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Flashcards in Environmental Health Deck (225):
0

One of the primary determinants of individual and community health

Environment

1

Basic nursing competencies in environmental health

1. Mechanisms and pathways of exposure to environmental health hazards
2. Basic prevention and control strategies
3. Interdisciplinary nature of effective interventions
4. Role of research and advocacy
5. Diagnosis, treatment and prevention of environmentally related diseases
6. History taking
7. Exposure assessment
8. Risk communication
9. Required reporting
10. Advocacy

2

Environmental health comprises...

Those aspects of human health, including quality of life, that are determined by physical, chemical, biological, and social and psychologic problems in the environment

3

Environmental health refers to...

The theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially adversely affect the health of present and future generations

4

Number of chemicals that did not exist before the 1940s that have been introduced into the environment

Tens of thousands

5

Publicly accessible toxicity data are not available for ----- of the 3,000 high-production industrial chemicals

71%

6

Of the top 20 environmental pollutants that were reported to the EPA in 1997, nearly 75% were known or suspected -------

Neurotoxins

7

-------- pounds of pesticide products are intentionally and legally released each year in the United States

1.2 billion

8

More than 50% of Americans live in an area that exceeds current national ambient air quality standards for......

1. Ozone
2. Nitrous oxide
3. Sulfuric oxide
4. Particulates

9

Number of states that have issued one or more health advisories for mercury in their waterways

40

10

Number of states that have issued advisories for mercury for every lake and river within their borders

10

11

Number one cause of air pollution in the United States

Mobile sources (motor vehicles)

12

Substances found in measurable quantities in the nation's streams

1. Antibiotics
2. 17-b estradiol
3. Caffeine
4. Acetaminophen

13

Number if Americans who drink water that contains contaminants which exceed one or more of the EPA safe drinking water standards

Thirty million

14

Common contaminants in drinking water

1. Lead
2. Other heavy metals
3. Nitrites
4. Dioxin
5. Hydrocarbons
6. Pesticides
7. Radon
8. Cyanide

15

Body systems in laboratory animals affected by combinations of commonly used agricultural chemicals in levels typically found in groundwater

1. Immune system
2. Endocrine system
3. Neurological system

16

Thirty seven pesticides registered for use on food are...

Neurotoxic organophosphates

17

Radon may be responsible for 20% of --------- among non smokers

Lung cancers

18

Examples of endocrine disrupters

1. Plasticizers
2. Polychlorinated biphenyls
3. Many pesticides
4. Dioxins

19

Endocrine disrupters appear in ----- of the population

95%

20

Dioxins mimic

Estrogens

21

Which diseases severity is increased by poor indoor and outdoor air quality

Asthma

22

Host factors that determine the relationship between environment and health

1. Age
2. Gender
3. Genetic makeup
4. Underlying diseases
5. Dose-response factors
6. Length of time exposed

23

Environmental health is based on what type of model?

Public health model with a emphasis on prevention

24

Preventive interventions in environmental health include:

1. Pollution prevention
2. Product design
3. Engineering controls
4. Purchasing choice
5. Eduction

25

US environmental standards are based on health risks to...

1. Healthy
2. 70kg (154lb)
3. White
4. Male

26

Environmental standards may not provide sufficient protection to:

1. Pregnant women and fetuses
2. Young children
3. Frail and elderly
4. Immunocompromised

27

Synthetic chemicals can be found in...

1. Food
2. Air
3. Soil
4. Water
5. Workplaces
6. Schools
7. Homes
8. Communities

28

Synthetic chemicals can be found within -------- in measurable amounts

Human bodies

29

There is limited information regarding ------------- associated with many of the synthetic chemicals in our environment

Human health effects

30

Neurotoxins account for more than -------- pounds released into air, water and land

A billion

31

In 1998 Consumer Reports tested leading-brand beef baby food and measured....

Dioxin levels the exceeded the EPA allowable quantities by 100 times

32

Several pesticides and herbicides have been linked to.....

Leukemia

33

Exposure to endocrine disrupters very early in life can have the potential to disrupt critical endocrine pathways with the possibility of causing adverse effects to...

1. Reproductive systems
2. Neurologic systems
3. Immunologic systems

34

Risks that occur in environments where people live, work, play and learn

1. Chemical
2. Biologic
3. Radiologic

35

Chemical and radiologic exposures can be.....

Cumulative

36

Occupational and environmental health nurses must assess a person's ----- exposure to environmental risks in order to understand and address potential health threats

Total

37

Very specific gestational ages can be associated with....

Exquisite vulnerability to the effects of certain toxic chemicals

38

Opportunities for informed decision are created by...

Information via labeling and other forms of "right to know"

39

Potential environmental exposures and environmentally related diseases can be assessed....

1. Individually
2. Community wide basis

40

Individual environmental health assessments should take into account all potential exposures including....

1. Home
2. Workplace
3. School
4. Community

41

National Library of Medicine's resource that provides easily accessible, peer reviewed information about the potential health hazards in our environments

ToxTown

42

ToxTown covers a broad range of information about health risks associated with...

1. Factories
2. Farms
3. Homes
4. Offices
5. Schools
6. Drinking water
7. Recreational water
8. Pests
9. Vehicles
10. Hazardous waste sites
11. Airplanes
12. Construction
13. EMFs (electric and magnetic fields)

43

Within ToxTown there is a database of likely chemical exposures associated with....

An extensive list of specific job categories

44

Household product information found on www.household.nlm.nih.gov

1. Auto products
2. Landscape/yard
3. Home maintenance
4. Pet care
5. Arts and crafts
6. Personal care
7. Cleaning products

45

---------- provides high quality information regarding children's exposures; their e-house website specifically provides information about home related environmental health risks

The Children's Health and Environment Coalition

46

The EPA website provides...

A range of environmental exposure information

47

EnvironFacts

EPA website that provides geographically related information

48

EnviroMapper

EPA website provides air, water and hazardous waste site information by location/region

49

The Children's Environmental Health Network

Website that has developed a health assessment tool for children

50

EnviRN

- University of Maryland's website
- Has a home assessment survey that includes information about the health implications of environmental exposures

51

Agency of Toxic Substances and Disease Registry

- agency within the CDC
- created ToxFacts

52

ToxFacts

Provides excellent toxicological information on chemicals that are commonly associated with environmental health risks

53

Community environmental health assessments identify potential exposures in

1. Water (including drinking water)
2. Air (including indoor air)
3. Dust (including lead based paint particles)
4. Soil (including exposures from current and previous land use)
5. Radiation (ionizing and nonionizing)

54

Environmental assessments may depend on extrapolating from...

Aggregate national, statewide, county or metropolitan exposure data

55

Geographic information system (GIS)

-A method for assessing community risks to environmental exposures and potential health problems
-consists of computerized mapping of graphically related data
-environmental and exposure data can be entered and evaluated for geographic relationships
-data can be presented in map form

56

Sources of more information on GIS

1. www.gisportal.com
2. Agency for Toxic Substances and Disease Registry
3. Geography departments in universities

57

Essential competences for environmental health assessments

Knowledge of:

1. Federal, state and local health and environmental statues and regulations
2. Practices regarding what data are collected and how they are accessed

58

Principle sciences used to determine the relationship between environmental exposures and health outcomes

Epidemiology and toxicology

59

Environmental epidemiology

Uses epidemiologic techniques to examine environmental exposures

60

Study design of choice in environmental health

Analytical studies (cohort and case control)

61

Type of study rarely done in environmental health

Experimental

Because it is unethical to intentionally expose individuals or communities to environmental hazards

62

Cluster investigations are often used to...

Respond to community concerns about an excess of cancer or birth defects

63

Common results of cluster investigations

Negative or equivocal results

64

Cluster investigations are most convincing when....

The disease in question is rare and very specific for the putative etiologic exposure

65

Example of a disease that a cluster investigation would be useful

Asbestos causing mesothelioma

66

Limitations of environmental epidemiology

1. Exposures often poorly defined and measured
2. A very limited understanding of mixed exposures
3. Relatively small number of individuals constitute the study populations
4. Lack of understanding about variability in the susceptibility of segments of the populations
5. Long latency between many environmental exposures and the evidence of chronic disease

67

Most common type of environmental exposure

Mixed exposure

68

Why is small study population a limitation of environmental epidemiology

Small study populations yield limited statistical power to detect an association between exposures of concern and health effects

69

Segments of population that could have variable susceptibility rates

1. The poor
2. Children
3. Elderly

70

Why is lack of understanding about variability of susceptibility in a population a limitation of environmental epidemiology

It limits the ability to compare findings across studies

71

Environmental toxicology

The science that examines the toxic effects of agents in the environment

72

Toxicology

The science that investigates the adverse affects of chemicals on health

73

Toxicology is similar to...

Pharmacology

74

The effects of hazardous chemicals can be...

1. Immediate (acute)
2. Long term
3. Present after a latency period

75

Effect of hazardous chemicals often associated with presentation after a latency period

Cancer

76

Host factors that must be considered when looking at hazardous chemicals

1. Age
2. Sex
3. Genetics
4. Weight
5. Drugs that a person may be taking
6. Pregnancy status

77

Host factors may affect....

The therapeutic or toxic effect of a drug or chemical

78

Hazardous chemical exposures are often....

Involuntary

79

Pharmacology

Scientific study of the origin, nature, chemistry, effects and use of drugs

80

Toxicology

Science that investigates the adverse effects of chemicals on health

81

Definition of dose in pharmacology

Refers to the amount of a drug absorbed from an administration

82

Definition of dose in toxicology

Refers to the amount of a chemical absorbed into the body from a chemical exposure

83

Definition of administration in pharmacology

A drug can be administered:
1. One time
2. Short term
3. Long term

84

Definition of exposure in toxicology

The actual contact that a person has with a chemical

Can be:
1. One time
2. Short term
3. Long term

85

Dose-response curve in pharmacology

Graphically represents the relationship between the dose of a drug and the response elicited

86

Dose-response curve in toxicology

Describes the relationship of the body's response to different amounts of an agent such as a drug or toxin

87

Routes of administration in pharmacology

1. Oral
2. Intramuscular
3. Intravenous
4. Subcutaneous
5. Dermal
6. Topical

88

Routes of entry in toxicology

1. Ingestion
2. Inhalation
3. Dermal absorption

89

In pharmacology with drugs there are ------- (desirable effects) and ----- (undesirable effects)

Therapeutic responses

Side effects

90

In toxicology only ----- effects are of concern

Toxic

91

Toxicity

The ability of a chemical to damage an organ system, disrupt a biochemical process or disturb an enzyme system

92

In pharmacology beyond the therapeutic dose a drug.....

May become toxic

93

Potency in pharmacology

Refers to the relative amount of a drug required to produce the desired response

94

Potency in toxicology

Refers to the relative amount of a toxic chemical it takes to elicit a toxic effect compared with other chemicals

95

In pharmacology examples of biologic monitoring and the drugs it is done for

1. Anticoagulants (warfarin) and clotting time
2. Digoxin and actual drug levels

96

In toxicology examples of biologic monitoring and the toxic exposures it is done for

1. Lead and Blood lead levels
2. Environmental tobacco smoke and metabolites of chemicals such as cotinines

97

US regulatory process for drugs includes....

Several stages of animal and human testing

98

US regulatory process for hazardous chemicals that are not food or drugs....

Requires virtually no original testing

99

How many chemicals in widespread use today-including those regularly found in human tissue, including umbilical cord blood and amniotic fluid- have been submitted to any testing to determine possible neurologic, reproductive or developmental impacts?

Few

100

European Union chemical policy

REACH

101

REACH

EU comprehensive chemical policy that requires more pre-market testing and disclosure than in the US

R: registration
E: evaluation and
A: authorization of
CH: chemicals

102

Examples of unique risks that children have related to environmental exposures

1. Different metabolic and physiologic processes from adults
2. Normal exploratory behavior
3. Spend 90% of day in a variety of indoor environments
4. Children born today will cumulatively have more exposures to toxic chemicals than children born previously
5. Exposure to toxins can cause permanent damage
6. Exposure to toxins in diet is significant

103

Children have higher rates of absorption of toxic materials than adults via the following routes

1. Skin
2. Respiratory
3. Gastrointestinal

104

What types of normal exploratory cause children to have increased opportunities to ingest toxins?

1. Hand to mouth activity
2. Crawling

105

Main indoor environments where children spend 90% of their time on developed countries

1. Homes
2. Day care centers
3. Schools
4. Motor vehicles
5. Other

106

Chemicals and pollutants often present in indoor environments

1. Tobacco smoke
2. Building materials
3. Consumer products
4. Pets
5. Insects and other pests
6. Mold
7. Inadequately ventilated cooking and heating devices
8. Influx of outdoor air pollutants

107

The concentration of indoor pollutants can be ------- than outdoor pollutants

4 to 10 times more

108

Exposure to environmental toxins can disrupt and cause permanent damage to the following developing systems:

1. Nervous
2. Immune
3. Respiratory

109

Main source of child's exposure to toxic chemicals through their diet

1. Pesticide residues on apples and other fruits/vegetables
2. Lead in drinking water
3. Polychlorinated biphenyls and dioxins in breast milk

110

----- have not been routinely included in environmental risk assessment

Children

111

Most environmental health regulations are based on studies on ----------

Adult males

112

------------ can create varying degrees of vulnerability to toxic chemicals, even in healthy humans

Humans developmental stages

113

Reproductive disorders that may result from exposure to toxic substances

1. Male and female infertility
2. Menstrual irregularities
3. Spontaneous abortion or fetal loss
4. Major and minor birth defects
5. Developmental abnormalities

114

------ US children live within four miles of a toxic waste dump

10 million

115

Living close to a toxic waste dump creates increased potential for hazardous chemical exposures via....

1. Air
2. Drinking water
3. Direct contact

116

------ children in the US exceed currently acceptable levels of lead in their blood

One million

117

Acceptable blood lead level for child

10 microliters/dl or less

118

Lead exposure is associated with...

1. Behavioral effects (violent behavior)
2. Cognitive effects

119

Environmental tobacco smoke is responsible for ------ lost school days by children

7 million

120

Epidemiologic studies suggest a relationship between nitrates in drinking water and -------

Juvenile diabetes

121

------ of the children in Arkansas who live near an herbicide manufacturing plant had herbicide residues in their urine

20%

122

-------- is the number one reason that children miss school and are hospitalized in the US

Asthma

123

Over -------- children under the age of 18 are affected by asthma in the US

5 million

124

Indoor triggers for asthma include:

1. Second hand smoke
2. Dust mites
3. Cockroach feces and exoskeleton dust
4. Mold
5. Pets

125

Outdoor triggers for asthma include:

1. Ozone
2. Nitrogen oxides
3. Diesel exhaust
4. Pollen

126

Children can be exposed directly by contact to -------- in play structures, decks and other items

Arsenic treated (chromated copper arsenate) wood (ie treated wood or pressure treated wood)

127

Arsenic from treated wood can leach.....

Into groundwater that may be a source of drinking water

128

--------- are more sensitive to the effects of ozone

Developing lungs

129

Pollutants in some fish can cause.....

Developmental problems

130

Toxic chemicals that are know. To affect the brain and can play a role in brain disorders

1. Lead
2. Mercury
3. Manganese
4. PCBs
5. Tobacco smoke and nicotine
6. Bisphenol A
7. Perchlorate
8. Solvents

131

Lead exposures during infancy and childhood can cause:

1. Attention problems
2. Hyperactivity
3. Impulsive behavior
4. Reduced IQ
5. Poor school performance
6. Aggression
7. Delinquent behavior

132

Mercury crosses the placenta

True

133

Mercury exposure in pregnant women can impair.... of unborn child

1. IQ
2. Language development
3. Visual-spatial skills
4. Memory
5. Attention

134

The "safe" level of mercury continues to ----- the more mercury is studied

Drop

135

High levels of manganese in hair is associated with.....

ADHD

136

Laboratory experiments with animals link manganese with......

1. Hyperactivity
2. Parkinson's disease

137

PCBs

Polychlorinated biphenyls

138

PCBs, especially in fatty tissue can....

1. Impair reflexes and IQ
2. Delay mental development and development of motor skills
3. Associated with hyperactivity

139

One of the best studied agents for its effects on the developing brain

Tobacco smoke and nicotine

140

Children born to women who smoke during pregnancy are at risk for....

1. IQ deficits
2. Learning disorders
3. Attention deficits

141

Bisphenol A effects on brain

Alters the expression of genes that are important for long term memory formation and for early brain development

142

Perchlorate

A rocket fuel that now contaminate drinking water in many communities in the western United States

143

Effects of perchlorate

Interferes with thyroid hormone control of brain development in mice

144

Toluene effects

Solvent that causes learning, speech and motor skill problems in children

145

Environmental justice

Refers to the fair treatment for people of all races, cultures, incomes, regarding the development of environmental, laws, regulations and policies

146

The environmental health status that poor communities experience is compounded by effects of:

1. Poor housing
2. Poor nutrition
3. Poor access to healthcare
4. Unemployment
5. Underemployment
6. Employment in the most hazardous jobs

147

Environmental risk burden is generally greater for...

Minorities and those who are economically disadvantaged

148

Why is the environmental risk burden get ally greater for minorities and those who are economically disadvantaged?

They are exposed to a greater number and intensity of environmental pollutants in food, air, water, homes and workplaces

149

The National Health and Nutrition Exam Study results indicate....

Minority women have higher levels of toxic chemicals in their bodies than do white women

150

Information sharing may be less effective in economically disadvantaged communities as a function of....

Language and literacy issues including the challenge of understanding technical language in warning signs and other right to know material

151

Indicators of increased environmental risk burden include:

1. Proximity to hazardous waste sites, polluting industries and incinerators
2. Substandard housing

152

What substandard housing conditions place people at increased environmental risk?

1. Friable asbestos
2. Deteriorating lead paint
3. Yards with contaminated soil
4. Pests
5. Pesticides
6. Mold

153

Federal mandates to address environmental justice include:

1. Environmental Justice Act (1993)
2. Executive Order 12898 (1994): Federal Actions to Address Environmental Justice in Minority Populations

154

The passage of federal legislation to address environmental justice resulted in:

The development of policies to more comprehensively reduce the incidence of environmental inequality by mandating that every federal agency act in a manner to address and prevent environmental illnesses and injuries

155

National Environmental Justice Advisory Council

-created in 1994
- created as a federal advisory committee to the EPA to convene community, governmental and business constituents to assess environmental justice issues and make recommendations to the Administrator of the EPA

156

------ and -------- are interrelated concepts of critical importance to the field of environmental health and to occupational and environmental health nurses

Advocacy
Social justice

157

Case advocacy

Refers to the process of advocating for individual clients and families to solve problems and secure needed services

158

Class advocacy

Is aimed at changing policy, institutional systems, and norms, laws or patterns of resource allocation to improve the health of the group or community

159

Collaborative approaches in class advocacy

Are characterized as citizens and authorities working collaboratively to reach an agreed-upon goal

160

Example of collaborative approaches

Membership on planning and advisory committees

161

Campaigning approaches in class advocacy

Require that citizens or professionals work singly or collectively to persuade authorities (lawmakers and regulators) that new problem definitions and solutions are needed

162

Examples if campaigning approaches

Lobbying

163

Contest strategies in class advocacy

Involve citizens organizing to force attention to community problems that they feel are being ignored or mishandled by authorities

164

Examples of contest strategies

Protest marches

165

Examples of legal remedies in class advocacy

Class action lawsuits

166

Types of class advocacy

1. Collaborative approaches
2. Campaigning approaches
3. Contest strategies
4. Legal remedies

167

------ are often primary health care providers in poor and disenfranchised communities

Nurses

168

Risk

The probability of undesirable effects (or unhealthy outcomes) arising from exposure to hazard

169

Strategies for dealing with environmental risks:

1. Risk assessment
2. Risk management
3. Risk communication

170

Risk assessment

Refers to the use of available information to evaluate and eliminate exposure to a substance and the resulting adverse health effects

171

Formal risk assessment is used by almost all....

Federal regulatory agencies

172

Formal risk assessment should be distinguished from ---------- to identify health risks

Nursing assessments

173

Risk assessment is.....

Formulaic

174

Risk assessment virtually always depends on estimates for each of the following steps:

1. Hazard identification
2. Dose-response evaluation
3. Exposure assessment
4. Risk characterization

175

Hazard identification

Relies on toxicologic and epidemiologic studies of the potential of a substance to cause harm

176

Dose-response evaluation

Measures whether the harm increases with increasing doses of the substances

177

Exposure assessment

Involves measuring the amount of the chemical or other harmful substance to which a population is exposed with a goal of estimating the dose

178

Risk characterization

Involves eliminating the public or environmental impact or problem

179

Estimations of risk can be widely diverse, depending on.....

Who is doing the risk assessment

180

The context in which a risk assessment is typically used is in.....

Policy and regulatory development

181

During the time when a risk assessment is used in policy and regulatory development ---------------- are likely to be equally important variables influencing the final policy or standard

Political and economic interests

182

Risk management

The process of evaluating alternative strategies for reducing risk and prioritizing or selecting among them

183

Risk management strategies often involve....

Policy development

184

Types of risk management strategies

1. Regulatory
2. Legislative
3. Voluntary

185

Levels targeted by risk management strategies

1. Company-institutional level
2. Local government
3. State government
4. National government
5. International

186

Example of international level risk management strategy

Kyoto agreement

187

The Kyoto Agreement

- aka Kyoto Protocols
- framework laid down by 38 countries to prevent global warming

188

Kyoto Agreement main proposal

In 1997, the nations joining in the treaty agreed to reduce their emission of greenhouse gases by 2012

189

Why are greenhouse gases related to global warming?

Greenhouse gases trap heat within our planet's atmosphere and cause an increase in global temperatures

190

Average emission cuts by the Kyoto Agreement are calculated to be about....

5.2%

191

Under the United Nations Convention on Climate Change, governments...

1. Gather and share information on greenhouse gas emissions, national policies and best practices
2. Launch national strategies for addressing greenhouse emissions and adapting to expected impacts, including the provision of financial and technological support to developing countries
3. Cooperate in preparing for adapting to the impacts of climate change

192

The reduction of emissions is grouped into two classes of greenhouse gases:

1. Relates to carbon dioxide, nitrous oxide and methane
2. Relates to hydroflurocarbon gases, perfluorocarbons and sulphur hexafluoride

193

Reductions made to carbon dioxide, nitrous oxide and methane are compared to emission levels from what year?

1990

194

Reductions made to hydroflurocarbon gases, perfluorocarbons, and sulphur hexafluoride are compared to emissions from what year?

1995

195

True or false: The United States is among the signatories of the Kyoto Agreement

False

196

----------- can be a critical took in risk management

Environmental engineering

197

Engineering strategies to control exposure to environmental hazards are similar to......

Industrial hygiene hierarchy of controls

198

Environmental strategies to control exposure to environmental hazards include.....

Elimination of the exposure through substitution of products or processes

199

Examples of environmental strategies to control exposure to environmental hazards

1. Reduction of pollution at its source
2. Waste minimization
3. Reuse, recycling
4. Emissions control
5. Waste cleanup

200

Risk management strategies should always include involvement of....

All stakeholders regarding the nature of risk and the costs and benefits of proposed risk-management options

201

------- and ------- are vehicles to successful risk management

Coalition building
Community action

202

---------- may be used to manage risk in combination with other strategies

Legal remedies

203

------------ should always "be at the table" regarding decisions to are being made about their risks

Community members

204

Precautionary Principle

Assumes that where there are possible threats of serious or irreversible damage, lack of scientific certainty shall not be used as a reason for postponing measures to prevent risks

205

In 2003, the ANA adopted the ------------, based in the ------------, as the primary tenet on which they will base their environmental health policy/ advocacy work

Precautionary Approach

Precautionary Principle

206

Precautionary Principle is based on the following statement:

When an activity raises threats of harm to the environment or human health, precautionary measures should be take. Even if dorm cause and effect relationships are not fully established scientifically

207

All statements of the Precautionary Principle contain a version of this formula:

When the health of humans and the environment is at stake, it may not be necessary to wait for scientific certainty to take protective action

208

The Precautionary Principle is based on the common sense idea behind many adages:

1. Be careful
2. Better safe than sorry
3. Look before you leap
4. First do no harm

209

"Precautionary Principle" is a translation of:

The German Vorsorgeprinzip
Vorsorge literally means forecaring

210

The ethical assumption behind the Precautionary Principle is.....

Humans are responsible to protect, preserve and restore the global ecosystems on which all life, including our own, depends

211

Any action that contributes to preventing hr, to humans and the environment, learning more about the consequences of actions, and acting appropriately is...

Precautionary

212

Precaution is best linked to the following methods:

1. Exploring alternatives to possibly harmful actions, especially clean technologies that eliminate waste and toxic substances
2. Placing the burden of proof on proponents of an activity rather than on victims or potential victims of the activity
3. Setting and working towards goals that protect personal health and the environment
4. Bringing democracy and transparency to decisions affecting health and the environment

213

In 2003 the ANA adopted the "Precautionary Approach" as a guiding tenet for....

Their environmental health policy and advocacy work

214

The ANA's Precautionary Approach is based on....

The Wingspread definition of the Precautionary Principle

215

Risk communication

In the context of environmental health, is the art of communicating about the potential health risks associated with environmental exposures

216

Four elements to consider in risk communication

1. The message
2. The messenger
3. The audience
4. The context

217

Considerations related to message include:

1. Environmental health risks are often hard to define
2. Exposures may be difficult to characterize
3. The exposed population can be very diverse in age and many other important variables
4. Exposures will always include multiple chemicals, whereas most scientific investigation is primarily about individual chemicals and rarely chemical mixtures
5. Sometimes scientific evidence is inconclusive or nonexistent

218

Characteristics of the successful messenger include:

1. The messenger must be perceived as trusted and credible.
2. The messenger must be prepared to communicate with empathy and care when the message evokes hostile emotions

219

Characteristics of the audience include:

1. Audiences bring individual biases to any forum in which environmental health risks must be discussed
2. Audience's distrust of the messenger may be based on their feelings about whom the messenger represents (eg government, industry, an environmental organization)
3. An audience may trust or distrust a messenger based on his or her age, race, sex

220

Considerations related to context are as follows:

1. Risk communication does not occur in a vacuum; it often occurs when there has been a perceived environmental health threat such as a potentially contaminated water supply, an accidental release of hazardous chemicals,or a newly identified hazardous waste site adjacent to a daycare center
2. The conditions and context will influence the audience's ability to listen and trust
3. The media can play an important part in a community's understanding and biases regarding environmental risk

221

Risk communication is affected by...

Risk perception

222

Factors that affect perceptions of risk as less risky

1. Voluntary
2. Familiar
3. Controllable
4. Controlled by self
5. Not memorable
6. Not dread
7. Chronic
8. Diffuse in time and space
9. Not fatal
10. Immediate
11. Natural
12. Individual mitigation possible
13. Detectable

223

Factors that affect perceptions of risk as more risky

1. Involuntary
2. Unfamiliar
3. Uncontrollable
4. Controlled by others
5. Memorable
6. Dread
7. Acute
8. Focused in time and space
9. Fatal
10. Delayed
11. Artificial
12. Individual mitigation impossible
13. Undetectable

224

The EPA has created a list of 7 Cardinal Rules for Risk Communication

1. Accept and involve the public as a legitimate partner
2. Plan carefully and evaluate your efforts
3. Listen to your audience
4. Be honest, frank and open
5. Coordinate and collaborate with other credible sources
6. Meet the needs of the press
7. Speak clearly and with compassion

Decks in Occupational & Environmental Health Class (49):