Environmental medicine
– also called conservation medicine, ecological medicine, or medical geology-
A In simple terms, environmental medicine deals with the interaction between human and animal health and the environment. It concerns the adverse reactions that people have on contact with or exposure to an environmental excitant . Ecological health is its primary concern, especially emerging infectious diseases and pathogens from insects, plants and vertebrate animals.
B Practitioners of environmental medicine work in teams involving many other specialists. As well as doctors, clinicians and medical researchers, there may be marine and climate biologists, toxicologists, veterinarians, geospatial and landscape analysts, even political scientists and economists. This is a very broad approach to the rather simple concept that there are causes for all illnesses, and that what we eat and drink or encounter in our surroundings has a direct impact on our health.
C Central to environmental medicine is the total load theory developed by the clinical ecologist Theron Randolph, who postulated that illness occurs when the body’s ability to detoxify environmental excitants has reached its capacity. His wide-ranging perception of what makes up those stimuli includes chemical, physical, biological and psychosocial factors. If a person with numerous and/or chronic exposures to environmental chemicals suffers a psychological upset, for example, this could overburden his immune system and result in actual physical illness. In other words, disease is the product of multiple factors.
D Another Randolph concept is that of individual susceptibility or the variability in the response of individuals to toxic agents. Individuals may be susceptible to any number of excitants but those exposed to the same risk factors do not necessarily develop the same disease, due in large part to genetic predisposition; however, age, gender, nutrition, emotional or physical stress, as well as the particular infectious agents or chemicals and intensity of exposure, all contribute.
E Adaptation is defined as the ability of an organism to adjust to gradually changing circumstances of its existence, to survive and be successful in a particular environment. Dr Randolph suggested that our bodies, designed for the Stone Age, have not quite caught up with the modern age and consequently, many people suffer diseases from maladaptation, or an inability to deal with some of the new substances that are now part of our environment. He asserted that this could cause exhaustion, irritability, depression, confusion and behavioural problems in children. Numerous traditional medical practitioners, however, are very sceptical of these assertions.
F Looking at the environment and health together is a way of making distant and nebulous notions, such as global warming, more immediate and important. Even a slight rise in temperature, which the world is already experiencing, has immediate effects. Mosquitoes can expand their range and feed on different migratory birds than usual, resulting in these birds transferring a disease into other countries. Suburban sprawl is seen as more than a socioeconomic problem for it brings an immediate imbalance to the rural ecosystem, increasing population density so people come into closer contact with disease-carrying rodents or other animals. Deforestation also displaces feral animals that may then infect domesticated animals, which enter the food chain and transmit the disease to people. These kinds of connections are fundamental to environmental medicine and the threat of zoonotic disease looms larger.
G Zoonoses, diseases of animals transmissible to humans, are a huge concern. Different types of pathogens, including bacteria, viruses, fungi and parasites, cause zoonoses. Every year, millions of people worldwide get sick because of foodborne bacteria such as salmonella and campylobacter, which cause fever, diarrhoea and abdominal pain. Tens of thousands of people die from the rabies virus after being bitten by rabid animals like dogs and bats. Viral zoonoses like avian influenza (bird flu), swine flu (H1N1 virus) and Ebola are on the increase with more frequent, often uncontainable, outbreaks. Some animals (particularly domestic pets) pass on fungal infections to humans. Parasitic infection usually occurs when people come into contact with food or water contaminated by animals that are infected with parasites like cryptosporidium, trichinella, or worms.
H As the human population of the planet increases, encroaching further on animal domains and causing ecological change, inter-professional cooperation is crucial to meet the challenges of dealing with the effects of climate change, emergent cross-species pathogens, rising toxicity in air, water and soil, and uncontrolled development and urbanisation. This can only happen if additional government funds are channelled into the study and practice of environmental medicine.
Questions
Questions 14–19
Reading Passage 2 has eight paragraphs, A–H. Which paragraph contains the following information?
Write the correct letter, A–H, in boxes 14–19 on your answer sheet.
14. an explanation of how population expansion exposes humans to disease
15. the idea that each person can react differently to the same risk factors
16. types of disease-causing agents that move between species
17. examples of professionals working in the sphere of environmental medicine
18. a definition of environmental medicine
19. how ill health results from an accumulation of environmental stressors
Questions 20–26
Complete the sentences below. Choose NO MORE THAN THREE WORDS from the passage for each answer.
Write your answers in boxes 20–26 on your answer sheet.
20. According to Dr Randolph, people get sick because of ……………….. – in other words, a failure to adjust to the modern environment.
21. Vague, far-off concepts like global warming are made more urgent when ……………….. are studied together.
22. Rising temperatures result in more widespread distribution of disease because some insects are able to ……………….. .
23. Large-scale removal of trees forces wildlife from their habitat and brings them into contact with ……………….. .
24. Uncontrollable ……………….. of zoonotic viruses are becoming more numerous.
25. Collaboration between many disciplines is needed to confront the problems of urban development, pollution, ……………….. and new pathogens.
26. Environmental medicine should receive more ……………….. to help it meet future demands.
ANSWERS
Questions 14–19
14. F
- It is mentioned in paragraph F that: “Suburban sprawl is seen as more than a socioeconomic problem for it brings an immediate imbalance to the rural ecosystem, increasing population density so people come into closer contact with disease-carrying rodents or other animals.”
- population expansion ~ increasing population density
- exposes humans to disease ~ people come into closer contact with disease-carrying rodents or other animals.
- This means the increase in population makes it more likely for humans to be exposed to disease through closer contact with animals.
- > The answer is F.
15. D
- It is mentioned in paragraph D that: “Another Randolph concept is that of individual susceptibility or the variability in the response of individuals to toxic agents. Individuals may be susceptible to any number of excitants but those exposed to the same risk factors do not necessarily develop the same disease…”
- idea = concept
- each person can react differently ~ the variability in the response of individuals
- The paragraph mentioned the idea that each person’s reaction to a risk factor is different and listed some reasons to expain why it is different.
- > The answer is D.
16. G
- It is stated in paragraph G that: “Zoonoses, diseases of animals transmissible to humans, are a huge concern. Different types of pathogens, including bacteria, viruses, fungi and parasites, cause zoonoses.”
- disease-causing agents that move between species ~ diseases of animals transmissible to humans
- The paragraph mentioned several zoonoses, which are the diseases that can be transferred from one species to another, through types of pathogens such as foodborne bacteria, rabies virus, avian influenza (bird flu), swine flu (H1N1 virus) and ebola and parasitic infection. Pathogens are the agents which cause zoonoses.
- > The answer is G.
17. B
- It is stated in paragraph B that: “Practitioners of environmental medicine work in teams involving many other specialists. As well as doctors, clinicians and medical researchers, there may be marine and climate biologists, toxicologists, veterinarians, geospatial and landscape analysts, even political scientists and economists.”
- Professionals working in the sphere of environmental medicine ~ practitioners of environmental medicine
- The paragraph listed a number of professionals that work in the sphere of environmental medicine such as doctors, clinicians, medical researchers and others.
- > The answer is B.
18. A
- It is stated in paragraph A that: “In simple terms, environmental medicine deals with the interaction between human and animal health and the environment. It concerns the adverse reactions that people have on contact with or exposure to an environmental excitant”.
- definition ~ (simple) terms
- The paragraph provided a simple definition of environmental medicine. It deals with the relationship between human and animal health and the environment.
- > The answer is A.
19. C
- It is stated in paragraph C that: “… illness occurs when the body’s ability to detoxify environmental excitants has reached its capacity. His wide-ranging perception of what makes up those stimuli includes chemical, physical, biological and psychosocial factors. If a person with numerous and/or chronic exposures to environmental chemicals suffers a psychological upset, for example, this could overburden his immune system and result in actual physical illness.”
- The paragraph mentioned Randolph’s theory that when a person cannot get rid of environmental excitants (=stressors/stimuli), they will suffer from illness, and then provided an example of exposure to chemicals. These accumulate in the human body, and they reach capacity when the body can no longer detoxify them.
- ill health = illness
- excitants = stressors
- > The answer is C.
Questions 20–26
20. maladaptation
- It is stated in paragraph E that: “Dr Randolph suggested that our bodies, designed for the Stone Age, have not quite caught up with the modern age and consequently, many people suffer diseases from maladaptation, or an inability to deal with some of the new substances that are now part of our environment.”
- get sick ~ suffer diseases
- failure to adjust ~ inability to deal with
- This means that maladaptation to the new environment is the reason why many people get sick, because their bodies cannot deal with some of the new substances in our modern environment.
- > The answer is “maladaptation.”
21. environment and health/health and environment
- It is stated in paragraph F that: “Looking at the environment and health together is a way of making distant and nebulous notions, such as global warming, more immediate and important.”
- vague, far-off concepts = nebulous and distant notions
- more urgent = more immediate and important
- to be studied together ~ to be looked at together
- This means that when people study the environment and health together, broad ideas like global warming suddenly become directly relevant to our lives.
- > The answer is “environment and health / health and environment.”
22. expand their range
- It is stated in paragraph F that: “Even a slight rise in temperature, which the world is already experiencing, has immediate effects. Mosquitoes can expand their range and feed on different migratory birds than usual, resulting in these birds transferring a disease into other countries.”
- rising temperatures = a slight rise in temperature
- result in = have effects
- a widespread distribution of disease ~ transferring a disease into other countries
- are able to = can
- This means that when temperature rises, more mosquitoes will appear and they expand their range by sucking blood of migratory birds. These birds travel and as a result, spread diseases from the mosquitoes.
- > The answer is “expand their range.”
23. domesticated animals
- It is stated in paragraph F that: “Deforestation also displaces feral animals that may then infect domesticated animals, which enter the food chain and transmit the disease to people.”.
- large-scale removal of trees ~ deforestation
- forces wildlife from their habitat ~ displaces feral animals
- brings into contact with ~ infect
- This means that when deforestation occurs, wild animals have to leave their habitat, which means that they may interact with domesticated animals.
- > The answer is “domesticated animals.”
24. outbreaks
- It is stated in paragraph G that: “Viral zoonoses like avian influenza (bird flu), swine flu (H1N1 virus) and Ebola are on the increase with more frequent, often uncontainable, outbreaks.”
- uncontrollable = uncontainable
- zoonotic viruses ~ viral zoonoses
- become more numerous ~ on the increase
- This means that the number of uncontrollable outbreaks of zoonotic viruses is increasing sharply.
- > The answer is “outbreaks.”
25. climate change
- It is stated in paragraph H that: “… inter-professional cooperation is crucial to meet the challenges of dealing with the effects of climate change, emergent cross-species pathogens, rising toxicity in air, water and soil, and uncontrolled development and urbanisation.”
- collaboration between many disciplines = inter-professional cooperation
- confront the problems = meet the challenges
- urban development ~ uncontrolled development and urbanisation
- new pathogens ~ emergent cross-species pathogens
- pollution ~ rising toxicity in air, water and soil
- The only problem left that is mentioned in the paragraph but is missing in the statement is climate change.
- > The answer is “climate change.”
26. (government) funds
- It is stated in paragraph H that: “This (meeting the challenges) can only happen if additional government funds are channelled into the study and practice of environmental medicine.”
- This means that only if more government funds are invested in the study and practice of environmental medicine can it deal in future with all of the problems already mentioned.
- > The answer is “(government) funds.”
