ENVIRONMENTAL HEALTH FROM GLOBAL TO LOCAL 3RD EDITION BY HOWARD FRUMKIN TEST BANK by QuentinAxel

TEST BANK Environmental Health: From Global to Local 3rd Edition by Howard Frumkin

TABLE OF CONTENTS: Chapter 1 Introduction to Environmental Health Chapter 2 Ecology and Ecosystems as Foundational for Health Chapter 3 Sustainability and Health Chapter 4 Environmental and Occupational Epidemiology Chapter 5 Geospatial Data for Environmental Health Chapter 6 Toxicology Chapter 7 Genes, Genomics, and Environmental Health Chapter 8 Exposure Science, Industrial Hygiene, and Exposure Assessment Chapter 9 Environmental Psychology Chapter 10 Environmental Health Ethics Chapter 11 Environmental Justice and Vulnerable Populations Chapter 12 Climate Change and Human Health Chapter 13 Air Pollution Chapter 14 Energy and Human Health Chapter 15 Healthy Communities Chapter 16 Water and Health Chapter 17 Solid and Hazardous Waste

Chapter 18 Pest Control and Pesticides Chapter 19 Food Systems, the Environment, and Public Health Chapter 20 Buildings and Health Chapter 21 Work, Health, and Well-Being Chapter 22 Radiation Chapter 23 Injuries Chapter 24 Environmental Disasters Chapter 25 Nature Contact Chapter 26 Environmental Public Health: From Theory to Practice Chapter 27 Risk Assessment in Environmental Health Chapter 28 Communicating Environmental Health

Chapter 1 test questions 1.

In ancient times, our ancestors confronted which of the following environmental health challenges: a. b. c. d. e.

With the development of industrialization and urbanization in the 17th through 19th centuries, which of the following most contributed to heightened public health threats? a. b. c. d. e.

Urban mass transit Crowding and substandard housing in cities Mass production of industrial products The development toxic pesticides Bubonic plague

In the first half of the 20th century in the U.S., infant mortality and total mortality fell dramatically, and life expectancy rose. Which intervention accounted for the largest part of these gains? a. b. c. d. e.

Food sanitation Water sanitation Human waste management Solid waste management All of the above

Antibiotics Improved literacy The defeat of Jim Crow laws Improved surgical techniques Improved potable water supplies

John Snow, a seminal figure in the history of public health, made his mark by: a. b. c. d.

Conducting the first analysis of vital statistics in England Identifying workplace hazards in a rapidly industrializing England Identifying contaminated water as the cause of a cholera outbreak in London Proposing postulates, or requirements, that establish a causal connection between a microorganism and human disease e. Campaigning against unsafe housing in the tenements of London 5.

Which of the following environmental health disasters does NOT correctly identify the toxic exposure? a. Minamata Bay, Japan - mercury b. Bhopal, India – isocyanates c. Woburn, Massachusetts – organic chemicals in drinking water

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d. Donora, Pennsylvania – severe air pollution e. Love Canal, New York – contaminate fish from the Great Lakes 6.

Which of the following represents a unique, defining feature of environmental justice? a. b. c. d. e.

A focus on land conservation A focus on environmental exposures of vulnerable populations such as racial minorities A focus on the enforcement of environmental laws A focus on ecosystem functioning A focus on public-private partnerships to improve environmental health

Which of the following statements is NOT an accurate reflection of upstream thinking in environmental health? a. b. c. d.

Water treatment plants are generally placed upstream from sources of drinking water. The root causes of disease may operate at a location far from the affected population. The root causes of disease may operate long before the disease appears. The root causes of disease may operate outside the health sector, say, in the energy or food sectors. e. Complex systems thinking is often necessary to understand fully the risks a population faces.

Key: 1. 2. 3. 4. 5. 6. 7.

E B E C E B A

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Frumkin 3rd Ed. - Test Bank Items Chapter 2 1 Chapter 2 Ecology and Ecosystems as Foundational for Health Test Bank Questions 1. The word ecology comes from the Greek word oikos meaning a. b. c. d.

Planet Earth The interconnected web of life Home, place to live The study of living organisms

2. Hierarchy and scale are important constructs in ecology. Which of the following phrases correctly describes the relationship between a particular level of scale and a related discipline and its focal area? a. b. c. d.

Cells, anatomy, behavior Communities, community ecology, evolution Tissues/organs, morphology, infection None of the above

3. Understanding food webs is important for environmental health in particular because a. b. c. d.

Humans can be consumed by predators at the top of the food chain Decomposers can be sources of infectious disease in human populations Persistent pollutants can bioaccumulate or biomagnify up the food web Humans need food to survive

4. Examples of factors that limit population growth include all except a. b. c. d.

Competition for resources Predation Activities of decomposing microorganisms Activities of parasitic organisms

5. The field of Conservation Biology seeks to prevent species extinction, which becomes irreversible when a. The death rate for all populations of that species exceeds the birth rate b. The birth rate for all populations of that species exceeds the death rate c. The birth rate and death rate for all populations of that species are approximately equal 6. Air and water quality, climate, erosion, disease transmission, pest proliferation, and pollination are all examples of which category of ecosystem services, defined by the Millenium Ecosystem Assessment

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Frumkin 3rd Ed. - Test Bank Items Chapter 2 2

a. b. c. d.

Provisioning Regulating Cultural Supporting

7. Which of the following is not a feature of complex systems a. b. c. d.

Lack of boundaries Feedback loops Resilience Unpredictability

8. Complex systems exhibit emergent properties, which refers to a. b. c. d.

Properties requiring urgent attention to prevent extinction of a population Properties essential to support human health Properties requiring a reductionist approach to study Properties that can only be observed when parts of the system are interacting with each other

9. Critical ecosystem functions supporting human health include all except a. b. c. d.

Soil formation Phosphorous cycling PCB cycling Water cycling

10. Which of the following is an example how humans indirectly drive environmental change a. b. c. d.

Consumption choices Harvest and resource consumption Both of the above None of the above

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Frumkin 3rd Ed. - Test Bank Items Chapter 2 3 Answer Key Chapter 2 1. c 2. d 3. c 4. c 5. a 6. b 7. a 8. d 9. c 10. a

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Frumkin 3rd Ed. - Test Bank Items Chapter 3 1 Chapter 3 Sustainability and Health Test Bank Questions 1. The current geological era is described informally as the Anthropocene, a time of human a. b. c. d.

Ingenuity and creativity Alteration of fundamental Earth processes Population decline Colonization of other planets

2. All of the following grew exponentially during the Great Acceleration except a. b. c. d.

Biodiversity Atmospheric reactive nitrogen Atmospheric carbon dioxide Water use

3. Which international document was the first to popularize the concept of sustainable development? a. b. c. d.

The Stockholm Declaration (1972) IUCN’s World Conservation Strategy (1980) The Brundtland Report Our Common Future (1987) The Rio Declaration on Environment and Development (1992)

4. A simple equation for humans’ impact (I) on Earth’s systems is I = PAT (Erlich and Holdren 1971). The A in this equation represents a. b. c. d.

Anthropogenic influences Apathy Affluence Afforestation

5. The average current global ecological footprint has been estimated at 2.6 global hectares per person (Borucke et al. 2013). This is approximately [select the appropriate term below] what is estimated to be available. a. b. c. d.

Ten percent of Two thirds more than Ten times more than None of the above

6. Of the seven planetary boundaries quantified by Rockström et al. (2009), which three have already been crossed

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Frumkin 3rd Ed. - Test Bank Items Chapter 3 2

a. b. c. d.

Climate change, ocean acidification, global freshwater use Climate change, stratospheric ozone depletion, biodiversity loss Climate change, global freshwater use, biodiversity loss Climate change, nitrogen cycle, biodiversity loss

7. A paradox of sustainability is that a. Sustainable economic growth requires higher birth rates b. Global environmental problems must be addressed with local responses c. Residents of wealthy countries have lower carbon footprints than residents of less affluent countries d. None of the above 8. All of the following are considered sustainability metrics except a. b. c. d.

Consumer price index City development index Human development index Genuine progress indicator

9. Neo-sustainability emphasizes which three rules a. b. c. d.

Human health, environmental primacy, systems approach Human health, limits to growth, systems approach Human health, limits to growth, environmental primacy None of the above

10. Which of the following is not an example of what sustainability in health care might look like? a. b. c. d.

Supporting local agriculture through food purchasing policies Promoting community resilience through emergency planning Reducing/reusing/recycling materials and chemicals Encouraging patients to bring their own healthy food from home during hospital stays

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Frumkin 3rd Ed. - Test Bank Items Chapter 3 3 Answer Key Chapter 3 1. b 2. a 3. c 4. c 5. a 6. d 7. b 8. a 9. d 10. d

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Frumkin 3rd Ed. - Test Bank Items Chapter 4 1 Chapter 4 Environmental and Occupational Epidemiology Test Bank Questions 1. Of Hill’s (1965) 9 criteria used to evaluate whether a particular exposure causes a particular disease, which is absolutely required for a causal hypothesis to be plausible a. b. c. d.

Proper temporal relationship Consistency Large effect size Positive dose-response relationship

2. What is the main reason why randomized clinical trials, the gold standard for evidence in medicine, are not commonly used in environmental and occupational epidemiology a. They are very expensive so can generally only be conducted by large hospitals and health care systems b. It is impossible to randomize study participants since the exposed group knows they were exposed c. It would be unethical to randomize participants into exposed and unexposed groups d. Environmental and occupational exposures generally take place outside a clinical setting 3. Of the different epidemiological study designs, the ecological design is considered the weakest because a. It makes speculative inferences about the links between ecosystems and human populations b. Very large sample sizes are needed to detect exposure-disease correlations in human populations c. Across a population, individuals with risk factors are not necessarily the same individuals who contract the disease d. None of the above 4. In a cohort study, epidemiologists usually begin with an exposed group, then assemble a nonexposed group for comparison. This approach is good for a. b. c. d.

Rare exposures and rare diseases Rare exposures and common diseases Common exposures and rare diseases All of the above

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Frumkin 3rd Ed. - Test Bank Items Chapter 4 2 5. A case-control study, if properly designed, should provide the same answer about the exposure-disease relationship as a cohort study, however case-control studies are generally more vulnerable to all but which of the following challenges a. b. c. d.

Recall bias Difficulty measuring past exposures Difficulties in rare disease diagnosis Difficulties in choosing representative cases and controls

6. A cross-sectional study, if properly designed, should provide results that can be confirmed by cohort or case-control studies, however cross-sectional studies generally face the following major challenge (pick one) a. b. c. d.

Recall bias Difficulty measuring past exposures Difficulties in choosing representative cases and controls None of the above

7. Confounding can bias results of epidemiological studies. Which of the following is true about confounders in environmental and occupational health studies a. b. c. d.

A confounder must be associated with the exposure A confounder must be associated with the disease A confounder must be associated with both the exposure and the disease Confounding is another term for effect modification

8. Exposure mismeasurement or misclassification can also bias results of epidemiological studies. Which of the following is true about exposure misclassification/ mismeasurement a. b. c. d.

If it is nondifferential, it usually biases results away from the null hypothesis If it is differential, it biases results toward the null hypothesis It is a common problem of case-control studies It is a common problem of prospective cohort studies

9. Epidemiologists generally prefer confidence intervals over p values as a measure of precision because a. b. c. d.

Confidence intervals do not depend on sample size p values are vulnerable to random error A range of plausible values is more informative than a single p value All of the above

10. Environmental disease clusters are often difficult to confirm because

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Frumkin 3rd Ed. - Test Bank Items Chapter 4 3 a. Determining temporal and geographic boundaries is difficult b. Small numbers of cases mean low statistical power c. The disease of concern may be a broad category with different sub-types, which have different causes d. All of the above

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Frumkin 3rd Ed. - Test Bank Items Chapter 4 4 Answer Key Chapter 4 1. a 2. c 3. c 4. b 5. c 6. d 7. c 8. c 9. c 10.d

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Frumkin 3rd Ed. - Test Bank Items Chapter 5 1 Chapter 5 Geospatial Data for Environmental Health Test Bank Questions 1. Consideration of spatial scale is important because the spatial extent of an exposure may in turn define the spatial extent of _______ and potential ______ a. b. c. d.

Exposure, risk Exposure, health impacts Health impacts, interventions Interventions, health impacts

2. An attribute is a component of georeferenced data that is best described as a. b. c. d.

The color and size of a map feature The shape of a map feature A measurement’s geographic location A measurement taken at a given location

3. Buffering is a basic GIS operation which involves a. b. c. d.

Adjusting the pH of a map feature Downloading streamed geographic data before plotting a map Linking two or more databases by their underlying geography None of the above

4. Which best describes the following sentence, “Mapping is usually more useful for ambient exposures than overall personal exposure” a. b. c. d.

The first half of the sentence is generally true, while the second half is not The first half of the sentence is generally false, while the second half is true Both halves of the sentence are generally true Both halves of the sentence are generally false

5. Distance decay weights and kriging are both methods of a. b. c. d.

Layering Buffering Spatial queries Spatial interpolation

6. Even though spatial proximity rarely provides an accurate surrogate for measured exposure values, the ____________ may be sufficient for exploratory analyses. a. Interpolated values

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Frumkin 3rd Ed. - Test Bank Items Chapter 5 2 b. Relative ranking c. Participant addresses d. Kriged data 7. Increasing geographic resolution in maps of disease risk can ____ statistical power and _____ precision a. b. c. d.

Increase, improve Increase, reduce Decrease, improve Decrease, reduce

8. Spatial analysis of local disease risk involves investigating whether or not local rates are higher or lower than expected based on demographic characteristics; methods for assessing potential clusters of high risk are _______ part of standard biostatistics training or software. a. b. c. d.

always usually sometimes rarely

9. Some of the familiar assumptions in biostatistics are not valid with spatial data. For example, biostatistics methods typically assume nearby observations are _____ while they are often ____. a. b. c. d.

Correlated, independent Independent, correlated Unweighted, weighted Weighted, unweighted

10. Most GIS studies are observational rather than experimental so _______, ________, and ______ must be considered when interpreting results a. b. c. d.

Bias, confounding, effect modification Scale, resolution, projection Location, correlation, demographics None of the above

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Frumkin 3rd Ed. - Test Bank Items Chapter 5 3 Answer Key Chapter 5 1. c 2. d 3. c 4. c 5. d 6. b 7. d 8. d 9. b 10. a

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Frumkin 3rd Ed. - Test Bank Items Chapter 6 1 Chapter 6 Toxicology Test Bank Questions 1. Paracelcus (Philippus Aureolus Theophrastus Bombastus von Hohenheim) was the first to articulate the foundational principle of toxicology, that the _____ makes the ______ a. b. c. d.

Poison, disease Dose, poison Poison, toxin Toxicant, poison

2. All of the following except which are examples of different levels at which toxicity can occur in humans a. b. c. d.

Molecule Cell Organ Ecosystem

3. The dose-response relationship for a particular compound may be influenced by exposure route. All of the following are major routes through which adults may be exposed to chemicals except a. b. c. d.

Inhalation Dermal exposure Cellular absorption Ingestion

4. Since no chemical is completely free of adverse effects, given the right dose and conditions, which of the following statements is most likely to be true a. b. c. d.

Natural products are safer than synthetic products Natural products are usually safer than synthetic products Natural products are usually less safe than synthetic products None of the above

5. In general, toxicants are classified by a. b. c. d.

Chemical class, exposure source, or target organ Exposure source, exposure route, or health effect Chemical class, exposure route, or health effect Exposure source, dose-response, or health effect

6. Of the four key steps in toxicokinetics, metabolism involves

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Frumkin 3rd Ed. - Test Bank Items Chapter 6 2

a. b. c. d.

Chemicals gaining access to the inside of the body Chemicals moving within the body to various organs Chemical processing to facilitate elimination Elimination from the body via urine, feces, exhaled breath

7. Which of the following most accurately illustrates a way in which a compound’s solubility influences its absorption into the body a. b. c. d.

Polar, hydrophilic molecules can easily cross lipid barriers (e.g., skin) Polar, hydrophobic molecules can easily cross lipid barriers (e.g., skin) Non-polar, hydrophilic molecules can easily cross lipid barriers (e.g., skin) Non-polar, hydrophobic molecules can easily cross lipid barriers (e.g., skin)

8. Toxicants generally follow the laws of ________, moving from areas of high concentration to areas of lower concentration a. b. c. d.

Toxicokinetics Thermodynamics Osmolality None of the above

9. Of the four main categories of biotransformation reactions, which is considered a phase II reaction a. b. c. d.

Oxidation Reduction Conjugation Hydrolysis

10. Which part of the dose-response curve is used by the U.S. Environmental Protection Agency to determine a reference dose for a particular chemical a. b. c. d.

The origin The NOAEL Where the curve passes through the y-axis The slope of the curve in the high dose range

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Frumkin 3rd Ed. - Test Bank Items Chapter 6 3 Answer Key Chapter 6 1. b 2. d 3. c 4. d 5. a 6. c 7. d 8. d 9. c 10. b

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Frumkin 3rd Ed. - Test Bank Items Chapter 7 1 Chapter 7 Genes, Genomics, and Environmental Health Test Bank Questions 1. There are approximately ______ genes in the human genome a. b. c. d.

23 46 24,000 3 billion

2. _______ and _______, in that order, are processes through which genetic code in DNA is used to synthesize a protein in a cell a. b. c. d.

Translation, transcription Transcription, translation Coding, translation Coding, transcription

3. Of the following types of genetic variability in humans, which is the most common a. b. c. d.

Single nucleotide polymorphisms Copy number variations Deletion polymorphisms Disease-causing mutations

4. Environmental chemicals that either activate the estrogen receptor or block estrogen from binding to the receptor are referred to as a. b. c. d.

Phenotypes Transcription factors Ligand-activated nuclear transcription factors Endocrine disruptors

5. The epigenome responds dynamically to a. b. c. d.

Food Stress Toxicants All of the above

6. The fetal origins of adult disease hypothesis asserts that early developmental exposures involve _______ that influence disease susceptibility as an adult

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Frumkin 3rd Ed. - Test Bank Items Chapter 7 2 a. b. c. d.

DNA mutations Epigenetic mutations DNA modifications Epigenetic modifications

7. In a set of observed differences between variables, a certain percentage of the differences will be statistically significant due to random chance (false discoveries); the larger the set, the greater the number of false discoveries. This is referred to as the ________ problem in biostatistics. a. b. c. d.

Multiple comparisons Multiple regression Regression to the mean Error rate

8. An important difference between candidate gene studies and genome-wide association studies (GWAS) is that a. Candidate gene studies have higher false discovery rates b. Candidate gene studies begin with a specific hypothesis, while GWAS studies might not c. GWAS studies have a much larger sample size d. Candidate gene studies require a diseased and a non-diseased group while GWAS studies do not 9. People with the ALDH2*2 polymorphism become flushed and experience hangover-like symptoms after drinking alcohol. This is an example of a ______ a. b. c. d.

Pharmacogenetic response Gene-environment interaction Disease gene DNA methylation reaction

10. 75-97% of beryllium-exposed workers who develop ________have a common HLA-DPB1 gene variant versus 30-45% of beryllium exposed workers who do not develop the disease a. b. c. d.

Lung cancer Beryllium disease Chronic berylliosis Asthma

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Frumkin 3rd Ed. - Test Bank Items Chapter 7 3 Answer Key Chapter 7 1. c 2. b 3. a 4. d 5. d 6. d 7. a 8. b 9. b 10. c

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Frumkin 3rd Ed. - Test Bank Items Chapter 8 1 Chapter 8 Exposure Science, Industrial Hygiene, and Exposure Assessment 1. In research (in contrast to public health practice) quantifying harmful agent exposures is important for a. b. c. d.

Assessing potential problems Directing preventive efforts Checking compliance with regulations Quantifying associations between exposures and health outcomes

2. Which of the four steps of the industrial hygiene paradigm is typically performed by industrial hygienists but not exposure scientists a. b. c. d.

Anticipation Recognition Evaluation Control

3. The recognition phase is usually accomplished during a ________________ a. b. c. d.

Document review Permit inspection Walk-through Sample collection

4. All of the following are population sampling strategies used in exposure assessment except a. b. c. d.

Convenience sampling Stratified sampling Best-case sampling Worst-case sampling

5. Passive air sampling devices use ________ to draw air across an absorbing medium a. b. c. d.

Electric pumps Friction Ventilation Diffusion

6. Which of the following workplace hazard control approaches is the least preferable a. Substitution b. Isolation

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Frumkin 3rd Ed. - Test Bank Items Chapter 8 2 c. Administrative controls d. PPE (personal protective equipment) 7. Exposure refers to the mass of a contaminant that ______ a tissue barrier, while dose refers to the mass of a contaminant that _____ a tissue barrier a. b. c. d.

Contacts, harms Contacts, crosses Adsorbs to, harms Harms, crosses

8. All of the following are principal routes of contaminant exposure for humans except a. b. c. d.

Injection Inhalation Ingestion Dermal exposure

9. Which of the following methods is considered the gold standard for exposure assessment a. b. c. d.

Time-location studies Environmental measurements Personal exposure measurements Biomarker measurements

10. Assessing aggregate exposure to a series of compounds with the same biological mechanism is called ________ exposure assessment a. b. c. d.

Aggregate Indirect Personal Cumulative

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Frumkin 3rd Ed. - Test Bank Items Chapter 8 3 Answer Key Chapter 8 1. d 2. d 3. c 4. c 5. d 6. d 7. b 8. a 9. d 10. d

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Frumkin 3rd Ed. - Test Bank Items Chapter 9 1 Chapter 9 Environmental Psychology 1. Environmental psychology emerged in the 1960s out of the field of _______ a. b. c. d.

Environmental health Urban planning Family medicine Social psychology

2. While the more traditional biomedical perspective of toxicology is to focus on a singular physiological outcome, environmental psychology is concerned with a broad set of outcomes including all of the following except a. b. c. d.

Stress Cause of death Mental health Social interaction

3. All of the following are examples of how physical layout can promote social capital except a. b. c. d.

Well-designed social spaces Low traffic congestion Free health clinics Elements inhibiting criminal behavior

4. All of the following are Newman’s (1972, 1996) principles of defensible space except a. b. c. d.

Encourage firearm ownership by homeowners Limit the scale of buildings to three to five floors Increase visual surveillance Use environmental design elements to create continuum of spaces

5. In a number of research studies, ______ has been shown to affect auditory discrimination and reading acquisition in children a. b. c. d.

Poor quality housing High sugar diet Noise Broken windows

6. To date, research studies have shown that all of the following changes to the physical environment encourage healthy behaviors except

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Frumkin 3rd Ed. - Test Bank Items Chapter 9 2 a. b. c. d.

Larger workplace parking lots Green outdoor childcare play areas Increased supermarket availability Increasing convenience, attractiveness, and normativeness of fruits and vegetables in school cafeterias

7. Psychology-based strategies that have shown to be successful in promoting proenvironment behaviors include all of the following except a. b. c. d.

Public humiliation Goal setting and commitments Altering environmental cues Increasing convenience

8. Including a comparison of your household’s monthly electricity use with that of your neighbors on your electricity bill is an example of the use of _______to promote proenvironment behavior a. b. c. d.

Social shaming Social comparison Social psychology Social control

9. Eyestrain at work, falls in older adults, and seasonal affective disorder are all examples of how _____ affects health a. b. c. d.

Diet Physical activity Light Color

10. All of the following decreased after the creation of mini-neighborhoods in the crimeridden Five Oaks neighborhood of Dayton, Ohio except a. b. c. d.

Violent crime Robberies Traffic accidents Housing values

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Frumkin 3rd Ed. - Test Bank Items Chapter 9 3 Answer Key Chapter 9 1. d 2. b 3. c 4. a 5. c 6. a 7. a 8. b 9. c 10. d

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Frumkin 3rd Ed. - Test Bank Items Chapter 10 1 Chapter 10 Environmental Health Ethics 1. In professional life, ethics is a _________ process of deciding what we ought to do or not do a. b. c. d.

Informal Normative Realistic Optimistic

2. Utilitarianism is a modern ethics approach which asserts that the right act is that which maximizes the likely balance of ______ over _______ a. b. c. d.

Health, disease Personal choice, group preferences Good, evil Happiness, unhappiness

3. Scientific integrity, _______, and welfare are three modern ethics principles essential to environmental health a. b. c. d.

Morality Justice Bioethics Realism

4. The Global Burden of Disease Project, which gathers data on health and environment, and compares the amount of misery caused by a key list of health conditions, is an example of which modern ethics principle in practice a. b. c. d.

Scientific integrity Realism Welfare Bioethics

5. What does it mean to be a professional? Members of professions do all of the following except a. Provide a socially valued service b. Possess a high degree of dependence on the job and are closely supervised by others c. Have a skill or craft that if incompetently conducted would be harmful d. Cooperate with members of other disciplines and organizations toward common goals

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Frumkin 3rd Ed. - Test Bank Items Chapter 10 2

6. All of the following are examples of typical elements in professional codes of ethics except a. b. c. d.

Obedience to a common moral law Assurance of high levels of competence Protection of confidentiality Disclosures of conflicts of interest

7. Because scientists and academics need to maintain their _____, and their reputation for it, they are cautious in making claims about the implications of data for behavior and policy a. b. c. d.

Competence Confidentiality Objectivity Transparency

8. The timeframe of environmental health has expanded to address _______ consequences of present practices a. b. c. d.

Multigenerational Unjust Unethical Intercultural

9. Uncertainty about the future leads to ________ expectations; not ______the future in planning might be the appropriate public health approach a. b. c. d.

Unrealistic, excluding Realistic, excluding Discounted, discounting Lowered, including

10. A unique ethical challenge posed by climate change is that, at current (2015-2020) rates of warming, most of the globe is likely to be uninhabitable by mammals by the year _____ (McMichael & Dear 2010) a. b. c. d.

2020 2200 2300 3000

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Frumkin 3rd Ed. - Test Bank Items Chapter 10 3 Answer Key Chapter 10 1. b 2. d 3. b 4. c 5. b 6. a 7. c 8. a 9. c 10. c

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Frumkin 3rd Ed. - Test Bank Items Chapter 11 1 Chapter 11 Environmental Justice and Vulnerable Populations 1. In the United States, the modern environmental justice movement has roots in all of the following other movements except a. b. c. d.

Civil rights Indigeneous peoples rights Right to free speech Farmworkers rights

2. The modern environmental justice movement in the United States emerged in 1982 when a predominantly African American community in Warren, North Carolina protested the siting of what type of facility in their community a. b. c. d.

Coal-fired power plant Nuclear power plant Hazardous waste incinerator Hazardous waste landfill

3. The environmental justice movement has evolved to promote a framework for social change based on all of the following except a. Upholding the rights of all individuals to be protected from environmental degradation and its associated health impacts b. Protection of intellectual property rights in environmental research and development c. Advocating for a precautionary approach in environmental regulatory actions d. Demanding that regulatory agencies proactively redress disproportionate and cumulative risk burdens 4. Childhood lead exposure is considered an environmental justice issue in the United States because data show that ____________________ (Wheeler & Brown 2013) a. Children eat more contaminated soil and dust than adults b. The blood-brain barrier in young children is not fully developed so more lead can reach the child’s brain c. Children absorb lead from their digestive tracts more efficiently than adults d. Black children have higher blood lead levels than white children 5. The landmark 1987 United Church of Christ report, Toxic Wastes and _____ in the United States, was the first national study of demographic disparities in the location of hazardous waste sites a. Poverty

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Frumkin 3rd Ed. - Test Bank Items Chapter 11 2 b. Children c. Race d. Urbanization 6. In the United States, longitudinal studies of demographic disparities in hazardous facility siting provide evidence refuting the minority move-in hypothesis, which is the idea that ___________ a. Minorities tend to live in locations with environmental hazards b. Hazardous facilities move in to minority communities after white communities kick them out c. Minorities move to locations with environmental hazards because of lower housing prices and other market dynamics d. Minorities tend to move in to their parents’ and grandparents’ homes on the outskirts of town where hazardous facilities are typically located 7. The cumulative impacts of social vulnerability, environmental exposure inequalities, and biological/physiological susceptibility combine to form _________ among racial/ethnic and socioeconomic groups a. b. c. d.

Cumulative vulnerability Aggregate vulnerability Health differences Health disparities

8. Health impact assessment provides an alternative approach to ___________ for incorporating cumulative impacts into decision making a. b. c. d.

Vulnerability assessment Risk assessment Locational studies Cumulative impact screening assessments

9. The fact that children can bear a disproportionate burden of the adverse health effects of toxic environmental exposures is sometimes referred to as a _____________ issue a. b. c. d.

Cumulative vulnerability Windows of vulnerability Generational equity Climate gap

10. The idea that the wealthy set the standard for what constitutes a high-status lifestyle, leading others to consume more, is an example of how _________ can contribute to environmental degradation

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Frumkin 3rd Ed. - Test Bank Items Chapter 11 3

a. b. c. d.

Social inequality Asymmetry in power-weighted social decisions Racial segregation Erosion of trust and cooperation

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Frumkin 3rd Ed. - Test Bank Items Chapter 11 4

Answer Key Chapter 11 1. c 2. d 3. b 4. d 5. c 6. c 7. d 8. b 9. c 10.a

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Chapter 12 test questions 1.

Which of the following is NOT a significant greenhouse gas that contributes to global warming? a. b. c. d. e.

Global climate change contributes to each of the following EXCEPT: a. b. c. d. e.

Carbon dioxide Methane Water vapor Carbon monoxide Chlorofluorocarbons

Rising sea levels Ocean acidification Species extinctions Peak petroleum production More severe storms

The impacts of climate change on food and agriculture include all of the following EXCEPT: a. Reduced production of wheat, maize, and other staple crops in much of the world, especially parts of Africa and Asia b. Increased production of staple crops in some parts of the world, such as parts of Canada and Russia. c. Reduced growth of most weeds, enhancing crop production. d. Reduced nutrient content of some foods. e. Increased crop loss due to plant diseases.

Which of the following statements about heat waves is true? a. Risk factors for death during heat waves are well defined. b. Heat waves are more severe in rural areas than in urban areas. c. Most excess deaths during heat waves are attributed to “heat stroke” or “hyperthermia” on death certificates. d. Heat waves in recent years have been most severe near the equator, and mild in norther latitudes. e. Heat wave preparedness planning is ineffective in reducing deaths during heat waves.

Which of the following air pollutants is NOT expected to increase as a result of climate change? a. b. c. d.

Dioxins Ozone Allergens such as pollen Particulate matter from wildfires

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Climate change may contribute to water contamination through all of the following mechanisms EXCEPT: a. b. c. d.

Harmful algal blooms Coliform contamination from combined sewer outflows following severe rainfall Vibrio contamination due to warmer marine waters Contamination by cryptosporidium or giardia from increased non-point source runoff after storms e. Increased chlorine concentrations due to water treatment malfunctions 7.

Each of the following is a vector-borne disease that has expanded its range in recent years, in a pattern consistent with climate change contributions, EXCEPT: a. b. c. d. e.

Dengue fever Lyme disease Polio Malaria Chikungunya

Which of the following is true regarding mental health in the context of climate change? a. Individual resilience following a disaster is mainly a function of personality structure; social networks play little or no role. b. Post-traumatic stress following a disaster is generally irreversible; those who develop it confront a lifelong condition. c. Violent behavior is associated with cold weather, so violence is expected to decline with advancing climate change. d. People with severe mental illness such as schizophrenia are at increased risk during heat waves. e. To date, populations that have been displaced by climate-related effects have not shown evidence of mental health consequences of displacement.

Which of the following statements about climate change mitigation and adaptation is true? a. Mitigation occurs on a local scale, while adaptation occurs on a global scale. b. Climate change adaptation may justifiably be deferred for future generations, because it will be far less costly in the future. c. Mitigation includes both reducing the emission of greenhouse gases, and promoting the removal of greenhouse gases from the air through sequestration. d. Climate mitigation is the responsibility of the energy and transportation sectors, while the health sector is primarily responsible for climate adaptation. e. Climate change adaptation is counterproductive because it distracts from climate change mitigation.

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10.

Which of the following is true regarding public belief in climate change? a. Family and friends are powerful determinants of a person’s beliefs about climate change. b. A majority of Americans deny that climate change is occurring. c. Beliefs about climate change are constant across political parties, religious affiliation, and age. d. Providing authoritative scientific information about climate change is associated with substantial shifts in opinion. e. Health professionals are not trusted sources regarding climate change and its risks; public trust is higher for elected officials and sports and media personalities.

11.

The most widely supported economic strategy for combatting climate change is: a. b. c. d.

“Putting a price on carbon” through a carbon tax or “cap and trade” mechanism. The “War on Coal,” prohibiting coal production after 2025. Placing large export tariffs on fossil fuels. Reforestation of parts of Brazil, Indonesia, and other areas where severe forest loss has occurred. e. Forcing OPEC to increase oil production to avoid any fuel shortages.

Key: 1. D 2. D 3. C 4. A 5. A 6. E 7. C 8. D 9. C 10. A 11. A

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Frumkin 3rd Ed. - Test Bank Items Chapter 13 1 Chapter 13 Air Pollution 1. According to the 2010 Global Burden of Disease Study (Lim et al., 2012), ambient particulate matter, one type of air pollution, was responsible for over _____ premature deaths and ________ of global disability-adjusted life years in 2010 a. b. c. d.

3,200, 3.1% 320,000, 3.1% 320,000, 31.0% 3,200,000, 3.1%

2. Ambient concentrations of an air pollutant can be highest under conditions of stagnant winds and ________ a. b. c. d.

Temperature inversions Atmospheric turbulence Seasonal transitions Nighttime deposition

3. Anthropogenic emissions result from human activity while ____ emissions come from natural sources (e.g., vegetation, volcanoes, deserts) a. b. c. d.

Natural Organic Biogenic Ecological

4. Which of the following major ambient air pollutants are considered primary pollutants, vs., secondary or primary and secondary a. b. c. d.

Lead, sulfur dioxide, carbon monoxide Sulfur dioxide, particulate matter, nitrogen oxides Sulfur dioxide, nitrogen oxides, ozone Lead, toxic pollutants, volatile organic compounds

5. The United States Clean Air Act mandates health-protective national ambient air quality standards for which group of key outdoor pollutants (i.e., the criteria pollutants) a. b. c. d.

Lead, sulfur dioxide, carbon monoxide Lead, sulfur dioxide, carbon monoxide, nitrogen dioxide, particulates, ozone Lead, toxic pollutants, volatile organic compounds Lead, toxic pollutants, volatile organic compounds, biological pollutants

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Frumkin 3rd Ed. - Test Bank Items Chapter 13 2 6. All of the following except which affect an air pollutant’s ability to penetrate the respiratory system a. b. c. d.

Size Chemical properties Exercise Weather

7. In a landmark epidemiological study of ambient air pollution and mortality in six U.S. cities, Dockery et al. (1993) found a ____ higher mortality rate in the city with the highest pollution compared to the city with the lowest a. b. c. d.

2.6% 26% 260% 2600%

8. In general, which particle size category is likely to penetrate most deeply into the lung a. b. c. d.

TSP PM100 PM10 PM2.5

9. All of the following are true about tropospheric ozone except a. b. c. d.

It is a powerful oxidant that can trigger asthma attacks It is formed by the reaction of precursors (VOCs, NOx) and sunlight It protects us from ultraviolet radiation Indoor concentrations are usually lower than outdoor concentrations

10. All of the following except which are regulatory strategies used to control air pollution in the United States a. b. c. d.

NAAQS for criteria air pollutants MACT for hazardous air pollutants Power plant cap-and-trade for SOx emissions Power plant cap-and-trade for CO2 emissions

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Frumkin 3rd Ed. - Test Bank Items Chapter 13 3 Answer Key Chapter 13 1. d 2. a 3. c 4. a 5. b 6. d 7. b 8. d 9. c 10. d

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Chapter 14 test questions 1.

Energy use varies greatly between the poorest countries with the least access to energy, and the wealthiest countries with greatest access. The ratio in per capita energy use between highest to lowest is closest to: a. b. c. d.

The “energy ladder” refers to a sequence of energy courses. In general, as a society moves up the energy ladder, each of the following increases EXCEPT: a. b. c. d.

Three-fold Ten-fold 100-fold 1000-fold

Cleanliness Distance between the energy production and end user Adverse health impacts Cost

Which of the following statements about the human health impacts of energy use, at the scale of societies or countries, is true? a. There is no association between a society’s per capita energy use and the average health of the society. b. Increasing per capita energy use is associated with improved health. c. Increasing per capita energy use is associated with improved health, but only if fossil fuels provide most of the energy. d. Increasing per capita energy use is associated with improved health but only up to a point; after that, increasing energy use confers no further health benefit.

John Snow, a seminal figure in the history of public health, made his mark by: a. b. c. d.

Which of the following is NOT a primary energy source? a. b. c. d.

Coal combustion Electricity Hydroelectric Wind

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e. Biomass combustion 6.

Which of the following is NOT a fossil fuel? a. b. c. d.

The vast majority of the world’s energy comes from which of the following? a. b. c. d. e.

Allergies Contributions to climate change Air pollution Mercury exposure

Health concerns related to nuclear power include all of the following except: a. b. c. d.

11.

Wood Charcoal Dung Fuel cells

Major health impacts of fossil fuel combustion include all of the following EXCEPT: a. b. c. d.

10.

Nuclear and hydroelectric power. Nuclear power and coal. Biomass and diesel. Natural gas and petroleum. Coal and petroleum.

Households in low- and middle-income countries often burn solid fuels for heating and food preparation. This can result in high levels of indoor air pollution. The highest levels of indoor particulate matter (PM) are associated with which of the following solid fuels? a. b. c. d.

Biomass Coal Petroleum Natural gas

Radiation exposure from nuclear waste Potential of accidents at nuclear plants Substantial contributions to climate change Potential of weaponization of nuclear fuel

Each of the following sources of energy is considered renewable EXCEPT: a. b. c. d.

Wind Natural gas Solar Hydroelectric

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12.

Energy conservation may offer considerable health co-benefits, as exemplified by which of the following: a. b. c. d.

More fuel efficient cars reduce levels of air pollution. More walking and cycling promote cardiovascular health. More natural daylighting in buildings improves well-being and performance. Eating lower on the food chain—foods that require less energy to produce—reduces the risk of cancer. e. All of the above.

Key: 1. C 2. C 3. D 4. C 5. B 6. A 7. E 8. C 9. A 10. C 11. B 12. E

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Frumkin 3rd Ed. - Test Bank Items Chapter 15 1 Chapter 15 Healthy Communities 1. The _________ of late 19th century U.S. and Europe, when the connection between urban planning and infectious disease transmission became recognized, was a formative stage in public health history a. b. c. d.

Industrial revolution Urbanization movement Migration waves Sanitary movement

2. In the early 2000s, the world’s urban population surpassed its rural population for the first time; in the future, the fastest growth will take place in _______ cities in ________. a. b. c. d.

Mega-cities, Asia Mega-cities, Europe & North America Small & medium-sized cities, Asia & Africa Small & medium-sized cities, Europe & North America

3. Approximately how many people lived in urban slums (i.e., without access to basic services such as potable water and sanitation) in 2013, according to United Nations estimates a. b. c. d.

8.63 million 86.3 million 863 million 8.63 billion

4. All of the following features of urban sprawl have been associated with unintended negative health consequences except a. b. c. d.

Uniform setback requirements Separation of land uses through zoning Automobile-oriented transportation systems Divestment in central cities

5. In the United States, all of the following are examples of policies that regulate land use except a. b. c. d.

Zoning codes Subdivision regulations Comprehensive plans Ambient air quality standards

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Frumkin 3rd Ed. - Test Bank Items Chapter 15 2 6. Overweight and obesity are a costly and preventable epidemic in the United States and elsewhere; currently, _________ U.S. adults are considered overweight (BMI ≥ 25) (Ogden et al. 2014) a. b. c. d.

1 in 4 1 in 10 2 in 4 2 in 3

7. Reducing vehicle miles traveled in ____________ is a primary way to reduce air pollution and the resulting health consequences a. b. c. d.

Single-occupancy vehicles Older vehicles with outdated emissions control technologies Public transportation Diesel trucks and buses

8. All of the following are smart growth principles to promote equitable, healthy, and sustainable communities except a. b. c. d.

Create a range of housing opportunities and choices Strengthen and direct development towards unused farmland Make development decisions predictable, fair, and cost-effective Encourage community and stakeholder collaboration in development decisions

9. Cities aiming to strengthen local ecological functioning and ecosystem services through reduced/renewable energy use, capturing/reusing rainwater, planting local vegetation, and other strategies, are referred to as __________ a. b. c. d.

Healthy cities Green cities Eco-cities Sustainable cities

10. ________ and _______ are examples of healthy community design policies that encourage physical activity and reduce automobile dependence a. b. c. d.

Ride Score, bundled parking Ride Score, unbundled parking Joint use policies, bundled parking Joint use policies, unbundled parking

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Frumkin 3rd Ed. - Test Bank Items Chapter 15 3 Answer Key Chapter 15 1. d 2. c 3. c 4. a 5. d 6. d 7. a 8. b 9. c 10. d

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Frumkin 3rd Ed. - Test Bank Items Chapter 16 1 Chapter 16 Water and Health 1. What percent of Earth’s total volume of water is potentially available for human use (e.g., drinking, irrigation, other uses) a. b. c. d.

<1% 10% 50% 100%

2. Water used as a drinking-water source is called _________ a. b. c. d.

Groundwater Surface water Source water Receiving water

3. The United Nations (2014) estimates that, by 2025, what fraction of the world’s population could be living under water-stressed conditions a. b. c. d.

1/10 1/4 2/3 3/4

4. The process by which heavy nitrogen and phosphorus loadings from human activities leads to algae blooms, increased microbial activity, and oxygen depletion in a receiving body is called ____________ a. b. c. d.

Nutrient stimulation Chemical contamination Eutrophication Channelization

5. It was long thought that ________ was the solution to water pollution, something we now know is not accurate, especially for hydrophobic chemicals a. b. c. d.

Natural attenuation Dilution Eutrophication Channelization

6. Recently, waterborne disease outbreaks in North America have been linked to exceptionally heavy rainfall and the resultant _________

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Frumkin 3rd Ed. - Test Bank Items Chapter 16 2

a. b. c. d.

Reservoir overflows Impoundment Ecological damage Flooding

7. According to World Health Organization estimates (Prüss-Ustün et al. 2014), inadequate water, ______, and ________ are responsible for 56% of the 1.5 million deaths per year from diarrheal disease a. b. c. d.

Impoundment, flood control Channelization, dam construction Sanitation, flood control Sanitation, hygiene

8. Safe drinking water requires a _________ approach, incorporating source protection as well as treatment a. b. c. d.

Public health engineering Multibarrier Multi-stakeholder Disinfection

9. A drinking water distribution system, with potentially hundreds of miles of pipes, is vulnerable to _________ and microbial ___________ a. b. c. d.

Filtration, disinfection Leakage, residuals Cross-contamination, regrowth Chemical contaminants, toxins

10. In the United States, the Safe Drinking Water Act mandates legal limits, called _____________, on the levels of chemical and microbiological contaminants allowed in drinking water provided by utilities serving 25 people or more a. b. c. d.

Maximum contaminant levels Maximum contaminant level goals Permissible exposure limits National Secondary Drinking Water Regulations

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Frumkin 3rd Ed. - Test Bank Items Chapter 16 3 Answer Key Chapter 16 1. a 2. c 3. c 4. c 5. b 6. d 7. d 8. b 9. c 10.a

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Frumkin 3rd Ed. - Test Bank Items Chapter 17 1 Chapter 17 Solid and Hazardous Waste 1. In 2012, which type of material accounted for the largest percentage of the municipal solid waste stream in the United States (EPA 2012) a. b. c. d.

Paper Food scraps Plastics Glass

2. The average American generated around ______ of municipal solid waste per day in 2012; this is up from around ______ per day in 1960 (EPA 2012) a. b. c. d.

2.68 pounds, 3.42 pounds 3.42 pounds, 4.38 pounds 2.68 pounds, 4.38 pounds 0.52 pounds, 20.34 pounds

3. According to World Bank estimates, per capita municipal solid waste generation in highincome countries is approximately _______ that of low-income countries (Hoornweg & Bhada-Tata 2012) a. b. c. d.

½ 2 times 4 times 10 times

4. In low-income countries, the municipal solid waste stream tends to have more _______ and less _______ than in high-income countries a. b. c. d.

Plastics, organic material Organic material, paper Paper, yard trimmings Wood, metals

5. Of the different types of special wastes in the United States, which one generates more volume than all the others combined a. b. c. d.

Medical waste Construction debris Mining waste Sewage sludge

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Frumkin 3rd Ed. - Test Bank Items Chapter 17 2 6. Which two federal laws govern solid and hazardous waste management in the United States today? a. Solid Waste Disposal Act, Resource Conservation and Recovery Act b. Reduce, Reuse, Recycle Act, Comprehensive Environmental Response Compensation and Liability Act c. Reduce, Reuse, Recycle Act, Superfund Act d. Resource Conservation and Recovery Act, Comprehensive Environmental Response Compensation and Liability Act 7. The best waste management strategy from an environmental health standpoint is a. b. c. d.

Not to produce it in the first place Reuse/recycling Landfilling Burning in a waste-to-energy facility

8. The percentage of the U.S. municipal solid waste stream that gets recycled grew from 6.4% in 1960 to _____ in 2012 (EPA 2012) a. b. c. d.

8.0% 34.5% 58.2% 78.7%

9. Modern sanitary landfills often have systems for collecting, storing, and treating ________, the liquid, organic waste decomposition product, sometimes contaminated with chemicals, that can migrate down and into local aquifers a. b. c. d.

Stormwater Wastewater Runoff Leachate

10. A major health concern associated with burning solid and hazardous waste, either in open-burning operations or incinerators, is the production of highly toxic chlorinated compounds collectively called ___________ that bioaccumulate in the food chain a. b. c. d.

Volatile organic compounds Dioxins Heavy metals Polycyclic aromatic hydrocarbons

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Frumkin 3rd Ed. - Test Bank Items Chapter 17 3 Answer Key Chapter 17 1. a 2. c 3. c 4. b 5. c 6. d 7. a 8. b 9. d 10.b

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Frumkin 3rd Ed. - Test Bank Items Chapter 18 1 Chapter 18 Pest Control and Pesticides 1. The introduction of DDT (dichlorodiphenyltrichloroethane) and other ________ pesticides into agriculture after World War II changed pest control and food production worldwide a. b. c. d.

Lead-containing Arsenical Chlorinated Biological

2. Cockroaches are not known to transmit any serious human diseases but cockroach antigen is an important risk factor for the development of a. b. c. d.

Skin rashes Head lice Epidemic typhus Asthma

3. All of the following are major human diseases transmitted by mosquitoes except a. b. c. d.

Malaria Lyme disease Dengue fever West Nile virus

4. Pesticides are classified by their target pest or their chemical structure and ______ a. b. c. d.

Toxicity Mode of action Target organ Target crop

5. All of the following are among the 4 most commonly used classes of pesticides today except a. b. c. d.

Lead arsenate Organophosphates Carbamates Pyrethroids

6. Organophosphate pesticides, which exert their neurotoxicity by inactivating acetylcholinesterase, can trigger a potentially lethal _______ in humans

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Frumkin 3rd Ed. - Test Bank Items Chapter 18 2

a. b. c. d.

Cardiac episode Cholinergic crisis Anti-cholinergic crisis Serotonergic crisis

7. Although DDT is banned in many Stockholm Convention countries because of concerns over chronic and ecological toxicity, the WHO (World Health Organization) supports its use in areas with persistent ________ a. b. c. d.

Malnutrition Rodent infestation Malaria Lyme disease

8. Children’s exposure to pesticides used indoors, occupational exposures, and ______ are other public health concerns associated with widespread pesticide use a. b. c. d.

Self-poisoning Radionuclides Particulate air pollution Bacillus thuringiensis

9. In the United States, the Food Quality Protection Act of 1996 requires U.S. EPA to set health-based tolerances for pesticides in food, in particular to protect ________ a. b. c. d.

Infants and children Elderly people Immunocompromised people Low socioeconomic status people

10. Integrated pest management was developed in the 1960s as a comprehensive approach to pest control using a combination of methods, with ________ as a last resort a. b. c. d.

Structural maintenance Biological control agents Chemical pesticides Management and cultural practices

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Frumkin 3rd Ed. - Test Bank Items Chapter 18 3 Answer Key Chapter 18 1. c 2. d 3. b 4. b 5. a 6. b 7. c 8. a 9. a 10. c

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Frumkin 3rd Ed. - Test Bank Items Chapter 19 1 Chapter 19 Food Systems, the Environment, and Public Health 1. Energy, water, chemicals, knowledge, and labor are examples of food system ________ a. b. c. d.

Influences Inputs Activities Outputs

2. Almost half of U.S. cropland is used to grow __________ of _________ (U.S. EPA 2009); these can create economies of scale but also threaten biodiversity and are vulnerable to pest invasions and plant diseases. a. b. c. d.

Monocultures, wheat Monocultures, corn and soybeans Polycultures, wheat and corn Polycultures, wheat and vegetables

3. Nutrient (N and P) run-off into water bodies from agricultural fields where synthetic fertilizers have been applied excessively can create aquatic dead zones through a process known as ___________ a. b. c. d.

Deoxygenation Hypoxification Harmful algal blooms Eutrophication

4. This popular herbicide used extensively on herbicide-resistant GM crops in the United States was recently designated a probable human carcinogen by the World Health Organization (Guyton et al. 2015) a. b. c. d.

Atrazine DDT Glyphosate Organophosphate

5. All of the following are KNOWN potential pathways for the spread of antibiotic-resistant bacteria from animals to humans except a. Resistant bacteria spread from to consumers via contaminated meat products b. Resistant bacteria spread to farm workers and food processors through contact with contaminated animals or meat c. Resistant bacteria spread to community residents via bats and raccoons d. Resistant bacteria spread to soil and water from contaminated animal waste

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Frumkin 3rd Ed. - Test Bank Items Chapter 19 2

6. Which of the following is not generally considered a sustainable agricultural practice a. b. c. d.

Planting GM herbicide-resistant seeds Conservation tillage Integrated pest management Use of cover crops

7. In the United States, which of the following food categories was responsible for the largest number of foodborne illness deaths from 1998 to 2008 (Painter et al. 2013) a. b. c. d.

Produce Meat and poultry Dairy and eggs Fish and shellfish

8. Older pesticides (e.g., DDT), PCBs, and dioxins are examples of ________ that bioaccumulate and contaminate the global food chain a. b. c. d.

Persistent organic pollutants Mycotoxins Biological pathogens Potentially hazardous food

9. Responsibility for enforcing food safety regulations in the United States is spread across which combination of agencies a. b. c. d.

FDA, USDA, USTR, state and local health departments FDA, USDA, EPA, state and local health departments NASA, FDA, USDA, state and local health departments NASA, USDA, EPA, state and local health departments

10. The federal Farm Bill allocates billions of dollars to support the production of ______________ while providing little support for producing ___________. a. b. c. d.

organic food, processed foods fish, dairy sugar, corn and soybeans commodity corn and soybeans, fruits and vegetables

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Frumkin 3rd Ed. - Test Bank Items Chapter 19 3 Answer Key Chapter 19 1. b 2. b 3. d 4. c 5. c 6. a 7. b 8. a 9. b 10. d

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Chapter 20 test questions 1.

Manufactured structures are widely used in each of the following settings EXCEPT: a. b. c. d. e.

Following Hurricane Katrina in 2005, millions of people were sheltered in manufactured structures (“FEMA trailers”). Which of the following contaminants raised major health concerns? a. b. c. d.

Reduced eye strain Reduced operating costs Improved subjective comfort Improved performance Reduced risk of cancer

Good design can help prevent falls, a major public health concern for which of the following groups? a. b. c. d. e.

Insect and rodent bites Falls Poisonings Burns

Natural daylighting in buildings is associated with each of the following EXCEPT: a. b. c. d. e.

Lead DDT Formaldehyde Radon

About 18,000 accidental deaths occur in homes each year in the United States. Each of the following accounts for a major proportion of these deaths EXCEPT: a. b. c. d.

Emergency housing Medical clinics Long-term housing Classrooms Construction offices

The elderly Cancer patients Infants Immigrants Low-income people

Which of the following is NOT a recommended strategy for reducing fire risk in buildings?

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a. b. c. d. e. 7.

If mold is discovered in a building, which of the following is a key part of the response? a. b. c. d. e.

Painting the affected area with mold-resistant paint. Identifying and removing sources of moisture. Applying pesticides. Demolition and replacement of the building. Diagnostic testing to determine what types of mold are present.

Mold in buildings is associated with each of the following EXCEPT: a. b. c. d.

Fire escapes Stairways separated from interior spaces Asbestos insulation Nonflammable structural elements Sprinkler systems

Toxic responses to volatile organic compounds Immune responses such as asthma attacks Increased risk of cancer Infections among immunocompromised people

Which of the following statements about radon is true? a. Radon exposure combines synergistically with cigarette smoking, among smokers, to increase lung cancer risk. b. The major source of radon exposure for most people is air travel. c. Commercially available canisters can provide effective radon protection in most affected homes. d. In affected homes, radon levels are highest in the attic and lowest in the basement.

10.

Which of the following statements about asbestos is true? a. As a naturally occurring fiber, asbestos is part of a healthy diet. b. While asbestos workers are at high risk of asbestos-related diseases, other kinds of exposure (such as in homes) are inconsequential. c. Asbestos exposure essentially ended with the advent of regulations in the 1970s. d. Asbestos-related diseases, including cancers and fibrotic lung disease, can appear years after exposure has ended.

11.

Which of the following statements about sick building syndrome is true? a. With advanced diagnostic technology, the specific cause can generally be determined. b. The cause of sick building syndrome is generally microbial. c. The symptoms people report in cases of sick building syndrome are usually nonspecific (such as headache, fatigue, dizziness, and rashes).

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d. Sick building syndrome became rare when energy efficiency practices in the 1970s led to more advanced building design. 12.

Features of green buildings include: a. b. c. d. e.

Energy efficiency measures. Reduced use of hazardous chemicals. Attractive staircases to motivate walking. Natural daylighting. All of the above.

Key: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

B C A E A C B C A D C E

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Frumkin 3rd Ed. - Test Bank Items Chapter 21 1 Chapter 21 Work, Health, and Well-Being 1. According to the U.S. Bureau of Labor Statistics and the International Labor Organization, the estimated number of work-related fatalities per year exceeds ______ in the United States, and _____ worldwide a. b. c. d.

47, 2.3 million 4,700, 2.3 million 4,700, 230 million 4.7 million, 2.3 million

2. Estimating numbers of workplace injuries is difficult because of _______ while estimating numbers of work-related illnesses is difficult because of the ________ between hazardous exposures and the development of symptoms a. b. c. d.

Worker privacy concerns, weak association between Worker privacy concerns, time lag Underreporting, weak association between Underreporting, time lag

3. The 2013 Rana Plaza factory collapse, which killed 1,100 mostly female workers, is a reminder that, globally, many people work in _________ a. b. c. d.

Bangladesh The garment/textile industry Dangerous structures Childhood

4. In the United States, the industry with the highest number of work-related injuries per year is _______ (U.S. Bureau of Labor Statistics 2014, 2015) a. b. c. d.

Health care and social assistance Agriculture, forestry, fishing, and hunting Arts, entertainment, and recreation Transportation and warehousing

5. First-generation immigrant (especially undocumented) workers in high-hazard occupations are especially vulnerable to workplace illness and injury for all of the following reasons except a. b. c. d.

They are less likely to report hazardous conditions They are less likely to pay state income tax They are less likely to receive compensation and medical benefits if injured They are unlikely to be represented by a union

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Frumkin 3rd Ed. - Test Bank Items Chapter 21 2

6. Passage of workplace safety and worker protection laws typically follows major workplace disasters. Which of the following workplace tragedies marks the beginning of concerted government intervention in workplace safety in the United States a. Hazardous conditions in Chicago meatpacking plants, brought to public attention in Upton Sinclair’s The Jungle b. 1911 Triangle Shirtwaist fire in lower Manhattan c. 1907 Monongah Mine explosion in West Virginia d. Silicosis epidemic among African American tunnel diggers in Gauley Bridge, West Virginia during the Great Depression 7. The Occupational Safety and Health Act of 1970 created _________, the primary U.S. federal agency responsible for setting and enforcing workplace safety regulations a. b. c. d.

Occupational Safety and Health Administration Occupational Safety and Health Agency Occupational Health and Safety Administration Occupational Health and Safety Agency

8. In the United States, regulatory tools for protecting workers include legally enforceable __________ for specific workplace chemicals a. b. c. d.

Threshold limit values Threshold exposure limits Permissible chemical concentrations Permissible exposure limits

9. In the United States, who bears the largest proportion of the cost of worker injuries a. b. c. d.

State and federal taxpayers State workers’ compensation programs Families/out-of-pocket Private health insurance

10. Countries with limited resources to develop their own occupational safety and health standards can adopt those recommended by international organizations such as the ________ a. b. c. d.

Mine Safety and Health Administration Sustainability Accounting Standards Board International Labour Organization International Workers’ Union

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Frumkin 3rd Ed. - Test Bank Items Chapter 21 3 Answer Key Chapter 21 1 b 2. d 3. c 4. a 5. b 6. b 7. a 8. d 9. c 10. c

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Frumkin 3rd Ed. - Test Bank Items Chapter 22 1 Chapter 22 Radiation 1. With electromagnetic radiation (i.e., energy traveling through space), as wavelength ______ and frequency _______, more energy is released at close range, potentially harming living things a. b. c. d.

Lengthens, increases Lengthens, decreases Shortens, increases Shortens, decreases

2. Ionizing radiation contains sufficient energy to strip the _____ from an atom a. b. c. d.

Orbiting neutrons Orbiting protons Orbiting electrons Orbiting neutrinos

3. All of the following are forms of ionizing radiation except a. b. c. d.

Cosmic rays Gamma rays X-rays Infrared

4. The type of ultraviolet radiation that plays the most important role in sunburn and skin carcinogenesis is a. b. c. d.

UVA UVB UVC UVR

5. The cumulative effective dose of radiation to be received over time from an intake of radioactivity is called a. b. c. d.

Absorbed dose Effective dose Committed effective dose Collective effective dose

6. On average, which natural source of ionizing radiation accounts for the largest proportion of the natural background radiation dose to the general population

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Frumkin 3rd Ed. - Test Bank Items Chapter 22 2 a. Uranium deposits in the Colorado Plateau b. Inhaled radon decay products c. 40K in bananas, spinach, broccoli, etc. d. 210Po and 210Pb in cigarette tobacco 7. Of all the human-made sources of ionizing radiation received annually by a U.S. resident, which type accounts for the largest percentage a. b. c. d.

Medical Consumer products Occupational Nuclear fallout

8. Cells in the body that are particularly radiosensitive (i.e., sensitive to ionizing radiation) are those which a. b. c. d.

Contain chromosomes Contain outer shell electrons Are dividing Are atrophying

9. Epidemiological evidence for the carcinogenic effects of ionizing radiation comes from studies of all of the following subpopulations except a. b. c. d.

Nuclear medicine technicians Radium dial painters Underground hard rock miners Atomic bomb survivors

10. The most preferred external radiation protection strategy is a. b. c. d.

Eliminate the source Minimize exposure time Maximize distance from the source Shield the source

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Frumkin 3rd Ed. - Test Bank Items Chapter 22 3 Answer Key Chapter 22 1 c 2. c 3. d 4. b 5. c 6. b 7. a 8. c 9. a 10.a

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Frumkin 3rd Ed. - Test Bank Items Chapter 23 1 Chapter 23 Injuries 1. According to the 2010 Global Burden of Disease Study (Murray et al. 2012), injuries accounted for ____ of the world’s disability-adjusted life years (DALYs), and were a top 10 cause of death worldwide a. b. c. d.

1% 11% 41% 81%

2. The columns of the Haddon matrix, used successfully in the United States to conceptualize injury prevention opportunities, are titled a. b. c. d.

Phases, host, agent, environment Phases, host, vector, environment Phases, host, prevention, control Phases, prevention, control, response

3. All of the following are one of Haddon’s 10 generic options for injury control except a. b. c. d.

Prevent creation of hazard Separate, by time or space, the hazard from the host Separate, by time or space, the host from the environment Stabilize, repair, and rehabilitate the injured person

4. Of the three E’s of injury control, which takes the least amount of voluntary cooperation from the people it is designed to protect a. b. c. d.

Education Enforcement Engineering Evaluation

5. The U.S. agency with jurisdiction over safety of infant cribs and similar items is called a. b. c. d.

National Highway Traffic Safety Administration Consumer Product Safety Commission American National Standards Institute National Center for Injury Prevention and Control

6. Approximately half the 1.4 million deaths from intentional injury worldwide in 2012 (WHO 2013) were

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Frumkin 3rd Ed. - Test Bank Items Chapter 23 2 a. b. c. d.

War-related killings Terrorist attacks Suicides Family/partner violence

7. Worldwide, _______ have the highest mortality rates from burns and drowning of any age group a. b. c. d.

Teenage males Adult males The elderly Children < 5 years old

8. Data are scarce but suggest that the following type of chemicals are responsible for the most poisoning fatalities in developing countries (Konradsen et al. 2003) a. b. c. d.

Radioactive wastes Heavy metals Pesticides Household cleaners

9. Poison control centers are examples of which type of countermeasure against acute poisonings a. b. c. d.

Education Enforcement Engineering Environmental

10. The global epidemic of _______ is expected to increase, accompanying increased levels of ________ around the world a. b. c. d.

HIV/AIDS, needle stick injuries Road traffic injuries, motorization Poisonings, organochlorine pesticide use Self-directed violence, semi-automatic weapon availability

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Frumkin 3rd Ed. - Test Bank Items Chapter 23 3 Answer Key Chapter 23 1 b 2. a 3. c 4. c 5. b 6. c 7. d 8. c 9. a 10. b

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Frumkin 3rd Ed. - Test Bank Items Chapter 24 1 Chapter 24 Environmental Disasters 1. All of the following are conditions that meet the international Emergency Events Database (EM-DAT) definition of a disaster except a. b. c. d.

10 or more people reported killed 10 or more people reported affected Declaration of a state of emergency Call for international assistance

2. Earthquakes, landslides, volcanic eruptions, and tsunamis are examples of which type of disaster a. b. c. d.

Hydrometeorological Geophysical Thermal Mechanical

3. Although technological disasters typically have higher mortality and injury rates, which type of natural disaster accounts for the greatest public health burden, in terms of overall numbers of deaths, people affected, and cost a. b. c. d.

Hydrometeorological Geophysical Thermal Mechanical

4. The type of natural disaster with the highest mortality (mean number of deaths per event and deaths per 100,000 affected) and death-injury ratio is a. b. c. d.

Drought Earthquake Flood Tsunami

5. The type of technological disaster with the highest mortality rate (deaths per 100,000 affected) and death-injury ratio is a. b. c. d.

Transportation Structure collapse Radiation Explosion

6. All of the following are types of morbidity that typically follow disaster events except

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Frumkin 3rd Ed. - Test Bank Items Chapter 24 2

a. b. c. d.

Noncommunicable disease Toxic exposures Burns Malnutrition

7. Major categories of attributes affecting vulnerability to disasters include all of the following except a. b. c. d.

Demographics (e.g., age, gender, family position) Education and personal experience Material resources Health status

8. Each of the following is one of the U.S. Federal Emergency Management Agency’s four types of mitigation measures except a. b. c. d.

Local plans and regulations Tertiary prevention Natural systems protection Education and awareness programs

9. Each of the following are important public health capabilities associated with all disasters except a. b. c. d.

Access to safe water Pest and vector control Sanitation, excreta disposal, and hygiene promotion Transportation infrastructure

10. The idea that common capabilities can serve a variety of disaster situations is called a. b. c. d.

Emergency operations planning All-hazards preparedness Risk transfer Breaking the disaster cycle

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Frumkin 3rd Ed. - Test Bank Items Chapter 24 3 Answer Key Chapter 24 1 b 2. b 3. a 4. d 5. a 6. c 7. c 8. b 9. d 10.b

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Chapter 25 test questions 1.

Biophilia is the idea that: a. b. c. d.

Attention restoration is the idea that: a. b. c. d.

Living in a green neighborhood Viewing nature out the window Hypnosis with nature cues Contact with animals

What is the usual way of quantifying the “greenness” of a neighborhood? a. b. c. d.

Stress reduction Improved concentration Taller height Improved behavior

There is evidence for health benefits for each of the following forms of nature contact EXCEPT: a. b. c. d.

Nature contact can snap a person out of feeling bored. It is therapeutic to focus intently on a small natural feature. Meditation techniques, such as focusing on breathing, can increase inner calm. Nature contact can help recover from attentional fatigue—improving focus, memory, and interpersonal interactions.

For children, outdoor play may offer all of the following EXCEPT: a. b. c. d.

People feel an innately emotional affiliation with other living organisms. People have a strong life force and instinctively fight for survival. People care about other people more than they care about animals. People are inherently interested in studying biology and ecology.

Extent of tree canopy Species distribution of trees Size of front and back yards relative to lot size Age of trees

Landscape preference may have evolutionary origins. Which of the following settings most closely resembles the habitat in which humans are thought to have evolved? a. b. c. d. e.

A display of banzai trees An English garden A golf course with rolling hills, scattered copses of trees, and ponds A mountain range with dramatic distant views An oceanside cliff

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The following features of a city park predict increased park use, EXCEPT: a. b. c. d. e.

Easy access to where people live. Well-maintained trails, lawns, and other features. Bathrooms. Safety. Creative graffiti.

Which of the following statements about green exercise is true? a. Green exercise involves deep, prolonged immersion in nature such as multi-day treks. b. Green exercise requires direct tactile contact with trees and plants. c. Green exercise refers to ordinary forms of physical activity, such as jogging, carried out in outdoor, natural settings. d. Green exercise is pleasant, but provides fewer health benefits than exercise in a gym with modern exercise equipment.

Which of the following statements about the association between nature contact and socioeconomic status is true? a. Wealthy people benefit more from a given level of nature contact than do poor people. b. In most metropolitan areas, poor people live in greener neighborhoods than do wealthy people. c. In most metropolitan areas, poor people have greater access to parks than do wealthy people. d. Community gardens in cities can provide poor people with nature contact and with other benefits such as fresh food and social opportunities.

Key: 1. 2. 3. 4. 5. 6. 7. 8. 9.

A D C C A C E C D

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Frumkin 3rd Ed. - Test Bank Items Chapter 26 1 Chapter 26 Environmental Public Health: From Theory to Practice 1. The mission of environmental public health is to control hazards and _________. a. b. c. d.

Control diseases Monitor disease incidence Improve disease treatment Promote health

2. In a theoretical DPSEEA model applied to the problem of population growth and trafficrelated air pollution, the P could refer to a. b. c. d.

Traffic-related injuries Obesity Increases in vehicle miles driven Phaseout of lead in gasoline

3. Primary prevention in environmental public health involves which types of interventions (in contrast to secondary and tertiary prevention) a. b. c. d.

health promotion, specific protection health promotion, early detection early detection, disease treatment early detection, specific protection

4. All of the following are important prevention principles in environmental public health except a. b. c. d.

Precautionary principle Intergenerational equity Economic discounting Polluter pays principle

5. Many of the important prevention principles in environmental public health were formally articulated in 1992 at the United Nations Conference on _________ a. b. c. d.

Sustainable Development Environment and Development Environmental Public Health Environment and Health

6. Assessment, policy development, and ________ are the three core functions of public health, as defined by the U.S. Institute of Medicine (IOM)

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Frumkin 3rd Ed. - Test Bank Items Chapter 26 2 a. b. c. d.

Insurance Assurance Surveillance Financing

7. Environmental health surveillance systems serve which one of the 10 essential services of environmental health (U.S. CDC 2008, 2011) a. Monitor environmental and health status to identify and solve community environmental health problems b. Enforce laws and regulations that protect environmental health and ensure safety c. Link people to needed environmental health services and assure the provision of health care when otherwise unavailable d. Evaluate effectiveness, accessibility, and quality of personal and populationbased environmental health services 8. All of the following are examples of trends evaluated by the U.S. National Environmental Public Health Tracking Program except a. b. c. d.

Nuclear weapons testing and radiation sickness Air pollution and asthma Water contamination and cancer Extreme heat and heat-related illness

9. All of the following are examples of the many different types of environmental health professionals working in the United States except a. b. c. d.

Registered Sanitarian Certified Professional-Food Safety Licensed Esthetician Healthy Homes Specialist

10. An advantage of the complex nature and multiple federal, state, and local jurisdictions involved in the delivery of environmental public health services in the United States is the potential for developing ________ approaches a. b. c. d.

Streamlined Standardized Cost-effective Community-specific

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Frumkin 3rd Ed. - Test Bank Items Chapter 26 3 Answer Key Chapter 26 1 d 2. c 3. a 4. c 5. b 6. b 7. a 8. a 9. c 10.d

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Frumkin 3rd Ed. - Test Bank Items Chapter 27 1 Chapter 27 Risk Assessment in Environmental Health 1. Risk is the _________ that some adverse event will occur (Rodricks, 2006), while risk assessment involves characterizing the _________ of those adverse effects in the population a. b. c. d.

Chance, possibility Possibility, probability Probability, possibility Probability, probability

2. Rachel Carson’s 1962 book, Silent Spring, popularized concerns about long-term lowdose exposure to _______ a. b. c. d.

Radiation Air pollution DDT Saccharin

3. The U.S. National Academy of Sciences book from 1983 that formalized the four-step risk assessment process is generally referred to as the _________ Book a. b. c. d.

Yellow Green Red Blue

4. The U.S. National Academy of Sciences Silver Book (2009) added a fifth, up-front ________ step to the four-step risk assessment process a. b. c. d.

Problem identification Problem formulation Risk communication Decision making

5. In the hazard identification step of risk assessment, a __________ analysis judges the quality, nature, and strength of the scientific evidence that exposure to a particular contaminant causes an adverse health outcome a. b. c. d.

Weight of evidence Evidentiary Summary judgment Peer review

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Frumkin 3rd Ed. - Test Bank Items Chapter 27 2 6. In risk assessment for noncarcinogens, the RfD (reference dose) is an estimate of the daily human exposure, with ___________ spanning perhaps an order of magnitude, that is likely to be without an ___________ risk of deleterious effects during a lifetime a. b. c. d.

Uncertainty, appreciable Estimates, estimated Doses, acceptable Uncertainty, unacceptable

7. A key difference in dose-response assessment for carcinogens vs. noncarcinogens is that carcinogens are assumed to have no biological _____________ while noncarcinogens might have one a. b. c. d.

Effect Response Threshold Mode of action

8. In exposure assessment, the potential human intake of a chemical is typically expressed in which units a. b. c. d.

mg/L mg/m3 mg/kg-BW mg/kg-BW/day

9. In risk characterization, the population cancer risk is calculated as the cancer slope factor multiplied by the ____________ a. b. c. d.

No observed adverse effect level (NOAEL) Lifetime average daily dose (LADD) Point of departure (POD) Margin of exposure (MOE)

10. All of the following are examples of factors that might be considered for each policy option identified during the risk management stage except a. b. c. d.

Acceptable level of risk Economic costs and benefits Political campaign promises Stakeholder perceptions

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Frumkin 3rd Ed. - Test Bank Items Chapter 27 3 Answer Key Chapter 27 1 d 2. c 3. c 4. b 5. a 6. a 7. c 8. d 9. b 10.c

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Frumkin 3rd Ed. - Test Bank Items Chapter 28 1 Chapter 28 Communicating Environmental Health 1. The U.S. Occupational Safety and Health Administration’s Hazard Communication Standard, and Consumer Confidence Reports required under the U.S. Safe Drinking Water Act, are examples of policies enabling __________ a. b. c. d.

External communication Message repetition The right to know Social marketing

2. The formula for effective communication involves all of the following except a. b. c. d.

Simple, clear messages Precise technical explanations Message repetition Trusted messengers

3. Using marketing methods to promote behavior change for the benefit of people and society is called _____________ a. b. c. d.

Health-based messaging Public health marketing Public health messaging Social marketing

4. Which of the following is not one of the three primary objectives of environmental risk communication a. b. c. d.

Inform and educate people Calm/allay fears Build, strengthen, and repair trust Encourage appropriate action

5. Conditions associated with increased fear and concern and perceptions of high risk include all of the following except a. b. c. d.

Involuntary nature of exposure Children specifically at risk Caused by acts of nature or God Effects dreaded

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Frumkin 3rd Ed. - Test Bank Items Chapter 28 2 6. Effective environmental risk communication is based on models describing how information is processed, risk perceptions are formed, and risk decisions are made; these models include all of the following except a. b. c. d.

Risk Perception Model Mental Noise Model Positive Dominance Model Trust Determination Model

7. Which of the following is not one of U.S. EPA’s 7 cardinal rules of risk communication (Covello and Allen 1988) a. b. c. d.

Decline to answer leading questions from journalists Be honest and transparent Plan/tailor strategies to goals, audiences, communication channels Avoid technical jargon

8. One type of bias potentially affecting people’s response to risk communications is ___________ bias, or the tendency to seek/accept information consistent with one’s beliefs, ignore/discount information that isn’t, and interpret information in ways that confirm those beliefs a. b. c. d.

Bandwidth Overconfidence Confirmatory Conformity

9. Many consider the single most important factor for effective risk communication to be _____________ a. b. c. d.

Simple, clear language Trust Compassion Listening

10. Research shows that one effective risk communication strategy after a major environmental disaster is providing clear, specific, prioritized instructions and action items that convey a sense of ________ and concrete things to do (Tinker et al. 2012) a. b. c. d.

Honesty Empathy Compassion Self-efficacy

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Frumkin 3rd Ed. - Test Bank Items Chapter 28 3 Answer Key Chapter 28 1 c 2. b 3. d 4. b 5. c 6. c 7. a 8. c 9. b 10.d

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