Preventive Medicine: Preventive Medicine 4
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Questions and Answers

What is a common example of an acute traumatic injury in the workplace?

  • Carpal tunnel syndrome among clerical workers
  • Degenerative joint disease in materials handlers
  • Lumbar disc disease in nurses
  • Falls from a height (correct)

    • Which of the following occupational groups is most likely to be exposed to high levels of radiation?

  • Clerical workers
  • Materials handlers
  • Nurses and nurses' aides
  • Aircraft pilots and crews (correct)

    • What is the primary challenge in determining the cause of a workplace injury?

  • Determining the exact moment of injury
  • Deciding whether to file a workers' compensation claim
  • Identifying the type of equipment involved
  • Establishing a causal link between exposure and health condition (correct)

    • What is the primary source of radiation exposure in the general population?

    <p>Radon gas in homes</p> Signup and view all the answers

    Which of the following is an example of a gradual, repetitive strain injury?

    <p>Lumbar disc disease in nurses</p> Signup and view all the answers

    What is Raynaud's disease?

    <p>Vasospasm resulting in reduced blood flow to fingers</p> Signup and view all the answers

    Which of the following occupations is at risk for degenerative joint disease?

    <p>Materials handlers</p> Signup and view all the answers

    What is a potential health effect of acute radiation sickness?

    <p>Ulceration and bleeding in the gastrointestinal tract</p> Signup and view all the answers

    Which group of workers has an increased risk of leukemia and lung cancer?

    <p>Nuclear workers</p> Signup and view all the answers

    What is a potential health effect of heat stress?

    <p>Circulatory collapse</p> Signup and view all the answers

    Which condition is characterized by fatigue, malaise, and shortness of breath?

    <p>Acute mountain sickness</p> Signup and view all the answers

    What is a potential health effect of cold exposure?

    <p>Frostbite</p> Signup and view all the answers

    What is the primary hazard of high-altitude environments?

    <p>Reduced oxygen content</p> Signup and view all the answers

    What is the primary route of exposure to solvents?

    <p>Inhalation and skin absorption</p> Signup and view all the answers

    Which solvent is known to cause aplastic anemia and acute myelogenous leukemia?

    <p>Benzene</p> Signup and view all the answers

    What is the purpose of biologic monitoring in assessing workplace exposure to solvents?

    <p>To measure urinary solvent metabolites</p> Signup and view all the answers

    Which metal exposure is associated with hyperpigmented skin lesions and peripheral neuropathy?

    <p>Arsenic</p> Signup and view all the answers

    What is the syndrome caused by chronic exposure to beryllium in certain individuals?

    <p>Berylliosis</p> Signup and view all the answers

    Which of the following is a toxic effect of chronic exposure to solvents?

    <p>Chronic encephalopathic changes</p> Signup and view all the answers

    What is the result of extremely heavy exposure to halogenated solvents?

    <p>Cardiac arrhythmias and sudden death</p> Signup and view all the answers

    What is the purpose of assessing workplace exposure to solvents?

    <p>To consider the possibility of combined toxicity and dermal exposure</p> Signup and view all the answers

    What is the primary mechanism of action of simple asphyxiants like methane and nitrogen?

    <p>Diluting oxygen in an enclosed space</p> Signup and view all the answers

    What is the typical effect of gases with high water solubility, such as ammonia and sulfur dioxide?

    <p>Rapid absorption and irritant effect in the upper respiratory tract</p> Signup and view all the answers

    What is a common hazard for workers in outdoor environments, such as groundskeepers and park rangers?

    <p>Diseases spread by arthropod vectors</p> Signup and view all the answers

    What is the estimated risk of seroconversion to HIV after a needlestick injury?

    <p>0.3%</p> Signup and view all the answers

    What is the primary route of transmission for blood-borne pathogens in health care settings?

    <p>Needlesticks or splashes of blood or other infectious body fluids</p> Signup and view all the answers

    What is the purpose of providing hepatitis B vaccine to workers at risk for exposure?

    <p>To prevent infection after exposure</p> Signup and view all the answers

    What is the typical effect of low-solubility gases, such as phosgene and nitrogen oxide?

    <p>Delayed effects in the lower respiratory tract</p> Signup and view all the answers

    What is the purpose of antiretroviral prophylaxis after a needlestick injury?

    <p>To prevent HIV transmission after exposure</p> Signup and view all the answers

    What is the term for the scarring process in the lungs caused by chronic silica exposure?

    <p>Silicosis</p> Signup and view all the answers

    Which type of cancer is associated with asbestos exposure?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the group of substances formed from incomplete combustion of coal or oil?

    <p>Polycyclic aromatic hydrocarbons</p> Signup and view all the answers

    What is the primary mechanism of action of organophosphates and carbamates?

    <p>Inhibiting the enzyme acetylcholinesterase</p> Signup and view all the answers

    What is the term for the scarring process in the lungs caused by chronic asbestos exposure?

    <p>Asbestosis</p> Signup and view all the answers

    Which type of cancer is linked to polycyclic aromatic hydrocarbons exposure?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the rare tumor of high mortality affecting the pleural lining of the lung?

    <p>Malignant mesothelioma</p> Signup and view all the answers

    What is the primary concern of inorganic gases in industrial settings?

    <p>All of the above</p> Signup and view all the answers

    Which type of cancer is associated with coal exposure?

    <p>No known association</p> Signup and view all the answers

    What is a unique characteristic of TB transmission?

    <p>It can spread on suspended aerosol particles over longer distances</p> Signup and view all the answers

    What is the purpose of yearly and postexposure monitoring of employees for TB?

    <p>To prevent the spread of TB in health care settings</p> Signup and view all the answers

    What is the precautionary principle?

    <p>A principle that if the level of harm may be high, action should be taken to prevent or minimize that harm</p> Signup and view all the answers

    What is the significance of the precautionary principle in occupational health?

    <p>It relates to a broad range of decisions necessary to protect working populations whenever new and inadequately characterized hazards are introduced</p> Signup and view all the answers

    What is an example of an infection that may spread on suspended aerosol particles over longer distances?

    <p>Influenza</p> Signup and view all the answers

    What is the significance of enhanced systems for recognition of potentially infectious patients in health care settings?

    <p>It reduces the risk of transmission to health care workers</p> Signup and view all the answers

    What is a factor that may enhance opportunistic airborne spread of infections?

    <p>Favorable patterns of air movement</p> Signup and view all the answers

    What is the main source of ambient air pollution?

    <p>Human activity, particularly industrial and vehicular combustion</p> Signup and view all the answers

    What is the goal of National Ambient Air Quality Standards in the United States?

    <p>To protect the general public, including those predisposed to harm from air pollution</p> Signup and view all the answers

    What is the effect of fine particulate matter on the lungs?

    <p>Increases airway inflammation</p> Signup and view all the answers

    What is the purpose of systems designed to reduce indoor radon levels?

    <p>To establish a pressure gradient to reduce travel of radon into basements</p> Signup and view all the answers

    Which organization sets guidance for certain air pollutants?

    <p>World Health Organization</p> Signup and view all the answers

    What is the health outcome related to radon exposure in underground miners?

    <p>Lung cancer risk</p> Signup and view all the answers

    Which of the following groups is at increased risk of occupational infectious diseases due to frequent animal contact?

    <p>All of the above</p> Signup and view all the answers

    What is a particular risk for those who work in outdoor settings?

    <p>Diseases requiring an arthropod vector</p> Signup and view all the answers

    Which of the following is a risk for those who work in the developing world?

    <p>Malaria, typhoid, and dengue</p> Signup and view all the answers

    What is a potential physiologic effect of chronic exposure to stress in the workplace?

    <p>All of the above</p> Signup and view all the answers

    What is the key distinguishing characteristic of environmental hazards versus workplace hazards?

    <p>Environmental hazards may impact all age groups at all times</p> Signup and view all the answers

    What is a source of environmental radon exposure?

    <p>Uranium in rocks and soil</p> Signup and view all the answers

    What is a common route of environmental exposure to hazardous substances?

    <p>All of the above</p> Signup and view all the answers

    What is a potential health effect of radon exposure?

    <p>Cancer</p> Signup and view all the answers

    Which of the following is an example of an environmental hazard with pervasive and significant health impact?

    <p>Both A and B</p> Signup and view all the answers

    What is the primary mechanism of radon decay?

    <p>Release of an alpha particle</p> Signup and view all the answers

    Study Notes

    Physical Hazards

    • Acute traumatic injuries can occur in various workplaces, such as industrial accidents, motor vehicle crashes, falls, and trauma involving farming or mining equipment.
    • Establishing a causal link between workplace exposure and health outcome can be challenging for gradual traumas, such as repetitive strain injuries.
    • Examples of health conditions caused by gradual traumas include lumbar disc disease in nurses, carpal tunnel syndrome in clerical workers, and degenerative joint disease in materials handlers.

    Radiation

    • Radiation exposure is a widespread physical hazard, with occupations accounting for only a small portion of overall population exposures.
    • The largest occupational group monitored for radiation is health care workers, although most exposures do not exceed typical background levels.
    • Extremely high levels of radiation exposure can cause acute radiation sickness, with symptoms including skin sloughing, bone marrow damage, and gastrointestinal ulcers.
    • Survivors of very high acute radiation doses are at elevated risk of blood and solid-organ malignancies.

    Noise

    • Noise is a prevalent physical hazard in workplaces, with more than 10 million U.S. workers exposed to greater than 80 decibels.
    • By age 50, an estimated half of heavily exposed construction workers and 90% of heavily exposed miners will have hearing impairment.
    • Substantial noise exposure occurs in various industries, including manufacturing, mining, construction, and transportation.

    Heat and Cold

    • Thermal stress is a physical hazard in workplaces, with excessive heat exposure occurring in foundries, smelting operations, firefighting, and outdoor settings.
    • Health effects of heat exposure include lightheadedness, swelling, muscle cramping, and in severe cases, agitation, delirium, and kidney failure.
    • Cold exposure can cause hypothermia, frostbite, Raynaud's phenomenon, and cold-induced hives.

    Chemical Hazards

    • There are over 80,000 chemicals in common use, with many posing health risks to workers.
    • Solvents are widely used in industrial processes and can cause acute encephalopathic effects, skin irritation, and defatting of dermal tissue.
    • Certain solvents have uniquely toxic properties, such as n-hexane and methyl-n-butyl ketone, which can cause a mixed motor and sensory neuropathy.

    Metals and Mineral Dusts

    • Metal exposures can trigger a broad range of health effects, including behavioral and cognitive effects, anemia, peripheral neuropathy, and chronic encephalopathy.
    • Lead exposure is a significant risk to workers, particularly in construction, welding, and battery manufacturing.
    • Other metals, such as arsenic, mercury, and beryllium, can also cause a range of acute and chronic effects.

    Hydrocarbons and Pesticides

    • Polycyclic aromatic hydrocarbons (PAH) are a risk factor for lung cancer and have been linked to increased lung cancer risk in various industries.
    • Pesticides are a broad category of chemicals used to control insect, plant, and fungal species, and can cause acute and chronic health effects.
    • Exposure to pesticides can occur among farm and orchard workers, landscapers, and others.

    Inorganic Gases

    • Inorganic gases are a concern in industrial settings due to their acute toxicity and potential for long-term sequelae.
    • Simple asphyxiants, such as methane and nitrogen, can dilute oxygen in enclosed spaces, while cyanide and carbon monoxide interfere with cellular respiration and oxygen transport.

    Biologic Hazards

    • Occupational biologic hazards are encountered in health care workplaces, areas of contact with animals or arthropod vectors, and locations with exposure to altered ranges of diseases.

    • Blood-borne pathogens, such as HIV, HBV, and HCV, are a significant risk to health care workers, particularly through needlestick injuries.

    • Aerosol and droplet-spread infections, such as tuberculosis, measles, and influenza, can also be transmitted in health care settings.### CDC Recommendations for Health Care Workers

    • In the event of a rapidly spreading virus with a high risk to younger people, the CDC recommends the use of fit-tested N95 respirators for health care workers caring for affected patients.

    • This recommendation is based on the precautionary principle, which states that if the level of harm may be high, action should be taken to prevent or minimize that harm even when there is uncertainty about the likelihood of harm occurring.

    Occupational Infectious Diseases

    • Major groups at increased risk of occupational infectious diseases include:
      • Those with frequent animal contact (e.g., farmers, veterinarians, animal handlers)
      • Those likely to have contact with arthropod vectors (e.g., outdoor workers)
      • Those working in other than their native microbiologic milieu (e.g., workers in developing countries)
    • Examples of zoonotic diseases include:
      • Brucellosis
      • Cat-scratch disease
      • Leptospirosis
      • Plague
      • Psittacosis
      • Tularemia
      • Cryptococcosis
      • Histoplasmosis
      • Ringworm
      • Giardiasis
      • Cryptosporidiosis
      • Hantavirus
      • Monkeypox
      • Rabies
    • Diseases requiring an arthropod vector include:
      • West Nile virus
      • Rocky Mountain spotted fever
      • Lyme disease
      • Babesiosis
      • Ehrlichiosis
      • Several viral encephalitides

    Psychosocial Stress

    • Long hours, rotating work shifts, demanding jobs, limited decision latitude, competing time demands, repetitive tasks, threat of violence, job insecurity, and poor management contribute to stress in the workplace.
    • Chronic exposure to such work circumstances may have adverse physiologic effects, including:
      • Increased cardiovascular disease
      • Increased injury risk
      • Perception of poor health
    • The physiologic connection between stress and adverse health outcomes is not completely understood, but possible etiologic links include:
      • Elevated catecholamine levels
      • Abnormalities of the pituitary-adrenocortical axis
      • Effects on the immune system

    Environmental Hazards

    • Environmental hazards differ from workplace hazards in that they:
      • Affect all age groups at all times
      • Usually have lower exposure levels
    • Examples of environmental hazards include:
      • Water contamination from industrial effluents or toxic waste disposal
      • Soil contamination from fallout of fumes or particulates released into the air
      • Food contamination from compromised soils, water, or processing methods
      • Air pollution from industrial or natural sources

    Radon Exposure

    • Radon is a product of the radioactive breakdown of uranium and can become concentrated in indoor spaces.
    • Epidemiologic studies have shown that exposure to radon in the home may elevate lung cancer risk.
    • The U.S. Environmental Protection Agency (EPA) recommends retesting and mitigation of homes where basement radon levels exceed 4 pCi/L.
    • Radon mitigation systems work by establishing a pressure gradient to reduce travel of radon into basements from surrounding soil and rock.

    Ambient Air Pollution

    • Ambient air pollution is derived largely from human activity, particularly industrial and vehicular combustion.
    • Pollutants of major concern include:
      • Sulfur dioxide
      • Nitrogen oxides
      • Acid aerosols
      • Particulates
      • Volatile organic compounds
      • Lead
      • Ozone
    • Health outcomes linked to air pollution include:
      • Increased cardiopulmonary mortality
      • Increased numbers of visits to emergency departments and physician offices
      • Increased rates of hospitalization
      • Exacerbations of asthma
      • Higher frequency of respiratory infection
    • Laboratory studies have revealed that air pollution can increase airway inflammation, decrease lung function, and increase upper respiratory irritation.

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    This quiz covers the effects of different types of toxic gases, including simple asphyxiants, cyanide, carbon monoxide, and irritant gases like ammonia and sulfur dioxide.

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