Lecture 16 review pressure state response and heavy metals and cancer and the environment
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Lecture 16: Review, Pressure/State/Response and Heavy Metals and Cancer and the Environment. Some final words on water…. Boil water advisories: Mostly to kill fecal coliform bacteria Estimates range from 1-5 minutes Boiling is not helpful for heavy pollution or chemical contamination

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Lecture 16 review pressure state response and heavy metals and cancer and the environment l.jpg

Lecture 16: Review, Pressure/State/Response and Heavy Metals and Cancer and the Environment


Some final words on water l.jpg
Some final words on water…. Metals and Cancer and the Environment

  • Boil water advisories:

    • Mostly to kill fecal coliform bacteria

    • Estimates range from 1-5 minutes

    • Boiling is not helpful for heavy pollution or chemical contamination

    • Giardia is resistant to chlorine

    • In BC, 240 boil water advisories currently serve ~ 15,000 people

    • Since 1985 there have been 18 outbreaks of water-borne disease


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Some final words on water…. Metals and Cancer and the Environment

  • Bottled water:

    • Look for reverse osmosis, ozonation and distillation

  • Testing your water:

    • Environmental health division of your local health unit or health dept. The Environmental health officer should be able to help you with what to test for in your area

      FYI: Seymour Filtration Plant presentation http://www.gvrd.bc.ca/water/pdfs/SLWaterSystemOverview040114.pdf


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Review: Key Concepts and Learning Objectives Metals and Cancer and the Environment

Learning Goals:

  • Vulnerable Populations: Occupational exposures: Why are workers vulnerable and what can be done to protect them?

  • The Precautionary Principle: what is it, how we can use it and how does it relate to scientific uncertainty?

  • Global warming and climate change: what are the range of anticipated effects?


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Key Concepts and Learning Objectives Metals and Cancer and the Environment

Learning Goals:

  • Global warming and climate change: what are the anticipated effects and implications for human health?

    • Greenhouse gases

    • Infectious diseases range

    • Ground level and upper atmosphere ozone

  • How is British Columbia unique and what progress has been made here?


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Key Concepts and Learning Objectives Metals and Cancer and the Environment

Learning Goals:

  • Air pollution: what are the differences between area, point and linear sources?

  • When we talk about multiple sources, multiple routes and multiple interactions what do we mean?

  • What types of air pollution do we monitor most regularly in Canada?

  • Why are temperature inversions problematic for air pollution levels?


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Key Concepts and Learning Objectives Metals and Cancer and the Environment

Learning Goals:

Water: What are the important sources of water consumption?

What are the basic processes in water treatment?

Where does the majority of our water come from?

What are MACs, TDIs and NOAELS?

What are the major chemical and biological threats to water?

How are we doing in British Columbia with regard to water quality?


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“Environmental epidemiology/environmental Health” Metals and Cancer and the EnvironmentDade Moeller, 1992

4 steps to examining environmental health

1. Determine the source and nature of each environmental contaminant or stress.

2. Assess how and in what form it comes into contact with people.

3. Measure the effects.

4. Apply controls when and where appropriate.


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WHO DPSEEA model for environmental health Metals and Cancer and the Environment


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Pressure- State- Response Metals and Cancer and the Environment

  • P1,P2… Human activities that put pressure on the environment

     Land, air and water

  • S1, S2… States of ambient environment quality

  • I1, I2, I1… Human Health, Ecosystem Health, Economic and Social

  • Aesthetic Impact due to ambient consequences

  • R1, R2… Policy Responses Hello Mom!


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Human Health and Heavy Metals Metals and Cancer and the Environment

  • Wide dispersion

  • Tendency to accumulate

  • Ability to do damage/be toxic at low levels

    GLOBAL CONCERNS AND LOCAL TOXIC HAZARDS WASTE

    1 lead, 2 mercury 3 arsenic, 6 cadmium


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Human Health and Heavy Metals Metals and Cancer and the Environment

  • Routes of Exposure:

    • Food

    • Inhaled


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Human Health and Heavy Metals Metals and Cancer and the Environment

LEAD – most studied

Sources:

Lead organic compounds such as motor vehicle fuel

Batteries (MV)

Pigments, glazes, solder, plastics

root vegetables

water with low pH

ceramic glazes,


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Human Health and Heavy Metals Metals and Cancer and the Environment

LEAD

Dose: 5-25 ug/L children

must stay below 40 ug/L workers

Lead organic compounds such as motor vehicle fuel

Batteries (MV)

Pigments, glazes, solder, plastics

root vegetables

water with low pH

ceramic glazes

Toxicity: IQ, hypertension, convulsions, coma, renal failure

Canada drinking water IMAC 10 ug/L


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Human Health and Heavy Metals Metals and Cancer and the Environment

MERCURY

Sources: thermometers, dental amalgams, batteries

must stay below 40 ug/L workers

Exposure:

-If left standing or aerosolized it is taken into lungs

-Dispersed through waste incineration

-soil and water deposits; converted into methyl mercury by microorganisms then bio-concentrated up the food chain (fish, tuna, mackerel)


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Human Health and Heavy Metals Metals and Cancer and the Environment

MERCURY

Toxicity:

Tremors, memory loss, excitability, insomnia, delirium – “mad as a hatter”

Readily crosses the placenta and appears in breast milk

Minimata Japan 1955: mental retardation, cerebellar symptoms

CANADA MAC 1 ug/L below levels found


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Human Health and Heavy Metals Metals and Cancer and the Environment

ARSENIC

Sources: earth’s crust, smelting industry, wood preservatives, pesticides, paints, fossil fuel combustion, folk remedies, wells

Exposure: toxic and carcinogenic. Scientists are debating safe exposure standards


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Human Health and Heavy Metals Metals and Cancer and the Environment

ARSENIC

Toxicity:

- Depends on its valence state (0, 3, 5 valent) and its form (inorganic or organic)

- Inorganic is most toxic

  • Collects most in skin, hair and nails

  • can lead to skin, liver, lung, bladder and kidney and colon cancer

  • skin hyperpigmentation, peripheral nerve damage

  • US drinking water guideline is 50 ug/L considered too high

  • Canada IMAC 25 ug/L


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Human Health and Heavy Metals Metals and Cancer and the Environment

CADMIUM:

Source: toxicity is relatively uncommon but exposure causes distinctive clinical syndromes

Exposure:

Industries dealing with pigment, metal plating, plastics, batteries

Cadmium pollution introduces cadmium into sewage sludge, fertilizers and groundwater resulting in contamination in foodstuffs, grains, cereals and leafy vegetables

-cigarette smoking


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Human Health and Heavy Metals Metals and Cancer and the Environment

CADMIUM:

Toxicity:

  • complicated by inability of humans to excrete cadmium (b/c reabsorbed by kidneys)

  • Chronic lung disease, testicular degeneration, prostate cancer?

  • Kidneys ; effects tend to be irreversible

  • Itai-itai disease in Japan contaminated rice stocks ; also bone fractures


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Prescriptions Metals and Cancer and the Environment

  • Even though well studied still need to know about lead:

  • and subpopulations

  • and reversible effects on mental development and children

  • Role in degenerative diseases like Alzheimer’s and Parkinsons


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Prescriptions Metals and Cancer and the Environment

  • Accelerate phase-out of leaded gasoline

    • Italy, Greece, Spain, Australia, Chile lag

    • South Africa, Nigeria, Israel haven’t committed

  • Monitor trends world wide:

    • Take regular samples, standardize methods, find out about levels in air, water and foods

  • Establish population-based monitoring for metals

  • Educate governments, scientists and public on metal toxicity

  • Declare moratorium on production/dist./use of heavy metals

  • Continue basic research on impacts of heavy metals on human health


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Exposure Histories Metals and Cancer and the Environment

  • Description of the patient’s past and present jobs

  • Listing of materials in the home, yard, garden, garage or shop

  • Exposure at school, travel and play

  • Living in proximity to industrial plants or contaminated drinking water

  • Dietary history

  • Smoking and alcohol consumption

  • Recreational and medical drugs


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Cancer and the Environment Metals and Cancer and the Environment

  • 1. the background of cancer incidence and mortality

  • 2. types of exposures that are known or suspected causes of cancer clusters

  • 3. implications for health care providers who wish to provide guidance for worried patients or communities


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Cancer and the Environment Metals and Cancer and the Environment

  • Last 25 years

  • US Age-adjusted all sites:

    • 320/100,00 in 1973 to 395/100,000 in 1998

  • CANADA Age-adjusted all sites:

    • 280/100,00 and 338/100,000 in 1972 for males and females respectively

    • to 344/100,000 and 444/100,000 in 2001


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Sites with decreasing incidence and mortality Metals and Cancer and the Environment

Oral cavity and pharynx

Stomach

Colon

Pancreas

cervix and uterus

Hodgkin’s disease

Leukemias

breast

Sites with increasing incidence and mortality

Esophagus

Liver

Lung

Melanomas

Prostate

Kidney

Brain

*Non-Hodgkin’s lymphoma

Multiple myeloma

Cancer and the Environment: Trends 1973-1998

* Associated with environmental and occupational exposures


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Cancer and the Environment Metals and Cancer and the Environment

Lifetime risk:

US 43% for males and 38% females

Canada 40% for males and 36% females

Harvard Centre for Cancer Prevention:

  • 30% cancer deaths due to tobacco

  • 30% adult diet/obesity


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Cancer and the Environment Metals and Cancer and the Environment

Melanoma of the skin

Non-Hodgkin’s lymphoma

exposure to UV light, to herbicides, genetic factors,

viral exposures


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Cancer and the Environment Metals and Cancer and the Environment

Communities at risk:

  • workers, facilities

  • Medical waste incineration

  • Canadian National Pollutant Release Inventory


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Summary Metals and Cancer and the Environment

  • Live well

  • Exercise

  • Quit or Don’t smoke

  • Eat healthy

  • Use protective equipment when necessary

  • Minimize exposures when possible

  • Be an advocate


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References Metals and Cancer and the Environment

  • Clapp, R.W. (2002) Cancer and the Environment, Ch 11, Life Support, the Environment and Human Health, ed., M. McCally, MIT Press, USA.

  • Hu, H. (2002) Human Health and Heavy Metals Exposure, Ch 5, Life Support, the Environment and Human Health, ed., M. McCally, MIT Press, USA.


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