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1
Q

Topics to include in an enviormental history are:

A

hobbies, recent remodoling of home, age of the home, type of heating, near by industries

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2
Q

Will indoor or outdoor air pollientes have a greater effect on health?

A

Indoor (most amerian’s spend about 90% of time inside)

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3
Q

what are aspergillium, penicillium, and stachybotrys examples of?

A

Mold

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4
Q

What health effects have been linked to mold?

A

allergic symptoms, respiratory irritation, and asthma exacerbations (NOT pulmonary hemorrhage or Cancer).

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5
Q

What is the doiagnostic test for mold?

A

None

and the only thing really helpful for inspecting the home is visual inspection since there is no “normal” limit.

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6
Q

What are volatile organic chemicals? what are they seen in?

A

carbon + hydorgen chemicals
they usually have at least one phenol - ring

seen paint stabilizers and adhesives and in some pesti- cides and wood preservatives.

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7
Q

What are the health effects of VOCs?

A

respiratory mucous membrane irritation and symptoms (burrning, itch eyes, cough, congestion).

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8
Q

Recommended dx test for VOCs?

A

None

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9
Q

When is Radon released?

A

radioactive decay from radim. used in home foundadtion and building materials.

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10
Q

What are the potential health effects of Radon?

A 
lung cancer (especially if coupled with smoking) 
2nd most common cause of lung cancer
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11
Q

What can create products of combustion (Co2, NO2, particulate matter)?

A

Cooking with gas ranges, burning wood in fireplaces or wood stoves, and back draft of exhaust flues

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12
Q

What health problems can products of combustion cause?

A

irritate mucus membranes
exacerbate asthma
increased suseptablity to lung infections

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13
Q

What can smoking in the home do?

A

leave residues in the air that cause increased lower respiratory tract infections, mucous membrane irritation, and lung cancer.

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14
Q

What are the six ‘‘criteria pollutants’’ that the EPA has limited in the air concentration over time?

A

PM, NO2, ground-level ozone (O3), sulfur dioxide (SO2), CO, and lead.

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15
Q

What is particulate matter?

A

dirt, dust, smoke, or droplets resulting from combustion or chemical reactions that produce aerosols

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16
Q

what do PMs do to the body?

A

induce inflammatory responces within the airways.

increase the risk of lung cancer

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17
Q

How is NO2 generated?

A

fossil fuel combustion and through the ox- idation of nitrogen oxide

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18
Q

What effects can NO2 cause to the resirotory system?

A

increase in susceptibility to respiratory infections (especially in pediatric and elderly patient groups), worsening asthma symptoms, and severe lung injury resulting in death when exposure occurs in confined spaces without adequate ventilation

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19
Q

What is the other possible concern with NO2 not discussed in the class notes?

A

cardiovascular disease (cardiac failure, ischemic heart disease, and myocardial infarction).

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20
Q

What is the adverse effect of O3?

A

respiratory irritant

respiratory inflammatory

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21
Q

what are sulfer dioxide substances?

A

coal, crude oil, and metal ores

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22
Q

what are the health effects of sulfer dioxide exposure?

A

cough and decreased lung function, and aggravation of pre-existing cardiovascular and respiratory illnesses.

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23
Q

What are the acuate and chonic effects of CO exposure?

A

headache, nausea, vomiting, and lightheadedness, adverse cardio- vascular events such as angina,

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24
Q

How is lead released into the air?

A

by processes that include coal and waste burning, metal mining/smelting and other industrial processes, and volcanic emissions.

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25
What is the tool that the EPA uses to infrom us about the qulity of outdoor air?
AQI 100 = national air qulity standard below 100 = good above 100 = bad
26
What is currently the major rout of lead exposure in the US
car battery production, living in older homes containing lead paint, demolition of older homes painted with lead paint, lead paint removal activities, and, more recently, toys painted with leaded paint.
27
What is lead exposure associated with?
neurologic, hematologic, renal, reproductive problems
28
What are the signs of acute lead posining?
``` headaces irritablity abdominal pain sleeplessness restlessness confusion reduced consciousness and aute psycosis ```
29
what are the signs of chronic lead posining?
encephlopathy, nephropathy, hypertension, anemia deficiencies in memory and learning periferal motor neuropathy, slow sensory motor reaction changes in visual/motor preformacne, memory, attention, verbal comprehension anemia spontanious abortion/reduced sperm count low body weight
30
at what age should lead screening begin?
9-12 months old then test again at 24 months
31
what is the primary route of human exposure to murcry?
Inhalation of elemental mercury vapor, 80% of which is taken up by the lungs.
32
what are the acute and chonic effects of elemental murcury exposure?
cough, dyspnea, fever, tremors, malaise, axonal sensorimotor polyneuropathy, gingivitis, delusions, and hallucinations.
33
What is Erethism?
a syndrome that consists of intention tremor, excitability, memory loss, insomnia, timidity, and delirium. it is caused by chronic exposure to elemental mercury.
34
How does murcry exposure during pregnancy effect the fetus?
Inhaled elemental mercury vapors absorbed dur- ing pregnancy may diffuse across the placenta and accumulate in the fetal brain, resulting in neurodevelopmental anomalies.
35
What are the typical manifestations of acute methylmercury posinings?
blurred vision, hearing impairment, olfactory disturbances, gus- tatory abnormalities, ataxic gait, clumsiness of the hands, dysarthria, and somatosensory and psychiatric disorders.
36
what are the typical results of chronic methlmercry posinings?
distal extremity paresthesias that may persist even after exposure ceases. cerebellar ataxia seen at first but improves once the exposure is gone
37
What is the Minamata disease?
in Japan a bunch of mom's ate fish while prego - they were mild to asymtamtic but theire kids came out with neurological problems: mental retardation, primitive reflexes, hyperkinesis, deafness, blind- ness, cerebral palsy, cerebellar ataxia, seizures, strabismus, dysarthria, and limb de- formities.
38
what is thimerosal?
a perserviative used in routine vaccines. it is metabolized to ethylmercury - no research shows that this actually acts like mercury in the system though.
39
what is arsenic used for?
insecticides, herbicides, fungicides, algicides, sheep dips, wood preservatives, dyestuffs, and medicines for the eradication of tapeworms in sheep and cattle.
40
How can arsinic exposure happen?
ingestion (through naturally occuring levels in the water and diet)**MC, inhalation, dermal contact, parenterally
41
What heavy metals do you get exposed to though seafood?
murcury, arsinic
42
what are the acute toxcicty symptoms of arsinic posining?
gastrointestinal (hemorrhagic gastroenteritis), cardiovascular (fluid loss, shock), renal (renal failure), and central nervous system (seizures)
43
What might you see in serviors of acute arsnic posining?
bone marrow depression, hemolysis, hepatomegaly, melanosis, polyneur- opathy, peripheral vascular disease, and encephalopathy
44
what is chronic low level arsnic ingestion associated with?
elevated risk for mortality from lung, bladder, and kidney cancer hypertension/cardiovascular disease, diabetes, reproductive effects, cerebrovascular disease, neurologic effects
45
What is cadmium found in?
batteries, pigments, metal coatings, plastics, and as a contaminant of some commercial fertilizers. Plants (in particular leafy vegetables). Cigarette smoking
46
Acute, high-level inhalational exposure to cadmium fumes or particles causes:
life-threatening pulmonary effects
47
Where does cadmum accumulate? what happens there?
kidneys tubular dysfunction, which results in the excretion of low molecular weight pro- teins, such as b2-microglobulin and b1-microglobulin, into the urine.
48
What does long term high-level cadmium exposure cause?
disrupts the signaling pathways responsible for calcium homeostasis and may lead to osteomalacia and osteoporosis.
49
How does the IARC classify cadmium?
group 1 human carcinogen: lots of evidence that this causes cancer.
50
Proton Pump Inhibitors have been associated with fractures in which location?
Hip Spine Wrist
51
What do proton pump inhibitors do?
They stop stomach acid from being produce to treat GERD They also stop the ability to absorb calcium
52
What is the max number of days over the counter PPIs should be taken in a year?
14
53
Why does the level of mercury present vary between species of tuna?
murcuy accumulates in the muscle more than the fat, so there will be higher levels in leaner tuna.
54
Symptoms of common air pollutents
``` couch phlegm wheezing shortness of breath chest tightness ```
55
common air pollutens cause an increased risk of which respiratory disease episodes/sickness?
asthma bronchitis emphysema pneumonia
56
What new respiratory disease can develop because of common air pollutnets?
chronic bronchitis | premature aging of the lungs
57
what effect does common air polluents have on lung function?
bronchoconstriction | decreased air flow
58
What processes are involved in airway inflammation?
increased white blood cells abnormal mucus production fluid/edema in lungs death/shedding of cells that line the airways
59
What are the cardiovascular symptoms caused by common air pollutents
``` chest tightness chest pain (angina) palpitations shortness of breath unsusal fatigue ```
60
What CV diseases are going to have increased episodes/sickness because of common air polutents
coronary artery disease abnormal heart rhythm congestive heart failure
61
How do common air pollenates effect the CV function?
cause - low oxygenation of red blood cells - abnormal heart rhythms - altered autonomic NS control of heart
62
What are the effects of common air pollutants on vascular inflammation?
increased risk of blood clot formation vasoconstriction increased atherosclotic plaue rupture
63
What does acute rodenticid poisoning look like?
bleeding from the nose, gums, and gastrointestinal tract and easy bruising.
64
What is Strychnine and what does it cause?
Non-anticoagulant rodenticide that causes the rapid onset of violent seziures
65
What is the use of pest strips, termite treatments, flea collarts, and garden pesticide treatments associated with?
pediatric cancers - lukemia - brain tumors
66
What are the effects of acute exposure to the herbicide diquat?
erosive gastroenteritis, airway injury, renal failure, CNS toxcity
67
What dose the herbicide chlorophenoxy toxic effect look like
- mostly just irritation to mucus membranes and skin - mental status changes, vomit, diarrhea, headache - systemic toxcicty, acidosis, renal failure, multiple organ failure
68
What are pesticide residuals?
small amount of pesticides that remain on cultivated foods
69
What is an effective way to remove pesticides from foods?
rinse that shit with water | reductions in 9-12 pesticides with only 15-30 seconds
70
What are the 5 key questions you should ask if you expect occupational exposure to toxicity?
1. what do you do? 2. do you think your health problems are related to work? 3. are your symptoms different between work and school 4. are you currently exposed to chemicals, dust, metals, radiation, noise, or repetitive work? how about in the past? 5. are your coworkers experiencing similar symptoms?
71
What are the categories of electromagnetic fields?
Extremly low-frequencey fields | radio-frequency radiation
72
How are ELFs produced?
from electrical devices
73
How is RF energy produced?
wireless devices
74
do EM transmit energy to absorbing tissues?
NO | These are non-ionizing
75
Can ELF EM be absorbed by people?
Yeah - muscles and skin. | they can penetrate physical barriers are so can make it deep into the body.
76
Have ELF EM been linked to any diseases?
none in adults | childhood leukemia in kids
77
Can RF waves be absorbed by people?
Yeah - but only the skin and subcutanous tissue. They don't make it to the deep stuff.
78
What are Phthalates?
family of compounds added to plastics to make them more flexible.
79
What has been associated with the Phthalate DHEP?
dysfunction in the testes, cancer, and reproductive problems in lab animals.
80
What are BPAs in?
Plastics and food containers - when heated they can leach into food or liquids
81
What is associated with BPAs?
prostate cancer declining semen quality early onset of puberty in girls
82
What are Polybrominated diphenyl ethers found in?
fabrics, foam, upholstry
83
What have Polybrominated diphenyl ethers been shown to cause in animals?
thyroid, liver, reproductive, and neurodevelopmental effects neonatal exposure: hyperactivity and memory problems, impairment of sperm development, and cryptorchidism

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