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Assignment 2

Assignment 2: Chapters 5-9

Stephanie Sandoval

Department of Health Science and Human Ecology, California State University San Bernardino

HSCI 6230: Advanced Topics in Environmental and Occupational Health

Dr. Swat Kethireddy, PhD

March 26, 2023

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Assignment 2
Chapter 5 Epidemiology

1. Name the types of epidemiologic study designs? How bias can impact the study
outcomes and how many types of biases exist and what are those?

Epidemiology is the study of the distribution and determinants of diseases among the
population; the goal is finding patterns between the environment and disease
consequences. There are many different types of epidemiologic study designs those
include: cross sectional studies, cohort studies, case control studies, and ecologic studies.
Cross sectional studies examine the association between exposure to the prevalence of
health outcomes. Cohort studies monitor the occurrence of adverse health outcomes
among exposure groups. Case control studies compares the health outcome of an
exposure group and the control group. Ecologic studies require the presence of
information for both the exposure and disease of an entire group. Despite the efficacy of
each study there are still existing biases that may occur. This can affect the results and
produce an incorrect estimate of the association between exposure and health outcome.
There are different biases that include: information bias, confounding bias, selection bias,
and healthy workers’ bias.

2. In the case of the fabrics plant, the suspect neurotoxin was in the print department,
so it was possible to create a within-plant comparison. Of the 1,597 disease free
workers in the plant, 194 worked in the print department and 44 of these workers
had onset of peripheral neuropathy during the past year. Among the 1403
remaining workers, there were 25 new cases.

Calculate the incidence rate ratio and risk ratio in the above example study.

Incidence Rate Ratio Formula: number of new cases/ total population at risk during the
specific time

44/194 = 22.6 per 100 workers

Risk Ratio Formula: [a/ (a+b)] / [c/ (c+d)]

25/1403= 1.78 per 100 workers

22.6/1.78= 12.69
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Chapter 6 Occupational and Environmental Health Surveillance

3. How is environmental health surveillance carried out?

There are many environmental hazards that change over time and space that may
potentially be contributing to chronic diseases among the population. Additionally, this
can severely affect the well-being of workers who are exposed to serious work-related
health problems. One great way in which this concern can be alleviated is through
environmental health surveillance. Surveillance is defined as, “the ongoing systematic
collection, analysis, and interpretation of health data essential to the planning,
implementation, and evaluation of public health practice” (Levy, et al. 2011). The main
objective of surveillance is to characterize the common types of injuries and illnesses that
occur in an environment, to identify their causes. Additionally, this helps to characterize
the most affected demographics.

4. Discuss on the case-based and population-based surveillance systems, what is the

role of NIOSH and SENSOR, BLS and the Childhood Lead Poisoning Prevention
Program in the surveillance of health, injury, and illness?

There are different types of surveillance systems. The first is the Case-Based Surveillance
which is used specifically for communicable or infections disease. This model was
developed by the National Institute of Occupational Safety and Health NIOSH and
Sentinel Event Notification System for Occupational Risks (SENSOR). The NIOSH is a
research agency that studies worker safety and health, to ensure that employers are
supplying their workers with a safe work environment. SENSOR is a NIOSH funded
project that reports and recognizes occupational hazards within the workplace.
The second is the Population-based or Rate-based surveillance that collects data that
monitors trends among populations over time, location, and population characteristics.
An entity that carries out this type of surveillance is the Childhood Lead Poisoning
Prevention Program and the Bureau of Labor Statistic (BLS). The Childhood Lead
Poisoning Prevention Program is a government funded agency that prevents lead
exposure through surveillance and prevention methods. The BLS provides data and
statistics on specific health concerns.

Chapter 8 Occupational and Environmental Hygiene

5. Highlight some general strategies of workplace assessments for occupational or

environmental hygienist?

Occupational hygiene is the science of anticipating, evaluating, recognizing, and

controlling the various health hazards that occur in the workplace, to ensure workers are
staying healthy. The occupational hygienist oversees the identification of hazardous
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agents within a work environment. They control the exposure; this can be through
elimination of the exposure completely or through the implementation of safety
measures. Environmental hygiene is the science of anticipating, recognizing, evaluating,
and controlling health hazards in the environment to help protect the health of the general
population. Collaboration is key among occupational hygienist, physicians, and safety
specialist to ensure that the best strategies are implemented to achieve better health
outcomes.

6. What are TLV’s and PEL’s? Explain in detail how and in what ways they both are
different from each other?

An occupational hygienist must make difficult decisions when a hazard is identified in

the workplace. There are three different routes they can take to control this hazard:
1. Threshold Limit Value (TLV’s) standard. Unlike a PEL, TLV is not a regulated,
mandated limit monitored by the government. Instead TLV is a recommended
guideline to be used at the discretion of each occupational hygienist.
2. Permissible Exposure limits (PEL’s). PEL is the legal limit in the United States that
an employee may be exposed to a chemical agent. This regulation is established and
regulated but the Occupational Safety and Health Administration (OSHA).
3. Information based on the health evaluations of individuals exposure to the hazard.

Chapter 9 Toxicology

7. Who is called a toxicologist? Name some subdisciplines discussed, and what

discipline you like most among the subdisciplines and why?

A toxicologist is an individual that is trained to examine and communicate the chemical

layout of a toxin. This helps to identify an approach to prevent or mitigate the harm that
can be done to humans, animals, and the environment. There are many subdisciplines that
a toxicologist may choose to pursue, those include:
1. Regulatory: Chemical or drug that can pose a risk to the health of an individual
2. Forensic: Utilizes analytical methods to lead to medicolegal outputs
3. Mechanistic: Identify and analyze the chemicals on a cellular, biochemical, and
molecular level
4. Environmental: Identify the chemicals in the environment that affect the health of
individuals
5. Computational: The utilization of computer models to predict adverse health
outcomes

One of the disciplines that I like most of the computational aspect. The reason I am
drawn to this the most is because the possibilities are endless. Technology is continuously
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updating and developing faster software. I think that it would be very interesting to be
able to visualize a future on a screen that can be adapted to the real world.

8. Why does threshold dose an important measure of assessing toxicity? What happens
above a threshold dose? Read the topic in the course textbook or do your own
research to respond to this question.

The threshold dose is when the toxic response is first observes, below the level response
is zero. The threshold dose is measured in terms of TTC, the threshold of toxicological
concern; this is the establishment of a level of exposure for all chemicals, below which
would not be appreciable risk to human health.
The term threshold is used to indicate the amount of intake or exposure that a chemical
can have without potentially developing adverse health effects. The graph below (taken
from PowerPoint, Chapter 9: Principles of Toxicology, slide 26) demonstrated the
reaction that occurs between dose and bodily response.
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References:

Levy, B. S. (2011). Occupational and Environmental Health: Recognizing and preventing

disease and injury. Lippincott Williams & Wilkins.