20/04/2021
© Medskl.com
Public Health – Environment and Health: By Alan Abelsohn M.D.
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Public Health – Environment and Health
Whiteboard Animation Transcript
with Alan Abelsohn, MD
https://medskl.com/Module/Index/environmental-and-health
Many patients you see will have been affected by the environment where they live, work and play; but the environmental factors are not visible or obvious when the patient presents. For example, an asthma exacerbation case seen in the ER is related to exercising in an area with air pollution.
To investigate this, use an Exposure History using the mnemonic CH2OPD2:
C: Community
What was the health risk from air pollution that day or on the preceding day? The Air Quality Health Index for communities across Canada can be found online at airhealth.ca. Was she exercising outdoors, thus increasing minute volume and pollutants delivered to the alveoli. Was she exercising near a busy road, or an industrial smoke stack? Is it allergy season?
H: Home
Are there indoor allergens e.g. a new cat or dog, cockroaches, mould from a flood in the basement? Is there a woodstove or fireplace (particulate matter), or are they using a poorly vented gas stove for cooking (nitrogen dioxide)? Might there be off-gassing from a new carpet or in-door painting? Is someone smoking (environmental tobacco smoke)?
H: Hobbies
Is she affected by off-gassing from glues, solvents or paint?
O: Occupation/ School
There might be poor ventilation with build up of dust, mould, cleaning products etc. in the school. If she is working, there are many occupational exposures that might exacerbate pre-existing asthma, and also sensitizers and irritants that can induce asthma.
P: Personal habits
Is she smoking?
D: Diet
Is this an allergic reaction to food e.g. nuts or shellfish?
D: Drugs
What prescription, non-prescription and alternative medications and supplements does she take?
More detailed forms for a full Exposure History are available.
Public Health – Environment and Health
Whiteboard Animation Transcript
with Alan Abelsohn, MD
https://medskl.com/Module/Index/environmental-and-health
Many patients you see will have been affected by the environment where they live, work and play; but the environmental factors are not visible or obvious when the patient presents. For example, an asthma exacerbation case seen in the ER is related to exercising in an area with air pollution.
To investigate this, use an Exposure History using the mnemonic CH2OPD2:
C: Community
What was the health risk from air pollution that day or on the preceding day? The Air Quality Health Index for communities across Canada can be found online at airhealth.ca. Was she exercising outdoors, thus increasing minute volume and pollutants delivered to the alveoli. Was she exercising near a busy road, or an industrial smoke stack? Is it allergy season?
H: Home
Are there indoor allergens e.g. a new cat or dog, cockroaches, mould from a flood in the basement? Is there a woodstove or fireplace (particulate matter), or are they using a poorly vented gas stove for cooking (nitrogen dioxide)? Might there be off-gassing from a new carpet or in-door painting? Is someone smoking (environmental tobacco smoke)?
H: Hobbies
Is she affected by off-gassing from glues, solvents or paint?
O: Occupation/ School
There might be poor ventilation with build up of dust, mould, cleaning products etc. in the school. If she is working, there are many occupational exposures that might exacerbate pre-existing asthma, and also sensitizers and irritants that can induce asthma.
P: Personal habits
Is she smoking?
D: Diet
Is this an allergic reaction to food e.g. nuts or shellfish?
D: Drugs
What prescription, non-prescription and alternative medications and supplements does she take?
More detailed forms for a full Exposure History are available.
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