Environmental Health

This introductory course in Environmental Health is intended for undergraduate- and graduate-level students of medicine, environmental sciences or public health, and provides foundational theoretical and practical knowledge and skills. All components of this training (like all NextGenU.org trainings) are free, including registration, learning, testing, and a certificate of completion.

There are 9 modules to complete, providing a basic introduction to the study of environmental health, exposure assessment, toxicology, and risk management, among other topics. You’ll learn through online study, peer-to-peer activities, and optional local activities and discussion with an environmental health mentor that you or your institution identify.

There are practice quizzes in each module, and at the end of the course you’ll have a final exam, and a chance to give your assessment of this training. We will give you all the results of your assessments, such as your final exam and peer activities. We can report your testing information and share your work with anyone (your school, employer, etc.) that you request. We hope this is a wonderful learning experience for you, and that your assessments will teach us how we can make it even better.

This course was developed in partnership with the Association for Prevention Teaching and Research and the U.S. Centers for Disease Control and Prevention (CDC). This course is co-sponsored by: the International Society of Doctors for the Environment, Physicians for Social Responsibility, Simon Fraser University's Faculty of Health Sciences, and the University of the Incarnate Word. Like all NextGenU courses, it is competency-based, using competencies from the Association of Schools and Programs of Public Health and the Association of Schools of Public Health in the European Region. This course uses learning resources from world-class academic and governmental organizations such as Harvard Medical School, the U.S. Centers for Disease Control and Prevention, the U.S. National Institutes of Health, and the World Health Organization. The course developer is Lindsay Galway, and our Advisory Group is: Ryan Allen, PhD; Kristian Dubrawski, PhD; Sylvia Struck, PhD; and Tim Takaro, MD, MPH, MSc

Competencies covered in this module:

1. Know and understand the significant elements and incidents in the history of environmental and occupational sciences
2. Know and understand the scale and the trends of current health problems associated with major environmental contaminations

This module will act as a foundation for the rest of the course, providing you with an introduction to the field of environmental health. You will also learn about the history and evolution of environmental health, including how it is related to occupational health. Finally, to understand the importance of environmental health research and practice, you will explore the scale and trends of current health problems associated with major environmental hazards.

 Learning Objectives:

Upon completion of this module, students should be able to:

• Identify the milestones of historical development in the field of environmental health
• Describe the importance and impact of environmental health issues on population health, and the burden of disease due to environmental factors
• Define critical environmental health terms
• Discuss the links between environmental and occupational health
• Give examples of major environmental disasters, and discuss their relevance to the field of environmental health in general

Competency covered in this module:

1. Describe the direct and indirect human, ecological, and safety effects of major environmental and occupational agents

Module 2 will provide an overview of direct and indirect environmental and occupational hazards and their potential effects on human health and ecosystems. You will learn about important environmental hazards at various scales (from local to global), and in both the developed and developing world. Understanding environmental and occupational hazards and their potential health impacts is a first step towards protecting human health and well-being at the population level.

Learning Objectives:

Upon completion of this module, students should be able to:

• Describe different types of exposures (i.e., acute vs. chronic)
• Identify hazardous chemicals in our daily lives and give examples of health effects related to exposure to these chemicals
• Give examples of health hazards in the occupational setting
• Discuss possible consequences of ecosystem change for human health and well-being

Competency covered in this module:

1. Know and understand the principles of exposure assessment to major environmental contaminations, current methods and tools

In module 3, you will be introduced to the principles of exposure assessment. Exposure assessment is an important tool in the environmental health toolbox. It also plays an important role in the risk assessment process that you will learn about in module 5. Upon completion of this module, you should be familiar with current methods and tools relevant to exposure assessment, as well as their limitations. You will also be introduced to new and exciting developments in exposure assessment, and the direction in which this field of study is headed.

Learning Objectives:

Upon completion of this module, students should be able to:

• Define and describe the difference between exposure and dose
• Demonstrate an understanding of key characteristics of exposure and exposure pathways
• Demonstrate an understanding of exposure assessment strategies used in environmental and occupational health
• Identify strengths and weaknesses of various exposure assessment methods and tools
• Define basic exposure assessment terms and concepts
• Describe the role of biomarkers in exposure assessment as well as the benefits and limitations of using biomarkers

Competencies covered in this module:

1. Explain the general mechanisms of toxicity in eliciting a toxic response to various environmental exposures
2. Know and understand the basic limitations of toxicology and of assessment measures for environmental pollutions, and how they affect assessment outcomes
3. Know and understand the specific design of epidemiologic studies in environmental health

In this module, you will become familiar with the basic principles and practices of toxicology and epidemiology in the context of environmental health science. Both toxicology and epidemiology are fundamental to the overall field of environmental health and are important aspects of the risk assessment process. You will learn toxicological concepts and be introduced to the tools available to examine and understand the mechanism of toxicity to various environmental exposures. You will also encounter epidemiological study designs relevant for environmental health research and practice.

Learning Objectives:

Upon completion of this module, students should be able to:

• Describe the role of toxicology in environmental and occupational health
• Explain how toxicity is assessed, and define important toxicological concepts (i.e., dose-response, LD 50, etc.)
• Demonstrate a general understanding of mechanisms of toxicity
• Discuss the limitations of toxicological methods and the implications of these limitations for public health
• Find accurate and reliable information about the toxicity of agents
• Describe the most common study designs in environmental epidemiology

Competency covered in this module:

1. Specify current environmental risk assessment methods

Module 5 will present the major concepts and applications of human health and ecological risk assessment. You will not only become familiar with the steps involved in conducting a risk assessment, but you will also learn why this process plays such an important role in environmental health research and practice. You will encounter two risk assessment case studies; these will strengthen your overall knowledge and understanding of the risk assessment process. By the end of the module, you should be able to specify current risk assessment methods, and understand the strengths and weaknesses in the risk assessment process.

Learning Objectives:

Upon completion of this module, students should be able to:

• Define and understand the concept of risk and how it differs from hazard
• Describe the steps involved in performing a risk assessment
• Explain how human health risk assessments are used in public health

Competencies covered in this module:

1. Discuss various risk management and risk communication approaches in relation to issues of environmental justice and equity
2. Specify approaches for assessing, preventing, and controlling environmental hazards that pose risks to human health and safety.
3. Describe regulatory programs, guidelines, and authorities that control environmental (and occupational) health issues

In module 6, you will be introduced to risk management and risk communication.   You will gain an understanding of key elements to consider when communicating with the public about risk, issues in environmental health decision-making, and the role of the precautionary principle in risk management. You will also encounter examples of regulatory programs as well as approaches for preventing and controlling environmental and occupational hazards and risks.

Learning Objectives:

Upon completion of this module, students should be able to:

• Demonstrate an understanding of key elements in risk communication for environmental health hazards
• Identify possible strategies for preventing and controlling environmental and occupational health hazards
• Explain the meaning of the precautionary principle and its role in environmental health management, regulation, and decision-making
• Outline air quality guidelines and standards, and give examples of those authorities responsible for regulating environmental health hazards

Competencies covered in this module:

1. Describe genetic, physiological and psychosocial factors that affect susceptibility to adverse health outcomes following exposure to environmental hazards
2. Know and understand gene-environment interactions
3. Assessment of social inequalities of environmental hazards

The field of public health is particularly concerned with susceptibility, vulnerability, and inequality. In module 7, you will be introduced to these issues in relation to environmental hazards, exposures, and health outcomes. You will examine susceptible sub-populations (such as children), as well as vulnerability factors (such as socio-economic status). By the end of this module, you will have a basic understanding of inequalities in environmental health, and of what can be done to address these inequalities.

Learning Objectives:

Upon completion of this module students should be able to:

• Identify and explain factors that make children particularly susceptible to environmental hazards
• Explain how and why environmental hazards and their related health effects vary across countries, regions, or groups
• Explain how gender, age, and socio-economic status can influence susceptibility to environmental hazards
• Describe the importance of gene-environment interactions and epigenetics

Competencies covered in this module:

1. Assess, evaluate, and remediate environmental exposures and environmental health issues (Develop a testable model of environmental insult)
   • Global Scale: Global climate change and human health and well-being
2. Assess, evaluate, and remediate environmental exposures and environmental health issues (Develop a testable model of environmental insult)
   • Regional Scale: Built Environment and healthy communities
3. Assess, evaluate, and remediate environmental exposures and environmental health issues (Develop a testable model of environmental insult)
   • Local Scale: Pesticides in occupational settings

This module will bring together many of the ideas, concepts, tools, and approaches that you have learned throughout the course. You should now be able to assess, evaluate, and remediate environmental exposures and issues effectively. You will be given the opportunity to demonstrate this ability in a final activity looking at an environmental health issue in depth at one of the local, regional, or global scales.

Learning Objectives:

Upon completion of this module, students should be able to:

• Find, evaluate and synthesize relevant information about an environmental health issue, and identify possible strategies to address the issue
• Explain the causes of climate change
• Outline evidence of climate change and the evidence indicating that climate change is induced by human activities
• Describe the impacts of climate on ecosystems and health
• Define and explain concepts related to climate change (vulnerability , adaptation, mitigation etc.)

In module 9, you will be introduced to ecohealth and ecological public health. Both are emerging perspectives in public health and environmental health that focus on the connections between human and ecosystem health.

Learning Objectives:

Upon completion of this module, students should be able to:

• Describe the ecohealth and ecological public health perspectives
• Explain how ecohealth and ecological public health differ from a more traditional environmental health perspective
• Apply the ecohealth and ecological public health perspectives to environmental and /or public health issues

The final exam consists of 50 multiple choice questions. It is timed. You will have 70 minutes to complete the exam. If you are taking the course for a final certificate, you must record yourself while taking the exam. 

The final exam is password protected. When you are ready to take the final exam send an email message to techsupport@nextgenu.org