1. Environmental Health: Risk, Toxicology, and Human Health

2. Key Concepts  Hazards people face  Defining and measuring toxicology  Chemical hazards  Biological hazards  Risk estimation, management, and reduction

3. Risk and Probability  Risk  Probability  Risk assessment  Risk management

4. Hazards  Cultural hazards  Physical hazards  Chemical hazards  Biological hazards

5. Hazards

6. Toxicology  Toxicity  Dosage  Bioaccumulation  Biomagnification  Synergism  Response  Acute effect  Chronic effect

7. Toxicology

9. Poisons  Poison  Median lethal dose (LD 50 )

10. Dose-Response Curves  Dose-response  Nonthreshold  Threshold

11. Table 9-1 Toxicity Ratings and Average Lethal Doses for Humans Toxicity Rating Supertoxic Extremely toxic Very toxic Toxic Moderately toxic Slightly toxic Essentially nontoxic LD50 (milligrams per kg of body weight)* Less than 0.01 Less than 5 5–50 50–500 500–5,000 5,000–15,000 15,000 or greater Examples Nerve gases, botulism toxin, mushroom toxins, dioxin (TCDD) Potassium cyanide, heroin, atropine, parathion, nicotine Mercury salts, morphine, codeine Lead salts, DDT, sodium hydroxide, sodium fluoride, sulfuric acid, caffeine, carbon tetrachloride Methyl (wood) alcohol, ether, Phenobarbital, amphetamines (speed), kerosene, aspirin Ethyl alcohol, Lysol, soaps Water, glycerin, table sugar Average Lethal Dose† Less than 1 drop Less than 7 drops 7 drops to 1 teaspoon 1 teaspoon to 1 ounce 1 ounce to 1 pint 1 pint to 1 quart More than 1 quart *Dosage that kills 50% of individuals exposed †Amounts of substances in liquid form at room temperature that are lethal when given to a 70.4-kg (155-pound) human

12. Chemical Hazards  Hazardous chemicals  Mutagens  Teratogens  Carcinogens  Neurotoxins  Hormonally active agents  Precautionary principle

13. Hormone Receptor Cell Normal Hormone ProcessHormone MimicHormone Blocker Estrogen-like chemicalAnti-androgen chemical Endocrine Mimics

14. Biological Hazards: Diseases  Nontransmissible disease  Transmissible disease  Pathogens  Vectors  Tuberculosis  HIV/AIDS  Malaria

15. Malaria

16. Viruses HIV (AIDS) Hepatitis B Smallpox Ebola On this scale, a human hair would be 6 meters (20 feet) wide 1 micrometer Bacteria Vibrio cholerae (cholera) Mycobacterium tuberculosis (tuberculosis) Treponema pallidum (syphilis) 6 micrometers Protozoa Plasmodium (malaria) 10 micrometers

17. Painful and sometimes fatal. Carried by four related viruses and strikes during rainy season. 2.5 million people at risk; 50 million new cases a year. Dengue Fever

18. Endemic in more than 100 countries. Caused by four protozoa species. 270–500 million new cases and 1 million deaths per year. Malaria

19. Dreaded far more than 400 years. Viral disease that causes symptoms from mild to severe illness and death. 200,000 new cases and 30,000 deaths a year. Yellow Fever

20. Genetic material Surface proteins HIV Virus

21. The viral genetic material uses the host cell's DNA to replicate again and again. Each new copy of the virus directs the cell to make it a protein shell. The new viruses emerge from the host cell capable of infecting other cells. This process often destroys the first cell. The virus attaches to the host cell. The entire virus may enter or it may inject its genetic material, or genome. Virus Cell membrane Host cell New viruses

22. Disease (type of agent) 3.2 million Pneumonia and flu (bacteria and viruses) HIV/AIDS (virus) Diarrheal diseases (bacteria and viruses) Tuberculosis (bacteria) Malaria (protozoa) Hepatitis B (virus) Measles (virus) Deaths per year 3.0 million 1.9 million 1.7 million 1 million 800,000

23. Deaths per 100,000 people <2.5 2.5-10 10-35 35-70 70-100 100+

24. 12040200 100+ 95-99 90-94 85-89 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 MaleFemale Population (thousands) Age With AIDS 608010 20100120806040 Without AIDS

25. 7-10 years Poverty Smoking Overweight (35%) Unmarried Overweight (15%) Spouse smoking Driving Air pollution Alcohol Drug abuse AIDS Drowning Pesticides Fire Natural radiation Medical X rays Oral contraceptives Toxic waste Flying Hurricanes, tornadoes Living lifetime near nuclear plant 6-10 years 5 years 2 years 1 year 7 months 5 months 4 months 3 months 2 months 1 month 8 days 5 days 4 days 1 day 10 hours Flu Air Pollution 6 years 5 months 1 month 7.5 years Hazard Shortens average life span in the United States by Born male

26. Solutions Infectious Diseases Increase research on tropical diseases and vaccines Reduce poverty Decrease malnutrition Improve drinking water quality Reduce unnecessary use of antibiotics Educate people to take all of an antibiotic prescription Reduce antibiotic use to promote livestock growth Careful hand washing by all medical personnel Immunize children against major viral diseases Oral rehydration for diarrhea victims Global campaign to reduce HIV/AIDS

27. Bioterrorism  Possible targets: air, water, and food  Inexpensive  Fairly easy to produce biological agents  Recombinant DNA techniques

28. Agent Smallpox (virus) Hemorrhagic fever (viruses) Inhalation anthrax (bacterium) Botulism (bacterium) Pneumonic plague (bacterium) Tularemia (bacterium) Contagious Yes No Yes No Symptoms Fever, aches, headache, red spots on face and torso Vary but include fever, bleeding, shock, and coma Fever, chest pain, difficulty breathing, respiratory failure Blurred vision, progressive paralysis, death within 24 hours if not treated High fever, chills, headache, coughing blood, difficulty breathing, respiratory failure Fever, sore throat, weakness, respiratory stress, pneumonia Mortality (if untreated) 30% Varies 90–100% 60–100% 90–100% 30–60% Existence of vaccine Yes No Yes No Yes (in testing) Treatment Vaccination within 4 days after exposure, IV hydration Ebola has no cure, antiviral riboflavin and some antibiotics may help Early treatment with Cipro and other antibiotics Equine antitoxin given early. Intensive care, respirator Antibiotics

29. Risk Analysis  Risk analysis  Comparative risk analysis  System reliability  Risk management  Risk perception

30. Risk Analysis Comparative Risk Analysis Most Serious Ecological And Health Problems High-Risk Health Problems Indoor air pollution Outdoor air pollution Worker exposure to industrial or farm chemicals Pollutants in drinking water Pesticide residues on food Toxic chemicals in consumer products High-Risk Ecological Problems Global climate change Stratospheric ozone depletion Wildlife habitat alteration and destruction Species extinction and loss of biodiversity Medium-Risk Ecological Problems Add deposition Pesticides Airborne toxic chemicals Toxic chemicals, nutrients, and sediment in surface waters Low-Risk Ecological Problems Oil spills Groundwater pollution Radioactive isotopes Acid runoff to surface waters Thermal pollution