Environmental Risk Transition
-changes in environmental risks that happen as undeveloped regions of the world evolve
-prior to this this is poor air,food and water quality
-results in increase of chronic conditions
-being sound in body, mind or spirit
-not just the absence of disease
Life Quality
-physical status and functional ability
-psychological status and well-being
-social interactions
-economic and vocational factor
-religious and spiritual status
Health Status
-Life expectancy
-Functional Status and Capacity
-Quality of life
Basic Environmental Requirements for Health
-clean air
-safe and sufficient water
-safe and adequate food supply
-safe and peaceful settlements
-stable global environment
-the circumstances, objects, or conditions by which one is surrounded
Environment (more technical)
complex of climatic, edaphic (soil-based) and biotic factors that act upon an organism or an ecological community
Environment (Public Health Definition)
– all which is external to the individual host. It can be divided into physical, biological, social and cultural factors which influence health status in populations
-trouble or condition of the living animal or plant body of one of its parts that impairs the performance of a vital function; morbidity
Contributors to the “Environment” (6)
Environmental Epidemiology
-study of patterns of illness amount humans and the factors that might create these patters (exposure to environmental agents and development of disease)
Environmental Toxicology
-mechanisms between exposure and development of disease
-understanding toxicokinetics and toxicodynamics of environmental chemicals
Environmental Justice (3 aspects)
-Equal Protection
-Equal Access
-Fair treatment and meaningful involvement of people
-e.g. Baltimore’s Wagner’s Point
Executive Oder 12898 (1994)
-created to address Environmental Justice in minority and low income populations
Health Improvements in 20th Century
-Water, food, milk sanitation
-Reduced physical crowding
-Improved nutrition
-Central heating + cleaner fuel
-Chlorination of water
-Removal of lead from gasoline
Lead Paint
-banned in 1977
-Still exist
Arsenic in Groundwater
– In Bengaladesh and West Bengal
-causes lung/live/bladder cancer and skin lesions
what the body does to the agent
(I.E. absorption, distribution, metabolism, excretion, storage)
-what the agent does to the body
(i.e. the molecular, biochemical, cellular and organ changes that occur)
Risk Assessment
– the determination of the probability that an adverse effect will result from the defined exposure
This includes:
+hazard identification
+exposure assessment
+risk characterization
Risk Management
-the process of weighing policy alternatives and selecting the most appropriate regulatory actions based on the results of risk assessment
Clinical Intervention Model
-prevent diseases from becoming death
Public Health Intervention Model
-Prevent public + environment form causing disease
Environmental Stewardship Model
-Prevent public from harming environment
The Three P’s (Principle Determinants of Health Worldwide)
Environmental Impact Model
I = P x A xT

I = environmental impact
p = population
a = affluence
t = technology

Types of Waste (5)
– Municipal Solid Waste
– Industrial Waste
– Medical Waste
– Radioactive Waste
– Hazardous Waste
Characteristics of Hazardous Waste
– Ignitability
– Corrosivity
– Reactivity
Hazardous Waste Wake-up Calls (Superfund)
-Love Canal
-Valley of the Drums
-Times Beach
-Libby, Montana
RCRA (Resource Conservation and Recovery Act)
– 1976
– defined hairdos waste
– instituted “manifest system” for tracking
– set standards for hazardous waste facilities and issued operating licenses
CERCLA (Comprehensive Environmental Response, Compensation and Liability Act)
– Established a national priority list for expenditure of superfund cleanup dollars
– land previously used from industrial purposes of certain commercial uses. The land may be contaminated by low concentrations of hazardous waste or pollution.
-Concentrated Animal Feeding Operations
-Factory Farms
-Produce large amounts of waste – lagoon
-Nitrogen and phosphorus
-Contaminate groundwater and drinking wells
– when an agent enters the body
– can be acute or chonic
– can occur indoors or outdoors
– by various vectors (routes)
exposure =intensity x frequency x duration

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-often is related unequal protection

Exposure Assessment
– qualification of the human engagement with environmental contaminants and health problems
Health Assessment in the contact of Environmental Exposure
– the quantification of health effects that may be related to specific exposures
– study of patterns of illness amount human populations
-uses math and statics to make deductions
-uses disease clusters
– occurrence of new disease of mortality within a defined period of observation
– a measure of disease frequency and refers to existing cases of diseases or deaths
Point Prevalence
– all cases of a disease that exist at a particular point in time relative to a specific population from which cases are derived
Odds Ratio
– measure of association for case-control studies
-the odd in favor of exposure among the disease group (cases) to the ratio in favor of exposure among the no-disease group (control)
Relative Risk
– the ratio of the incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a non-exposed group
– causal association must exist between an agent factor and disease in the host for there to be casusality
Factors that make disease hard to identify (6)
– latency
– multi-factorial etiology
– disease non-specificity
– individual characteristics
– changed in response with chaining does
– mixed exposures
– chemical, molecular, biochemical or cellular alterations that are measurable in biological media such as human tissues, cells or fluids
Common Law
Judge made law
Statutory Law
– written law
– state, local and national governments
Environmental Law
-Laws that protect nature and ecology, public health and welfare
agency decisions that affect groups of people, especially the regulated community
– a decision about a particular claim by a particular entity
The Benzene Decision
-Risk Assessment = chosen methodology for environmental standard setting
Industrial Union Dep’t, AFL-CIO v. American
Petroleum Institute, 448 U.S. 607 (1980)
– Agency does not need scientific certainty to regulated if at the frontiers of scientific knowledge
Risk Assessment Process (4 steps)
-Hazard Identification
– Dose/Response Assessment
-Exposure Assessment
– Risk Characterization
the utilization of biomarkers in the measurement of the body burden of toxic chemical compounds, elements, or their metabolites in biological materials
Patterns of Exposure (5)
Water Improvements
-Filtration and Chlorination
-Typhoid and Cholera