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PD III > Environmental Health > Flashcards

Environmental Health Flashcards

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1
Q

What are the five main points about chemistry?

A
  1. Everything is a chemical
  2. Dose makes the poison (low dose = safe)
  3. There is no difference between natural and synthetic form of a chemical
  4. “Natural” is not automatically good, artificial is not automatically bad.
  5. A chemical’s toxicity is based on what is bound to (things that would normally be dangerous may be safe it bound to something stable)
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2
Q

What is the #1 killer of anything in the US?

A

Chronic disease - 70% of all deaths

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3
Q

How percentage of people have chronic diseases?

A

50% have 1 +
25% have 2+

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4
Q

Why do we have more chronic disease deaths compared to other deaths?

A

Increased life span, improved detection and diagnosis
Higher rates of chronic disease in younger pts

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5
Q

What is the #1 and #2 cause of death in the US?

A

Cardiovascular disease
Cancer

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6
Q

What is the #1 cause of disability?

A

Arthritis

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7
Q

What is the #1 cause of preventable death?

A

Tobacco use

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8
Q

What preventative screenings do people not take advantage of?

A

Mammograms
Colonscopies

can help decrease Chronic disease burden if you get it checked!!!

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9
Q

What are the things that ACTUALLY kills people?

A

Tobacco use #1

Pollutant and toxins is 2.3% though!
This is above motor vehicle crashes, firearms, risky sexual behavior, illicit drug use

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10
Q

What are the 4 ways that we come into contact with toxic substances?

A

The food chain
Polluted water
Airborne exposure
Dermal exposure

increase in human population leads to more pollutants :(

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11
Q

What is bioaccumation vs bioremediation?

A

Bioaccumulation is us making toxic byproducts, and this is greater than the rate at which it is bioremediated - leading to pollution with time

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12
Q

Exposures to environmental pollutants leads to what percent of global disease burden?

A

24%

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13
Q

What do pollutants induce that leads to problems?

A

signaling pathways that lead to oxidative-stress

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14
Q

What can carcinogens do?

A

Alter DNA and its expression
Stimulate rapid growth
May also impact inflammation/immune processes
Confound cell repair mechanisms in hormone-sensitive tissues
Increased inflammation
Impaired immune surveillance

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15
Q

What are some common carcinogens?

A

radon, asbestos, benzene, coal, soot and smoke, arsenic, triclosan

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16
Q

What is triclosan?

A

Antimicrobial back in the day that was put in everything but is actually a carcinogen

try closan up your wound? more like try cancer!

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17
Q

What is cancer alley?

A

85-mile stretch along Mississippi River
Over 150 refineries and factories

Lots of synthetic chemicals, leading to a LOT more cancer cases

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18
Q

What chemicals can cause problems regarding Obesity/Metabolic Syndrome/Diabetes

A

Chemicals → herbicide, triclosan, flame retardants, stain repellents, nonstick compounds, DDT
interfere with thyroid function
can mimic naturally occurring hormones
xenobiotics stored in fat released in blood with wt loss
may undermine further efforts to lose weight
Others → arsenic, cadmium
increase pancreatic oxidative stress
may contribute to DM

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19
Q

How do toxins lead to vascular disease?

A

Toxic metals → oxidative stress
Strong connection w/development & progression of vascular diseases

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20
Q

How do toxins lead to endocrine disruption

A

Pesticides, toxic metals, and many other common chemicals can interfere with **hormonal signals **to various organ systems

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21
Q

What is environmental toxicology?

A

Deals with potentially harmful impact of chemicals in our environment

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22
Q

What is acceptable daily intake?

A

daily intake of a chemical that appears to be associated with minimal to no risk over lifetime
In the US - FDA and Dept of Agriculture regulate
Different standards in different countries

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23
Q

What is a hazard of an agent?

A

ability of an agent to cause injury

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24
Q

What is risk

A

frequency of undesirable occurrence after exposure

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25
What two routes of exposure do yoyu get with industrial and atmospheric?
inhalation, transdermal
26
What is the route of exposure for water/soil
inhalation, ingestion, dermal contact
27
What is the duration of exposure for acute vs chronic?
acute - single or multiple over a brief period (seconds to 1-2 days) chronic - multiple exposures over a longer period of time
28
Difference between bioaccumulation vs biomagnification?
Bioaccumulation - intake of contaminant > ability to excrete or metabolize Biomagnification - increased concentration of a given contaminant as it goes up food chain
29
Explain the bioaccumulation of DDT
Small herbicides start in smaller things, and then magnifies
30
What are the secondary effects of DDT
blaque plague d/t more mice
31
What is persitence of a toxin?
resist environmental, often animal metabolic breakdown
32
What is toxicity?
rating based on repeated exposures which result in human or environmental adverse outcomes
33
What is CO
carbon monoxide Colorless, tasteless, odorless, nonirritating
34
What are the s/s of CO poisoning
Hypoxia - affects brain/heart the most Headaches, nausea, dizziness, LOC Variability in individual responses Chronic exposure to low levels may lead to undesirable effects
35
What is the treatment for CO poisoning?
removal from source, maintaining respiration, administer O2 within limits of O2 toxicity give O2 get rid of CO basically
36
What is SO2 and what does it form when it comes into contact with mucous membranes?
colorless IRRITANT gas from fossil fuels Colorless, irritant gas - fossil fuels Forms sulfuric acid on contact with mucous membranes Irritant to eyes, mucous membranes, skin and respiratory tract Eye and nasal drainage, bronchospasm
37
What is chronic SO2 lead to?
Adaptation, but leads to development of heart and lung disease
38
Treatment of SO2 exposure
symptomatic
39
What does most of SO2 come from?
Electricity makes up 69%
40
What is NO2
Brownish, irritant gas Fires, fresh silage deep lung irritant | think brown = dead trees, dead lungs
41
What are the s/s of NO2 and biggest concern
eye and nose irritation, cough, mucoid/frothy sputum, dyspnea, chest pain biggest concern: Can cause pulmonary edema, subacute inflammation, or chronic lung lesions
42
Treatment of NO2
Symptomatic Manage lung irritation, pulmonary edema
43
What is ozone
Bluish irritant gas occurring normally in atmosphere → absorbs UV light High concentrations - high-voltage electrical equipment, air/water purifiers, polluted urban air | think water has oxygem, water is blue, blue electrical current
44
what does ozone lead to?
irritates mucous membranes mild - upper respiratory inflammation severe - deep lung irritation, pulmonary edema long term → morphologic/functional respiratory tract changes
45
What is the treatment of ozone
symptomatic management of deep lung irritation, pulmonary edema
46
What is a halogenated aliphatic hydrocarbon?
chloroform - can make people pass out
47
What is a patient population that is often exposed to halogenated aliphatic hydrocarbon?
dry cleaners
48
What are the common symptoms of acute halogenated aliphatic hydrocarbon exposure? Chronic?
CNS depression (MC) can effect EVERY organ system impaired memory, peripheral neuropathy
49
What are the three aromatic hydrocarbons?
Benzene Toluene Xylene
50
Where are benzenes found?
Combustion liquids (dyes, detergents, pesticides, cleaning products, paint strippers, adhesives_ solids (plastics, resins, synthetic fibers, rubber lubricants, pharmaceutical solvent)
51
What are the chronic symptoms seen in benzene that are not seen in other aromatic hydrocarbons (toluene and xylene)?
Myelotoxicity | bone marrow suppression
52
Which aromatic hydrocarbon is fetotoxic?
toluene | toluene = toddler
53
What are the symptoms of toluene and xyelene
CNS depressant, skin irritant
54
What is DDT and the symptoms?
Organochlorine Pesticide - causes CNS STIMulation (unlike the others that is depression) tremor, convulsions chronic → enhanced tumor formation (endocrine disruption) | Double D battery
55
What are the organophosphorics?
Not persistent Have cholinergic properties (opposite of anticholinergics - leads to tremors, dyspnea, lacrimation, confusion, fasciculations Some compounds have neuropathy target esterase → progressive demyelination of longest nerves)
56
Treatment of organophosphorics
Acute - symptomatic - O2, airway maintenance No treatment for delayed neurotoxicity
57
What are bipyridyls?
Reduce to free radicals - has been fatal in humans Accumulates slowly in lung → edema, alveolitis, fibrosis
58
What are the symptoms of bipyridyls?
initially manifest as hematemesis, bloody stools Few days → respiratory distress, hemorrhagic pulmonary edema Hepatic, renal, myocardial involvement possible Death may take several weeks | Think of pyr = pyro = blood. Bi = 2 = effects lungs
59
What is the treatment of bipyridyls?
absorption prevention (gastric lavage, cathartics, adsorbents) after absorption, tx successful <50% of time O2 cautiously for dyspnea - may aggravate pulmonary lesions
60
What is agent orange and what does lead to?
Kills plants instantly Large doses - coma, generalized muscle weakness and hypotonia Kidney or liver dysfunction Linked to Non-Hodgkin’s Lymphoma
61
What is glycophasate?
most widely used herbicide in world May damage important crops even when used as directed Skin and eye irritant Can be fatal in large doses (less so than other herbicides) No tx for glyphosate toxicity
62
What people are exposed to lead the most?
Workers in lead smelters and storage battery factories also other mechanical
63
What does lead bind to and what does it lead to?
99% binds to Hb initially in soft tissues (kidney and liver) eventually redistributed to bone, teeth, hair does cross placenta
64
What are the symptoms of lead?
Neurotoxic (cognitive delays, lead palsy) CV and renal Anemic Other systems Metallic taste, anorexia, muscle discomfort, malaise, headache, constipation or diarrhea, “lead colic “
65
What is the treatment of lead poisoning?
removal of source, symptomatic, chelation in acutely high levels
66
What is the exposure of mercury most common?
Fish chloralkali industry (bleach), alkaline batteries, fluorescent bulbs, thermometers, scientific equipment, dentists, gold mining, pigments Thimerosal - antimicrobial - preservative in vaccines
67
What does mercury affect first? Chronic?
lungs first then acute or chronic - insomnia, memory loss, fatigue, cognitive difficulties Neuromuscular - muscular atrophy, weakness, paresthesia, tremors, movement disorders, paralysis Sensory - deficit in vision/hearing, slurred speech, movement disorders, paralysis Death may occur with enough exposure Other symptoms - ↑ HR, labile pulse, salivation, N/V/D, abdominal pain, gingivitis, renal damage Fetal - mental retardation, neuromuscular deficits Even if no maternal symptoms symptomatic care | LMNS Lungs Mercury Neuromuscular Sensory
68
What is arsenic MC exposure?
Drinking water also exposure in herbicides/insectides humans are more susceptible than other animals to arsenic toxicity
69
What are the symptoms of arsesnic?
inhibits ATP, can cause cell apoptosis
70
What are the Polychlorinated Biphenyls
Industrial fluids and lubricants, plasticizers, wax extenders, flame retardants
71
What are the symptoms of PCBs?
dermatologic problems, hepatotoxicity, elevated plasma triglycerides Psych - Adverse behavioral effects, intellectual deficits Carcinogenic (melanoma, breast, pancreatic, thyroid) Possible immunotoxicity and teratogenicity Wasting syndrome, thymic atrophy
72
What are brominated flame retardants?
Added to plastics, foam, and fabrics Escape into general environment where they resist degradation Widespread exposure in virtually all pts Concentrations of several BFRs in blood and breast milk in US Nearly 10x higher than in Europe Polybrominated diphenyl ethers (PBDEs) - type of BFR that can interfere with normal brain development/function and cause other adverse health effects
73
What are perfluorinated compounds?
PCF leads to thyorid disease and cholestrol
74
What are endocrine disruptors?
Any chemical with effects on endocrine system ubiquitous effects hormones (typically thyroid, estrogen, or testosterone)

PD III (6 decks)

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