Chapter 11: Risk, Toxicology, & Human Health

11-1: Risk, Probability, and Hazards The risk of a particular hazard causing damage to humans or the environment is expressed in terms of pro a ility! Calculating this pro a ility is an inexact science "here many varia les have to e considered! Risk management is the process of determining ho" serious a particular risk is and ho" to go a out #or not go a out$ reducing the risk or preparing for its aftereffects! Take ird flu for example! %ast year it "as determined that the virus had a out a 1 in 1,&&& chance of mutating into a deadly strain! ' mean, "hat do you do "ith that information( Ho" many resources do you allocate to dealing "ith the possi ility of this turning into a pandemic( Ho" a out Hurricane )atrina( *hat "as the pro a ility of a Class + hurricane striking do"nto"n ,e" -rleans( Ho" many resources should have een reserved for strengthening the flood protection( Ho" many for emergency response( 't.s such a tough call ecause people "ill complain if money is spent and the risk is never realized! /eople "ill also complain if the risk actually occurs and not enough "as done to deal "ith the situation! Risk hazards can e roken do"n into four categories: 1! 0! 1! 3! Cultural hazards: smoking, driving, crime, poverty, unsafe sex Chemical hazards: mostly synthetic chemicals in the air, "ater, food, etc! /hysical hazards: flood, tornado, earth2uake, hurricane, etc! 4iological hazards: pathogens #diseases$, allergens, and killer animals

11-2: Toxicology Toxicity is a measurement of exactly ho" harmful a su stance is! The toxicity of a su stance is heavily dependent on the dose, the num er of exposures, and the individual characteristics of the persons exposed! 5ome people are naturally going to e more sensitive to a toxin than others! Toxins that are "ater6solu le are often less harmful ecause they move through the ody 2uickly and can e eliminated through urination! 7at6solu le toxins on the other hand do not dissolve in "ater and are generally stored inside ody fat for a much longer period of time #THC "ould e an example for all you potheads out there$! 'n the environment, the persistence of the chemical is important to its risk! The longer it takes to reak do"n, the more chance of damaging exposure to humans or "ildlife! Bioaccumulation occurs "hen certain toxins tend to uild up in specific organs! 7or example, radioactive compounds collect in the thyroid, elevating the risk of cancer there! Biomagni ication occurs "hen a toxin uilds up in species in the upper trophic levels of a food "e ! /ersistent, fat6 solu le organic compounds are the est candidates for iomagnification! 88T is an example of a chemical that often ecomes iomagnified! 4ecause the chemical is stored in the ody and very slo" to meta olize, it gets sent right up the food chain! The 88T ends up collecting in the odies of the top predators and causing side effects like the "eak egg shells that affected ald eagles and ro"n pelicans ack in the days "hen 88T "as legal in the 9!5! Consult 7igure 1163 on page 011! :n acute effect is an immediate physical response to toxin exposure! ;xamples include rashes, s"elling, or something more severe like cardiac arrest! : c!ronic effect is a permanent or long6term response to toxin exposure! :n example "ould e permanent rain damage from eating leaded paint chips or emphysema from years of smoking! -ften chemicals have a synergistic reaction that can multiply the effects of each "hen com ined together in the ody! This is "hy there are drug6drug interaction "arnings on the prescription medication you take! T"o drugs taken separately may e fine, ut taken together they can have a totally different effect! : asic concept of toxicology is that every chemical has the potential to hazardous if the dose is high enough! ;ven something as enign as "ater can kill you if you drink too much! *ater poisoning #hyponatremia$ killed a lady in California a couple of months ago after a radio6station contest to see "ho could drink the most "ater "ithout peeing! College students die every year from alcohol poisoning and people sometimes commit suicide y taking huge amounts of over the counter medication! <any people have the mistaken idea that synthetic chemicals are inherently more dangerous than natural ones! This is not al"ays the case, as plenty of natural toxins are do"nright deadly!

Remem er the units used for chemical concentration: ppm, pp , and ppt! "#$% stands for median lethal dose, "hich is the amount of a chemical received in one dose that kills exactly +&= of the animals in a test population "ithin a 13 day period! 5ometimes the term "&$% is used instead, "hich stands for median lethal concentration! The legal definition of a poison is a chemical that has an %8+& of +& mg or less per kg of ody "eight! Chemicals are assigned toxicity ratings ased on their %8+&, ranging from supertoxic #dead in one drop$ to essentially nontoxic #you.d have to drink a lot$ 5upertoxic ;xtremely toxic ?ery toxic Toxic <oderately toxic 5lightly toxic less than 1 drop less than > drops > drops to 1 tsp! 1 tsp! to 1 oz! 1 oz! to 1 pint 1 pint to 1 2uart nerve gas, dioxin, mushrooms cyanide, heroin, nicotine morphine, codeine 88T, sulfuric acid, caffeine speed, kerosene, aspirin alcohol, %ysol, soap "ater, sugar

;ssentially nontoxic more than 1 2uart

'pidemiology is the study of the patterns of disease or toxin exposure! 't is difficult to figure out the exact toxic doses of chemicals for humans ecause o viously can.t really run planned control experiments! @ou can use natural events to compare groups, such as comparing various health pro lems of those exposed to Cherno yl.s radiation, vs! those "ho "eren.t! 'nformation can also e gleaned from case studies such as accidental poisonings, suicide attempts, and murders, ut in many cases it is impossi le to tell exactly "hat the original dose "as and so exact toxicities are difficult to esta lish! Toxicity tests can e run on la animals to esta lish a dose6response curve, "hich is a graph that sho"s the effects of a toxin at increasing doses! High doses are used to elicit acute responses and the effects of lo" doses are usually extrapolated from the collected data! Chronic responses are rarely if ever tested A remem er the same issue came up regarding pesticide safety! : nont!res!old dose-response cur(e is one "here the acute effects occur at asically any dosage and continue to gro" as the dose is increased! : t!res!old dose-response cur(e is one "here acute effects do not egin to manifest until a certain dose is reached! 'n other "ords, small doses are harmless #not taking potential chronic effects into account$! To account for the uncertainty of these models, actual safety regulations for toxic chemicals are usually set at 1B1&& or 1B1,&&& the experimental figure to e on the safe side! 11-): &!emical Hazards : mutagen is an agent that causes random mutations in the 8,: of an organism.s cells! Radiation is the most common mutagen, although some chemicals can also cause mutations! *hen mutations occur in a sperm or egg cell, the mutation can e passed do"n to the next generation #and possi ly ecome permanent$! 5ickle6cell anemia, cystic fi rosis, and hemophilia are common genetic disorders caused y mutations! : teratogen is an agent that causes irth defects, especially "hen a pregnant "oman is exposed "ithin the first three months of her pregnancy! <ercury and lead are notorious teratogens, as "ell as alcohol #fetal alcohol syndrome$! Thalidomide is a famous teratogen that "as marketed from 1C+>61CD1 as a sleep aid and cure for morning sickness for pregnant "oman! 9nfortunately it caused a out 1&,&&& irth defectsE the trademark irth defect of thalidomide exposure "as a ies orn "ithout the long ones in their arms or legs, causing their extremities to appear like little flippers! : carcinogen is an agent that causes a cancerous tumor to form! Cancer can e caused y exposure to various chemicals, radiation, or viruses! ,ot all cancers are environmentalE many are congenital! <alignant cancerous tumors "ill metastasize, or spread to other areas of the ody, "hich makes treatment much more difficult!

Common carcinogen categories include: Cigarettes #1&63&= of cancers$ 8iet #0&61&=$ -ccupational exposure #+61+=$ ;nvironmental pollutants #161&=$

Carcinogens often have a time6lag effect, meaning that the actual occurrence of the cancer may not manifest until many years after the carcinogen exposure! The three systems of the human ody most often affected y toxic chemical exposure are the immune, nervous, and endocrine! The endocrine system is a net"ork of glands that emit hormones "hich control sexual reproduction, gro"th, developmental timing and ehavior! Certain chemicals, kno"n as hormonally active agents #H::s$ mimic the action of naturally occurring hormones and disrupt the functioning of the endocrine system! /ossi le effects of H::s include accelerated pu erty, especially in females, and lo" sperm counts in men! 7or an expanded #terrifying$ list, consult page 01+$! 11-*: Biological Hazards: #isease in #e(eloped and #e(eloping &ountries +ontransmissible diseases are those that cannot e passed directly from person to person, such as heart disease, cancer, dia etes, etc! They.re not contagious! Transmissible diseases are those that can e passed on from one person to another! : pat!ogen is the infectious agent that causes the disease! The most common pathogens are viruses and acteria, although some protists and parasitic animals also 2ualify! Remem er that acteria can e killed "ith anti iotics, "hile viruses cannot! Remem er also that natural selection y the pathogenic acteria against the anti iotics is making these acterial diseases harder and harder to treat! The (ector is the means y "hich the pathogen is spread! Common vectors include air, "ater, food, lood, and insects! :s a country gains "ealth it makes the epidemiological transition! The num er of deaths from transmissi le diseases declines "hile the num er of deaths from nontransmissi le diseases rises! ' mean, people gotta go one "ay or the other, right( 31= of all deaths in developing countries are from transmissi le diseases, compared to only 1= of deaths in developed countries! The "orld.s > deadliest infectious diseases are: 1! 0! 1! 3! +! D! >! ,cute respiratory in ections, mostly pneumonia and flu #1!C million deaths per year$ ,-#. #:c2uired 'mmune 8eficiency 5yndrome$ #1 million$ #iarr!eal diseases #0!1 million$ Tuberculosis #T4$ #1!D million$ /alaria #1!1 million$ Hepatitis B #1 million$ /easles #F&&,&&&$

+e0 viruses emerge all the time! ; ola and *est ,ile are a couple of examples! ; ola is too po"erful to spread very farE it incapacitates and kills people too 2uickly for it to spread properly! The most dangerous viral health threat, though, "ould e a mutated form of the lu! 't is highly contagious and air orne! 8uring the "inter of 1C1F61C1C, a mutated form of the flu #5panish flu$ infected half the "orld and killed 0&6 1& million people! 't "as also a little unusual in that it killed other"ise healthy adults, not Gust children and old folks like the typical flu! -nce you get the flu there.s little a doctor can do for youE it.s up to your ody.s immune system to fight it off! 5o that.s a little scary! .T#s are out there! :ccording to the author of the ook, 01= of :mericans are "alking around "ith an 5T8! 'f they.re sho"ing ?altrex commercials on T?, ' guess ' elieve that! '.d also hazard a guess that the figure is higher than 01= in good old 5outh Carolina! ' think ' read some"here that 5!C! is a syphilis or gonorrhea hot ed! -ne or the other!

-f course H-1 is the ig daddy! H'? "asn.t even named until 1CF1, right around the time "hen Henny Iump died! 5ince that time a out 1& million have died, "ith another >& million expected to perish "ithin the next 0& years! Currently around 3&6+& million people are carrying the virus inside their ody! 'n many su 65aharan :frican countries, et"een 0&63&= of adults are infected "ith H'?! The average life spans in these countries have dropped 1&61& years since 1CF&! :lthough :frica is currently the epicenter of :'85, 'ndia and 5outheast :sia are expected to experience a maGor H'? influx "ithin the next t"o decades! 1accines are the ultimate ans"er to effectively com at viral pathogens! /revious monsters like smallpox and polio have een virtually "iped out through vigilant vaccination programs! <easles and hepatitis 4 have een kept under control, at least in developed countries! 7lu shots are common! The faster a virus mutates, the harder it is to develop an effective vaccine! 5mallpox mutates very slo"ly, so it didn.t have a chance to change efore everyone in the "orld "as immune! H'?, on the other hand, changes frantically, so y the time a vaccine "as developed and spread, it "ould already have changed! TB is a lung disease caused y air orne acteria! 4efore anti iotics "ere developed it "as a maGor killer glo ally! 't "as on the decline for decades until 1CC&, "hen rates egan to rise! : out 1 in 1 people in the "orld carry the T4 acteria in their lungs! 7or most people this is not a ig deal, as the T4 only goes active a out +61&= of the time, usually "hen the immune system is under stress from other issues! :ctive cases usually occur in association "ith malnutrition from poverty or :'85! <ulti6drug strains are evolving all the time and pose a huge threat due to their extreme difficulty to kill "ithout harming the patient! /alaria is a disease that occurs in tropical and su tropical countries! <alaria is caused y a protist that lives inside tropical mos2uitoes! 't is transmitted "hen a mos2uito ites an infected person and then ites an uninfected person, transferring the protist to the ne" host! The malarial protist affects the liver and red lood cells, causing symptoms such as fever, chills, anemia, a dominal pain, and headaches! 't is highly, highly recommended that you take a malaria vaccine efore visiting a tropical country! ;ven though the disease is treata le #"ith 2uinine$ "ith modern medicine and you pro a ly "ouldn.t die, you still don.t "ant it! 'n the 1C+&.s and 1CD&.s malaria rates dropped dramatically due to "idespread s"amp drainage, aggressive 88T spraying programs, and the spread of improved drugs to developing countries! 9nfortunately, since the 1C>&.s malaria rates are ack up, ecause the mos2uitoes are ecoming resistant to the pesticides and the protists are ecoming resistant to the ne" drugs! 7actors that may influence infectious diseases in the future: 'ncreased international air travel makes it easy for a disease to travel half "ay around the "orld in one day! 9r anization makes it easier for diseases to e spread! Ilo al "arming may allo" the insects that carry diseases in tropical areas to survive in temperate areas!

' "as attacked y a s"arm of :sian tiger mos2uitoes at ;disto 4each a out + years ago! @ou do not "ant any piece of them! ' feared for my life and hid inside the house! 11-$: Risk ,nalysis : lot of 116+ is a unch of la Take the perceived risk 2uiz! <ost people do relatively poorly in assessing the relative risks from the hazards that surround us! Here.s a list of factors "hich can alter someone.s a ility to assess the true danger of an environmental hazard! 1! 0! 1! 3! 'f something is ne" or hard to understand, it is Gudged as eing more harmful than something familiar or simple! ;x: nuclear vs! coal po"er plants! 'f an action is perceived as involuntary, the perceived risk is higher than if the action is voluntary! ;x: food additives vs! smoking! 'f an action is perceived as eing necessary the risk is Gudged to e lo"er than if it is unnecessary! ;x: driving! 'f an action involves large or "ell6pu licized death tolls it is perceived to e more dangerous! ;x: plane crash, shark attack, or sting ray ar #J$ vs! lung cancer or dia etes! ety6 loo ut there are some decent nuggets to take out of there!

9ncommon deaths are overpu licized y the media and often cause unnecessary fear of the risk y the pu lic! 7or further examination of the role of the media in the rain"ashing of the :merican pu lic, see the excellent independent film KThe ;nd of 7rankL #0&&D$, availa le at a fine retailer near you!