I'm Kathy Fagan, Pune Sabari is up there, Kushinga is here, we're running this. People coming in, join a group. We've got, which groups do we have now? Which is group one? Group one, there. Group two, I think that's group two. Group three, or four, what are you? You're group four, this will be confusing. You're group four, and you guys are group five, probably, right? So we've got, I think we have four groups now. One, we need some more ones. That's group two, this is group four, that's group five. Join a group. We have it. Yes. All right. That's great. I did six groups. Okay, so we have six groups. So if we don't have six, it's fine, but. So your groups, you might want to huddle a little bit closer together so that you can come up with which column you want to select. Did we announce these? I did. Well done. Fantastic. All right, great. Well, thank you so much. I think, Kathy, you introduced all of us. We have a judge. John Meyer is our judge, if we have any big fights going on with the answers. He already connected me. Fantastic. Thank you so much. I appreciate it. Okay. All right, great. So what we're going to do is we have our floor crew who's going to see who's buzzing first, and then, thank you. And yeah, and so we designed this as a way, as a kind of a way of essentially exploring some environmental health topics. So if that's your thing, you're in the right session. We know that some of you might contest us on our answers. That's what we want. There's also a lot of discussion points for each one. So we hope to kind of not just go through them, have a discussion about them. And yeah, so get friendly with each other. Get friendly with your group. See who's in your group. And then one person becomes your buzzer person. And then like this buzzer here is like all by its lonesome right here, right on this chair here. So yeah. So all right. Very good. Okay. So let's see. Yeah. So maybe we'll give you a minute to kind of just like sit close to each other. Come on in. Either join a group or you can join a sixth group back there. I was going to try and do a daily double, but yeah, yeah, exactly. Fantastic. Introduce yourselves to your group. And whoever comes in, I think there's a sixth group forming back there. For those of you coming in, come on in. Join a group. We're going to get started in just a minute. Okay. All right. So hopefully you've introduced yourselves to your groupmate and we'll go ahead and get started. And to see which group is going to pick first, maybe we'll ask, and this one, you can either use the buzzer to just test it out or you can raise your hand if you like. That's fine. Hey, okay. I was going to ask a question, but all right. And then so maybe just so I know, because I can't see the numbers from here, just tell me what's your group number so then I'll know which group to assign the points to. Okay. Fantastic. So whoever answers, oh, it's 1, 2, 3, 4, 5, 6. Fantastic. Great. Thank you. Okay. Group 2, you go first. Symptoms of this zoonotic disease include fever, macula papula rash, vesicles, pustules, and in some cases, anorectal pain and bleeding. What is MPOX, or formerly known as monkey pox? Very good. Group 5. Group 5. So I'll tell you a little bit more about MPOX. This is a disease that actually was first identified in Africa in 1970. This was formerly known as monkey pox. The reemergence of MPOX may be due to the combination of both environmental and ecological changes as well, and also increased human and animal movement as well. So vaccinations have helped reduce the numbers as well as better detection and diagnosis as well, and genetic variations of the changes in the virus has also kind of led to the reemergence of this virus. So that's pretty much it, and those references are from the CDC. Fantastic. This reminds me, we do have a handout with all the questions and answers, including the references where the answers were taken. And so at the end of this, this is why nothing was uploaded, so that the answers aren't given away. However, at the end, we will disseminate the handout. We'll put it up and then, yes. For those of you coming in, please join a group, three groups on this side, three groups on this side. This is Jeopardy. People are waving their hand, asking for you to join them. Okay. All right. Well, group five, please. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Periarticular pain and marbling of skin after diving. Group six. What is DCS? More specific. More specific. Translate the abbreviation. That's right. Decompression sickness. What is type one decompression sickness? That is correct. That is correct. So as the diver descends and breathes air under increased pressure, the tissues become saturated with dissolved, does anybody know what gas it is? Nitrogen. Nitrogen, that's correct. And this is predicted by which law? Henry's law. That's a nice fun fact. Always on the boards I'm told. And then treatment. I'm sure we all know. What is the treatment for decompression syndrome? Hyperbaric oxygen. Hyperbaric oxygen, exactly. The administration of pure oxygen will displace the inert gas, primarily the nitrogen, from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. And then this increased gradient will enhance the removal of nitrogen from the lungs and it also increases oxygen and nitrogen gradient between the lungs and other tissues. All right, awesome. Okay, group six. This substance injured approximately 200,000. All right. Okay, 200,000. Okay, 200,000 people and killed around 1,800 people in Bhopal, India in 1984. Group one, please. Methyl isocyanate, yes. You are correct. You are correct. What is methyl isocyanate? Oh, good, good. So, you know, most deaths were due to severe lung damage. Long-term illnesses include both restrictive and obstructive disease, chronic conjunctivitis, and neurobehavioral effects such as learning disabilities. And who knows what company was involved in both this and the Hoxnest silicosis disaster. And Hoxnest, you know, silica gully bridge disaster in the 40s. And you were right. 30s. And both. He said it. Just a fun fact. Union carbide. You're right. He said it. You said? Union carbide, yeah. I just wanted to make sure I'm not. Both groups said it. All right. Fantastic. Okay. All right. Group one. Oh. Thank you. What? For 200. Okay. In this location from 1953 to 1985, half to 1 million people were exposed to high levels of chlorinated hydrocarbons, including trichloroethylene, perchloroethylene, and vinyl chloride, along with benzene in their drinking water. Was this group four? Four. What is Camp Lejeune? You got it. What is Camp Lejeune, North Carolina? So a little comment. Good job, guys. This location was traced to both military waste disposal site and a nearby dry cleaner. And studies show an association between contaminated drinking water and increased mortality rates from cancers of the kidney, rectum, and oral cavity, leukemias, multiple myeloma, Parkinson's disease. And in addition, there's an association with neural tube defects and a weak association with childhood hemopoietic cancers. We don't have the toll-free number for you. So for those of you joining, this is a Jeopardy game. There's three groups, one, two, three on this side, four, five, six on that side. Please come on up. Join one of the groups. The groups in the front here need folks as well. Introduce yourselves. And so we're going to keep going. And so group four. Okay. Team four got it. And then teams goes next. At this blood lead level, CDC recommends that children be provided, I got you, case management to mitigate its health effects and remove or control lead exposure sources. This is group four. Very good. That's right. They recently changed it from five, right? And the purpose was to address both disparities in childhood lead exposure in the U.S. and also the fact that with COVID there's been a decrease in kids getting their blood lead levels taken. Okay. Very good. Come on up. Join a group. We go next. Group four. The incorrect use of the test for this toxin in 1840 in a high profile murder case launched the field of toxicology. Very good. Right. And I'm going to briefly say that the test was the Marsh test, which you add acid and zinc and you get arsine gas and then arsenic deposits. And that the doc in this case, who was I think from Spain, whose name is Matthew Joseph Bonaventure Orfila. Orfila. Thank you. Yeah. I don't know. I think that's how you say his last name. Yeah. He is considered the father of toxicology. And this was the very first time that a tax test was used in a court case. Right. So I think the story was that Charles Lafarge, that's it, that's it. He was murdered. They said his wife did it by arsenic. They did the Marsh test. The Marsh test didn't show that she did it. And Dr. Orfila realized that they were doing the Marsh test incorrectly. And so when they did do it, it did show arsenic. And then the wife was then found guilty. A little bit of a twist there. For those of you who just joined us, please join up front here. This is Jeopardy! Three groups. Join a group. Introduce yourselves. And then folks up here would like some members to join them. So this was group six. Okay. So group six goes next. Urine hyperic acid is the metabolite used as the biological exposure index of the substance. Was that group three? Group three. Benzene. Wrong answer. Does another group want to try? This has been a hint. The substance has been implicated in some deaths due to inhalant abuse. A.K.A. Glue sniffing. A.K.A. Glue sniffing. Glue sniffing. This is stumping the gang. Just another group. She was in the right track when she said benzene. Yes, you were in the right track. She was in the right track. Who said that? Was it group four? Toluene. Oh, sorry. I gave the answer. Sorry. I thought you said that. Okay. Nobody gets a point, I guess. So the beauty of this Jeopardy! is that nobody gets points taken away. So this is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. This is group five. All right, okay, so then team five goes next. Denotes the equal treatment of all people in society, irrespective of their racial background, country of origin, and socioeconomic status. Was it team three? Oh, team one, I'm sorry. Team one. Ask the question. Team two. Yes. What is environmental justice, or EJ? You were kind of close with that, EOC. You were almost there, yeah. So team three got it, okay. They're very collaborative. Oh, oh, and this is me, this is me. Sorry, I forgot, I got it, okay. Do you want us to do it, or are you okay? If, it's up to you, yeah, you wanna do it? Sure. It's up to you. Okay. Because you've got a lot to do. So in 2020, EPA created an action agenda for environmental justice. The agenda requires the EPA to focus on environmental and public health issues confronting the nation's minority, low-income, tribal, and indigenous populations. And although it can be difficult and time-consuming, community-based participatory research is an effective way to achieve environmental justice goals. Team three, the floor is yours. This door out for two hundred. Okay. It causes between 3,000 to 8,000 lung cancers in nonsmokers. It was group four? Wrong answer. They hit the buzzer first. Oh, these guys hit the buzzer after. Yeah, after the wrong answer. So, group four. So then who ranked it next? Group four. Yes. Yes. Oh, group five, sorry. What is environmental tobacco smoke, aka secondhand smoke? So radon only causes about 2,100 to 2,900 lung cancer deaths per year. This is from a Jonathan Samet article from 2009, but it's quite good. But between the two of them, between lung cancer and environmental tobacco smoke, they cause, they are the top two that cause lung cancer deaths in nonsmokers. And he said, what they said, the author said, was approximately 10 to 15% of all lung cancers arise in never-smokers, making lung cancer in never-smokers one of the leading causes of cancer-related mortality. Interestingly enough. Okay. All right, team five. Okay, waste not the 400, why not? Okay. You guys just go. Also known for the color of the containers that stored it, this highly toxic chemical can be the product of incineration of medical waste. Five. Who was that? Five. Okay. Group five. What's the group? Oh, group three. So you're close. You're close, Becky. It's the, it's the, it's the, toxic, it counts? Okay, it's the toxic chemical that is the product of incineration of medical waste. So you're very close. Do you want to give it another go? No, okay. Group one. Yes, that's right. That's exactly right. So you were so close. Yes. So while Agent Orange has some dioxin in it, right, but it's not, it's not exactly, Agent Orange is not the product of the medical waste. It's the dioxin that gets released into the air. Right, and there was a whisper of dioxin. Oh. Oh, you did? Oh, I'm sorry, I didn't hear you. Okay. So who gets it? Group three gets it? Okay. Okay. All right, so, is that me? Is that, oh, that is me, okay. Give me, let me see. Oh yeah, here, I got it. Thank you. Do you want me to go? Okay, go ahead. Okay. So its chemical name is so long that I'm not even going to bother to pronounce it, but it's TCDD. It is a persistent organic pollutant that contaminated Agent Orange and some other color-coded herbicides when the production of one of their components was accelerated during wartime. TCDD is the most toxic of about 419 types of similar toxic compounds, which include polychlorinated biphenyls. The chemical companies that produce the Vietnam-era herbicide say they were unaware how toxic the dioxin contaminant was. Dr. Meyer, anything you want to say about that, or are you good? No, I'm good. You're good, okay. All right, so let's see. So I guess we're team three. Okay. How about we stop for three minutes? Okay. The National Academy of Sciences recommends screening for dyslipidemia, thyroid disease, kidney cancer, testicular cancer, and ulcerative colitis at serum levels about 19 nanogram per ml of this class of chemical. Is it? It's the time. Here we go, bam, bam. Do you want a hint? It's the subject of the very last session. That is such a big clue. Who just buzzed? Team four? Did you buzz? No. No, not quite the same. Oh, who just buzzed? Team one? No. No. Team three? Team two? Yes, say it louder. Yes. PFAS, PFAS. Right. What are per and polyfluoroalkyl substances or PFAS? That's right. And come to the very last session. It's gonna be good. Team two, okay. Yes. Very good. Wait, oh, this is me again. Actually, I'll give a little, this is an environmental health session, the very last session, and there will be some people from that committee at the session. There'll be a panel, so it's gonna be good. Okay, so the National Academy of Sciences recommends screening for dyslipidemia, oh yeah, I already read that. This is the topic being presented in the very last session, and that in the face of uncertainty about the health effects of PFAS, NASEM developed their guidance because PFAS is widespread persistent pollution, particularly near vulnerable, impoverished, socially disadvantaged communities, and public concern. Okay. There's a special issue in an excellent occupational medicine journal this month on occupational PFAS exposures. Ah, good to know. It's the color of your shirt. I can't remember what it is. I'm sorry. Not me. Just had to read them all. Okay, great. Remind me, that was team two, so team two goes next. For those of you who have just joined us, please come on in, please join a group, introduce yourself, contribute to the group. This is Jeopardy. Team four needs some members. Team four needs members. Team three's in the back. Make sure you introduce yourself there. Come on in, join up. Toxicologist. While we're shuffling chairs, just a quick question for the audience. Are there any first year residents here? Anybody a first year? Yay, okay, we got one or two. Okay. So, just as an aside for our first year residents, our specialty by the RRC and soon to be the ABPM is now occupational and environmental medicine, which also goes for the board, so there is going to be a component of EM on the OM exam, so pay attention to this stuff and tell your friends. And we are now officially occupational and environmental medicine, as of not for the graduating senior residents, but for the ones in the pipeline now. All right, fantastic. Group two. Please. Oh, okay. 48 hour absolute lymphocyte count is predictive of this. I'll give you that. Yes, I'm sorry, the judge. Okay, the judge. What is death due to radiation exposure? As soon as Dr. Cummings joined your team, I was like, wow, that was a perfect one to pick for that one. And to me, too. That's right. That's you, Kushinga, yeah. So, there's actually three classic acute radiation sicknesses. They're based into systems. Does anybody want to take a jab which systems they are? Bone marrow, that's correct. Yes? I'm not here to pay a judge for radiation safety, health management. Other people first. No, no, no, no, no. We're here to learn. Gastrointestinal system. And the last one. GI, GI. Exactly. Yes, so bone marrow, you tend to get the neutropenia and pancytopenia. GI, you'll get your dehydration. And typically, death within two weeks. And then the CNS, you can get brain edema and death within three to five days. In terms of the doses of the radiation for the hematological group, it's almost like 70 to 1,000 RADs. The GI, about 1,000 RADs. And then the central nervous system, 50,000 RADs. Fantastic. All right, group four. What absolute count is fatal? What is the absolute count that's fatal? Absolute lymphocyte count that's always fatal. Always fatal? Well, you know. Yeah, right, right. Remember, there's always wrong, right? A few hundred, yeah, yeah. Yeah, the CDC, I think, says less than 100, but yeah. Okay, great. Group four. Still indoor or outdoor? The EPA has determined that values of this above 100 are unhealthy for sensitive groups. Was that group four also? Okay. Okay. You're very close, but not exactly. I'll give you a little, who was the other group? One. Actually, who's the third group? What was it? PM. So, okay, we'll give you a clue. The measure of this combined the two answers that the two groups just gave. Huge clue. Aggregate. An aggregate of both. That's correct. Air quality index. What is air quality index? Right, so the measure of the 100 is an aggregate of these air metrics, air standards. Yeah, everybody was picking one particular. Yeah, okay, so they were, oh yeah, that's a good idea, but they were repeating, they were saying like PM 2.5 or ozone or particulates. They said particular matter, they said ozone. They said particular matter, 2.5 microns, and then so the air quality index is an aggregate of all of that, and Dr. Fagan will tell you a little bit more about it right now. You can kind of think about it as a heat index, right, but it's an air quality index, and we're seeing it on our telephones now, and there's an app that you can get for this, and it's called Air. Air Now, the one I like. Yeah, that's the one I like. And what they've done, it's technical, but what they've done is they look at a given locale in time, they look at all the air pollutants for the six NAAQS air pollutants, PM 2.5, PM 10, CO, sulfur dioxide, nitrogen dioxide, and then the pollutant at the highest risk level in the index is the one that's reported when you look at your phone, you know, and look at the index, so it may vary depending on what's going on outside. Okay. We have lots of roughs. So was it group six that gave the answer response? Yep. Yep. All right. So group six, please go next. Causes dermatologic, neurologic, respiratory, and gastrointestinal symptoms in boaters and swimmers. Five. What is nitroglycerin? What is nitroglycerin? Nigleria. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. No. It's close enough. What did you guys, what were you guys doing? They said red tide in group four. The judge is going to give it to them because they believe it's close enough. What is the algal bloom or algal toxins? It's cyanobacteria. That's right. Right. Our hint was going to be colorful water. But these outbreaks are increasing due to eutrophication of water from agricultural runoff, wastewater discharges, and global warming. Can someone define eutrophication? Correct? Yeah, adding nutrients. Exactly right. Yeah. Particularly phosphorus and nitrogen. No. No. Adding nutrients. Adding nutrients. Fertilizing. Fertilizing. Adding nutrients. There's a good one though for that. Okay. Okay, group four, please go next. Multiple studies have linked this hazard in the environment to long-term cardiovascular health effects, such as heart attacks and strokes, but not to respiratory health effects. We'll see who gets this. Group one. Yeah. Whoa. Whoa. Fabulous. You got it. Woo-hoo. Woo-hoo. Yeah. Very good. So noise is, sorry. Environmental noise has been connected to increase in hypertension, MIs, CHF, and strokes. Road traffic noise greater than 65 decibels during the day and 55 decibels at night has been linked to these health effects plus things like trouble sleeping and increased stress. I told Kathy no one was going to get that. She should leave it out. Team 1, please go. Classified as endocrine disruptors that can be found in pillows, mattresses and carpets. What did they say? Formaldehyde? No. Team 3? They said phthalates. No. PFAS again. Team 4? Yes. Judges will give that one, too. You have to, however, answer what are they used for? They're not dust mites. So these are synthetic chemicals that have been used in consumer industrial products since the 1970s to reduce flammability. It's the PDBE. Does anybody know what that stands for? Yes. Polybormonated diphenyl ether. PDBEs are one of the original flame retardants notable for easy volatilization into the environment because they do not bond with the material to which they are applied. PDBEs persist in the environment for years and can bioaccumulate in adipose tissue, including breast milk and living organisms. Although PDBEs were phased out in the early 2000s, exposure continues because the chemicals are still present. The primary routes of exposure in humans are ingesting dust contaminated food, inhalation from environmental release or dermal contact. Exposure may be highest among young children with hand to mouth behaviors. Team 4. The Love Canal incident led to the creation in 1980 of this U.S. public health agency for chemical safety. It's not the EPA. And group 4 buzzed. Were you going to say the EPA? Because it's not the EPA. If group 5 needs to buzz, please go ahead and buzz. Group 3. Who went first? I think group 3. No. But you're getting closer. Carter. That's correct. Yay, Aaron. What is agency for toxic substances and disease registry or ATSDR? I think that's me. Okay. So is the lead for federal public health agency responsible for determining human health effects associated with toxic exposures preventing continued exposures and mitigating associated human health risks? The discovery of contamination in New York state's Love Canal first brought the problem of hazardous waste to national attention in the 1970s. There are more than 1,500 national priority list sites for clean up. Does anyone know the company? Hoover. You're right. Was that team 6? All right. Team 6. Please go. This act dictates requirements for transportation and temporary storage of hazardous waste. Spoken like a true politician. They call it Neal's law. Let's give other teams a chance and if nobody else, then we'll go. That's right. What is the resource conservation recovery act of 1976 or RCRA? Very good. For residents taking the board's quote cradle to grave. That's all the buzz word you need to remember. Cradle to grave. Okay. So this is an amendment of solid waste disposal act. So not too far from team 4's answer. The resource, the RCRA enacted in 1976 is the principle federal law in the U.S. government for disposal of solid waste and hazardous waste. RCRA amended the solid waste disposal act of 1965 to address the increasing problems in the nation faced from its growing volume of municipal and industrial waste. It set national goals for protecting human health and the natural environment from the potential hazards of waste disposal, conserving energy and natural resources, reducing the amount of waste generated through source reduction, recycling, and ensuring management of waste in an environmentally sound manner. Team 3, please go next. Did I give you guys your score? All right. Team 3. This city hosted the first Earth Day event. Come on. What did they say? They said San Francisco. No. No. Yes. Very good. I'm like, come on. You're in Philly. Of course we got to give you Philly questions. Okay. So the date was April 22nd, 1970. So that's actually next week. Former U.S. Senator Edmund Muskie, author of the historic Clean Air Act of 1970, agreed to be the keynote speaker on this day in this city. Other notable speakers that week included poet Allen Ginsberg and political activist Ralph Nader. All right. Team 1. This is a resource for learning about toxic chemical releases and pollution prevention activities reported by industrial and federal facilities. Its data supports informed decision-making by communities, government agencies, companies, and others. Team 4. NIEHS? No. IRIS database? No, but you're getting close. It's related. Team 1. Hazmat? No. Is there a clue? Hint. The EPA created the program as part of a response to several events that raised public concerns about local preparedness for chemical emergencies and the availability of information on hazardous substances. Team 2. What is FEMA? No. Emergency Response Act? No. Do we have any groups left? Getting close. TASCA? No. So one of the events was Bhopal, where lots of stuff went into the air. Right. What is it when something goes into the air? Julia, we're notifying your employer. You got the first one. You're very close. You got super close. Very close. What did you say? Oh, got it. That's not a bad way to do it, because you got very close. Okay. Do you want to be the No, you go ahead. What is a Toxic Release Inventory, or TRI? In 1986, TRI was part of a new approach to environmental protection. By making information about the industrial management of toxic chemicals available to the public, TRI creates a strong incentive for companies to improve environmental performance. Who was the last group that went? I'm asking the floor judges. Who was the last group? Maybe one. Okay. One. Please go. EKG Finding in Hypothermia. Here we are. Group 5. I think floor judges are saying group 5 buzzed first. We'll come to you next. No. And group 1 said bradycardia, which is actually part of the answer, although not always, as we'll find. Group 6. Depressed T waves. The word wave is in there. You can go through the alphabet. Yes. Who said it? Somebody just said it. Six said it. Six said it? Really? Okay. I thought I could have sworn two said it. J wave. J wave. Okay. What are on J waves? Okay. Hypothermia will prolong all of your intervals, the RR, PR, QRS, and the QT as well. But then you also get a characteristic elevation of the J point, and it produces the J or the Osborne wave. And the height of the Osborne wave is actually roughly proportional to the degree of hypothermia, and typically you'll find these findings more prominently in the precordial leads, which is V2 to V5. All right. Very good. So team 6? Wait, no. Was it team 6? Team 6. Yeah. Okay. Yep. All right, team 6, please go. As climate change increases frequency of extreme precipitation events, this feature of cities like Philadelphia leads to higher likelihood of water contamination. Elevation at sea level. It is that is one with extreme precipitation, but in a city like Philadelphia, it's not by the sea. But it's an urban feature. What is it? What about the built environment? The amount of built environment? Is that what you said? You're getting closer. Yeah. That's definitely one. Yes. Impermeable area. Water runoff sewer drainage. Are we going to give it to her? We're going to give it to you. What is combined sewer overflow? Okay. This is a term used to describe what happens when combined sewer systems become overwhelmed by excess stormwater and overflow into nearby streams and rivers. Combined sewer systems are stormwater and wastewater conveyances that carry domestic sewage, stormwater runoff, and sometimes even industrial waste in one pipe. Most combined sewer systems in the United States were installed in the mid to late 1800s as a result of a considerable population shift from rural to urban areas. As cities experienced significant population growth, they became overwhelmed with more wastewater that resulted in unsanitary conditions and sometimes even disease outbreaks, ultimately leading to a need for centralized wastewater management. At the time, combined sewer systems were the preferred option for managing stormwater and wastewater in urban areas because less pipe was needed to transport both stormwater and wastewater, and they were considered more affordable than systems that separated stormwater from domestic sewage. So for those of you who are interested in topics like this, on Wednesday night, there's a great event happening about the history of this topic in the city of Philadelphia as it involves Fairmount Water Works. It's in Manioc. It's by a historian named Dr. Adam Levine, and if you're interested in going to that, let me know. It should be a really great event. It's a little bit of a sitcom related, but it just so happens to happen during this week. Okay. So Team 2 gets their points. And Team 2 goes next. Okay. Makes up 80 percent of pollution in the oceans. Did you guys go? I heard Team 1, and I heard Team 5. I think 5 was first. Oh, they all got it. Right. Everybody's buzzing. Floor judges. Team 5. You guys call it. Okay. Plastics. That's correct. What is plastic waste? Okay. All right. We got one left. Indoor-outdoor for 100. The greenhouse gases were used in air conditioners, refrigerators, and cleaners for electric parts, but they were not used in air conditioners. Team 2 did. Team 3. Floor judges call it. 3. And they say chlorofluorocarbons. Chlorofluorocarbons. And is that you, Cathy? I can read it. Did we do that? Chlorofluorocarbons were banned globally because of the effects on the ozone layer. Greenhouse gases such as carbon dioxide, methane, chlorofluorocarbons absorb and emit radiant energy within the thermal infrared range, preventing the loss of heat to space. All right. Awesome. Fantastic. You were an awesome audience and awesome teams. Cathy has gifts for everyone. Everybody's a winner. If you liked this type of teaching and learning, let us know. You have to create it. It took a while for me to create this, but that's the software. Thank you, everyone.

Jeopardy-style game

environmental health topics

participants

six groups

answering questions

toxic chemicals

pollution

public health

environmental factors