ENV H 417 A - Midterm Flash Cards

What is the HHS (Healthy People 2020) Goal?

To achieve health equity, eliminate disparities, and improve the health of all groups

What is health equity?

The attainment of the highest level of health for all people

What is health disparity?

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

What groups of people are affected by health disparity?

People who have systematically experienced greater obstacles to health based on their racial/ethnic group; religion; socioeconomic status; gender; age; mental health; etc.

Who is the "father" of toxicology?

Paracelsus

Who is the "father" of epidemiology?

Dr. John Snow

What is childhood?

In the context of the evolutionary theory, as humans were evolving, our brains got bigger and the pelvic region for women got narrower, making babies come out sooner in order to get that big head out.

What is the first core concept?

"Children are not little adults" when it comes to environmental health.

What is the second core concept?

Exposure-Disease Model

What is the third core concept?

Life course perspective

What is the fourth core concept?

Prenatal exposure

What is the fifth core concept?

Critical windows - CNS (central nervous system) development

What are the stages Exposure-Disease Model?

Environmental contamination > Exposure > Biological uptake > Absorbed dose > Biological changes > Target organs > Clinical disease &/or subclinical effects

What is prenatal exposure?

During gestation, the majority of exposures (except for physical factors) occur transplacentally through exposure to the mother.

Exposures during infancy

After birth, exposures may either be directly to the child, with an additional route from the mother for those agents that maybe present in human milk

Target organ susceptibility

Somatic growth continues over the first year of life

- 4 months double birthweight

- 12 months triple

brain and lungs are highly vulnerable organ systems

What are the key toxicants of concern for newborns/infants

Lead, PCBs, Ethanol, Nitrate, DEET, Lindane

What are specific to Infants/Young Children?

Diet expands and Highly exploratory with increasing mobility

What are unique exposures to Infants/Young Children?

Diet changes in this stage, potentially increasing exposure to toxicants in food, As the infant and toddler expand their ability to interact with the environment, they are more vulnerable to oral, dermal, and inhaled environmental exposures, time spent in a particular environment and intensive contact with that environment such as developing motor skills near the floor &mouthing behavior exposes this stage to a unique source of toxicants

What is the exposure vulnerability to to Infants/Young Children?

soil & dust ingestion

What are the dietary exposures to Infants/Young Children?

Contaminants inadvertently or purposefully added to food supply and chemicals added to food products

What does the U.S. Food Quality Protection Act (FQPA) of 1996 do?

Considers needs & sensitivity of children and requires EPA to use a 10-fold margin of safety when setting standards for pesticide exposure when there is limited data on infants and children

What are the "around the home" exposures to Infants/Young Children?

Surface contaminants, such as pesticide residue and formaldehyde from new synthetic carpet

What are possible exposures to Preschool/School-Aged Children?

Home, play areas, day care, and school environment

Why is air quality important to consider for children?

Children spend 80-90% of time indoors and up to 10hours daily at day care/school

What is increasing childhood asthma incidence children associated with?

outdoor & indoor air pollutants

What are some examples of outdoor pollutants?

nitrogen dioxide (NO2), particulate matter (PM), ozone (O3), pollen, molds

What are some examples of indoor pollutants?

ETS, VOCs, animal and insect allergens, molds

What are unique exposures to adolescents?

Freedom from parental authority begins, substance use and abuse, occupational exposures begin at this stage

How does lead get into the environments of children?

Deterioration of lead-based paint, leaded gasoline contaminates soil, consumer products containing lead, etc

What are the Lead (Pb) mechanisms of toxicity?

interferes with calcium (Ca) and iron (Fe) systems

- forms complexes with sulfhydryl groups and others

- disrupts enzyme and leads to multisystem effects

What are the health effects by BLL

Most lead poisoning in the U.S. represents subclinical toxicity - e.g., cognitive, behavioral effects

What is the minimum threshold for lead (Pb) in children?

There is no safe blood lead level for children. Children are best protected by controlling or eliminating lead sources before they are exposed.

What is asthma?

Chronic inflammatory disease of children. Primarily affects the airways.

What is asthma characterized by?

coughing, dyspnea, wheezing, and chest tightness

How are asthmatic symptoms controlled?

avoiding or reducing asthma triggers (allergens and irritants) and appropriate medical care (asthma control medication)

Asthmatic disparities among children

more prevalent among those in families with low incomes and belonging to ethnic groups like black or hispanic

Asthmatic trends over time (2006-2018)

- Current asthma prevalence among all ages and adults did not change significantly

- Among children, a decrease occurred in asthma prevalence

Asthmatic disparities in prevalence between boys and girls

Among children, boys had a higher prevalence than girls, whereas among adults, women had a higher prevalence than men

Epidemiology of Asthma in WA

- 8-11% of middle & high school children have asthma

- Households <$20,000 annual income more likely to have child with asthma than >$50,000

U.S. Economic Impact from asthma

- 13.8 million missed days of school in 2013

- Child + adult asthma cost $81.9 billion in 2013

Asthmatic challenges in childhood

- Most asthma starts early in life, but diagnosis difficult

- Wheezing (with respiratory viruses) common in early childhood

- About 50% of kids wheeze prior to age 3 years

How does asthma develop?

- Atopy = "allergic" = genetic tendency to develop allergic diseases

- Parental history

- Certain respiratory infections during childhood

- Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood

What are some factors that can trigger asthma development?

Environmental Tobacco Smoke, Dust Mites, Mold, Chemicals, Animals, and Pests

What are some sources of outdoor air pollutants that can trigger asthma development?

ozone (O3), PM2.5, Stress