HS345 Global Environmental Public Health Exam #2

he questions will come almost exclusively from the lecture slides. The exam will cover all of the topics from Lectures 11 – 17 (i.e., class content from “Prevention and Risk Mitigation” through “Climate Change: Health Impacts” )

Define primary prevention

Prevent exposure

Define secondary prevention

Prevent disease onset

Define tertiary prevention

Prevent disease progression

Explain why primary prevention is best

• Health Promotion: Supports general health and well-being

• Specific Protection: Targets a specific hazard known to cause a disease

Identify examples of pollution/waste prevention that follow the reduce-reuse-recycle adage

1. Reduce source materials and  minimize waste—primary prevention because it uses fewer raw materials at the outset

2. Reuse and recycle materials—secondary prevention because it makes better use of the necessary materials

“SDG wedding cake”: Which goals are foundational? Bottom l ayer

Planet-related goals

SDG 6: Clean water and sanitation

SDG 13: Climate action

SDG14: Life below water

SDG15: Life on Land

“SDG wedding cake”: Which goals rely on other goals? middle layer

People-related goals

SDG 1: No poverty

SDG 2: Zero Hunger

SDG 3: Good Health and Wellbeing

SDG 4: Quality Education

SDG 5: Gender Equality

SDG 7: Affordable and Clean Energy

SDG 11: Sustainable cities and communities

SDG 16: Peace, Justice and Strong Insitutions Institutions

“SDG Wedding ”Cake”—Top layer 

Prosperity-related goals

SDG 8: Decent Work and Economic Growth

SDG 9: Industry, Innovation and Infrastructure

SDG 10: Reduced inequalities 

SDG 12: Responsible consumption and production

Is international cooperation necessary to meet these goals?

YES. Look at SDG 17: “partnerships for the goals”. It is imperative that countries work together to achieve all of these goals.

Define vulnerability

• Characteristics or conditions that make
  exposures more likely and/or the health
  impacts of those exposures more likely
  or more severe

• Social factors that inhibit the ability to
  prevent, prepare for, or recover from
  hazardous exposures

Identify examples of what is vulnerability (EJ context)

Examples of vulnerability include social determinants of health like low income, proximity to hazards, no insurance and lack of transportation. There are also physiological factors such as pre-existing conditions or child and older adults. children are the most vulnerable 

Identify examples of what isn’t a vulnerability (EJ context)

an exposure or impact experienced equally across diverse communities without disparity in social, economic, or institutional factors or without a systemic pattern of disadvantage.

Define climate justice

Climate justice is the concept and movement that addresses the unequal impacts of climate change on marginalized, low-income, and vulnerable populations (Global South), recognizing that those least responsible for causing climate change often suffer the most from its effects. It focuses on equity, human rights, historical responsibility, and fairness in both the burdens of climate change and the benefits of solutions. 

• Global North is responsible for majority of greenhouse gas emssions

Identify three specific actions to achieve climate justice globally

1. Climate impacts are not burdened
   on vulnerable communities. Solution—Giving voice to all countries in
   climate negotiations
   

2. Benefits of fossil-fueled
   development are shared. Solution—Financial assistance to LMIC for
   development and adaptation
   

3. Highest-emitting nations have
   greatest responsibility for action
   Climate Justice. Solution—Rapid reduction in GHG
   emissions in a just manner
   
   LMIC = low- and middle-income countries

Define redlining

• a racist US federal housing policy from 1935

• Denied mortgages to low-income communities and communities of color → intergenerational disinvestment in diverse communities

• Redlining was outlawed in 1968, but its
  impacts persist today
  

Explain how redlining is related to present-day, ongoing environmental injustices

Redlining → Denied homeownership →
Blocked key driver of intergenerational wealth → increased vulnerabilities and inequities

Redlining → lower property values → less tax revenue → less public service → increased vulnerabilities and inequities

Conclusion:
Historical Redlining Perpetuates Disinvestment and Inequities Today

Environmental Racism and Redlining

• Fewer parks, trees, and
  other green spaces

• Substantially higher
  temperatures

• More air pollution

• More hazardous waste sites

• Greater flood risks

What is Environmental Justice?

the principle that environmental hazards must not be disproportionately burdened on communities by race, income, or any other characteristic

 

Also stipulates that all communities should
have equal access to a healthy environment

Identify examples of what is environmental injustice

occurs when environmental health hazards are burdened on vulnerable communities

These communities already have higher rates of chronic illnesses and fewer resources to prevent or recover from hazards = Exacerbated health impacts

• Illegal dumping of pcb in warren county, NC

• Flint water crisis in Michigan 

Classify energy sources as renewable vs. non-renewable.

Renewable: Wind, Hydro, Solar

Non renewable: Nuclear and Fossil Fuels, Urainium

Classify energy sources carbon-based vs. zero carbon

Carbon-based: Fossil Fuels

Zero carbon: Wind, Hydro, Solar and Nuclear, Urainium 

Describe the fate of nuclear waste in the US (i.e., where does it go?)

There are no long term plans for nuclear waste in the U.S. It is not properly regulated

Indoor Biomass: Cooking

• 2.1 billion people worldwide use this for cooking
• 3.2 million deaths per year from this air pollution
• Increases risk of NCD, e.g., stroke, COPD
• Disproportionately affects women and children in low-income nations

Interventions to Protect Public Health:

“clean cookstoves” are more fuel-efficient and create substantially less smoke

Health Risks of Coal

Extraction:

• Occupational Hazards include Mining: pneumoconiosis, explosions, cave-ins, falls

• Ecological & Community Damage
  Coal ash, mudslides, water
  pollution, cancer, poverty

Distribution

• Freight Train Transport
  Noise, dust, crashes

• Refining: Dust, noise, carcinogens

Combustion * Largest public health burden *

• Air Pollution: CO₂, sulfur oxides, NOx, Hg, PM

• Climate Change: Extreme weather, food and water shortages, economic damages, ecosystem damages, vector-borne diseases, conflicts
  

Health Risks of Petroleum

Extraction:

• Occupational Hazards: Noise, toxicants, sleep deprivation

• Ecological Damages:
  Oil spills: 2010 Deepwater Horizon (BP) → decimated wildlife, poisoned
  seafood, damaged economies

Distribution

• Pipeline and Ship Transport
  Oil spills: 1998 pipeline explosion (Nigeria), 1990 Exxon Valdez (USA)

• Refining: Carcinogenic chemicals

Combustion

• Air Pollution: CO₂, CO, NOx, PM,

• Climate Change: Extreme weather, food and water shortages, ecosystem damages, vector-borne diseases, conflicts
  

Health Risks of Natural Gas

Extraction: 

• Occupational Hazards: Noise, toxicants, accidents

• Ecological & Community Damage: Methane leaks, groundwater contamination, mild seismic activity (earthquakes)

Distribution

• Pipeline Transport: Pipeline leaks, explosions

• Refining/Processing: Toxic chemicals, occupational hazards

Combustion

• Air Pollution: CO₂, CO, NOx, PM, others

• Climate Change: Extreme weather, food and water shortages, economic damages, ecosystem damages, vector-borne diseases, conflicts

• Household Leaks
  Carbon monoxide poisoning

Health Impacts of Nuclear Power

Extraction

• Occupational Hazards: Mining for uranium: radon exposure

• Ecological & Community Damage: Water contamination, radioactive wastes, heavy metals

Operatioin

• Air and Water Pollution: Radioactive gases & liquids, thermal pollution

• Radioactive Waste: Spent uranium—the US currently has no long-term storage solution

• Disasters: Meltdowns, explosions →
  displacement and cancer risks

Proliferation

• Nuclear Weapons: Potential for weaponization → incalculable health risks

Health Impacts of Solar Energy

Mining for PV Materials
• Silica mining → silicosis
• Toxic metal exposures for workers
• Air pollution from mining and transport

Types of solar energy 

• Photovoltaic (PV): Direct Energy Conversion

• Solar Thermal: Concentrates Sunlight to Use Heat for Electricity Generation

Health Impacts of Wind Energy

• Manufacturing: Typical EH risks associated
  with manufacturing

• Overall health benefits of wind
  energy far outweigh risks

• Noise: Neighbors may have disturbed
  sleep from noise of turbines

Health Impacts of Hydroelectricity

Ecological Impacts:  Disrupts rivers and ecosystems

Flooding: Intentional flooding (to create the dam)
and accidental (dam breaking) causes
displacement, deaths, and injuries

Infectious Diseases: Schistosomiasis risk (blocks migration of snails that carry this parasite)

Snail-borne illnesses are a health risk from which renewable energy source?

Hydroelectricity

Which fossil fuel emits the least amount of CO₂?

Natural gas

Natural gas emits ~45% less CO₂ than coal

Which fossil fuel emits the Most amount of CO₂?

Coal

Recognize the global health burden of indoor air pollution

Identify the most effective risk-
reduction strategy for improving indoor air quality globally

Identify the “ingredients” for forming ozone

Ozone is formed from complex chemical reactions that require:

NOx VOCs (“Precursors”) and UV Radiation

Ozone can travel with the wind, but it breaks down quickly once in contact with surfaces

identify where in the atmosphere it is “good” or
“bad” to have ozone in terms of human health

Good up high, bad nearby.”
• Can travel with the wind, but breaks down quickly upon contact with surfaces

• Tropospheric ozone
  (ground-level) is a
  pollutant and respiratory
  irritant (“bad nearby”

• The ozone layer is in the
  stratosphere and absorbs UV
  (“good up high”)

Describe the characteristics of air pollutants that make them more hazardous to health and why

• Particles that are insoluble go out the lower respiratory tract. Causing more damage. Want the particle to leave sooner rather than later

• Smallest particles (fine [PM2.5] and ultrafine [PM0.1] particles) penetrate deeply in the lungs and can be spread to the rest of the body (systemic damage)

• Chemical Composition: Metal content, acidity, sulfates, organics. Ex. Pb (a type of PM2.5) → neurological and renal impacts if they reach the applicable organ system

Identify the general trend of criteria air pollutants (NAAQS) in the US over the past decade

National Ambient Air Quality Standards (NAAQS): US Environmental Protection Agency (EPA) required to set and monitor NAAQS for criteria pollutants
- States and localities are required to bring their air pollution into compliance

-Criteria air pollutant concentrations have improved markedly over the past several decades in the US

Define inflammation and its relationship to long-term air pollution exposure

• Inflammation is the body’s immune response to pathogens and toxins.

• Air pollution—especially fine, water-insoluble pollutants—causes inflammation

• Chronic inflammation is associated with a wide range of non-communicable diseases, including autoimmune disorders, heart disease, asthma,
  mental health conditions, and Alzheimer’s

Identify ways to reduce indoor air pollution from cooking with a natural-gas stove

• Especially if using a gas stove, turn on
  the exhaust hood while cooking (if it
  vents to the outdoors) or crack the
  window

• HEPA filter in the kitchen

• Use microwave, toaster oven, or electric kettle instead

• When it’s time to replace the oven,
  consider electric induction

Which of the following is probably the BEST way to reduce the global burden of disease of indoor air pollution?

Giving or selling “clean cookstove” to people in LMIC

A gaseous, water-soluble air pollutant will probably be removed in the...

Upper-respiratory tracts

Explain the relationship between the temperature of an object and both the total energy and peak wavelength of the electromagnetic radiation that is emitted from it

Warmer objects emit more total
energy and at shorter wavelengths

• Shorter wavelength = higher energy

• Gamma rays are peak wavelength and energy

• The highest energy would be ultraviolet

What is ionizing radiation and give examples

• Radiation with sufficient energy to remove electrons from atoms and molecules, hence creating an ion. (More harmful on human health)

• Alpha Particles:
  • + charge
  • Radioactive decay of heavy
  elements, e.g., U, Ra, and Po
  • Blocked by skin

• Beta Particles:
  • – charge
  • Radioactive decay of unstable atoms
  like tritium (3H)
  • (Low) skin penetration

• X-rays penetrate soft tissue but not bones

• Gamma rays penetrate all body parts

What is non-ionizing radiation and give examples

Radiation with sufficient energy to cause atoms to vibrate, but not enough to remove electrons

• Lower energy; most do not have enough energy to directly damage cells

• Health impacts can still occur, though, especially with large acute doses or for people with susceptibilities, such as pacemakers

• Ex: TV’s and Remotes. Heat. Wi-Fi and Cell Phones
  *UV range straddles the ionizing / non-ionizing divide CDC (2024a

Does an MRI use ionizing or non-ionizing radiation?

Uses magnetic fields and radio waves to create
images inside the body

• Non-ionizing 

Does an ultrasound use ionizing or non-ionizing radiation?

Reflects acoustic radiation (aka sound waves). So it’s non-ionizing.

What kind of radiation does a PET scan use?

Imaging of organs and tissues using radioactive tracers that are absorbed more readily by diseased cells; detects cellular damage earlier than can be detected by CT and MRI; tracers emit ionizing radiation

What kind of radiation does an X-Ray use?

Uses X-ray electromagnetic radiation to get 2D images inside the body
• Used in dentistry and general medicine to identify fractures, cavities, tumors, and more
• Uses only a very small amount of radiation, especially newer devices
• Health impacts depend on the frequency of X-rays and the location they are taken

What kind of radiation does cancer radiation therapy use?

Uses ionizing radiation to
intentionally damage DNA of cancer
cells to prevent replication

Does an Computed Tomography (CT) Scan use ionizing or non-ionizing radiation?

Computed Tomography (CT) Scan
Essentially a 3D X-ray; sometimes called “CAT Scan”

• Uses ionizing radiation

Earth's emitted radiation has a wavelength that is _______ than that emitted by the Sun.

longer. The earth has less radiation than the sun.

Describe the composition of the atmosphere, including relative concentrations of the main gases

• Nitrogen is 77.7%

• Oxygen 20.8%

• Argon 0.9%

• Water vapor 0.5%

• Trace gasses/ Others <.1%

  • includes 425 ppm CO2, 18ppm Neon(Ne), 8ppm Ozone (O₃) 2ppm CH4

  • ppm = parts per million

Identify the property of a molecule that is required for it to be considered a greenhouse gas

Greenhouse gases (GHGs) are molecules in the atmosphere that absorb thermal infrared (longwave) radiation (heat) emitted by the Earth absorb

Define global warming potential (GWP)

amount of atmospheric warming per molecule compared to a molecule of CO2; differs depending on timeline considered

Define residence time

Length of time molecule spends in atmosphere; how long an emission of a molecule influences global temperatures

know the approximate/relative
GWPs and residence times of the major greenhouse gase

Water Vapor (H₂O) GWP and Residence time

Gaseous form of H₂O
• Most abundant GHG
• Concentration increases as air warms (warmer air holds more water)
• Human contribution to global warming is negligible
• Very short residence time in atmosphere (about 7-10 days); quickly
condenses and precipitates out of atmosphere
• Positive feedback loop with temperature

Carbon Dixoide (CO2 ) GWP and Residence time

Both natural and anthropogenic sources
• Concentration has increased 50% since 1750 due to human activities
• Primary driver of present-day climate change
• Residence time: hundreds to thousands of years

Methane (CH₄) GWP and Residence time

Both natural and anthropogenic sources
• Concentration has doubled since 1750 due to human activities
• Residence time: ~10 years
• Global warming potential (GWP): 30-80x greater than CO₂

Nitrous Oxide (N₂O) GWP and Residence time

• Agricultural sources (fertilizers) and fuel combustion

• Residence time: 110 years
• GWP: 273x greater than CO₂

Describe several observations of global warming and what the trends in these are

• average surface temperatures are increasing

• As the Arctic Ocean warms, the minimum sea ice extent decreases

• sea levels are rising

• glaciers are melting

• oceans are warming

Explain the greenhouse effect technical terms

The warming of the atmosphere that occurs when heat (longwave infrared
radiation) is absorbed and re-radiated by greenhouse gases.

Describe the basic principle behind the Clausius-Clapeyron equation.

• For every 1˚C warming, the atmosphere can hold about 7% more water vapor

• This leads to increased
  temperature → More moisture in atmosphere → Heavier precipitation &
  longer periods between precipitation event

Explain the greenhouse effect in layman’s terms.

The greenhouse effect is a natural process whereby GHGs keep some of Earth’s emitted heat close to the surface. Increased GHGs lead to an enhanced greenhouse effect (global warming).

Explain why the scientific community is confident that increased greenhouse gas concentrations are the main cause of present-day global warming (anthropogenic attribution).

• Climate model simulations
  accurately reproduce pre-industrial
  climate using only natural forces
  But they only reproduce observed
  modern-day warming when they
  account for human GHG emissions

• Yes. Robust physical concepts and theories, the geologic record, and sophisticated computer simulations all conclude that greenhouse gases are the primary cause of modern-day atmospheric warming

Which of the following greenhouse gases has the SHORTEST residence time?

H20 aka water vapor

Identify physical factors that increase the risk of flood

• increased frequency of heavy-precipitation events

• Snowmelt: More precipitation falling as rain. Faster melting of mountain snow in spring rushing into rivers downstream

• Sea-Level Rise: Melting glaciers and thermal expansion of ocean waters → Greater storm surges and “sunny-day flooding”

• Hurricanes: Increased frequency of the most- intense hurricanes (not necessarily more total hurricanes of any strength)

Identify the deadliest forms of extreme weather

Heat waves are the deadliest extreme weather event in the US

• Heat waves are projected to become
  more frequent, longer lasting, and more
  intense with climate change

Explain the mechanisms through which climate change can affect air pollution

1. Climate Penalty

• Warmer Temperatures Promote Ground-Level O₃ Formation

• more O3 air pollution

• Some of the gains in air quality improvement in the US will be offset by warmer temperatures
  1. Climate Penalty

1. Inversion layers

• occurs when colder air is wedged
  under warmer air

• Inversion layers trap air pollutants closer to the ground

1. Wildfires and droughts

• Wildfires are projected to burn
  larger areas due to increased
  drought and extreme heat

• Wildfires emit huge amounts of PM2.5 & O₃ precursors & other air pollutants

Describe what a combined sewer overflow (CSO) is and when it can pose health risks

• wastewater systems where sewage
  and rainwater are collected in the same pipe.

• Common in older cities, like Boston

• Raw sewage and industrial waste drains directly into rivers when there is too much water in the pipes too quickly

• Greater frequency of extreme rainfall → More toxic runoff

• HABs (Harmful Algal Blooms) are large amounts of toxin-spewing algae that form in warm, calm waters

• Can contaminate our fish supplies and cause illnesses like Vibrio vulnificus—a flesh-eating bacterium – thrives in warm saltwater
  • Transmitted by eating contaminated
  seafood or getting contaminated
  floodwater in a cut or wound
  

Describe what Lyme Disease is and things you should do to prevent it

• Most common tick-born illness in the US

• Causes rash and flu-like symptoms

• If untreated, it can spread throughout the body and cause severe damage

• Post-Treatment Lyme Disease Syndrome can cause ongoing
  illness for month

• Using bug spray and checking yourself for ticks can help prevent these diseases. Also wear long sleeves and hiking gear when in areas with small creatures.

• West Nile Virus

Explain how CO₂ fertilization generally affects the nutritional content of crops

• CO2 fertilization reduces the
  nutritional content of multiple
  staple crops, including wheat,
  rice, and potatoes
  Figure 4 from Ziska et al. (2016, p. 198)

• Warmer temps can result in greater food spoilage

• Extreme climate events can disturb food distribution. 

• Temp and extreme weather like floods can cause increase pathogen load

• Climate can alter weed, insect andfungal population and increase pesticide use 

Describe ways that individuals and governments can protect against the human health impacts of climate change

Which of the following climate-relevant hazards is associated with the most deaths per year, on average?

Exterme heat (the most deadliest weather event)

Climate change is likely to result in more hurricanes in the future

False. We don’t expect more hurricanes. We expect them to be more severe.