Shared Flashcard Set

Details

ENH 600 Modules 3 and 4
Terms and Concepts
97
Health Care
Graduate
06/27/2017

Additional Health Care Flashcards

 


 

Cards

Term
What are four ways we know that the environment causes cancer?
Definition
Occupational groups, migration, twin studies, time trends.
Term
What is an example of a cancer that was demonstrated by occupational groups?
Definition
Scrotal cancer in chimney sweeps.
Term
What is an example of a cancer that was demonstrated by migration studies
Definition

Stomach cancer being related to presence of Helicobacter pylori. Or Lymphomas decreasing as people move from Africa to U.S. (due to less sun exposure)

 

 

Asians have low rates of prostate and breast cancer but high rates of stomach in their native countries; once they immigrate to the US, these rates closely match the native US rate 

Term
What is an example of a cancer that was demonstrated by twin studies
Definition
Cervical and uterine cancers have a very low hereditary component, while prostate and colorectal cancers have a high hereditary component.
Term
What is an example of a cancer that was demonstrated by time trends
Definition
Rise in lung cancer rates in males 20-30 years after the rise in tobacco use world-wide. Rate is now declining.
Term
What are the three categories environmental exposures can fall into?
Definition
Lifestyle factors, occupational exposure, home/community
Term
Which categories are intentional, which are unintentional?
Definition
Lifestyle is intentional, others are unintentional
Term
Who published Diseases of Workers, considered to be the birth of occupational medicine.
Definition
Ramazzini
Term
Who studied scrotal cancer in chimney sweepers?
Definition
Percival Pott
Term
Who had the first study to demonstrate chemical induction of cancer.
Definition
Yamagiwa and Ichikawa
Term
Who isolated the carinogenic compound benzopyrene in coal tar.
Definition
Kennaway
Term
What was the first chemical shown to cause cancer?
Definition
Benzidine, fount in dies and textiles
Term
What type of cancer does benzidine usually cause
Definition
Bladder cancer due to it being eliminated via urine.
Term
causes angiosarcomas (blood vessel tumors in liver and brain) and lung cancer. Used in plastics industry
Definition

Vinyl chloride

Term
What is the IARC?
Definition
IARC (International Agency for Research on Cancer)
Term
What two criteria does the IARC use for selecting the cheimicals for review?
Definition
Evidence of human exposure
Some evidence or suspicion of carcinogenicity
Term
What are the five categories chemicals are placed in?
Definition
Group 1, Group 2a, Group 2b, Group 3, Group 4.
Term
Define group 1 and give an example. How many chemicals are in this group?
Definition
Sufficient evidence in humans or sufficient evidence in animals and strong mechanistic data in humans. Asbestos.
Term
Define group 2a and give an example. How many chemicals are in this group?
Definition
probably carcinogenic to humans (79). Limited evidence in humans and sufficient evidence in animals. DDT.
Term
Define group 2b and give an example. How many chemicals are in this group?
Definition
Possibly carcinogenic to humans (290). Limited evidence in humans and less than sufficient evidence in animals. Chloroform.
Term
Define group 3 and give an example. How many chemicals are in this group?
Definition
Not classifiable as to its carcinogenicity to humans (501). Inadequate in humans and inadequate or limited in animals. KNOW THAT THIS ONE HAS THE MOST. Prednisone.
Term
Define group 4 and give an example. How many chemicals are in this group?
Definition
Probably not carcinogenic to humans. (1) Complete Lack of carcinogenicity in humans and animals. (KNOW THAT THIS ONE HAS THE LEAST. Caprolactam.
Term
Agent whose administration to previous untreated animals leads to a statistically significant increased incidence of neoplasia compared with the incidence in appropriate untreated animals.
Definition
Carcinogen
Term
Neoplasm
Definition
new growth, relatively autonomous growth o tissue with abnormal regulation of gene expression, may be benign or malignant.
Term
Metastasis
Definition
secondary growth of cells from the primary neoplasm.
Term
Define tumor
Definition
(latin for swelling)- defined mass of extra cells. (can take 20 or 30 years to develop or months)
Term
Cancer is a __________ ___________
Definition
Malignant Neoplasm
Term
What are the three key features of cancer?
Definition
Cancer begins inside a single cell (change in DNA is heritable and allows cancer to outgrow its neighbors)
Cell starts to grow out of control (
Tumor may change over time and cells will invade and interfere with normal tissue (metastasis)
Term
When cancer metastasizes, does the cancer change to another type of cancer?
Definition
Cancer cells metastasize and form new tumors that exist in other parts of the body that are vital organs. Thus causing death. Breasts are not vital organs, but Breast cancer, (NOT LUNG CANCER) can spread to the lungs (AND REMAINS BREAST CANCER) and cause death.
Term
Oncogene (provide an analogy as well)
Definition
growth promoting gene. If mutated, can signal the cell to divide out of control. (gas pedal stuck on the floor)
Term
Tumor Suppressor Gene (provide an analogy as well)
Definition
tells a cell to stop growing. If mutated the cell loses the ability to stop growing (Not having a functional braking system)
Term
Differentiate between carcinogenesis and mutagenesis. Explain their relationship.
Definition
Carcinogenesis (development of cancer) is linked with mutagenesis (production of a change in DNA sequence) (HOWEVER, NOT ALL MUTATION LEAD TO CANCER, AND VERY FEW CANCERS ARE NOT CAUSED BY A MUTATION (epigenetic change))
Term
What are the three broad classes of carcinogenic agents? What does each class cause?
Definition
Chemicals- typically cause simple, local changes in the DNA sequence
Ionizing Radiation (physical)- typically cause chromosome breaks and rearrangements
Viruses(biological): introduction of foreign DNA into the cell.
Term
What are the two distinctions between chemical carcinogens?
Definition
Direct and Indirect Acting
Term
Give the characteristics and an example of direct acting carcinogens
Definition
Direct Acting
-only a few
-highly reactive electrophiles
-react with nitrogen and oxygen atoms in DNA
-Ex. EMS
Term
Give the characteristics and an example of indirect acting carcinogens
Definition
-most are this class
-unreactive, water-insoluble compounds
-must be converted to ultimate carcinogens (form that can damage DNA) with electrophilc center through the actions of Phase 1 enzymes (cytochrome P450s) often in the liver.
Ex. PAH
Term
What chemical found in cigarette smoke, burnt meat, and coal tar causes mutations that inactivate the p53 gene. Bioactivation also occurs with this chemical.
Definition
Benzopyrene
Term
_____ of lung cancers occur via mutations in the P53 gene.
Definition
60%
Term
What is the mutation commonly seen in lung cancer
Definition
CREATES A G-T (TRANSVERSION)
Term
What are three measures to take to avoid environmental cancers?
Definition
Reduce exposure to known or suspected carcinogens
Remove/reduce interacting compounds (tobacco use in a mine worker)
Increase exposure to anti-carcinogens. (good diet strong in natural antioxidants like: soy, red wine, chocolate, , dark berries, tumeric
Term
How can the legislation level reduce exposure for workers?
Definition
Manufacturing interventions or personnel requirements for use of protective equipment)
Term
What are the three ways a hazardous substance can cause cancer during its lifecycle.
Definition
Manufacture- workers are exposed to high concentrations and large quantities can be released into the environment.
Product Use- exposure of general population.
Disposal- escape of carcinogens to contaminate surrounding landfills and become pervasive in the environment.
Term
Fungal Toxins are likely to be exposed via what
Definition
the GI-ingestion
Term
Largest source of this chemical is mobile vehicle exhaust.
Definition
1,3-butadiene
Term
Who provided limited evidence of an increased risk of death from 1,3 butadiene ?
Definition
Occupational Groups
Term
DEscribe the classification history of 1,3 butadiene
Definition
Was in Group 2A initially, based on future data though, it was changed to group 1, making it a known human carcinogen.
Term
What are the three main exposure routes for 1,3 butadiene? Which is most common?
Definition
Lung, GI, Skin. Lung is most common
Term
What does 1,3 butadiene do to cause cancer?
Definition
Causes mutations in the K-ras (oncogene) cancer gene causing lung tumors,
Term
What type of a transoformation occurs in the K-Ras gene that leads to a mutation?
Definition
G—>C transformation
Term
What type of carcinogen is 1,3 butadiene?
Definition
Indirect acting, thus it must be bioactivated.
Term
What three interventions can be taken to reduce the risk of exposure to 1,3 butadiene? Which is most effective?
Definition
2) Legislative
EPA requires that spills of 1 pound or more be reported. OSHA and NIOSH protect workers.

3) Manufacturing
MOST EFFECTIVE way to reduce exposures.
enclose operations and provide local exhaust ventilation

4) Individual
-Wear respirators
-wear protective clothing
Term
Environmental justice represents the convergence of what two movements?
Definition
Civil rights movement
Environmental movement
Term
Birth of environmental justice began from what event?
Definition
1982, dumped PCB laced oil in roadway of north carolina, later had to be dug up and moved to Warren County area. First time environmental and civil rights groups worked together to bring environmental justice to the forefront.
Term
What was toxic wastes and race?
Definition
first national study that examined demographic patterns associated with the location of hazardous waste sites.
Term
Distinguish between environmental racism, justice, and injustice
Definition
Environmental racism-tendency of toxic waste sites and emitters to be located near communities of color.

Environmental Injustice- expanded definition of environmental racism, includes other groups such as lower socioeconomic classes.

Environmental Justice- states that all people and communities are entitled to equal protection of environmental and public health laws and regulations.
Term
What are the 5 components of disproportional impacts?
Definition
Proximity to pollution sources
Unique exposure pathways
Sensitive and Susceptible Populations
Multiple and Cumulative effects
Social vulnerability
Term
What do LULU and NIMBY stand for?
Definition
LULU (locally undesirable land use)
NIMBY (Not in my back yard)
Term
What is an example of a unique exposure pathway?
Definition
subsistence fishing may require individuals to expose themselves to polluted water in order to provide food.
Term
What are the four intrinsic factors related to susceptibility?
Definition
age
sex
Genetics
Race or ethnicity
Term
What are the seven acquired factors related to susceptibility?
Definition

Chronic medical conditions

health care access

nutrition

fitness

other pollutant exposures

drug and alcohol use

lack of political power (inability to commiunicate) 

Term
What is an example of multiple cumulative effects?
Definition
disavantaged and underserved communities are likely to suffer a wide range of environmental burdens
Term
What does social vulnerability recognize?
Definition
recognizes that social factors such as employment status, access to health insurance, language ability, and access to social capital can play a major role in determining the response to environmental insult.
Term
What impact can social problems have on environmental interventions?
Definition
Social problems may also significantly limit meaningful involvement in the environmental decision making process.
Term
What two perspectives must social vulnerability be looked at with?
Definition
Magnitude and severity of exposures. (External factors)
Nature of the receptor population. (People that external factors affect)
- biological and social aspects of vulnerability must be taken into account.
Term
What are the 4 factors that impact vulnerability?
Definition
Susceptibility
Exposure
Preparedness
Ability to respond and recover
Term
What was Executive Order 12898? What impacts have been seen?
Definition
demands that all government agencies make environmental justice part of its mandates. Qualified by “To the greatest extent practicable”

Been viewed as a directive to identify minority and low-income populations defined as protected groups.

Very little has been done as a result of this act, created offices within federal department for environmental justice but often this office only includes one person.
Term
What are three components of the multi-faceted nature of problem solving in environmental justice?
Definition
Both affected communities and public health practitioners must engage in a dialogue about what is needed to apply collaborative problem solving to the task of achieving environmental justice and healthy communities.
Communities and practitioners must work together to create community benefit agreements, build the strategic thinking, planning, and problem solving capacity of communities, and engage in community based participatory research.
Social capital helps determine social determinants of health, factors in the social environment that influence health, such as income distribution, discrimination, access to education, and housing policies.
Term
Know table on 1st, 2nd, and 3rd world countries!!!!!
Definition
Term
occur when developing nations move from one stage to the next.
Definition
Risk transitions and risk overlap
Term
Which transition is most severe?
Definition
third-->second
Term
What are the four drivers of environmental health disparities?
Definition
Vulnerability and coping capacity
Globalization
Agriculture and food security.
Urbanization
Term
Environmental Drivers
Definition
factors that motivate, stimulate, or push the environmental processes that affect human health. They contribute directly and indirectly to health disparities among the three worlds.
Term
What are the two main elements of vulnerability?
Definition
Exposure to environmental hazards (stressors, shocks, contingencies)
Coping capacity (resilience)- offers security in the face of exposure.
Term
Describe the spectrum that vulnerability occurs on.
Definition
high risk and low coping capacity for the third world) (high risk and high coping capacity for the USA) (low risk and high coping capacity is ideal)
Term
created as a result of high risk and low coping capacity.
Definition
environmental refugees
Term
Globalization
Definition
Process of interlocking, economic, social, technological, political, and cultural changes emerging around the world.
Term
Se deficiency) in China
Definition
Keshan-beck disease
Term
What are six things that impact undernutrition?
Definition
traditional beliefs that limit food choice
Reduced capacity for local food production
Declining investments in agriculture and irrigation.
Lack of education on advanced technologies.
Destruction of local ecosystems
Lack of adequate food storage and distribution systems.
Term
Differentiate between urbanicity and urbanization. Which is more important for predicting health?
Definition
urbanicity-the extent of urban population concentration, and urbanization- the process over time of urban growth.

Urbanization is a more important predictor of health in urban populations than size, because with rapid urbanization, growth outstrips available resources.
Term
What led to slum growth?
Definition
high rate of urban growth with increased demand for basic housing and services caused rapid expansion of illegal or unplanned and unserviced settlements with unhealthy living conditions and extreme overcrowding.
Term
What 7 things influence urban health in developing nations?
Definition
1) Outdoor (Ambient) Air Pollution
2) Indoor Air Pollution
3) Water
4) Infectious diseases
5) Waste Disposal
6) Disaster Vulnerability
7) Social and Behavioral Factors
Term
What disparities exist across the three worlds?
Definition
Air quality
Water and sanitation
Injuries
Term
What social and behavioral factors has urbanization impacted?
Definition
resulted in lower quality diets, increased sexual activity, insufficient access to adequate health, and few legal rights.
Term
what is benzidine? What cancer does it cause?
Definition
used in textiles, causes bladder cancers.
Term
what is benzopyrene? What cancer does it cause?
Definition
found in coal tar, causes lung cancers.
Term
what is 1,3 butadiene? What cancer does it cause?
Definition
comes from mobile vehicle exhaust, cigarette smoke, petroleum refineries. Leukemia's and lymphomas
Term
what is Vinyl chloride? What cancer does it cause?
Definition
found in plastics industries, lung cancers.
Term
How many types of cancer are known?
Definition
More than 100
Term
What enzyme bioactivates 1,3 butadiene? Which ones detox it?
Definition
P450, GST and EH
Term
What did the national law journal determine in 1994 about enforcement of environmental laws.
Definition

 

– only race mattered; independent of wealthy or poor 

Term
What gene does benzopyrene impact?
Definition
p53
Term
Define Ethics
Definition
reasoned or systematic approach to figuring out what is the right or wrong action or position
Term
What are the three modern principles of ethics that are primary to environmental health?
Definition

Scientific Integrity

Justice

Welfare

Term
What 4 ethical themes arise out of the question asking how important it is for us to incorporate the health of the environment into our work?
Definition

Our view of the future

Our concern for future generations

Ethical standing of nonhuman nature and animals

How holistic we ought to be. 

Term
Double jeopardy example in environmental health
Definition
Environmental hazard exposures and socioeconomic stressors
Term
Provides a promising approach for incorporating cumulative impacts into assessments to guide decision making
Definition
HIA (Health Impacts Assessment)
Term
Three pathways for unequal societies to be more likely to pollute the environment.
Definition

1) Asymmetry in power between wealthy and poor

2) Poor wanting to emulate the privileged by consuming more.

3) Inequality eroding social cohesion and trust, 

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