COMMUNITY AND ENVIRONMENTAL HEALTH PROFESSIONS

PRINCIPLES OF ENVIRONMENTAL HEALTH

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Please highlight, bold, or enter the correct answer for the questions below.  This is an open book exam. All questions are worth 2 points each (80 points total).

Multiple Choice  

1. According to Healthy People 2020, which of the following is not an environmental objective for outdoor air quality?

  1. Reducing the number of days that the AQI exceeds 100, weighted by population and AQI
  2. Increasing the production of clean coal as an energy source    
  3. Increasing use of alternative modes of transportation for work
  4. Reducing air toxic emissions to decrease the risk of adverse health effects

2. Which of the following covers a narrow range from about 6 miles above the earth to the surface of the earth to the deepest ocean trenches, some of which are 36,000 feet deep?

  1. Atmosphere
  2. Ecosystem
  3. Biosphere   
  4. Ozone layer

3. Which of the following outcomes is not usually associated with world population growth?

  1. Pollution
  2. Poverty
  3. Prosperity   
  4. Urban crowding

4. What Greek philosopher emphasized the role of the environment as an influence on people’s health and health status in his work titled On Airs, Waters, and Places?

  1. Aristotle
  2. Hippocrates   page 18
  3. Galen
  4. Pliny the Elder

5. The environment plays a role in human health through associations with which of the following?

  1. Acute conditions
  2. Allergic responses
  3. Chronic disease
  4. All of these are correct.  

6. The estimated global burden of disease (percentage) linked to environmental sources is:

  1. 5% to 20%.
  2. 25% to 33%. 
  3. 35% to 50%.
  4. 55% to 70%.

7. The British Parliament enacted the Public Health Act in 1848 to promote which of the following?

  1. Clean air
  2. Vaccines
  3. Safe working environments
  4. Clean water   

8. Compared with adults, children represent a group that is especially vulnerable to environmental hazards for the following reasons, except:

  1. Their immune systems are still developing.
  2. They may be exposed more often to toxins in the outdoor air.
  3. They may be exposed more often to toxins in the soil.
  4. They spend more time indoors.   

9. Reasons for the potential spread of avian influenza include which of the following?

  1. Restriction of international travel
  2. Demonstrated person-to-person transmission
  3. Intensive animal husbandry practices   
  4. Both restriction of international travel and demonstrated person-to-person transmission

10. During the first century CE, the toxic properties of sulfur and zinc were pointed out by which Roman scholar who invented a mask constructed from the bladder of an animal for protection against dust and metal fumes?

  1. Aristotle
  2. Hippocrates
  3. Galen
  4. Pliny the Elder   

11. __________, a London surgeon, was significant to the history of environmental epidemiology because he is thought to be the first individual to describe an environmental cause of cancer.

  1. Sir Percival Pott   
  3. John Snow
  4. John Graunt
  5. Walter Reed

12. The Nuisances Removal and Diseases Prevention Amendments bill was introduced in the British Parliament as a reform of Victorian public health legislation following the outbreak of what disease?

  1. Cholera   
  2. Malaria
  3. Plague
  4. Smallpox

13. What type of study design makes a one-time assessment of the prevalence of disease in a sample that in most situations has been sampled randomly from the parent population of interest?

  1. Cross-sectional studies   
  2. Case-control studies
  3. Ecologic studies
  4. Case series study

14. All of the following statements about the 2009 swine flu outbreak are true, except:

  1. It was spread through North America to other parts of the globe.
  2. It was classified as a pandemic by WHO.
  3. It showed evidence of person-to-person transmission.
  4. It was caused by the H5N1 virus.  

15. Environmental risk transition is most likely to be characterized by:

  1. increasing levels of poor food, air, and water quality.
  2. increasing frequency of diarrhea caused by unsafe water.
  3. air pollution from poor-quality indoor fuels.
  4. control of household risks and creation of a new set of problems.  

16. What type of study is among the weakest for making causal assertions, but can be useful for developing hypothesis for further study?

  1. Case-control studies
  2. Ecologic studies
  3. Case series study   
  4. Cross-sectional studies

17. Supplemental vitamins reducing the effects of needed prescription medicines such as antibiotics is an example of what action?

  1. Synergism
  2. Antagonism   
  3. Potentiation
  4. Collative interaction

18. What term describes repeated toxic exposure for 1 to 3 months?

  1. Acute
  2. Subacute
  3. Subchronic   
  4. Chronic

19. The highest levels of what type of radiation demarcate the dichotomy between ionizing radiation and nonionizing radiation?

  1. Infrared radiation
  2. Ultraviolet radiation   
  3. Low-frequency radiation
  4. Radio-frequency energy

20. The water (drinking water) delivered to the distribution system after treatment is referred to as which of the following?

  1. Finished water 
  2. Ground water
  3. Source water
  4. Surface water

21. Currently, the number of years required for the world’s population to double is approximately:

  1. 73 years.
  2. 53 years. 
  3. 43 years.  
  4. 13 years.

22. In 2050, the world’s three most populous countries will be:

  1. China, Indonesia, United States.
  2. United States, Russia, and Japan.
  3. China, Indonesia, and Brazil.
  4. India, China, United States.   

23. Which of the following, a main component of photochemical smog, has the sharp smell associated with sparks from electrical equipment?

  1. Carbon monoxide
  2. Ozone   
  3. Sulfur dioxide
  4. Nitrogen dioxide

24. What medical condition is ranked among the most frequent types of foodborne illness in the United States?

  1. Botulism
  2. Shigellosis
  3. Salmonellosis   
  4. Listeriosis

25. Which method for disposal of solid waste can be used to generate energy while at the same time reducing the volume and weight of waste?

  1. Incineration   
  2. Composting
  3. Recycling
  4. Leaching

26. Which of the following are contributions of epidemiology to environmental health?

  1. Concern with populations
  2. Use of observational data
  3. Methodology for study designs
  4. All of these are correct.  

27. The Texas Sharpshooter Effect illustrates:

  1. a new insect pest that is invading the southwest.
  2. a description of disease according to person variables.
  3. a description of disease according to etiologic factors.
  4. one cause of spurious or chance clustering.  

28. Environmental health science is concerned with agent, host, and environmental factors in disease (the epidemiologic triangle). Which statement is true about the triangle?

  1. Agent factors can include particles, toxic chemicals, and pesticides.
  2. The environment is the domain in which disease-causing agents may exist.
  3. The host is the person who affords lodgment of an infectious agent.
  4. All of these are correct.   

29. John Snow, in Snow on Cholera:

  1. was the father of modern biostatistics.
  2. established postulates for transmission of infectious disease.
  3. was an English anesthesiologist who used natural experiments.  
  4. argued that the environment was associated with diseases such as malaria.

30. Which of the following activities characterizes the epidemiologic approach (as opposed to the clinical approach)?

  1. Description of a single individual’s symptoms
  2. Treatment of a patient with lung cancer
  3. Diagnosis of a disease in a single individual
  4. Study of cancer occurrence in populations   

31. The risk of acquiring a given disease during a time period is best determined by which of the following?

  1. The case fatality rate (CFR) from that disease in the 0 to 4 age group
  2. A spot map that records all cases of the disease in the past year
  3. The prevalence for that disease during the past year
  4. The incidence rate for that disease in a given period of time   

32. Prevalence measures aid in:

  1. assessing variations in disease occurrence, the development of hypotheses, and describing the scope of health problems.  
  2. assessing variations in disease occurrence.
  3. determining the risk of disease.
  4. describing the scope of health problems.

33. A national survey of asthma conducted on May 1, 2012, obtained the following results for the state of Oklahoma:

X = The number of residents with asthma

Y = The population of the state on June 30, 2012, and all members of the population were considered at risk

Z = The number of new cases of asthma diagnosed during 2012.

The incidence rate of asthma during 2012 (per 100,000) would be expressed as:

  1. (X/Y) × 100,000.
  2. (Z/X) × 100,000.
  3. (Z/Y) × 100,000.   
  4. (X/Z) × 100,000.

34. Which of the following is not likely to characterize the approach of toxicology?

  1. Laboratory studies of the role of xenobiotics in carcinogenesis in mice
  2. Studies of disease occurrence in populations according to person variables   
  3. In vitro studies
  4. In vivo studies

35. The existence of a dose-response relationship may be used to establish which of the following kinds of information?

  1. Causal association between a toxin and biological effects
  2. Minimum dosages needed to produce a biological effect
  3. Rate of accumulation of harmful effects
  4. All of these are correct.  

36. The concentration and toxicity of a chemical in the body are affected by:

  1. route of entry into the body.
  2. duration of exposure.
  3. individual sensitivity.
  4. All of these are correct.   

37. In comparison with the general population, workers may receive exposures to toxic chemicals that are:

  1. at higher concentrations for much longer time periods.   
  2. at lower levels for shorter time periods.
  3. confined to a single time episode.
  4. more likely to be associated with acute effects than long-term effects.

38. Subacute exposures are those that last for:

  1. less than 24 hours and occur once.
  2. less than 24 hours and occur more than once.
  3. 1 to 3 months.
  4. 1 month or less.   

39. Which of the following aspects is not included in the built environment?

  1. City buildings
  2. Undeveloped land   
  3. Parks
  4. Roads

40. How can the built environment encourage healthy lifestyles?

  1. By causing greater use of private automobiles
  2. By encouraging people to walk more
  3. By encouraging the use of public transportation
  4. By encouraging people to walk more, encouraging the use of public transportation, and co-locating businesses and residences   

Essay – 4 points each (20 point total)

41. What is the significance of the guinea worm to waterborne diseases and how does it infect humans?

42. What is the difference between a foodborne infection and a foodborne intoxication?

43. The direct adverse effects of exposures to chemicals range from local effects, to systemic effects, to target organ effects. Explain/define local, systemic, and target organ effects on health.

44. Currently in the Congo there is a serious outbreak of Ebola Viral Hemorrhagic Fever.  Despite having an approved vaccine, the use is very limited due to cultural suspicions and rural access. What are the symptoms of Ebola and where was Ebola first recognized as a serious disease?

45. What was the main reason that the funding for malaria spraying programs was withdrawn?

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