Global Noncommunicable Disease and Environmental Factors. Department of Environmental and Occupational Health

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1 Course Title: Global Noncommunicable Disease and Environmental Factors Course Number: ENOH 0601 Course Location: SPH Room 306 Course Date & Time: Course Instructor: Tuesday 6:10 PM 9:00 PM Qingyu Meng, Ph.D. Assistant Professor Department of Environmental and Occupational Health Rutgers School of Public Health, Room 311 ( ; Office Hours: Course Assistant: Before and after class, and by appointment NA Required Course Text: Anne Nadakavukaren. Our Global Environment: A Health Perspective. 6th Edition. Waveland Press, Prospect Heights, Illinois, (Additional Reference) Ichiro Kawachi and Sarah Warnala. Globalization and Health. Oxford University Press, Oxford, Additional/Supplemental Readings/Resources: Reading materials will be distributed in class. Course Description: Topics central to global noncommunicable diseases (NCD) and risk factors are addressed. NCDs significantly contributing to global disease burdens are discussed in depth. Emerging global environmental risk factors are illustrated. Selected Department Competencies Addressed:Each Department identifies competencies for each degree offered. The competencies addressed in this course for the MPH for the Department of Environmental and Occupational Health include: Describe the major environmental health problems to the general public as well as specific communities within that population; Describe the federal and state regulatory programs that relate to environmental (community) and worker (occupational) protection; Develop a testable model of environmental exposures (one or more agents) and adverse health outcomes (causing injury, disability, other measure of morbidity or mortality); and Specify current environmental risk assessment approaches and methods for a particular hazard or risk in a community. Page 1

2 The competencies addressed in this course for the PhD for the Department of Environmental and Occupational Health include: Explain the importance of differences of susceptibility and vulnerability to environmental toxicant/toxins based upon age, gender, race, ethnicity, genetics and socioeconomic status in different populations; Provide an informed expert opinion to government and/or community leaders regarding the extent or level of risk associated with a particular environmental or occupational hazard or condition; The competencies addressed in this course for the DrPH for the Department of Environmental and Occupational Health include: Describe the direct and indirect human and ecological health and safety effects of various environmental and occupational exposure agents; Diagnose and apply appropriate approaches for assessing, preventing, and controlling environmental hazards that pose risks to health and safety; Provide an informed expert opinion to government and/or community leaders regarding the extent or level of risk associated with a particular environmental or occupational hazard or condition; Understand environmental and occupational policies and regulations at both the federal and state levels. Please visit the Department webpages on the School of Public Health s website at for additional competencies addressed by this course for other degrees and departments. Course Objectives: By the completion of this course, students will be able to: Describe major noncommunicable diseases which significantly contribute to the global burden of disease Explain the regional differences in noncommunicable diseases around the world Use existing tools and database for further study on noncommunicable diseases Identify the key drivers of noncommunicable diseases in different regions in the world Critically evaluate the contributions of various environmental factors to noncommunicable disease Page 2

3 Course Requirements and Grading: Activities, assignments, projects, exams, etc. that contribute to course grade, and the respective point/percentage value of each. Class Participation Homework 1 Homework 2 Homework 3 Midterm Exam Final Term Project 10 points 10 points (Late: -5 points/day) 10 points (Late: -5 points/day) 10 points (Late: -5 points/day) 25 points 35 points (Late: -5 points/day) Additional details about the course s projects and assignments will be provided during the semester. Grading scale. A (points 90); B+ (80 points < 90); B (70 points < 80); C+ (65 points < 70); C (60 points < 65); F (points 59) Course Schedule: Date Lecture 1 Topics Course Introduction Jan 17, 2012 International classification of diseases and disease burden measurements Noncommunicable disease in the world Trend of noncommunicable disease in developing and industrialized countries Risk factors Course logistics 1. Saar et al. Grand challenges in chronic non-communicable diseases. Nature, 2007, 450, Lopez et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet, 367, Boutayeb A and Boutayeb S. The burden of non communicable diseases in developing countries. International journal for equity in health, 2005, 4:2 doi: / Magnusson R. Non-communicable disease and global health governance: enhancing global processes to improve health development. Globalization and Health, 2007, 3:2 doi: / Margaret Chan. Prevention is best option to tackle noncommunicable disease. Opening remarks at the global noncommunicable disease net work global forum, Geneva, February 24, Preventing Chronic Diseases: A Vital Investment Part 1. Page 3

4 Lecture 2 Physiology and Toxicology of NCD (Drs. Junyan Hong and Stephan Schwander) Jan 24, 2012 Terms and definitions Cellular Physiology Cardiovascular Physiology Respiratory Physiology Renal Physiology Metabolic Functions of the Liver Toxic response to environmental stressors 1. Ray LB. Metabolism is not boring Introduction. Science 2010;330: Lage A et al. Therapeutic cancer vaccines: At midway between immunology and pharmacology. Current Cancer Drug Targets 2005; 5: Kim E. Barrett et al. Ganong's Review of Medical Physiology, 23rd Edition (ISBN: ), McGraw- Hill Medical, 2009 Homework 1 is assigned. Lecture 3 Diabetes, obesity, and under nutrition (Dr. Daniel Hoffman) Jan 31, 2012 Nutrition requirements Malnutrition, over nutrition, and under nutrition Physiology of diabetes Clinical approach to diabetes Diabetes in the world Risk factors of diabetes The global obesity epidemic 1. Yoon et al., Epidemic obesity and type 2 diabetes in Asia. Lancet, 2006, 368, Caballero, B. The global epidemic of obesity: an overview. Epidemiologic reviews, 2007, 29, Comuzzie AG and Allison DB. The search for human obesity genes. Science, 1998, 280(5368), Homework 1 is due. Lecture 4 Cardiopulmonary Disease (Dr. Robert Laumbach) Feb 7, 2012 Physiology of asthma Clinical approach to asthma Asthma in the world Risk factors of asthma Physiology of cardiovascular disease Clinical approach to cardiovascular disease Page 4

5 Cardiovascular disease in the world Risk factors of cardiovascular disease 1. Reddy KS. Cardiovascular disease in nonwestern countries. N Engl J Med 2004;350: Reddy and Yusuf. Emerging epidemic of cardiovascular disease in developing countries. Circulation 1998;97: Mendez GF and Cowie MR. The epidemiological features of heart failure in developing countries: a review of the literature. International Journal of Cardiology 2001;80: Richardson G. et al. How is the indoor environment related to asthma?: literature review. Journal of Advanced Nursing 2005;52: Lecture 5 Cancer (Dr. Junyan Hong) Feb 14, 2012 Cancer biology Clinical approach to cancer Cancer in the world Environmental carcinogens 1. Love R. Defining a global research agenda for breast cancer. Cancer, 2008, 113, Parkin DM et al. Estimating the world cancer burden: Globocan Int. J. Cancer 2001; 94: Finkel T. et al. The common biology of cancer and ageing. Nature 2007;448: DePinho RA et al. The age of cancer. Nature 2000; 408: Lecture 6 Global Mental Health (Dr. Javier Escobar) Feb 21, Schnurr et al. Another grand challenge: Mental health. Science, 2004, 303(5655), Miller G. Mapping mental illness: an uncertain topography, 2006, 311(5760), McGrath JJ and Selten JP. Mental health: don't overlook environment and its risk factors. Nature, 2008, 454(7206), 824 Feb 28, 2012 MIDTERM EXAM Page 5

6 Lecture 7 Climate Change Mar 6, 2012 Weather and climate Physics behind climate change Evidence for climate change Human activity and climate change The impact of climate change on global health 1. Myers S and Patz J. Emerging threats to human health from global environmental change. Ann. Rev. Environ. Resourc, 2009, 34, Costello et al. Managing the health effects of climate change. Lancet, 2009, 373, Patz et al. Impact of regional climate change on human health. Nature, 2005, 438, McMichael, A. J., Woodruff, R. E., & Hales, S. (2006). Climate change and human health: Present and future risks. The Lancet, 367, McMichael, A. J., Friel, S., Nyong, A., & Corvalan, C. (2008). Global environmental change and health: Impacts, inequalities, and the health sector. British Medical Journal, 336, Mar 13, 2012 Spring break. No class. Lecture 8 The Atmosphere and Air Pollution Mar 20, 2012 Chlorofluorocarbons and stratosphere ozone Ambient air pollution in megacities around the world Inter-continent transport of air pollutants Indoor air pollution Tobacco and ETS exposure Globalization and tobacco 1. Bruce et al. Indoor air pollution in developing countries: a major environmental and public health challenge. Bulletin of the world health organization, 2000, 78, Stone R. Counting the cost of London s killer smog. Science, 2002, 298, Yach, D. & Bettcher, D. (2000). Globalisation of tobacco industry influence and new global responses. Tobacco Control, 9, Gary Taubes, "The Ozone Backlash", Science Vol 260, 11 June 1993, pp Jurgen Wettestad, Clearing the Air: Europe Tackles Transboundary Pollution, Environment 44:2, March Homework 2 is assigned. Page 6

7 Lecture 9 Catastrophes and Public Health (Dr. Michael Gochfeld) Mar 27, 2012 Catastrophes associated with climate change Earthquake Nuclear disaster Resource and War Population explosion The interactions between human activities and natural disaster 1. WHO. Mental health in Emergencies ( /pht/mentalhealth/en/index.html) 2. Schecter et al. Agent Orange and the Vietnamese: The Persistence of Elevated Dioxin Levels in Human Tissues. American Journal of Public Health, 1995, 85(4), Galea et al. Psychological sequelae of the September 11 terrorist attacks in New York City. New England Journal of Medicine, 2002, 346(13), Homework 2 is due. Lecture 10 Water Resource and Water Pollution (Dr. Ananya Roy) Apr 3, 2012 Water resource distribution around the world Water contaminants and diseases Safe drinking water 1. de Wit M and Stankiewicz J. Changes in surface water supply across Africa with predicted climate change. Science, 2006, 311, Schwarzenbach et al. The challenge of micropollutants in aquatic systems. Science, 2006, 313, Oki T and Kanae S. Global hydrological cycles and world water resources. Science, 2006, 313, Hutton, G and Bartram, J. (2008). Global cost to attaining the Millennium Development Goals for water supply and sanitation. Bulletin of the World Health Organization 2008;86: Homework 3 is assigned. Lecture 11 Nutrition and Food Safety (Dr. Mark Robson) Apr 10, 2012 Pesticides, pesticides exposure, and health effects Food additives Genetically modified foods Alcohol addiction and other disorders of diet 1. Darnton-Hill I and Coyne ET. Feast and famine: socioeconomic disparities in global nutrition and health. Public health nutrition, 1998, 1, Reynolds, The globalization of organic agro-food networks. World Development, 32(5). Page 7

8 3. Caballero, B, A nutrition paradox-underweight and obesity in developing countries. New England Journal of Medicine, 352, 15, Satcher, D. (2004). Food safety: A growing global health problem. The Journal of the American Medical Association, 283(14), Popkin, Barry M. (2006). Global Nutrition Dynamics: the world is rapidly shifting toward a diet linked with non-communicable diseases. American Journal for Clinical Nutrition, 84, Lecture 12 Globalization, Poverty, and NCD (Dr. Ananya Roy) Apr 17, 2012 The Limits to Growth Poverty and inequality in a globalizing world International trade and NCD e-waste Dirty Dozen, PCBs and Dioxins in the environment Industrial, municipal and hazardous waste Chemical 'time bomb' Land use change, deforestation, and urbanization Transportation 1. Smith K. Environmental health for the rich or for all? Bulletin of the world health organization, 2000, 78, WHO. Noncommunicable disease and poverty. WHO, 2006, Geneva. 4. Lee at al. Bridging the divide: Global governance of trade and health. Lancet, 2009, 373, Iles, Mapping environmental justice in technology flows: computer waste impacts in Asia. Global Environmental Politics, 4(4). 6. Improving the health of the global poor. Science, 295(5562), Homework 3 Presentation In-Class Project Discussion Apr 24, 2012 Final Term Project Presentation Final exam is due. Page 8

9 School of Public Health Honor Code: The School of Public Health Honor Code is found in the student bulletin (sph.rutgers.edu/academics/catalog/index.html ). Each student bears a fundamental responsibility for maintaining academic integrity and intellectual honesty in his or her graduate work. For example, all students are expected to observe the generally accepted principles of scholarly work, to submit their own rather than another s work, to refrain from falsifying data, and to refrain from receiving and/or giving aid on examinations or other assigned work requiring independent effort. In submitting written material, the writer takes full responsibility for the work as a whole and implies that, except as properly noted by use of quotation marks, footnotes, etc., both the ideas and the works used are his or her own. In addition to maintaining personal academic integrity, each student is expected to contribute to the academic integrity of the school community by not facilitating inappropriate use of her/his own work by others and by reporting acts of academic dishonesty by others to an appropriate school authority. It should be clearly understood that plagiarism, cheating, or other forms of academic dishonesty will not be tolerated and can lead to sanctions up to and including separation from the Rutgers School of Public Health. Policy Concerning Use of Recording Devices and Other Electronic Communications Systems: When personally owned communication/recording devices are used by students to record lectures and/or classroom lessons, such use must be authorized by the faculty member or instructor who must give either oral or written permission prior to the start of the semester and identify restrictions, if any, on the use of mobile communications or recording devices. Page 9