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Environmental & Occupational Health Cheat Sheet by


Enviro PH: Study of the impact that enviro exposure plays on health outcomes of the community
Precau­tionary Principle: If you're unsure about risks, be safe
Causation: Cant be proven
Hill's Criteria of Causation: Tempo­­rality, dose response, biological plausa­­bi­lity, strength of effect, reverse of effect
Healthy Worker Effect: Ppl in workforce are inherently healthier than non-wo­­rking
POPs: Persi­­stent organic pollutants - Chemicals that persist in env. & body
Lipophilic: Stored in fat tissue (organic 
Bioacc­umulate: Builds up in body, usually lipoph­­ilic
Biomag­nif­ication: Builds up through the food chain
Heavy Metals: Naturally occurring, common in industry (ie lead, merc, arsenic, cadmium)
Endocrine Disruptors: Subst­­ances that either block, mimic, or antagonize normal hormone func.
Terato­genic: Causes mutations
Ionizing: Carci­­nog­­enic, causes mutations
Non-io­nizing: Non-m­­utation causing
Lead: Metal, affects nerv system (poisonous @ 10 microg­­ra­m­s­/liter of blood) 
Idiopathic Disease: "­Idi­ots­" don't know what's causing it
Sick Building Syndrome: a medical condition in which people in a building suffer from symptoms of illness temporally related to time in the building”. (WHO 2005)
Building related symptoms: the acute adverse health effects of building occupants related to time spent in the specific building. 
Common BRS: headache, fatigue, eye compla­ints, respir­atory problems
Building related illness: diagno­sable illness whose cause can be directly attributed to building exposures (doesn't improve when removed from building)
Exs: Toxicity (carbon monox poison­ing), Infectious Disease (legio­nnaires disease, asperg­ili­osis), Pulmonary (occup­ational asthma)
Pathon­eumonic: visible disease
Chemical half-life: persis­tence of chems in the body (blood­/urine)
Organic & Inorganic: w/ & w/o carbon
Organic solvent: organic substance (usually liquid) that dissolves another material (all indust­ries, common in cleaning supplies & cosmetics

Enviro­nmental Exposure Heirarchy

Exposure isnt dose, but it is used to calc dose
Co-exposure can confound - need to measure all
Enviro­nmental Exposure Heirarchy
Bioactive Dose
Internal Dose
Personal Exposure
Ambient Exposure
From top to bottom: the higher, the better the assess­ment. Co-exp­­osure can confound (need to measure all)
How to Measure Exposure 
Type of Env. chem or phys (i.e. radiation, noise, heat, etc)
Medium of Env. i.e air, water, soil pollution
Location of Env. i.e. ambient, work, residential
Duration of exposure time avg or cross-­sec­tional
Exposure -> Dose depends on... Chemical half-life (persi­stence in blood/­­ur­ine), route of exposure (i.e. ingest vs inhale), genetics, demogr­­aphics (i.e. babies & old ppl get higher doses, cant metabolize as fast), health status & nutrition, lifest­­yl­e­/­be­­hav­­iors, geography (proximity to hazards)

Driving & Traffic Mortality

Traffic Mortality Stats
>1.2 M deaths/yr (Israel 350/yr %25 pedest­rians) 
-Currently leading cause of ppl yrs lost < 60 (projected as 2nd cause of all deaths/yr by 2020)
-Driving forces, pressures, stresses: econ growth, explosive growth in # of cars
What kills? speed, fatigue, cellph­ones, mass, alc, young male drivers, pedest­rians (young and old)
1993 Israel ↑ speed limit 90 to 100kph -> ↑ death rate


Lead: 1975 ↓ lead in gas → ↓ in air → ↓ in ppl → ↓ crime & ↑ IQ 
Minamata Disease: Minamata Japan neuro disorder from severe merc poisoning: 1950 crazy cat disease → 1955 “An epidemic of an unknown disease of the central nervous system” → 1956 40 cases, 16 dead. → 1958 Vast # children living near water (eat & drink) thought it was food poisoning → 1959 hair samples of children in & out of city. Found kids in city had 3x more heavy metal → 1960 figured out the heavy metal was mercury coming from Chisso Chem Company dumping heavy metal biproduct in bay that bioacc­umu­lated in fish

Synthetic Chemical Compounds - Qs

What chemicals being used? 
What actual exposure? (conce­ntr­ations, amounts, route of exposure)
Are exposure levels health concern?
200k+ can never know toxicity of all

Water Pollution

Definition: Any chem, bio, or phys change in water quality that has a harmful effect on living organisms or makes water unsuitable for desired usage
Composed of:
Organic Chemicals
oil, gas, plastics, deterg­ents, industries & cleaners
Plant Nutrients water soluble nitrates, ammonia & phosphates (from sewage), agricu­lture & urban fertilizers
Sediment soils/­silts from land erosion (can disrupt photos­ynth, destroy spawning grounds, clog rivers & streams)
Inorganic Chems Acids & toxic chems, often from runoff, industries & household cleaners
Oxygen Demanding Wastes: Organic waste that needs oxygen, often from animal waste, paper mills, & food processing
Infectious Agents: bacteria & viruses, often from animal waste
Routes Industrial waste, urban runoff, ground­water contam­ination
How to Measure Water Quality? 
Bacterial Counts Fecal coliform counts from animals' intestines
- 0 per 100ml for drinking
- >200 per 100ml for swimming
Sources: humans, birds, animals
Dissolved Oxygen: Bio. O2 Demand (BOD) aka amount of O2 consumed by aquatic decomposers
Chemical Analysis: look for presence of inorganic or organic chems.
Suspended Sediment: water clarity
Drinking Water
-Purify drinking water via heat & UV exposure, fine cloths to filter, small amts of chlorine
-Bottled water may get contam­inated by plastics from bottle
Basis Drinking Water Standards
Primary source in toxicology & drinking water standards
Pros: control of exposure levels, living condit­ions, chance 4 followup, pathol­­ogical testing
Cons: is animal model approp­riate for human effects? do exposure conditions reflect real condit­ions?
Why is ground­water pollution a serious problem? Out of sight (under­ground) - wouldn't necess­arily see it, little dilution & disper­sion, no way to cleans itself (bacteria that would work to break down pollution needs warmth and movement to move), prime source for drinking, pollutant removal is difficult
Causes: Low flow rates, low O2, few bacteria, cold temps
Prevention: monitor aquifers, find less hazardous subs, leak detection systems, strictly regulate hazardous waste disposal, store hazardous materials above ground so it doesn't seep into ground­water
Ocean Pollution Sources: large amounts of untreated raw sewage, leaking septic tanks, runoff, algae blooms from nutrients (i.e. red tides-­create neurot­oxins), dead zones, airborne toxins, oil spills
Solutions Prevent ground­water contam, greatly ↓ nonpoint runoff, reuse treated wastewater for irriga­tion, substi­tutes for toxic pollut­ants, treat sewage naturally, 4 rs (refuse, reduce, recycle, reuse), ↓ resource waste, ↓ air pollution, ↓ poverty, ↓ birthr­ates, fertilize w manure or compost instead of inorganic fertil­izer, ↓ use of pestic­ides, never apply fert or pesticides near body of water, organic foods, dont dump chems or meds in drains­/to­ilets

Children Not Little Adults

Different & unique exposures
Dynamic devel physiology
Longer life expectancy
Politi­cally powerless
More surface area to be exposed
Exposed @ home, school, day-care, playgr­ound
Exposed to pesticide residues, wood preser­vat­ives, dust, etc.
Vast majority of deaths from uninte­ntional injuries globally

Physical Hazards

Noise, Temp., Ergono­mics, Vibration, Radiation (All have waves)
Most Common Symptom of Occupa­tional Exposures? back injuries from improper lifting
Noise Induced Hearing Loss (NIHL) Cumula­tive: 1 in 4 workers over age of 55
Industries @ risk Petroleum, lumber, food processing (~25% workforce maybe exposed > 90dB)
Control Measures 1. Engine­­­ering 2. Admin controls 3. Hearing protection

Fields of Toxicology

Descri­ptive Toxicology testing on lab animals/in vitro, provides info for safety eval/reqs. Used to eval risks for humans & enviro from exposure to specific chems
Mechanic Toxicology ID & undersand cellular, biochem, & molecular mechs by which chemicals exert toxic effects. Useful for showing adverse outcome in lab animals is relevant to humans
Regulatory Toxicology Estab of stnrds for amt of chems permitted in air, food, industrial atmos., & water. Oft integrates sci info from descri­­ptive & mech tox studies w approaches used risk assmt
All used for risk assessment

Enviro­nmental vs...

Larger affected population
Smaller affected population
Smaller concen­tra­tions
Higher concen­tra­tions
Fewer exposures
More exposures
Regional monitoring
Direct monitoring
Occ. health issues become enviro health issues
Enviro PH
Enviro MD
Recogn­­izing disease in specific community
Recogn­­izing disease in ind.
ID env. exposures in comm.
ID env. exposure of the ind
Make connection btwn exposure & disease
Make connection btwn exposure & disease
Reduce exposure to pollution
  Reduce exposure first, treat disease


Exposures to Env. Radiation: coal burning (power stations), phosphate industry (middle east phosphates high in uranium), household heating & cooking (less today), gypsum phosphate (industry, less today), radon exposure (basements, underground parking, etc), nuclear energy use, nuclear disasters, watches, fluorescent signs, fire detectors, air travel, industrial use (checking pipes, bottle filling of soft drinks, density measures, ground moister detectors)
Exposures to nonionizing radiation: smart wireless tech, WII games, remote controls, WIFI, cellphones, radars, RF radio equip, radio/tv station workers, security chips
Medical irradiation: diagnostic radiology = x-rays, CT, catheterizations, angiography, guided surgery & nuclear medicine = RA material injected IV then tracked by Gamma ray cam, heart scan, bone scan

Climate Change

Gradual inc. in temp
↑ in sea level -> salinated water
tropical region ↑ -> malaria, dengue, etc
↑ air pollution -> cardio­pul­monary, morbidity, & mortality
Temp extremes
heat waves -> dehydr­ation & heat stroke
drought -> ↓ crops & drinkable water
↑ fires -> burn injuries, air pollution
Cold events -> frost bite, hypothermia
Extreme climate events
drowning, displa­cement
↓ drinkable water
↑ infectious diseases
State of research very new & active area, lack of good research (poor outcome & exposure assess­ment), multiple confou­nders, delayed effect (need to observe population for decades)

Air Pollution

Definition A complex mixture of gases, partic­ulates, metals (i.e. arsenic, cadmium, merc, zinc, iron), & bioall­ergens suspended in ambient air
Measures: Personal (expen­sive) & Ambient (cheaper, use area monitors to estimate personal via map-re­d=h­igher exposure & dots where ppl live)
Natural sources: pollen, fungi, dust 
Anthro­pogenic sources: point (stays in place, i.e. factory) & mobile (i.e car, cow)
Criteria Air Pollut­ants: Ozone, nitro dioxide, partic­ulate matter (PM10 & PM 2.5), sulfur dioxide, lead
Partic­ulate Matter 
= Shmutz - Mixture of solid & liquid particles suspended in air
Types: UFP (<0.1 microns), PM2.5 (<2.5), PM10 (2.5-10)
Where to? 5-10 microm­eters: nasoph­arynx (nasal pathways)
3-5 Microm­eters: trachea
2-3 microm­eters: bronchial tubes
1-2 MMs: Bronch­ioles
0.1-1MMs: alveoli (blood­stream)
-Assoc­iated w ↑ pulmonary ER visits, ↓ pulmonary function
-Needs to be 2.5 or smaller to affect heart
Indoor Air Quality
: biomass (fuel 4 cookin­g/h­eat­)-c­arbon monoxide & partic­ulates, enviro tobacco smoke (ETS), radon, VOC (volatile organ compou­nds), mold
Illness: sick building syndrome (building related symptoms), building related illness
Problem of cooking & heating: approx 50% households worldwide & 90% households utilize solid fuels for cooking & heating 
-indoor, contained, higher exp.
-biomass fuels emit partic­ulates, carbon monoxide, nitrogen oxides, benzenes, formal­dehyde, 1,3 butadiene, & PAH like benzo(a)pyrene
-2004: indoor smoke from solid fuels was attrib­utable mort. #10 & attrib­utable DALY #9


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