CHAPTER 14

ENVIRONMENTAL HAZARDS AND HUMAN HEALTH

Outline
Key Questions and Concepts
14-1
What major health hazards do we face?

A.
1.

B.
1.

2.
3.
4.
5.
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Risks are usually expressed as probabilities.

A risk is the probability of suffering harm from a hazard that can cause injury, disease, death, economic loss, or damage.
a. Probabilitya mathematical statement about the likelihood that harm will be suffered from a hazard.
i.
The lifetime probability of developing lung cancer from smoking one pack of cigarettes per day is 1 in 250.
b. Risk assessment is the process of using statistical methods to estimate how much harm a particular hazard can cause to human health or
to the environment. It helps us to establish priorities for avoiding or managing risks.
i.
Hazard identification.
ii. Probability of risk.
iii. Consequences of risk.
c. Risk management involves deciding whether or how to reduce a particular risk to a certain degree.
i.
Comparative risk analysis.
ii. Risk reduction.
iii. Risk reduction strategy.
iv. Financial commitment.
We face many types of hazards.
Biological hazards from more than 1,400 pathogens that can infect humans.
a. A pathogen is an organism that can cause disease in another organism.
i.
Bacteria.
ii. Viruses.
iii. Parasites.
iv. Protozoa.
v. Fungi.
Chemical hazards from harmful chemicals in air, water, soil, food, and human-made products.
Physical hazards such as fire, earthquakes, volcanic eruptions, floods, and storms.
Cultural hazards such as unsafe working conditions, unsafe highways, criminal assault, and poverty.
Lifestyle choices such as smoking, making poor food choices, drinking too much alcohol, and having unsafe sex.

What types of biological hazards do we face?

Some diseases can spread from one person to another.
1. A nontransmissible disease is caused by something other than a living organism and does not spread from one person to another.
a. Examples include cardiovascular (heart and blood vessel) diseases, most cancers, asthma, and diabetes.
2. An infectious disease is caused when a pathogen such as a bacterium, virus, or parasite invades the body and multiplies in its cells and tissues.
a. Examples are tuberculosis, flu, malaria, and measles.
b. A transmissible disease (also called a contagious or communicable disease) is an infectious disease that can be transmitted from one
person to another.
c.
In 1900, infectious disease was the leading cause of death in the world.
d. Greatly reduced by a combination of better health care, the use of antibiotics to treat infectious diseases caused by bacteria, and the
development of vaccines.
B. Infectious diseases are still major health threats.
1. Infectious diseases remain as serious health threats, especially in developing countries.
2. Spread through air, water, food, and body fluids such as feces, urine, blood, and droplets sprayed by sneezing and coughing.
3. A large-scale outbreak of an infectious disease in an area is called an epidemic.
4. A global epidemic such as tuberculosis or AIDS is called a pandemic.
5. CASE STUDY: The Growing Global Threat from Tuberculosis.
a. Since 1990, one of the worlds most underreported stories has been the rapid spread of tuberculosis (TB).
b. According to the World Health Organization (WHO), this highly infectious bacterial disease strikes about 9 million people per year and
kills 1.6 millionabout 84% of them in developing countries.
c. In 2009, engineering students invented a small device that can diagnose TB in seconds at a cost of less than a dollar.
d. Most strains of the TB bacterium have developed genetic resistance to the majority of the effective antibiotics.
i.
A deadly and apparently incurable form of tuberculosis, known as multidrug resistant TB, has been increasing.
C. Some viral diseases kill large numbers of people.
1. Viruses evolve quickly, are not affected by antibiotics, and can kill large numbers of people.
a. The biggest killer is the influenza, or flu, virus.
b. Flu viruses regularly contribute to the deaths of about 1 million people a yearabout 36,000 of them in the United States.
c. The global flu pandemic of 1918, for example, killed 2050 million people within a few months and caused economic and social
disruption.
d. The second biggest viral killer is the human immunodeficiency virus (HIV).
i.
AIDS kills about 2 million people annually.
ii. Transmitted by unsafe sex, sharing of needles by drug users, infected mothers who pass the virus to their offspring before or during
birth, and exposure to infected blood.
iii. The third largest viral killer is the hepatitis B virus (HBV), which damages the liver and kills about a million people each year.
D. SCIENCE FOCUS: Genetic Resistance to Antibiotics Is Increasing.
3. A bacterium known as methicillin-resistant staphylococcus aureus, or MRSA, has become resistant to most common antibiotics.
4. In 2007, more than 94,000 people in the United States had MRSA infections, which contributed to the premature deaths of almost 19,000
peoplemore than the 15,000 people killed by AIDS that year in the United States.
5. Factors play key roles in fostering such genetic resistance.
a. Worldwide spread by human travel and international trade.
b. Overuse of pesticides, which increases populations of pesticide-resistant insects and other carriers of bacterial diseases.
c. Yet another factor is overuse of antibiotics.
6. Severe acute respiratory syndrome (SARS) virus, first appeared in humans in China in 2002. SARS, which has flulike symptoms, can quickly
turn into life-threatening pneumonia and is easily spread from person to person.
7. Health officials are concerned about the spread of West Nile virus, SARS, and other emerging viral diseases.
8. Greatly reduce your chances of getting infectious diseases by practicing good, old-fashioned hygiene.
a. Wash your hands thoroughly and frequently.
b. Avoid touching your face.
c. Stay away from people who have flu or other viral diseases.
E. We can reduce the incidence of infectious diseases.
1. CASE STUDY: The Global HIV/AIDS Epidemic.
a. About 33 million people worldwide (1 million in the United States) are living with HIV.
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b.
c.

2.

3.
4.
5.
6.
7.
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Currently, there is no vaccine to prevent HIV infection and no cure for AIDS.
Recommendations to slow the spread:
i.
Reduce the number of new infections below the number of deaths.
ii. Concentrate on the groups in a society that are most likely to spread the disease such as sex workers, intravenous drug users, and
soldiers.
iii. Provide free HIV testing and pressure people from high-risk groups to get tested.
iv. Implement mass advertising and education programs geared toward adults and school children to help prevent the disease.
v. Provide free or low-cost drugs to help slow the progress of the disease.
CASE STUDY: MalariaDeath by Parasite-Carrying Mosquitoes.
a. About one of every five people in the world is at risk from malaria.
b. Malaria is caused by a parasite that is spread by the bites of certain mosquito species.
c. Infects and destroys red blood cells, causing intense fever, chills, drenching sweats, anemia, severe abdominal pain, headaches, vomiting,
extreme weakness, and greater susceptibility to other diseases.
d. Kills an average of at least 2,700 people per day.
e. CONNECTIONS: Projected climate change is also likely to increase cases of malaria across a wider area of the globe.
f.
Working to develop new antimalarial drugs, vaccines, and biological controls.
g. Distribute free or inexpensive long-lasting, insecticide-treated bed nets.
h. Zinc and vitamin A supplements could be used to boost resistance to malaria in children.
i.
Spray the insides of homes with low concentrations of the pesticide DDT twice a year at a low cost.
From 1971-2006, the percentage of children in developing countries who were immunized with vaccines to prevent tetanus, measles,
diphtheria, typhoid fever, and polio increased from 10% to 90%saving about 10 million lives each year.
An important breakthrough has been the development of simple oral rehydration therapy administering a simple solution of boiled water,
salt, and sugar or rice.
CONNECTIONS: Drinking Water, Latrines, and Infectious Diseases.
A key to reducing sickness and premature death from infectious disease is to focus on providing people with simple latrines and access to safe
drinking water.
Philanthropists including Bill and Melinda Gates and Warren E. Buffet have donated almost $2 billion to improve global health.

What types of chemical hazards do we face?

Some chemicals can cause cancers, mutations, and birth defects.
1. A toxic chemical is one that can cause temporary or permanent harm or death to humans and animals.
2. U.S. Environmental Protection Agency (EPA) listed arsenic, lead, mercury, vinyl chloride (used to make PVC plastics), and polychlorinated
biphenyls (PCBs) as the top five toxic substances in terms of human and environmental health.
3. There are three major types of potentially toxic agents.
a. Carcinogens are chemicals, types of radiation, or certain viruses that can cause or promote cancer.
i.
Examples of carcinogens are arsenic, benzene, chloroform, formaldehyde, gamma radiation, nickel, PCBs, radon, certain chemicals
in tobacco smoke, ultraviolet (UV) radiation, X-rays, and vinyl chloride.
b. Mutagens are chemicals or forms of radiation that cause mutations, or changes, in the DNA molecules found in cells, or that increase the
frequency of such changes.
i.
Nitrous acid (HNO2), formed by the digestion of nitrite (NO2 ) preservatives in foods, can cause mutations linked to increases in
stomach cancer in people who consume large amounts of processed foods and wine.
ii. Harmful mutations occurring in reproductive cells can be passed on to offspring and to future generations.
c. Teratogens are chemicals that cause harm or birth defects to a fetus or embryo.
i.
Drinking during pregnancy can lead to offspring with low birth weight and a number of physical, developmental, behavioral, and
mental problems.
ii. Other teratogens are angel dust, benzene, cadmium, formaldehyde, lead, mercury, mescaline, PCBs, phthalates, thalidomide, and
vinyl chloride.
B. Some chemicals may affect our immune, nervous, and endocrine systems.
1. Our bodys immune system protects us against disease and harmful substances by forming antibodies that render invading agents harmless, but
some chemicals interfere with this process.
a. Arsenic.
b. Methylmercury.
c. Dioxins.
2. Neurotoxins can harm the human nervous system, causing the following effects.
a. Behavioral changes.
b. Learning disabilities.
c. Retardation.
d. Attention deficit disorder.
e. Paralysis.
f.
Death.
3. Examples of neurotoxins.
a. PCBs.
b. Methylmercury.
c. Arsenic.
d. Lead.
e. Certain pesticides.
4. The endocrine system is a complex network of glands that release tiny amounts of hormones regulate:
a. Reproduction.
b. Growth.
c. Development.
d. Learning ability.
e. Behavior.
f.
Hormonally active agents interfere with the lock-and-key relationship.
5. SCIENCE FOCUS: Mercurys Toxic Effects.
a. The EPA has warned that one-fourth of the nations rivers, one-third of its lakes (including all of the Great Lakes), and three-fourths of its
coastal waters are contaminated with mercury.
b. In 2007, the EPA estimated that about 1 of every 12 women of childbearing age in the United States has enough mercury in her blood to
harm a developing fetus.
c. Natural sources account for about one-third of the mercury reaching the atmosphere.
d. Remaining two-thirds come from human activities.
i.
Primarily from the smokestacks of coal-burning power plants and coal-burning industrial facilities.
ii. The United States emits about 49 metric tons (54 tons) of mercury a year.
e. Humans are exposed to mercury in three ways.
i.
Inhale vaporized elemental mercury (Hg) or particles of inorganic mercury salts such as HgS and HgC l2.
ii. Eat fish contaminated with highly toxic methylmercury (CH 3Hg+).
iii. High fructose corn syrup (HFCS), widely used as a sweetener in beverages and food products, may contain it.
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2011 Brooks/Cole Publishing, a Division of Cengage Learning

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g.
h.

6.

14-4
A.

B.

C.

D.

E.

F.

The greatest risk from exposure to low levels of methylmercury is brain damage.
Methylmercury may also harm the heart, kidneys, and immune system of adults.
EPA advised nursing mothers, pregnant women, and women who may become pregnant not to eat shark, swordfish, king mackerel, or
tilefish and to limit their consumption of albacore tuna.
i.
Mercury-containing products.
i.
Electric switches.
ii. Compact fluorescent light bulbs.
iii. Dry-cell batteries.
Hormonally active agents (HAA).
a. Hormone blockers disrupt the endocrine system by preventing natural hormones such as androgens (male sex hormones) from attaching
to their receptors.
i.
Estrogen mimics hormone blockers, sometimes called gender benders.
ii.
Thyroid disrupters cause growth, weight, brain, and behavioral disorders.
iii.
Very low levels of BPA cause brain damage, early puberty, prostrate disease, breast cancer, heart disease, liver damage, reduced
sperm count, impaired immune function, type 2 diabetes, hyperactivity, increased aggressiveness, impaired learning, increased
addiction to drugs such as amphetamines, decreased sex drive in males, and obesity in unborn test animals exposed in 100
studies.
iv.
12 studies funded by the chemical industry found no evidence, or only weak evidence, for adverse effects from low-level
exposure to BPA in test animals.

How can we evaluate chemical hazards?

Many factors determine the harmful health effects of a chemical.
1. Toxicology is the study of the harmful effects of chemicals on humans and other organisms.
a. Toxicity is a measure of the harmfulness of a substance.
b. Any synthetic or natural chemical can be harmful if ingested in a large enough quantity.
c. The dose is the amount of a harmful chemical that a person has ingested, inhaled, or absorbed through the skin.
d. The effects of a particular chemical can also depend on the age of the person.
e. Toxic chemicals usually have a greater effect on fetuses, infants, and children than on adults.
f. Toxicity also depends on genetic makeup, which determines an individuals sensitivity to a particular toxin.
g. Some individuals are sensitive to a number of toxinsa condition known as multiple chemical sensitivity (MCS).
h. How well the bodys detoxification systems (such as the liver, lungs, and kidneys) work.
i. Several other variables can affect the level of harm caused by a chemical.
i.
Solubility: water-soluble toxins and oil- or fat-soluble toxins.
ii. Persistence, or resistance to breakdown such as DDT and PCBs.
iii. Biological magnification, in which the concentrations of some potential toxins in the environment increase as they pass through the
successive trophic levels of food chains and webs.
2. The damage to health resulting from exposure to a chemical is called the response.
a. Acute effect is an immediate or rapid harmful reaction ranging from dizziness and nausea to death.
b. Chronic effect is a permanent or long-lasting consequence (kidney or liver damage, for example) of exposure to a single dose or to repeated
lower doses of a harmful substance.
3. CASE STUDY: Protecting Children from Toxic Chemicals.
a. In 2005, the Environmental Working Group analyzed umbilical cord blood from 10 randomly selected newborns in U.S. hospitals.
i.
287 chemicals detected, 180 cause cancers in humans or animals, 217 damage the brain and nervous systems in test animals, and
208 cause birth defects or abnormal development in test animals.
b. Young children are more susceptible because:
i.
They generally breathe more air, drink more water, and eat more food per unit of body weight than do adults.
ii. They are exposed to toxins in dust or soil when they put their fingers, toys, or other objects in their mouths.
iii. Children usually have less well-developed immune systems and body detoxification processes than adults.
Scientists use live laboratory animals and nonanimal tests to estimate toxicity.
1. The most widely used method for determining toxicity is to expose a population of live laboratory animals to measured doses of a specific
substance under controlled conditions.
2. Laboratory-bred mice and rats are widely used because, as mammals, their systems function somewhat like human systems.
a. Results plotted in a dose-response curve.
b. Determine the lethal dosethe dose that will kill an animal.
c. Median lethal dose (LD50) is the dose that can kill 50% of the animals (usually rats and mice) in a test population within an 18-day
period.
d. Toxicity ratings and average lethal doses for humans LD50.
i.
SupertoxicLess than 5; less than 7 drops nerve gases, botulism toxin, mushroom toxin, and dioxin (TCDD).
ii. Extremely toxic550; 7 drops to 1 teaspoon potassium cyanide, heroin, atropine, parathion, and nicotine.
iii. Very Toxic50500; 1 teaspoon to 1 ounce mercury salts, morphine, and codeine.
iv. Moderately toxic5005,000; 1 ounce to 1 pint lead salts, DDT, sodium hydroxide, sodium fluoride, sulfuric acid, caffeine, and
carbon tetrachloride.
v. Slightly toxic5,00015,000; 1 pint to 1 quart ethyl alcohol, Lysol, soaps.
vi. Essentially nontoxic15,000 or greater; more than 1 quart water, glycerin, and table sugar.
There are other ways to estimate the harmful effects of chemicals.
1. Case reports, usually made by physicians, provide information about people suffering some adverse health effect or death after exposure to a
chemical.
2. Epidemiological studies, which compare the health of people exposed to a particular chemical (the experimental group) with the health of a
similar group of people not exposed to the agent (the control group), but limited by:
a. Too few people have been exposed to high enough levels of a toxic agent to detect statistically significant differences.
b. Usually takes a long time.
c. Closely linking an observed effect with exposure to a particular chemical is difficult because people are exposed to many different toxic
agents throughout their lives and can vary in their sensitivity to such chemicals.
d. Cannot evaluate hazards from new technologies or chemicals to which people have not yet been exposed.
Are trace levels of toxic chemicals harmful?
1. Almost everyone is now exposed to potentially harmful chemicals.
2. In most cases, we do not know enough because there is too little data and because of the difficulty of determining the effects of exposures to
low levels of these chemicals.
3. Potential long-term effects on the human immune, nervous, and endocrine systems.
4. The risks from trace levels may be minor especially if an area has a short average life expectancy.
Why do we know so little about the harmful effects of chemicals?
1. All methods for estimating toxicity levels and risks have serious limitations.
a. Typically set allowed levels of exposure to toxic substances and ionizing radiation at 1/100 or even 1/1,000 of the estimated harmful
levels.
b. Toxicologists know a great deal about a few chemicals, a little about many, and next to nothing about most.
How far should we go in using pollution prevention and the precautionary principle?

2011 Brooks/Cole Publishing, a Division of Cengage Learning

1.
2.
3.

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Some are pushing for much greater emphasis on pollution prevention.

Do not release into the environment chemicals that we know or suspect can cause significant harm.
a. Look for harmless or less harmful substitutes for toxic and hazardous chemicals.
b. Recycle them within production processes to keep them from reaching the environment.
The precautionary principle advocates when there is reasonable but incomplete scientific evidence of significant or irreversible harm to
humans or the environment from a proposed or existing chemical or technology, we should take action to prevent or reduce the risk instead of
waiting for more conclusive (reliable) scientific evidence.
a. New chemicals and technologies would be assumed to be harmful until scientific studies could show otherwise.
b. Existing chemicals and technologies that appear to have a strong chance of causing significant harm would be removed from the market
until their safety could be established.

How do we perceive risks and how can we avoid the worst of them?
The greatest health risks come from poverty, gender, and lifestyle choices.
1. Risk analysis involves identifying hazards and evaluating their associated risks.
a. Risk assessment.
b. Ranking risks (comparative risk analysis).
c. Determining options and making decisions about reducing or eliminating risks (risk management).
d. Informing decision makers and the public about risks (risk communication).
2. The greatest risk by far is poverty.
a. The high death toll ultimately resulting from poverty is caused by malnutrition, increased susceptibility to normally nonfatal infectious
diseases, and often-fatal infectious diseases transmitted by unsafe drinking water.
3. The second greatest risk is gender.
4. Third greatest risk of premature death mostly results from lifestyle choices that people make.
a. Smoking and exposure to smoke.
b. Excess weight and consumption of unhealthy foods and drinks.
c. Excess sunlight.
d. Unsafe sex.
5. CASE STUDY: Death from Smoking.
a. Cigarette smoking kills an average of about 14,800 people every day.
b. Cigarette smoking is the worlds most preventable major cause of suffering and premature death among adults.
c. WHO estimates tobacco contributes to the premature deaths of at least 5.4 million people annually from 25 illnesses, including:
i.
Heart disease.
ii. Stroke.
iii. Lung cancer and other cancers.
iv. Bronchitis.
v. Emphysema.
d. Smoking kills about 442,000 Americans per yeara human tragedy that rarely makes the news.
e. Nicotine inhaled in tobacco smoke is highly addictive.
f. Passive smoking, or breathing secondhand smoke, poses health hazards too.
B.
Estimating risks from technologies is not easy.
1. The overall reliability or the probability (expressed as a percentage) that a person, device, or complex technological system will complete a
task without failing is the product of:
a. System/technology reliability.
b. Human reliability.
2. Three Mile Island and Chernobyl nuclear power plant accidents are examples.
C.
Most people do a poor job of evaluating risks.
1. Many people deny or shrug off the high-risk chances of death (or injury) from voluntary activities they enjoy, such as:
a. Motorcycling (1 death in 50 participants).
b. Smoking (1 in 250 by age 70 for a pack-a-day smoker)
c. Hang gliding (1 in 1,250).
d. Driving (1 in 3,300 without a seatbelt and 1 in 6,070 with a seatbelt).
2. Some of these same people may be terrified about their chances of being killed by:
a. A gun (1 in 28,000 in the United States).
b. Flu (1 in 130,000).
c. Nuclear power plant accident (1 in 200,000).
d. West Nile virus (1 in 1 million).
e. Lightning (1 in 3 million).
f. Commercial airplane crash (1 in 9 million).
g. Snakebite (1 in 36 million).
h. Shark attack (1 in 281 million).
3. Five factors can cause people to be being more or less risky than experts judge.
a. Fear.
b. Degree of control we have.
c. Whether a risk is catastrophic, not chronic.
d. Some people suffer from optimism bias, the belief that risks that apply to other people do not apply to them.
e. Highly pleasurable and give instant gratification.
D.
Several principles can help us evaluate and reduce risk.
1. Compare risks.
2. Determine how much risk you are willing to accept.
3. Determine the actual risk involved.
4. Concentrate on evaluating and carefully making important lifestyle choices.
E.
Three big ideas for this chapter:
1. We face significant hazards from infectious diseases such as flu, AIDS, tuberculosis, diarrheal diseases, and malaria, and from exposure to
chemicals that can cause cancers and birth defects and disrupt the human immune, nervous, and endocrine systems.
2. Because of the difficulty in evaluating the harm caused by exposure to chemicals, many health scientists call for much greater emphasis on
pollution prevention.
3. Becoming informed, thinking critically about risks, and making careful choices can reduce the major risks we face.
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2011 Brooks/Cole Publishing, a Division of Cengage Learning