Idiopathic Disease
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EPA's IRIS Assessment Plan for Inorganic Arseniclooks at whether or not early life exposures are addressed; feasibility of mode-of action information, modeling approachesWhat are the 3 major avenues of public policy?penalized failure, rewarding success, and education3 Stages of the EPA life cycle1. prevent observable pollution 2. prevent measurable pollution 3. maximize benefitsProcedural Requirements for Federal Regulationsnotice to the public public gets to comment recording of comments and responses executive ordersState Environmental Lawsmust issue state implementation plansFramework for Communicating RiskPhase 1 - formulate/scope the problem Phase 2 - Planning and Risk Assessment (3 stages) Phase 3 - risk managementHealth Disparatiesdifferences in the incidence, prevalence, mortality, and burden of disease and adverse health conditions that exist among specific defined population groups1985 US Health and Human Servicesreleased the first official report documenting the existence of health disparities for minorities in the USIndian Health Service 1955IHS was formed and showed the various health disparities among Native AmericansREACHRacial and Ethnic Approaches to Community Health tracks social determinants of diseaseWhat were the findings of REACH?residents of minority communities continue to have lower socioeconomic status, higher barriers to health-care access, and higher risk for diseaseHealthy People InitiativeA federal initiative to facilitate broad, positive health changes in large segments of the U.S. population every 10 years.What are the benchmarks of progress for the Healthy People Initiative?collaboration across communities and sectors empower individuals to make informed health decisions measure the impact of prevention activitiesUSA Leaptakes zip code data and estimates the lifespan in the neighborhoods; higher poverty and disease rates are related to lower life expectancyAll-Cause Mortality in Allegheny Countydecrease slightly since 1975; rates of death are still higher in black and minority populationsWhat populations tend to have higher health disparities?racial minorities low socioeconomic status immigrant populations children elderlyVulnerabilityenhanced adverse responses that arise through different probability of exposureSensitivitybiological factor that confers increased responsiveness to environmental insultSusceptibilitydifferential probability of experiences adverse effects from any given exposureCYP1A1 and GSTM1 Case StudyCYP1A1 gene polymorphism in a phase 1 enzyme that produces a reactive carcinogenic metabolite of benzopyrene GSTM1 polymorphism in phase II enzyme that inactivates the toxic metabolite wildtype allele is activeDifferences between children and adults in terms of susceptibility and vulnerabilitydifferent and unique exposures dynamic developmental physiology sensitive periods of development longer life expectancyWhat is a special problem for infantsnitrate toxicity - too much reduces the capacity of the blood to carry oxygen to the brainWhat factors influence health and well-being?social and economic behaviors (40%) Health behaviors (30%) Clinical care (10%) Physical environment (10%)Environmental Justicethe fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.Environmental Justice Communitymore than 20% of the population in poverty and more than 30% of the population is a racial minorityNational Pollutant Discharge Elimination System (NPDES)required the EPA to establish water quality criteria fish consumption used to calculate criteria (6.5 gm/dayWADOE Studyfound that the general population ate 16-56 gm/day of fish whereas tribal populations eat up to 797 gm/dayWhat other problems are impacting global health sensitivity and vulnerability measures?artisanal gold mining asbestos pesticides indoor biofuel cookstovesExpert Consensus of Climate Changemore than 97% of scientists agree that its real; backed by the IPCC 5th assessment report and the fourth national Climate AssessmentGreenhouse Effectsolar radiation passes into the atmosphere; its absorbed by the earth; some is radiated back into space; some of the outgoing IR is trapped by the atmosphereWhat cities are most at risk of sea level rise?South Asian cities; Miami, FL at risk by assetsWhat is causing global warming?many sources of manmade pollution, carbon emissions post-WWII, methane and N2O concentrationsHow much of the extra heat trapped by global warming pollution goes into the ocean?93%; 2018 was the hottest year on recordHow does climate change bring more precipitation?warm air holds moisture; heat waves are more frequent and last long (increases hurricanes); changes in ocean currents and jet stream; warm water expands and melts iceHow does increasing CO2 drive climate change?leads to trapped heat in the atmosphere and oceans; extreme weather eventsHow does methane contribute to climate change?leaks out of coal mines, oil and natural gas wells, and melting permafrost; 86x more potent as a heat trapper than CO2How do N2Os contribute to climate change?generated anywhere fossil fuels are burnedWhy is climate change a medial emergency?vector-borne diseases, heat stress, air pollution, and water-borne diseases; higher average temps and changing rainfall patterns; more extreme heat days; burning fossil fuels is polluting the airHow do GHGs contribute to human health?increases in temperature, changes in precipitation, increases in frequency and intensity, rising seasHeat Stressimpacts on human physiology directly - heat cramps, exhaustion, and stroke indirect - worsening of chronic conditions more deaths annually in the US than all extreme weather events combinedExtreme Weather as a threat to human healthincreased exposure to extreme events can lead to injury/death, illness, and mental health effects; destruction of infrastructure; vulnerability to coastal flooding; impact on hurricanesInfectious Disease Spreadvector-borne diseases are impacted by climate change because it impacts seasonality, distribution, and prevalence Water-borne diseases - high was temps promote toxic algal growth; more precipitation = increased runoff into drinking waterAir Quality on Human Healthwarmer/wetter and humidity worsens air quality; respiratory problemsWhat are the three major air pollutants?PM2.5, ground-level ozone, pollenWater and Climate Changepeople need more as temperatures rise (crops, animals, etc.)Food and Nutritionrefrigeration, storage, and distribution of food is threatened by rising temps and weather events; lower crop yields; more pests and pesticides; higher CO2 levelsMental Health and Climate Changestress is an adverse health effect; people cannot escape trauma from heat waves and poor air quality; health of other lifeforms is being threatenedThe Dry Corridor in MexicoHonduras ranked #1 out of all 184 countries on the global climate risk indexVulnerable Populationspregnant women, infants and children, elderly, poor, homeless, sick and disabled, mentally ill, outdoor laborers, first respondersVulnerable Communitiescities, coastlines, river valleys, zip codes near power plants, highways, and communities of colorWhat are some social, environmental, and economic costs associated with rising CO2 emissions?political instability floods and mudslides wildfires, drought, storm damage ocean acidification infrastructure loss climate refugees species extinction melting glaciers famine water scarcity infectious disease sea level riseBenefits of wind powerprovides tax revenues abundant and affordable clean energy jobs to people around the worldSolar Energyenough solar energy reaches the earth per hour to fill the world's energy needs for a year cost of solar has dropped storage is a problemTransportation Section and Climatepollution from vehicles is the 2nd largest source of emissionsAgricultural RevolutionThe time when human beings first domesticated plants and animals and no longer relied entirely on hunting and gatheringIndustrial Revolutioninvention and use of power-driven machines to dramatically increase productivityDigital Revolutionspread of new info and communication, leading to outsourced production and widespread data consumptionSustainability Revolutionreorganization of the economy around new forms of zero-emission, healthy, equitable, and sustainable growthWhat are some simple solutions to climate change?reduce/eliminate fossil fuel ASAP replace plastic with new materials conserve more eat less beef reduce energy consumption and waste eat real food eat locally buy fuel efficient vehicles mass transit education advocationCooperative Federalismnational, state, and local governments interact cooperatively and collectively to solve common problemsFederal Food, Drug, and Cosmetic Act1938 - gives authority to the FDA to oversee safety of food, drugs, and cosmeticsElixir Sulfanilamide DisasterHarris-Kefauver AmendmentsRequired that safety and efficacy be established before marketing a drug thalidomide and requirement for clinical trialsNEPA (National Environmental Policy Act)1969 - requires that all federal agencies prepare environmental assessments and environmental impact statements regarding permitting decisions, federal land management strategies, and public infrastructurePresident's Council on Environmental Qualityannual report on the environment, oversees EISs, and interagency coordinationHighway RevoltsSanta Barbara Oil SpillIn 1969 an oil spill off the coast of Santa Barbara combined with strong winds defiled 20 miles of white sand beach in this affluent community. Environmentalist blamed the disaster on the ills of life in modern America. This incident, combined with the publication of Silent Spring and the burning of the Cuyahoga River, increased public awareness on the threats Americans posed to the environment, (1969) 200,000 gallons of crude oil spilled, and even though it ended up not being that big of a deal, at the time it was huge because of the new mindset to save the environment.Clean Air Act(CAA, 1970) set emission standards for cars and limits for release of air pollutantsClean Water Act(CWA, 1972) set maximum permissible amounts of water pollutants that can be discharged into waterways; aims to make surface waters swimmable and fishableFederal Insecticide, Fungicide, and Rodenticide Act1947 and 1972 - mandates that EPA regulate the use and sale of pesticides to protect human health and the environment licensing of products and personal, specific applications, imports/exportsSafe Drinking Water Act (1974)Establishes drinking water standards for tap water safety, and requires rules for groundwater protection from underground injection; amended in 1986 and 1996. The 1996 amendments added a fund to pay for water system upgrades, revised standard: setting requirements, required new standards for common contaminants, and included public "right to know" requirements to inform consumers about their tap water.Toxic Substances Control Act (1976)Authorizes the Environmental Protection Agency to regulate the manufacture, distribution, import and processing of certain toxic chemicals.Resource Conservation and Recovery Actgives EPA the authority to control hazardous waste from the "cradle-to-grave." generation, transportation, treatment, storage, and disposal of hazardous wasteWhat are the two models of environmental regulation?command and control, and economic incentivesCommand and Controldirection of an industry/activity by legislation that states what is permitted and what is illegal standards of ambient air quality, emissions, and performanceCriticisms of Command and Controlexpensive (monitoring and enforcement); does not stimulate innovation; inequities between industriesEconomic Incentive Policiespolicies aimed to encourage polluters to find innovative and low-cost ways to reduce environmental emissions by offering them rewards or enforcing penalties in the form of taxes, fees, marketable permits, or liabilityAdvantages of Economic Incentivesless regulatory oversight, rewards innovation, lowers the total cost of mitigationPre-Market Approvala new drug cannot be marketed until it has been shown to be both safe and effective responsibility is on the developer safe does not mean 'risk free'Labelinginformation to be provided to the consumer regarding dosage, safe use, side effects, and contraindicationsAdulteration and Purityroutine inspections and tests done on the drug, the factory, and the containerDietary Supplement Health and Education Act of 1994protect public access to products that promote wellness and lower health care costs; a product DOES NOT have to be approved by the FDA before marketingHow does the FDA handle dietary and herbal supplements?FDA monitors safety post-marketing and can only withdraw a product for lack of safety, not lack of efficacyFailure of DSHEA - Ephedra case studyEphedra is a plant containing ephedrine alkaloids; use increased in 1994 and reports of increased heart failure; 1997 FDA proposed a ban on products with more then 8 mg of ephedra; Metabolife spent $4 M on lobbying; 2000 - FDA withdrew its changes; 2003 athlete died from drug; 2004 ephedrine alkaloids were bannedMajor Provisions of the Clean Air Actrequires National Ambient Air Quality Standards for certain common and widespread pollutants to protect health, including sensitive populations standards cannot be based on cost; review every 5 years EPA regulates a list of 187 hazardous air pollutantsTechnology Based StandardsReasonable Available Control Technologies (RACT) Best Available Control Technologies (BACT) Lowest Achievable Emission Rate (LAEL) Maximum Achievable Control Technologies (MACT)Top Hazardous Air Pollution Driversdiesel particulate matter formaldehyde benzene coke over emissions arsenic compoundsFood and Exposure PathwaysMethyl mercury in tuna pesticides in apples acrylamide in french fries per and poly-fluorinated substances in popcornPartitioningPhase 1 - water phase 2 - octanol phase 3 - airKow ScaleLarge KOA likes to be in the fat phase; not volatile (smaller air amounts) larger KOW likes to be in a fat phase (no water)Critical Chemicals in FoodMercury, arsenic, pesticides, BFRsWhy is today's food landscape so troublesome?diets are globalized, more foods are processed, and there are just a few dominant playersBasel Conventionan international treaty on the control of transboundary hazardous wastes and their disposalPBDE's in Seafoodmost important categories in terms of grams per day consumed: salmon, shrimp, cod, and catfish