Environmental Health - Board Review Course 2023-Spaeth Environmental Health Slides

Spaeth Environmental Health Slides
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The 2023 APCM Board Review course on Environmental Health, led by Dr. Ken Spaeth, covered various significant aspects of environmental medicine and regulation, providing comprehensive information on toxic exposures, federal agencies' roles, and crucial environmental laws.<br /><br />1. <strong>Environmental History Components</strong>: Emphasized the importance of obtaining a thorough exposure history during clinical evaluations. Even a negative response on forms does not rule out toxic exposure.<br /><br />2. <strong>Roles of Federal Agencies</strong>:<br />   - Regulatory: EPA, OSHA, FDA, etc.<br />   - Advisory: ATSDR, CDC, NIH, etc.<br /><br />3. <strong>Environmental Protection Agency (EPA)</strong>: Since its establishment in 1970, the EPA enforces regulations on pollution, hazardous and solid wastes, and chemical contamination.<br /><br />4. <strong>Key Environmental Laws</strong>:<br />   - Toxic Substances Control Act (TSCA) 1976: Regulates hazardous chemicals, updated in 2016.<br />   - Superfund Amendments and Reauthorization Act (SARA) 1986: Focuses on human health risks from hazardous waste sites and requires EPA to maintain a toxic chemical database.<br /><br />5. <strong>Lead Exposure</strong>:<br />   - Major sources include older buildings, contaminated soil, water, and paint.<br />   - No safe blood lead level identified; emphasis on screening children and reporting elevated levels.<br />   - Clinical pearls: evaluations and chelation treatments based on blood lead levels.<br /><br />6. <strong>Mercury Exposure</strong>: Primarily from seafood and occupational sources, with specific recommendations for pregnant women and clinical assessment based on the type of mercury.<br /><br />7. <strong>Arsenic and Other Chemicals</strong>: Discussed sources, clinical impacts, and treatments for mercury and arsenic poisoning.<br /><br />8. <strong>Pesticides</strong>:<br />   - Regulations include safety levels for humans, environmental impacts, and EPA oversight.<br />   - Clinical effects and treatments for exposure to organophosphates and pyrethroids were detailed.<br /><br />9. <strong>Key Pollutants and Air Quality</strong>: Highlighted the National Ambient Air Quality Standards (NAAQS) and the health effects of pollutants like PM2.5, ozone, and lead.<br /><br />10. <strong>Health Effects of Climate Change</strong>: Projected impacts include worsening air quality, vector-borne diseases, and increased morbidity/mortality.<br /><br />11. <strong>Water Safety and Contaminants</strong>: Covered disinfection methods, common contaminants, and recommendations like the fluoridation of water.<br /><br />12. <strong>Contemporary Environmental Emergencies</strong>: Covered lead contamination incidents (e.g., Flint Water Crisis) and disaster response strategies.<br /><br />13. <strong>Radiation and Chemical Exposure</strong>: Detailed management, decontamination, and the health effects of various types of radiation and chemical exposures.<br /><br />14. <strong>Built Environment and Public Health</strong>: Discussed how urban planning and access to green spaces affect community health.<br /><br />15. <strong>Risk Assessment and Management</strong>: Provided an overview of methodologies and the importance of effective risk communication.<br /><br />This lecture provided a robust review of environmental health, particularly addressing the importance of meticulous history taking, understanding regulatory frameworks, and the practical implications of various environmental hazards on public and occupational health.
Keywords
Environmental Health
Toxic Exposures
Federal Agencies
Environmental Laws
Lead Exposure
Mercury Exposure
Pesticides
Air Quality
Climate Change
Risk Assessment