSL]
REACH Substances of Very High Concern [SVHC]
International Chemical Secretariat Substitute It Now (SIN) List
Template Revised August 2018 – Website: guides.turi.org/beyondmsds
CAS #:
Data
PUBH 5061
Issues in Environmental Health
Joel A. Tickner, ScD
Fall 2018
• Why should public health professionals care
about the environment?
• What do you think is the most important
environmental health issue
• https://www.ehn.org/carbon-dioxide-makesfood-less-healthy-2598739140.html
Humans
Clearly
Impact the
Environment
Increasing population increases impact on environment, then
environment in turn impact humans
World Health Organization
Environmental health comprises those aspects
of human health, including quality of life, that
are determined by physical, chemical,
biological, social, and psychosocial factors in
the environment. It also refers to the theory and
practice of assessing, correcting, controlling, and
preventing those factors in the environment that
can potentially affect adversely the health of
present and future generations.
How does the built, social and natural
environment affect your health?
• Average adult
– Eats 1.5 kg food
– Drinks 2 kg water
– Breaths 20 m3 air
• Your health can be affected
by each component of your
environment (work,
community, school, home,
global)
• Effects can be caused by:




Chemical hazards
Biological hazards
Physical hazards
Socioeconomic stressors
WHAT ENVIROMENTAL
HEALTH RISKS ARE YOU
AWARE OF?
World Health Organization
DALY = disability adjusted life years. 1 DALY = one lost year of
“healthy” life…accounts for mortality and incident disease
WHO DALY calculation
• DALYs for a disease or injury are calculated as the sum of the
years of life lost due to premature mortality (YLL) in the
population and the years lost due to disability (YLD) for incident
cases of the disease or injury.
– YLL = the number of deaths at each age multiplied by a global standard
life expectancy of the age at which death occurs.
– YLD = number of incident cases in a period × average duration of the
disease × disability weight
– The disability weight reflects the severity of the disease on a scale from 0
(perfect health) to 1 (death) and an additional 3% time discounting and
non-uniform age weights that give less weight to years lived at young and
older ages
– Using discounting and age weights, a death in infancy corresponds to 33
DALYs, and deaths at ages 5–20 years to around 36 DALYs.
a)Mathers CD, et al. The burden of disease and mortality by condition: data, methods and results for 2001. In: Lopez AD, et al, eds.
Global burden of disease and risk factors.Oxford University Press, 2006:45–240. b)World health report 2004: changing history 2004 c)
Global Health Risks 2009 Introduction
http://gamapserver.who.int/gho/interactive_charts/phe/total_percentage/atlas.html
WHO Environmental Disease Burden
• ~ ¼ of global disease burden and deaths environmentallyrelated (greater in developing countries)
– environmental risk factors play a role in more than 80% of the
diseases regularly reported by WHO
• In children, environmental risk factors can account for >
1/3 of the disease burden.
• What do you think are the major environmental causes of
disease and death?
http://www.who.int/gho/phe/en/index.html
WHO Preventing disease through healthy environments:
WHO Environmental Disease
Burden
• Five environmental exposures together account for
nearly 10% of deaths and disease burden globally
– Lead, outdoor urban air pollution, indoor smoke from
solid fuel, unsafe water, sanitation, hygiene & climate
change
• For some diseases environmental causes key: 88%
of diarrheal disease
http://www.who.int/gho/phe/en/index.html
WHO Preventing disease through healthy environments:
Disparities in Environmental
Health
• Democratic Republic of the Congo:
– http://www.who.int/quantifying_ehimpacts/national
/countryprofile/demrepcongo.pdf?ua=1
• US
– http://www.who.int/quantifying_ehimpacts/national
/countryprofile/unitedstatesofamerica.pdf?ua=1
• Sweden
– http://www.who.int/quantifying_ehimpacts/national
/countryprofile/sweden.pdf?ua=1
Environmental Health and Global
Children’s Health
WHO 2000
• Over 40% of the global disease due to environmental
risk factors may fall on children <5. Yet they are only 10% of the world's population. – 1.3 million children <5 in developing countries died from diarrhea caused by unsafe water supplies and sanitation. – 60% of deaths each year in children <5 are due to acute respiratory infections and asthma caused by indoor air pollution (e.g., from the burning of biomass fuels) and/or unsanitary living conditions. More than 1 billion people lack access to safe water sources within reasonable distance of their home. Only 65% of people in the world have access to safe excreta disposal. Core Concepts • Environment and Human Environment Interactions are Complex Systems – The extent of impact humans have had on earth and our health has increased significantly over the past 50 years • Interconnectedness/Feedback loops/ lifecycle thinking – Damage to ecosystems will likely come back and damage human health • From problems come solutions • Focus on goals rather than inevitabilities WHO: Global change & Environmental Health http://www.who.int/globalchange/en/ UN Global Environmental Outlook • In 150 years human activity has – – – – increased CO2 by 30% , doubled the methane concentration, introduced ozone-destroying chloroflurocarbons, increased emissions of sulfur and nitrogen producing acid rain, – increased environmental levels of lead, cadmium and zinc by a factor of 18. • More than ½ of all the world’s surface fresh water is put to use by humans. If present consumption continues, 2/3 of population will live in waterstressed conditions by 2025. UN Global Environmental Outlook • 47 per cent of the worlds population lives in urban areas. Urban air pollution problems are reaching crisis dimensions in many cities in the developing world. • Some 20 per cent of the world's susceptible drylands are affected by human-induced soil degradation, putting the livelihoods of more than 1,000 million people at risk. Global Environmental Outlook • The high-income countries, home to 20 per cent of the world's population, account for about 60 per cent of world’s commercial energy use. • The countries projected to suffer from serious shortfalls in food and water supplies are also those faced with rapidly growing populations and urbanization, low productivity agriculture, high debt and insufficient wealth to import food. What can be done? Comments from UN Gobal Environmental Outlook 2000…. • A tenfold reduction in resource consumption in the industrialized countries is a necessary long-term target if adequate resources are to be released for the needs of developing countries. • The accumulation of people, their consumption patterns, travel behavior and their urban economic activities have a large impact on the environment in terms of resource consumption and waste discharges. However, cities also offer opportunities to manage a growing population in a sustainable way. • There are encouraging signs of real interest among consumers in more environmentally-sustainable products and services. For example, the 'Fair Trade' movement, which aims to achieve fair prices for small farmers who use environmentally-friendly methods. Environmental Risk Transition • Changes in environmental risks that happen as a consequence of economic development in the less developed regions of the world. • Before transition occurs, poor quality of: – Food – Air – Water Environmental Risk Transition (continued) • After transition, a new set of environmental problems take hold. Examples include release of: • • • • Acid rain precursors Ozone-depleting chemicals Greenhouse gases Toxic substances Core Concepts • Environment and Human Environment Interactions are Complex Systems – The extent of impact humans have had on earth and our health has increased significantly over the past 50 years • Interconnectedness/Feedback loops/ lifecycle thinking – Damage to ecosystems will likely come back and damage human health • From problems come solutions • Focus on goals rather than inevitabilities Biosphere – This theoretical “layer of life”, is called a biosphere because life is thought not to exist outside this area. – Most life occurs in a narrow layer extending from about a 600 foot depth in the ocean where sunlight is able to penetrate, to the summer snow line of high mountain peaks where a thin layer of soil supports plant life such as lichens and mosses. Biome/biotic community  Biomes are based on the dominant types of vegetation which are strongly correlated with regional climate patterns. Examples: – – – – Desert Tropical Deciduous forest Tundra Biomes defined by Climate/Temperature1-2 From Moore Living on Earth 29 Biotic community • A natural grouping of different kinds of plants and animals within any given habitat; a broad term – Organisms are not arbitrarily scattered – Removing one species or introducing a non-native one from a community can have unpredictable and disastrous consequences (ie beavers or rabbits or zebra mussels or rodents). • Populations – individuals of the same species living together within a specific area; different stages of life of individuals are more vulnerable • Balance is key – maintaining predators, etc. Some keystone predators maintain diversity • Adaptation occurs through long times, to create stability but hard to adjust quickly CLIMATE - What is it? – Climate can be viewed as average weather within a geographical area viewed over years, or even centuries. – Climate is most affected by temperature  changes in the earth’s orbital geometry (season);  changes in ocean temperatures;  volcanic activity with increased atmospheric dust and reduced sunlight penetration;  variations in solar radiation; or changes in atmospheric gases that alter the absorption or dissipation of heat energy. Climate Change The Ecological Model • Proposes that the determinants of health (environmental, biological, and behavioral) interact and are interlinked over the life course of individuals. • Intersection of health and social and environmental factors in disease and well being (Levins) – Eg. Protect soils and they protect from disease Figure 1-8 The ecological model of population health. Source: Adapted and reprinted with permission from Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, © 2003 by the National Academy of Sciences, courtesy of the National Academies Press, Washington, D.C., p. 33; and from Dahlgren G, Whitehead M. Policies and Strategies to Promote Social Equity in Health. Stockholm, Sweden: Institute for Futures Studies; 1991. Figure 1: The interrelation between vulnerability, resilience and adaptive capacity (adapted from Gallopin, 2006) Resilience Vulnerability - Capacity of response - Sensitivity - Exposure - Current State - Variability -latitude -resistance -precariousness Adaptive Capacity -ability to cope -ability to improve conditions -flexibility/rigidity Ecosystem • “An ecosystem is a dynamic complex of plant, animal, and microorganism communities and the nonliving environment interacting as a functional unit.” – Millennium Ecosystem Assessment, 2003 • Vary in size • Interconnected components are in a steady state that can be easily disrupted. • Survival of humans depends on ecosystem health and ecosystem “services” • Evolutionary biology tells us systems can fight back and diseases can survive. Complexity/feedback loops • Everything is interconnected in a complex system – affect one part of a system and it will likely impact another. Can’t just study parts of a system – System: a collection of interrelated parts that function together via driving processes. Damage to ecosystems will likely come back and damage human health – Feedback lops: component A influences component B which influences C – reactions – Many epidemics have followed periods of decaying infrastructure or dissolving social fabric • There will almost always be uncertainties as to cause and effect relations. Relationships are never simple. Biogeochemical cycles • Small number of materials provide physical framework for life and inorganic building blocks (gaseous and sedimentary) • 40 essential nutrients – macro nutrients (carbon, hydrogen, oxygen, phosphorus, potassium, calcium, magnesium, and sulfur); trace nutrients (iron, copper, manganese, zinc, chlorine, iodine) • Life is dependent on repeated cycling of these materials, changing from inorganic to organic (maintain nutrients in usable forms) Carbon Cycle Food Chains  Involves the transfer of food/chemical energy from a given source through a series of organisms  Consumers – animals (herbivores, carnivores)  Decomposers – fungi, bacteria, some insects(detritus food chain) return nutrients  At each transfer about 90% of the food/chemical energy is lost.  Higher levels in food chain, food is population limiting factor,  Lots of energy producing plants; still less herbivores; still less primary carnivores; still less secondary carnivores Subtraction from the Foodweb: Otters  Otter population declines starting in 1990’s  Reason unknown but could be increased pollution, bacterial and viral infections, or shark attacks  As Otter population declines  increase in sea urchin population (otter food source)  which resulted in decrease in kelp bed (urchin food source)  which caused decline in fish population (habitat was kelp bed)  Which decreased bald eagle population (fish and otter bab ... 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