Toxic Risks & Chronic Disease
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1 ENVIR 202: Lesson No. 19 Toxic Risks & Chronic Disease February 17, 2006 Chuck Treser University of Washington Department of Environmental & Occupational Health Sciences ENVIR 202: Lesson 19 1 Urbanization ENVIR 202: Lesson th Century Mortality ENVIR 202: Lesson 19 3 ENVIR 202: Population & Health 1
2 Cancers ENVIR 202: Lesson 19 4 Chemicals Chemical & Engineering News January 12, 1998 Copyright 1998 by the American Chemical Society ENVIR 202: Lesson 19 5 Chemicals ENVIR 202: Lesson 19 6 ENVIR 202: Population & Health 2
3 Fundamental Rules 1. "The Dose Makes the Poison" All substances are poisons. There are none that are not. The dose separates the remedy from the poison. Peracelsus (Theophrastus Bombastus von Hohenheim, ) ENVIR 202: Lesson 19 7 Fundamental Rules 2. Exposure must occur for the chemical to present a risk 3. The magnitude of risks is proportional to both the potency of the chemical and the extent of exposure Risk = Hazard x Exposure ENVIR 202: Lesson 19 8 Routes of Exposure 1. Direct Exposure (through Use and/or Accident) a) Ingestion (children; intentional) b) Skin contact (e.g., acids, solvents, pesticides) c) Inhalation (e.g., paints, pesticides) ENVIR 202: Lesson 19 9 ENVIR 202: Population & Health 3
4 Exposure Routes Continued 2. Indirect Exposure a) Contamination of drinking water b) Contamination of soil / house dust c) Contamination of indoor air ENVIR 202: Lesson Dose-Response Relationship The individual, or continuous, doseresponse curve ENVIR 202: Lesson Dose-Response Relationship The Frequency Distribution Curve ENVIR 202: Lesson ENVIR 202: Population & Health 4
5 Potency & Dose-Response ENVIR 202: Lesson LD 50 of Representative Substances TOXIC AGENT LD 50 TOXICITY RATING Ethanol 10,000 Slightly Toxic Sodium chloride 4,000 Moderately Toxic Phenobarbital 150 Very Toxic DDT 100 Very Toxic Parathion 7 Extremely Toxic Nicotine 1 Super Toxic Curare 0.05 Super Toxic Dioxin (TCDD) Super Toxic Botulinum Toxin Super Toxic ENVIR 202: Lesson Chemical Interactions Additive: = 5 Synergistic: = 20 Potentiation: = 10 Antagonism: = (-4) = = 1 ENVIR 202: Lesson ENVIR 202: Population & Health 5
6 Risk Assessment ENVIR 202: Lesson Understanding Risks Hazard identification Dose-response assessment Exposure assessment Risk Characterization Risk Management Risk Communications ENVIR 202: Lesson Translation Is there a potential problem? What is the problem? Who has the problem? How bad is the problem? What should we do about it? Who and what do we tell? ENVIR 202: Lesson ENVIR 202: Population & Health 6
7 Toxicological Methods ENVIR 202: Lesson Comparing Risks Probability Expected Value Exposure Outrage Experts Avoidance ENVIR 202: Lesson Uncertainties in Life One of the brightest gems in the New England weather is the dazzling uncertainty of it.... Mark Twain ENVIR 202: Lesson ENVIR 202: Population & Health 7
8 Comparative Risks Event Annual Risk Car injury 1:100 Killed hang gliding 1:1,000 Killed mountain climbing 1:1,585 Cancer: 1 diet cola/day 1:10,000 Cancer: 4 tbsp. peanut butter/day 1:100,000 Event Lifetime Risk Hit by Lightning 1:631,000 Cancer: drinking chlorinated water 1:1,000,000 Win state lottery grand prize 1:10,000,000 Win Readers Digest sweepstake 1:250,000,000 ENVIR 202: Lesson Comparing Risks Activities that increase annual risk by 1:1,000,000 Smoke 1.4 cigarettes Drink 0.5 liters of wine Live 2 days in New York or Boston Live 2 months with a cigarette smoker Live 150 years within 5 miles of a nuclear power plant ENVIR 202: Lesson Comparing Risks Voluntary vs. Involuntary Risks Immediate vs. Delayed Effects Common vs. Rare (Dread) Events Affects Everyone vs. Special Groups Reversible vs. Irreversible Effects ENVIR 202: Lesson ENVIR 202: Population & Health 8
9 Not Observable Unknown to those Exposed Effects Delayed Vectors Risk Unknown New Risk Science Microwave Ovens Water Fluoridation Saccharin Nitrates Water Chlorination Polyvinyal Chloride Diagnostic X-rays Oral Contrceptives Valium IUDs Antibiotics Electric Fields DES Nitrogen Fertilizers Pesticides PCBs DNA Technology Radioactive Waste Nuclear Reactor Accidents Uranium Mining Nuclear Weapons Fallout Asbestos Insulation Satellite Crashes Mercury Uncontrollable Dreaded Coal Burning Pollution Global/Catastrophic Consequences Fatal Not Equitable CO (Cars) Storage Nerve High Risk to Future Generations Black Lung Transport Gas Not Easily Reduced of LNG Accients Increasing Risk Large Dams Involuntary Skyscraper Fires Controllable Lead (Cars) Not Dreaded, Not Global/Catastrophic Lead Paint Aspirin Not Fatal Vaccines Equitable Low Risk to Future Generations Skateboards Easily Reduced Power Smoking Decreasing Risk Mowers Snowmobiles Voluntary Trampolines Tractors Chain Saws Nuclear Weapons (War) Elevators Underwater Construction Home Swimming Pools Sport Parchuting Coal Mining (Accidents) Downhill Skiing General Aviation Recreational Boating High Construction Bicycles Motorcycles Railroad Collisions Alcohol Related Accidents Commercial Aviation Auto Racing Fireworks Auto Accidents Handguns Observable Dynamite Known to those Exposed ENVIR H 311: 202: Lesson 519 Effects Immediate Old Risk Risk known to Science Changing Risks Understand the risks Understand who is at risk Characterize the risk Consider the alternatives Consider protective measures ACT!!! ENVIR 202: Lesson Risk Assessment Approaches Cost-benefit analysis Revealed preference Expressed preference Natural standards ENVIR 202: Lesson ENVIR 202: Population & Health 9
10 Cost-Benefit Analysis Definition: A systematic attempt to compare the costs with the anticipated benefits of a technology, product, substance or process. $ ENVIR 202: Lesson Cost-Benefit Analysis Veg-E-Wax Benefits Anticipated Value Storage loss prevented 1,000,000 Nutritive value preserved 800,000 Total $1,800,000 Costs Anticipated Value Application costs 100,000 Cancer in workers 100,000 Cancer in consumers 100,000 Unappealing appearance 1,600,000 Total $1,900,000 ENVIR 202: Lesson Cost-Benefit Analysis Examples of Regulations Evaluated by Cost per Life Saved Annual Lives Cost per Status Risk Saved Life Regulation & Year Estimate Annually Saved Asbestos Final in $7,400 Benzene Final in $17,100 Asbestos Final in $92,500 Formaldehyde Prop in 10 7 <1 $72,000,000 ENVIR 202: Lesson ENVIR 202: Population & Health 10
11 Revealed Preferences Definition: The acceptable risk for a new technology is the level of safety associated with ongoing activities having similar benefits to society. ENVIR 202: Lesson Expressed Preferences Definition: If people say it is safe, then it is safe enough. ENVIR 202: Lesson Natural Standards Definition: A technology is safe if its risk are no greater than those accompanying the development of the human species. ENVIR 202: Lesson ENVIR 202: Population & Health 11
12 Risk Assessment ENVIR 202: Lesson Regulation Philosophies Count the bodies Engineering solutions (BAT) Uniform Risk/Equal Rights Cost-Benefit Delaney Approach ENVIR 202: Lesson Current Federal Issues Risk and Regulation Cost-Benefit Analysis ENVIR 202: Lesson ENVIR 202: Population & Health 12
13 World View Deaths by Cause World-Wide, 1993 Infectious & Parasitic Cardiovasculer Cancers Injuries Perinatal & Neonatal Chronic Pulmonary Maternal Other / Unknown No. of Deaths (in millions) ENVIR 202: Lesson 19 Source: The World Health Report 1995, WHO, Geneva, Variable Picture ENVIR 202: Lesson Wealth & Health ENVIR 202: Lesson ENVIR 202: Population & Health 13
14 Questions ENVIR 202: Lesson Uncertainties in Life Remember to change your underwear you never know when you ll be in an accident. Your Mother ENVIR 202: Lesson Next Lesson Disasters: Natural and Unnatural ENVIR 202: Lesson ENVIR 202: Population & Health 14
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