Chapter 11

Environmental Hazards and Human Health

Chapter Overview Questions

What

types of hazards do people face? What types of disease (biological hazards) threaten people in developing countries and developed countries? What chemical hazards do people face? How can risks be estimated and recognized?

Updates Online
The latest references for topics covered in this section can be found at the book companion website. Log in to the books e-resources page at www.thomsonedu.com to access InfoTrac articles.

InfoTrac: Report Shows 2005 to Be 'Least Bad Year' of AIDS Epidemic. Lawrence K. Altman. The New York Times, May 31, 2006 pA6(L). InfoTrac: Concern Grows Over Increase In Diabetes Around World. Marc Santora. The New York Times, June 11, 2006 pA27(L). InfoTrac: Push for New Tactics as War on Malaria Falters. Celia W. Dugger. The New York Times, June 28, 2006 pA1(L). The National Academies: Genetically Altered Bacteria Could Block Malaria Transmission Science Daily: Study Shows Promise For Simplified Treatment Of HIV Infection The Gates Foundation

Core Case Study: The Global HIV/AIDS Epidemic

According

to the World Health Organization (WHO), in 2005 about 42 million people worldwide (1.1 million in the U.S.) were infected with HIV. There is no vaccine for HIV if you get AIDS, you will eventually die from it. Drugs help some infected people live longer, but only a tiny fraction can afford them.

Core Case Study: The Global HIV/AIDS Epidemic

AIDS

has reduced the life expectancy of subSaharan Africa from 62 to 47 years 40 years in the seven countries most severely affected by AIDS.

Projected age structure of Botswana's population in 2020.

Core Case Study: The Global HIV/AIDS Epidemic

The

virus itself is not deadly, but it cripples the immune system, leaving the body susceptible to infections such as Kaposis sarcoma (above).

RISKS AND HAZARDS

Risk

is a measure of the likelihood that you will suffer harm from a hazard. We can suffer from:

Biological hazards: from more than 1,400 pathogens. Chemical hazards: in air, water, soil, and food. Physical hazards: such as fire, earthquake, volcanic eruption Cultural hazards: such as smoking, poor diet, unsafe sex, drugs, unsafe working conditions, and poverty.

BIOLOGICAL HAZARDS: DISEASE IN DEVELOPED AND DEVELOPING COUNTRIES

Diseases

not caused by living organisms cannot spread from one person to another (nontransmissible disease), while those caused by living organisms such as bacteria and viruses can spread from person to person (transmissible or infectious)

Transmissible Disease

Pathway

for infectious disease in humans.

Pets

Livestock

Wild animals Mosquitoes

Food

Water

Air

Fetus and babies

Other humans

Humans

Transmissible Disease
WHO

estimates that each year the worlds seven deadliest infections kill 13.6 million people most of them the poor in developing countries.

Disease (type of agent) Pneumonia and flu (bacteria and viruses) HIV/AIDS (virus) Malaria (protozoa) Diarrheal diseases (bacteria and viruses) Tuberculosis (bacteria) Hepatitis B (virus) Measles (virus)

Deaths per year 3.2 million

3.0 million

2.0 million

1.9 million

1.7 million

1 million

800,000

Case Study: Growing Germ Resistance to Antibiotics

Rabidly

producing infectious bacteria are becoming genetically resistant to widely used antibiotics due to:

Genetic resistance: Spread of bacteria around the globe by humans, overuse of pesticides which produce pesticide resistant insects that carry bacteria. Overuse of antibiotics: A 2000 study found that half of the antibiotics used to treat humans were prescribed unnecessarily.

Case Study: The Growing Global Threat from Tuberculosis

The

highly infectious tuberculosis (TB) kills 1.7 million people per year and could kill 25 million people 2020. Recent increases in TB are due to:

Lack of TB screening and control programs especially in developing countries due to expenses. Genetic resistance to the most effective antibiotics.

Viral Diseases
Flu,

HIV, and hepatitis B viruses infect and kill many more people each year then highly publicized West Nile and SARS viruses.

The influenza virus is the biggest killer virus worldwide.

Pigs, chickens, ducks, and geese are the major reservoirs of flu. As they move from one species to another, they can mutate and exchange genetic material with other viruses.

Viral Diseases
HIV

is the second biggest killer virus worldwide. Five major priorities to slow the spread of the disease are:

Quickly reduce the number of new infections to prevent further spread. Concentrate on groups in a society that are likely to spread the disease. Provide free HIV testing and pressure people to get tested. Implement educational programs. Provide free or low-cost drugs to slow disease progress.

How Would You Vote?

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Should developed and developing nations mount an urgent global campaign to reduce the spread of HIV and to help countries afflicted by the disease?

a. No. A global AIDS campaign could divert attention and resources from efforts to combat other serious threats. b. Yes. The disease is decimating the populations and destroying the economies of many developing countries.

Case Study: Malaria Death by Mosquito

Malaria

kills about 2 million people per year and has probably killed more than all of the wars ever fought.

Female mosquito bites infected human, ingesting blood that contains Plasmodium gametocytes
Merozoites enter bloodstream and develop into gametocytes causing malaria and making infected person a new reservoir

Plasmodium develop in mosquito

Sporozoites penetrate liver and develop into merozoites

Female mosquito injects Plasmodium sporozoites into human host.

Female mosquito bites infected human, ingesting blood that contains Plasmodium gametocytes Merozoites enter blood-stream and develop into gametocytes causing malaria and making infected person a new reservoir Plasmodium develops in mosquito

Sporozoites penetrate liver and develop into merozoites

Female mosquito injects Plasmodium sporozoites into human host

Stepped Art

Case Study: Malaria Death by Mosquito

Economists

estimate that spending $2-3 billion on malaria treatment may save more than 1 million lives per year.

Case Study: Malaria Death by Mosquito

Spraying

insides of homes with low concentrations of the pesticide DDT greatly reduces the number of malaria cases.

Under international treaty enacted in 2002, DDT is being phased out in developing countries.

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

Ecological Medicine and Infectious Diseases

Mostly

because of human activities, infectious diseases are moving at increasing rates from one animal species to another (including humans). Ecological (or conservation) medicine is devoted to tracking down these connections between wildlife and humans to determine ways to slow and prevent disease spread.

CHEMICAL HAZARDS
A

toxic chemical can cause temporary or permanent harm or death.

Mutagens are chemicals or forms of radiation that cause or increase the frequency of mutations in DNA. Teratogens are chemicals that cause harm or birth defects to a fetus or embryo. Carcinogens are chemicals or types of radiation that can cause or promote cancer.

CHEMICAL HAZARDS
A

hazardous chemical can harm humans or other animals because it:

Is flammable Is explosive An irritant Interferes with oxygen uptake Induce allergic reactions.

Effects of Chemicals on the Immune, Nervous, and Endocrine Systems

Long-term

exposure to some chemicals at low doses may disrupt the bodys:

Immune system: specialized cells and tissues that protect the body against disease and harmful substances. Nervous system: brain, spinal cord, and peripheral nerves. Endocrine system: complex network of glands that release minute amounts of hormones into the bloodstream.

Effects of Chemicals on the Immune, Nervous, and Endocrine Systems

Molecules

of certain synthetic chemicals have shapes similar to those of natural hormones and can adversely affect the endocrine system.

Normal Hormone Process Hormone

Hormone Mimic Estrogenlike chemical

Hormone Blocker Antiandrogen chemical

Receptor Cell

Case Study: A Black Day in Bhopal, India

The

worlds worst industrial accident occurred in 1984 at a pesticide plant in Bhopal, India.

An explosion at Union Carbide pesticide plant in an underground storage tank released a large quantity of highly toxic methyl isocyanate (MIC) gas. 15,000-22,000 people died Indian officials claim that simple upgrades could have prevented the tragedy.

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Factors

determining the harm caused by exposure to a chemical include:

The amount of exposure (dose). The frequency of exposure. The person who is exposed. The effectiveness of the bodys detoxification systems. Ones genetic makeup.

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Typical

variations in sensitivity to a toxic chemical within a population, mostly because of genetic variation.

Number of individuals affected

Very sensitive

Majority of population

Very insensitive

Dose (hypothetical units)

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Estimating

human exposure to chemicals and their effects is very difficult because of the many and often poorly understood variables involved.

Water pollutant levels

Soil/dust levels
Food pesticide levels

Air pollutant levels

Nutritional health

Overall health

Mathematical measurements & modeling

Lifestyle Predicted level of toxicant in people Metabolism Accumulation Excretion Lung, intestine & skin absorption rates

Personal habits Genetic predisposition

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Children

are more susceptible to the effects of toxic substances because:

Children breathe more air, drink more water, and eat more food per unit of body weight than adults. They are exposed to toxins when they put their fingers or other objects in their mouths. Children usually have less well-developed immune systems and detoxification processes than adults.

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Under

existing laws, most chemicals are considered innocent until proven guilty, and estimating their toxicity is difficult, uncertain, and expensive.

Federal and state governments do not regulate about 99.5% of the commercially used chemicals in the U.S.

Protecting Children from Toxic Chemicals

The

U.S. Environmental Protection Agency proposed that regulators should assume children have 10 times the exposure risk of adults to cancer-causing chemicals. Some health scientists contend that regulators should assume a risk 100 times that of adults.

TOXICOLOGY: ASSESSING CHEMICAL HAZARDS

Some

scientists and health officials say that preliminary but not conclusive evidence that a chemical causes significant harm should spur preventive action (precautionary principle). Manufacturers contend that wide-spread application of the precautionary principle would make it too expensive to introduce new chemicals and technologies.

How Would You Vote?

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Should we rely more on the precautionary principle as a way to reduce the risks from chemicals and technologies?

a. No. Assuming that every chemical or technology is a serious health or environmental threat will lead to wasteful over-regulation, high costs and hinder the development of critically needed pesticides, plastics, and other commercial products. b. Yes. Preventing the commercialization of harmful chemicals and technologies is better than dealing with the high costs of medical treatments and environmental damage.

RISK ANALYSIS
Scientists

have developed ways to evaluate and compare risks, decide how much risk is acceptable, and find affordable ways to reduce it.

Comparative Risk Analysis

Most Serious Ecological and Health Problems

High-Risk Health Problems Indoor air pollution Outdoor air pollution Worker chemical exposure 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 & destruction Species extinction, loss of biodiversity Medium-Risk Ecological Problems Acid 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

RISK ANALYSIS
Estimating

risks from using many technologies is difficult due to unpredictability of human behavior, chance, and sabotage.

Reliability

of a system is multiplicative:

If a nuclear power plant is 95% reliable and human reliability is 75%, then the overall reliability is (0.95 X 0.75 = 0.71) 71%.

RISK ANALYSIS

Annual

deaths in the U.S. from tobacco use and other causes in 2003.

Cause of Death
Tobacco use Accidents Alcohol use Infectious diseases Pollutants/ toxins Suicides Homicides Illegal drug use

Deaths
442,000 101,500 (43,450 auto) 85,000 75,000 (16,000 from AIDS) 55,000 30,600 20,622 17,000

RISK ANALYSIS

Number of deaths per year in the world from various causes. Parentheses show deaths in terms of the number of fully loaded 400-passenger jumbo jets crashing every day of the year with no survivors.

Cause of death
Poverty/malnutrition/ disease cycle

Annual deaths 11 million (75) 5 million (34)

Tobacco Pneumonia and flu

Air pollution HIV/AIDS Malaria Diarrhea Tuberculosis Car accidents Work-related injury & disease Hepatitis B Measles

3.2 million (22)

3 million (21) 3 million (21) 2 million (14) 1.9 million (13) 1.7 million (12) 1.2 million (8) 1.1 million (8) 1 million (7) 800,000 (5)

Perceiving Risk
Most

individuals evaluate the relative risk they face based on:

Degree of control. Fear of unknown. Whether we voluntarily take the risk. Whether risk is catastrophic. Unfair distribution of risk.

Sometimes

misleading information, denial, and irrational fears can cloud judgment.

RISK ANALYSIS
Comparisons

of risks people face expressed in terms of shorter average life span.

Hazard Poverty Born male Smoking Overweight (35%) Unmarried Overweight (15%) Spouse smoking Driving Air pollution Alcohol Drug abuse Flu AIDS Drowning Pesticides Fire Natural radiation Medical X rays Oral contraceptives Toxic waste Flying Hurricanes, tornadoes Lifetime near nuclear plant

Shortens average life span in the U.S. by

710 years 7.5 years 610 years 6 years 5 years 2 years 1 year 7 months 5 months 5 months 4 months 4 months 3 months 1 month 1 month 1 month 8 days 5 days 5 days 4 days 1 day 1 day 10 hours

Becoming Better at Risk Analysis

We can carefully evaluate or tune out of the barrage of bad news covered in the media, compare risks, and concentrate on reducing personal risks over which we have some control.

Risk Assessment Hazard identification What is the hazard?

Risk Management Comparative risk analysis How does it compare with other risks? Risk reduction

Probability of risk How likely is the event?

How much should it be reduced?

Risk reduction strategy How will the risk be reduced?

Consequences of risk

Financial commitment How much money should be spent?

What is the likely damage?