Deck 8: Environmental Health and Toxicology
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Deck 8: Environmental Health and Toxicology
1
Hazardous substances ______________ while toxins are ______________.
A)React with specific cell components to kill cells; poisonous substances
B)Are dangerous substances; poisonous substances
C)Are usually of concern at all concentrations; dangerous substances
D)Are poisonous substances; also poisonous substances
E)None of the above is correct
A)React with specific cell components to kill cells; poisonous substances
B)Are dangerous substances; poisonous substances
C)Are usually of concern at all concentrations; dangerous substances
D)Are poisonous substances; also poisonous substances
E)None of the above is correct
Are dangerous substances; poisonous substances
2
Some particles or cells cause immune responses when your body's white blood cells recognize them as foreign objects.These are known as
A)Desensitizers
B)Antigens
C)Active asphyxiants
D)Irritants
E)Pollutants
A)Desensitizers
B)Antigens
C)Active asphyxiants
D)Irritants
E)Pollutants
Antigens
3
Diseases such as cholera and ebola are
A)Caused by pathogenic organisms
B)Called communicable diseases
C)Called emergent diseases
D)All of these are characteristics of diseases such as cholera and ebola
A)Caused by pathogenic organisms
B)Called communicable diseases
C)Called emergent diseases
D)All of these are characteristics of diseases such as cholera and ebola
All of these are characteristics of diseases such as cholera and ebola
4
Sick-building syndrome is a result of exposure to ___________.
A)asbestos
B)formaldehyde
C)radon
D)arsenic
A)asbestos
B)formaldehyde
C)radon
D)arsenic
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5
_______________, rather than ______________, are becoming the leading causes of disability and premature death worldwide.
A)Chronic conditions such as cardiovascular disease; infectious diseases such as malaria
B)Infectious diseases such as malaria; chronic conditions such as cardiovascular disease
C)Traffic deaths; infectious diseases such as malaria
D)Chronic conditions such as cardiovascular disease; traffic deaths
E)Infectious diseases such as malaria; traffic deaths
A)Chronic conditions such as cardiovascular disease; infectious diseases such as malaria
B)Infectious diseases such as malaria; chronic conditions such as cardiovascular disease
C)Traffic deaths; infectious diseases such as malaria
D)Chronic conditions such as cardiovascular disease; traffic deaths
E)Infectious diseases such as malaria; traffic deaths
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6
Health organizations now use the ______________, a tool to ______________________.
A)DALY; judge the total impact of the disease rather than only measuring how many people die
B)DALY; judge the total impact of how many people die
C)Morbidity Measure; judge the total impact of the disease rather than only measuring how many people die
D)Morbidity Measure; judge the total impact of how many people die
E)Mortality and Morbidity Measure (3M); judge the total impact of the disease rather than only measuring how many people die
A)DALY; judge the total impact of the disease rather than only measuring how many people die
B)DALY; judge the total impact of how many people die
C)Morbidity Measure; judge the total impact of the disease rather than only measuring how many people die
D)Morbidity Measure; judge the total impact of how many people die
E)Mortality and Morbidity Measure (3M); judge the total impact of the disease rather than only measuring how many people die
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7
Diseases usually develop in response to _______ factors.
A)Nutritional and diet
B)Infectious or toxic
C)Physical
D)Psychological stress
E)All of these are correct
A)Nutritional and diet
B)Infectious or toxic
C)Physical
D)Psychological stress
E)All of these are correct
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8
Historically, the greatest threats to human health came from
A)Carcinogenic or toxic chemicals
B)Psychological stress factors due to crowding
C)Pathogenic organisms
D)Teratogenic chemicals
E)Injuries (intentional and unintentional)
A)Carcinogenic or toxic chemicals
B)Psychological stress factors due to crowding
C)Pathogenic organisms
D)Teratogenic chemicals
E)Injuries (intentional and unintentional)
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9
Endocrine disruptors
A)Disrupt nerve cells
B)Alter genetic material
C)Repress the immune system
D)Disrupt normal hormone functions
E)Cause abnormalities in nervous tissue during embryonic growth and development
A)Disrupt nerve cells
B)Alter genetic material
C)Repress the immune system
D)Disrupt normal hormone functions
E)Cause abnormalities in nervous tissue during embryonic growth and development
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10
Allergens are substances that
A)Repress the immune system
B)Stimulate the nervous system
C)Prevent oxygen uptake
D)Activate the immune system
E)Interfere with oxygen uptake
A)Repress the immune system
B)Stimulate the nervous system
C)Prevent oxygen uptake
D)Activate the immune system
E)Interfere with oxygen uptake
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11
Between 1990 and 2010, what showed the biggest rank increase for the "Leading Causes of Global Disease Burden?"
A)HIV/AIDS
B)Stroke
C)Diabetes
D)Malaria
A)HIV/AIDS
B)Stroke
C)Diabetes
D)Malaria
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12
How many substances is the EPA responsible for monitoring?
A)657
B)500
C)275
D)1,000
A)657
B)500
C)275
D)1,000
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13
Tumors can grow because of exposure to
A)Neurotoxins
B)Mutagens
C)Antigens
D)Parasitic organisms
E)Allergens
A)Neurotoxins
B)Mutagens
C)Antigens
D)Parasitic organisms
E)Allergens
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14
Neurotoxins act by
A)Disrupting nerve cells
B)Altering genetic material
C)Repressing the immune system
D)Disrupting normal hormone functions
E)Causing abnormalities in nervous tissue during embryonic growth and development
A)Disrupting nerve cells
B)Altering genetic material
C)Repressing the immune system
D)Disrupting normal hormone functions
E)Causing abnormalities in nervous tissue during embryonic growth and development
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15
Toxic substances are dangerous because they
A)React or interfere with specific cell functions
B)Can physically remove or tear tissues
C)Are usually synthetic
D)Cause debilitating parasitic diseases
E)Cause excessive water accumulation in tissues
A)React or interfere with specific cell functions
B)Can physically remove or tear tissues
C)Are usually synthetic
D)Cause debilitating parasitic diseases
E)Cause excessive water accumulation in tissues
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16
MRSA is an example of
A)antibiotic resistant bacteria
B)one of the many regulations that the EPA enforces
C)a highly toxic and bioaccumulating substance
D)Marine Response and Safety Association
A)antibiotic resistant bacteria
B)one of the many regulations that the EPA enforces
C)a highly toxic and bioaccumulating substance
D)Marine Response and Safety Association
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17
The World Health Organization regards health as primarily a matter of ________ well-being.
A)Physical
B)Mental and physical
C)Social and mental
D)Physical, mental, and social
E)Physical and social
A)Physical
B)Mental and physical
C)Social and mental
D)Physical, mental, and social
E)Physical and social
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18
Morbidity is another word for
A)Death
B)Health
C)Unhappiness
D)Illness
E)Emergent diseases
A)Death
B)Health
C)Unhappiness
D)Illness
E)Emergent diseases
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19
Which of the following practices contributes the least to antibiotic or pesticide resistance?
A)Domestic farm animals are fed low doses of antibiotics to increase weight gain.
B)A person takes the full course of the appropriate antibiotic when she has a viral infection.
C)A person takes the full course of the appropriate antibiotic when she has a bacterial infection.
D)A person takes an anti-malarial drug when he does not have malaria.
E)Mosquito populations in the tropics have been sprayed with DDT for about 50 years.
A)Domestic farm animals are fed low doses of antibiotics to increase weight gain.
B)A person takes the full course of the appropriate antibiotic when she has a viral infection.
C)A person takes the full course of the appropriate antibiotic when she has a bacterial infection.
D)A person takes an anti-malarial drug when he does not have malaria.
E)Mosquito populations in the tropics have been sprayed with DDT for about 50 years.
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20
Infectious diseases such as diarrhea are closely linked to
A)Emotional stress
B)Malnutrition
C)Toxicity effects
D)The overconsumption of fats
E)All of these exacerbate infectious diseases such as diarrhea
A)Emotional stress
B)Malnutrition
C)Toxicity effects
D)The overconsumption of fats
E)All of these exacerbate infectious diseases such as diarrhea
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21
A group of cells that grow extremely fast and begin to obstruct other cells' functions is known as
A)A malignant tumor
B)A parasite
C)Teratogenesis
D)A pathogen
E)A benign tumor
A)A malignant tumor
B)A parasite
C)Teratogenesis
D)A pathogen
E)A benign tumor
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22
Among the most important characteristics of chemicals in determining their environmental risks is/are
A)Solubility
B)Reactivity
C)Persistence
D)Toxicity
E)All of these
A)Solubility
B)Reactivity
C)Persistence
D)Toxicity
E)All of these
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23
Highly persistent toxic chemicals
A)Retain their toxicity as they cycle through the food chain and environment
B)Lose their toxicity once released in the environment
C)Accumulate within one organism but break down at higher trophic levels
D)Are highly unusual among artificial chemicals
E)Are usually not that toxic in their life span
A)Retain their toxicity as they cycle through the food chain and environment
B)Lose their toxicity once released in the environment
C)Accumulate within one organism but break down at higher trophic levels
D)Are highly unusual among artificial chemicals
E)Are usually not that toxic in their life span
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24
A chemical interaction in which one substance exacerbates the effects of another is termed
A)A persistent reaction
B)A bioaccumulation
C)An antagonistic reaction
D)Synergism
E)Metabolic degradation
A)A persistent reaction
B)A bioaccumulation
C)An antagonistic reaction
D)Synergism
E)Metabolic degradation
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25
Fetal alcohol syndrome is caused by exposure to a(n)
A)Neurotoxin
B)Mutagen
C)Antigen
D)Teratogen
E)Allergen
A)Neurotoxin
B)Mutagen
C)Antigen
D)Teratogen
E)Allergen
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26
The biomagnification of DDT demonstrates that
A)Higher trophic level organisms can concentrate toxins in a type of "inverse biological pyramid."
B)Birds should not depend on fish for food
C)DDT is easily metabolized and excreted by most organisms
D)DDT is an extremely water-soluble material
E)Water-soluble toxins are widespread
A)Higher trophic level organisms can concentrate toxins in a type of "inverse biological pyramid."
B)Birds should not depend on fish for food
C)DDT is easily metabolized and excreted by most organisms
D)DDT is an extremely water-soluble material
E)Water-soluble toxins are widespread
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27
Which of the following statements is true?
A)If a substance is toxic, its toxicity is highly dependent on its form and where it is present in the environment.
B)If a substance is toxic, it is equally toxic regardless of its form or where it is present in the environment.
C)The most important factor in the toxicity of a substance is the route it enters our bodies.
D)The most important factor in the toxicity of a substance is its persistence in the environment.
E)None of these statements is true.
A)If a substance is toxic, its toxicity is highly dependent on its form and where it is present in the environment.
B)If a substance is toxic, it is equally toxic regardless of its form or where it is present in the environment.
C)The most important factor in the toxicity of a substance is the route it enters our bodies.
D)The most important factor in the toxicity of a substance is its persistence in the environment.
E)None of these statements is true.
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28
Cardiovascular disease is strongly related to which of these dietary factors?
A)Vitamin deficiencies
B)A lack of cruciferous vegetables
C)Excessive calorie consumption
D)Protein imbalances
E)High salt and fat intake
A)Vitamin deficiencies
B)A lack of cruciferous vegetables
C)Excessive calorie consumption
D)Protein imbalances
E)High salt and fat intake
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29
Fat-soluble contaminants
A)Tend to accumulate in the surface water of aquatic habitats
B)Are easily excreted by organisms
C)Tend to accumulate in soil, sediments, and organisms
D)Commonly biomagnify from lower to higher trophic levels
E)Have very low bioconcentration factors
A)Tend to accumulate in the surface water of aquatic habitats
B)Are easily excreted by organisms
C)Tend to accumulate in soil, sediments, and organisms
D)Commonly biomagnify from lower to higher trophic levels
E)Have very low bioconcentration factors
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30
Radiation can act as a mutagen because it
A)Deactivates the immune system
B)Interferes with the activity of nerve cells
C)Causes muscles to grow at unusual rates
D)Damages genetic material in cells
E)Represses oxygen uptake
A)Deactivates the immune system
B)Interferes with the activity of nerve cells
C)Causes muscles to grow at unusual rates
D)Damages genetic material in cells
E)Represses oxygen uptake
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31
If solubility is an important characteristic in toxic material movement in the environment and body, which of the following statements is true?
A)Water-soluble compounds require carriers to enter cells.
B)Oil-soluble compounds readily damage kidneys.
C)Water-soluble compounds move slowly in the environment.
D)Oil-soluble compounds accumulate in the body.
E)Solubility is not an important characteristic in toxic material movement.
A)Water-soluble compounds require carriers to enter cells.
B)Oil-soluble compounds readily damage kidneys.
C)Water-soluble compounds move slowly in the environment.
D)Oil-soluble compounds accumulate in the body.
E)Solubility is not an important characteristic in toxic material movement.
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32
Carcinogens are substances that cause
A)A sensitized reaction
B)Out-of-control cell growth and tumors
C)Birth defects
D)Immune responses
E)Carcinogens can cause all of these reactions
A)A sensitized reaction
B)Out-of-control cell growth and tumors
C)Birth defects
D)Immune responses
E)Carcinogens can cause all of these reactions
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33
Bioaccumulation is important because it allows cells to
A)Accumulate essential nutrients and minerals
B)Rid themselves of waste material
C)Protect themselves against toxins
D)Reproduce more quickly
E)Have a ready source of energy if it is needed
A)Accumulate essential nutrients and minerals
B)Rid themselves of waste material
C)Protect themselves against toxins
D)Reproduce more quickly
E)Have a ready source of energy if it is needed
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34
Bioaccumulation is a term that describes the way cells
A)Grow as they absorb all types of molecules
B)Selectively absorb and store molecules
C)Accumulate food stores as fat
D)Metabolize compounds that are absorbed
E)Allow water-soluble compounds to pass through membranes
A)Grow as they absorb all types of molecules
B)Selectively absorb and store molecules
C)Accumulate food stores as fat
D)Metabolize compounds that are absorbed
E)Allow water-soluble compounds to pass through membranes
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35
If 100 cups of strong coffee contain a lethal dose of caffeine, why don't coffee drinkers eventually die from caffeine overdose?
A)Coffee drinkers who drink more than 100 cups of coffee a week will eventually die from the bioaccumulation.
B)Because of its molecular form, all of the caffeine is not actually absorbed into the body.
C)Once the coffee cools, the caffeine is not as strong as it was when the coffee was fresh.
D)Coffee drinkers who drink more than 100 cups of coffee a month will eventually die from the bioaccumulation.
E)Our bodies metabolize the caffeine before lethal concentrations are reached.
A)Coffee drinkers who drink more than 100 cups of coffee a week will eventually die from the bioaccumulation.
B)Because of its molecular form, all of the caffeine is not actually absorbed into the body.
C)Once the coffee cools, the caffeine is not as strong as it was when the coffee was fresh.
D)Coffee drinkers who drink more than 100 cups of coffee a month will eventually die from the bioaccumulation.
E)Our bodies metabolize the caffeine before lethal concentrations are reached.
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36
Which of the following tissues is more likely to develop cancers?
A)Skin, because there is a high cellular reproduction rate to replace injured cells
B)Eyes, because they are always exposed to light
C)Fat, because of bioaccumulation
D)Bones, because of the increased radiation in our environment
E)No one tissue is more likely to develop cancer when compared to another type of tissue
A)Skin, because there is a high cellular reproduction rate to replace injured cells
B)Eyes, because they are always exposed to light
C)Fat, because of bioaccumulation
D)Bones, because of the increased radiation in our environment
E)No one tissue is more likely to develop cancer when compared to another type of tissue
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37
Teratogens cause abnormal growth specifically in
A)Nerve cells
B)Muscle cells
C)Embryos
D)The liver
E)Skin cells
A)Nerve cells
B)Muscle cells
C)Embryos
D)The liver
E)Skin cells
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38
Biomagnification is a concentration of toxins
A)Within certain cells of the body
B)within cells of predators as they consume and store the toxins that were in the bodies of their prey.
C)Within the liver as an organism gets older
D)Within the bodies of organisms at low trophic levels
E)None of these is true regarding biomagnification
A)Within certain cells of the body
B)within cells of predators as they consume and store the toxins that were in the bodies of their prey.
C)Within the liver as an organism gets older
D)Within the bodies of organisms at low trophic levels
E)None of these is true regarding biomagnification
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39
Our bodies minimize the effects of toxic compounds by all of the following except
A)Metabolic degradation
B)Excretion
C)Antagonistic reactions
D)Repair mechanisms
E)All of these are ways that our bodies minimize the effects of toxic compounds
A)Metabolic degradation
B)Excretion
C)Antagonistic reactions
D)Repair mechanisms
E)All of these are ways that our bodies minimize the effects of toxic compounds
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40
An advantage of testing for toxicity by exposing animals to chemicals is that using animals is
A)Cheaper than other methods
B)Faster than other methods
C)Usually quite humane
D)Easier than using computer models
E)A trusted and usually reliable way to get results
A)Cheaper than other methods
B)Faster than other methods
C)Usually quite humane
D)Easier than using computer models
E)A trusted and usually reliable way to get results
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41
The dose/response curve shows that
A)Some exposure is necessary before most individuals respond
B)Any exposure causes immediate response
C)Response levels off as dosage increases
D)The dose decreases as response increases
E)All of these are represented by the dose/response curve
A)Some exposure is necessary before most individuals respond
B)Any exposure causes immediate response
C)Response levels off as dosage increases
D)The dose decreases as response increases
E)All of these are represented by the dose/response curve
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42
Individuals represented by the right end of the dose/response curve (responding to doses between 30 and 40 ppm) are ____________ to the chemical.
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
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43
The DALY combines premature deaths and loss of healthy lives resulting from illness or injury.
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44
Most people do their own personal risk assessments based upon
A)Scientific data
B)Whimsical preference devoid of logic
C)Logical reasoning about relative risks
D)Personal biases and preferences as well as logic
E)Statistical probabilities
A)Scientific data
B)Whimsical preference devoid of logic
C)Logical reasoning about relative risks
D)Personal biases and preferences as well as logic
E)Statistical probabilities
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45
One positive aspect of the current state of world diseases is that domestic animals and wildlife are not experiencing epidemics.
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46
Two problems encountered in human health risk assessment are _______________________ and ___________________.
A)Use of chemical mixtures; lack of knowledge about synergistic effects
B)Lack of funding for federal mandates; lack of public support
C)Extrapolation of data to low doses; extrapolation of data from nonhuman species to humans
D)Lack of planning; the involvement of politics
E)There are no inherent problems in human health risk assessment
A)Use of chemical mixtures; lack of knowledge about synergistic effects
B)Lack of funding for federal mandates; lack of public support
C)Extrapolation of data to low doses; extrapolation of data from nonhuman species to humans
D)Lack of planning; the involvement of politics
E)There are no inherent problems in human health risk assessment
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47
Pathogenic organisms are those that cause diseases.
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48
Which of the following is not a problem with generalizing the results of LD50 to humans?
A)Closely related species can have different reactions.
B)Different individuals of the same species can have different reactions.
C)Differences in physiology and metabolism can lead to different reactions.
D)Smaller species generally have reactions that are more sensitive.
E)Differences in metabolism can lead to different reactions.
A)Closely related species can have different reactions.
B)Different individuals of the same species can have different reactions.
C)Differences in physiology and metabolism can lead to different reactions.
D)Smaller species generally have reactions that are more sensitive.
E)Differences in metabolism can lead to different reactions.
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49
An LD50 is a dose of a toxic chemical that
A)Is an acceptable level of risk for most individuals
B)All individuals react to
C)Kills individuals 50 years old and obove
D)Is 50 times less than the minimal dose
E)Kills half of the population
A)Is an acceptable level of risk for most individuals
B)All individuals react to
C)Kills individuals 50 years old and obove
D)Is 50 times less than the minimal dose
E)Kills half of the population
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50
The saying "the dose makes the poison" means that
A)Almost nothing is toxic at low levels
B)Nearly anything can be toxic at some level
C)Some things are more poisonous than other things
D)Toxic materials are measured in doses of lethal amounts
E)All things are equally poisonous at equal doses
A)Almost nothing is toxic at low levels
B)Nearly anything can be toxic at some level
C)Some things are more poisonous than other things
D)Toxic materials are measured in doses of lethal amounts
E)All things are equally poisonous at equal doses
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51
Detection of toxic chemicals depends upon
A)How many chemicals are present
B)How many individuals respond to them at a certain dosage
C)The sensitivity of measuring techniques and how many chemicals are present
D)Whether or not individuals or groups of individuals are sensitive to them
E)Whether or not groups of individuals are sensitive to them
A)How many chemicals are present
B)How many individuals respond to them at a certain dosage
C)The sensitivity of measuring techniques and how many chemicals are present
D)Whether or not individuals or groups of individuals are sensitive to them
E)Whether or not groups of individuals are sensitive to them
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52
As a society, we usually focus attention on health risks that are
A)Most serious
B)Easiest to clean up
C)Most well publicized and frightening
D)Statistically more likely to occur
E)All of these receive equal money and attention
A)Most serious
B)Easiest to clean up
C)Most well publicized and frightening
D)Statistically more likely to occur
E)All of these receive equal money and attention
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53
Malaria is caused by a parasite that is transmitted by mosquitoes.
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54
Individuals represented by the middle of the dose/response curve (responding to doses of 20 ppm) are ______________ for that population.
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
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55
Which of the following factors would explain the seemingly irrational behavior of a father who smokes (high-risk factor for baby) but throws away his baby's teething rings that may contain phthalates (seemingly low-risk factor for baby)?
A)People tend to downplay risks that are associated with activities they are committed to or enjoy.
B)Most people do not understand the concepts of probability.
C)News media can give a biased view of hazards.
D)People tend to have an irrational fear of certain technologies that are not as well understood.
E)All of these factors can lead to the relatively irrational behavior demonstrated by the father.
A)People tend to downplay risks that are associated with activities they are committed to or enjoy.
B)Most people do not understand the concepts of probability.
C)News media can give a biased view of hazards.
D)People tend to have an irrational fear of certain technologies that are not as well understood.
E)All of these factors can lead to the relatively irrational behavior demonstrated by the father.
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56
Acute effects of a toxin appear
A)Only after repeated exposure
B)Long after exposure
C)Immediately after exposure
D)When there is sustained contact
E)To cause permanent damage if the individual survives the initial exposure
A)Only after repeated exposure
B)Long after exposure
C)Immediately after exposure
D)When there is sustained contact
E)To cause permanent damage if the individual survives the initial exposure
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57
Toxins can be dangerous in very small concentrations.
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58
Individuals represented by the left end of the dose/response curve (responding to doses between 0 and 10 ppm) are ______________ for that population.
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
A)Very sensitive
B)Very insensitive
C)About average in sensitivity
D)Relatively insensitive
E)Relatively sensitive
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59
Chronic effects of a toxic response
A)Are less harmful than acute effects
B)Can last a long time or be permanent
C)Rarely show up in time to be diagnosed
D)Are unlikely to be lethal
E)Are likely to kill the individual during the initial exposure
A)Are less harmful than acute effects
B)Can last a long time or be permanent
C)Rarely show up in time to be diagnosed
D)Are unlikely to be lethal
E)Are likely to kill the individual during the initial exposure
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60
Historically, which of the following considerations in setting standards for toxic exposure has been emphasized the least?
A)Including information about how toxins affect natural ecological systems
B)Different members of the population have different sensitivities to toxins
C)Including information about both chronic and acute exposures to a toxin
D)Individuals in the human population have been exposed to many different kinds of toxins that may have additive or synergistic effects
E)All of these considerations have been used and are important in setting policy
A)Including information about how toxins affect natural ecological systems
B)Different members of the population have different sensitivities to toxins
C)Including information about both chronic and acute exposures to a toxin
D)Individuals in the human population have been exposed to many different kinds of toxins that may have additive or synergistic effects
E)All of these considerations have been used and are important in setting policy
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61
Compare three possible dose/response curves resulting from low doses of a toxin.Use a drawing of all three curves in your discussion with appropriate labels.Explain the differences between these responses.
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62
Some soft vinyls are softened with a potential carcinogen, phthalate plasticizers, that may leach out if a baby chews on the product.Discuss whether or not you would be worried about phthalates (and therefore not allow your child to have them) if you had a child.Use at least three items that support your reasoning.
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63
Evaluate at least five major environmental risks you have faced in the past year.List the risks you have encountered and rank them from most harmful to least harmful (in terms of increasing the chances of dying in any given year).Support your ranking with explanations.
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