EXAMINATIONS COUNCIL OF HEALTH SCIENCES/UNZA

FINAL EXAMINATIONS FOR DIPLOMA IN ENVIRONMENTAL SCIENCES

FOR
ENVIRONMENTAL HEALTH TECHNOLOGISTS

EEP 312: - ENVIRONMENTAL EPIDEMIOLOGY

DATE: JUNE, 2018

TIME: 9:00 – 12:00 HOURS

Candidate’s Examination Number:

Candidate’s NRC N umber.

Examination Centre :

INSTRUCTIONS TO CANDIDATES

1. Check that you have the correct examination paper in front of you.
2. There are SIX (6) sections in this paper, ONE, TWO, THREE ,FOUR, FIVE and
SIX
3. Read the instructions very carefully in each section before attempting to answer.
4. All questions must be answered on the examination answer booklet provided only.
5. Write down the number of the questions that you have answered on the cover of
the examination answer booklet.
6. No books, files or mechanical aids are permitted in the examination room.
7. There are shall be no form of communication between students during the
examination. Any student caught doing this will be disqualified

CELLPHONES & PROGRAMMABLE CALCULATORS ARE NOT ALLOWED IN

THE EXAMINATION ROOM

DO NOT TURN THIS PAGE UNTIL YOU ARE TOLD TO DO SO BY THE

INVIGILATOR

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 SECTION A: MULTIPLE CHOICE QUESTIONS
 Answer ALL questions in this section
 Write the best answer of your choice in the answer booklet
 (Total marks = 40)

1. The occurrence in the community of a number of cases of disease that is usually large
or unexpected is known as:
(a) Endemic
(b) Epidemic
(c) Pandemic
(d) None of the above
2. The frequency measure that is used to compare the occurrence of a variable in two
groups is called:
(a) Proportion
(b) Rate
(c) Ratio
(d) Prevalence
3. Incubation period is:
(a) The doubling time of the agent and the communicability time between
exposure
(b) When someone is infected but does not show any symptom
(c) The time from when the agent first invades and the time first symptoms show
(d) None of the above
4. Exposure to health hazard can be via:
(a) Inhalation
(b) Ingestion
(c) Direct skin contact
(d) All the above
5. If an Environmental Health Technologist working in the Mines attaches a small air
pump which draws air at a known rate across a sampling media the device used is
called:
(a) Breathing zone sampling device
(b) Passive sampling device

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 (c) Active sampling device
(d) Bio making sampling device
6. The equation for sensitivity in screening is:
(a) a/a+b
(b) a/a+c
(c) d/b+c
(d) d/b+d
7. The Attack rate is:
(a) A measure of probability or risk of becoming a case
(b) A measure of probability or risk of not becoming a case
(c) A measure of probability or risk of becoming an outbreak
(d) A measure of probability or risk of not becoming an outbreak

8. The health effects that develop in an individual rapidly after exposure are called:
(a) Permanent effects
(b) Chronic effects
(c) Acute effects
(d) Irreversible effects
9. Often, airborne pathogens or allergens cause inflammation in all except:
(a) Stomach
(b) Sinuses
(c) Lungs
(d) Nose
10. Target population is:
(a) The group of people at risk from which the study participants will be sampled
(b) The group of people to which the interpretation of study results will most
likely be generalized.
(c) The group of people in the general population who could develop the disease
of interest…..risk population
(d) The group of people sampled from the general population and included in the
study
11. Classic epidemiology is the study which is population oriented and it looks at all the
listed except:
(a) The environment

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 (b) The care of patients in hospital
(c) The human behaviour
(d) The nutrition
12. Population at risk is:
(a) The group of people at risk from which the study participants will be sampled
(b) The group of people to which the interpretation of study results will most
likely be generalized.
(c) The group of people in the general population who could develop the disease
of interest
(d) The group of people sampled from the general population and included in the
study
13. In cases where an Environmental Health Technologist want to study about the
presence of a diagnosed disease, the best type of epidemiological study to use is:
(a) Prevalence study
(b) Cohort study
(c) Longitudinal study
(d) Case Control study
14. One of the most challenging and important aspect of environmental epidemiology is:
(a) Statistical application of data
(b) Interpretation of collected information
(c) Use of elements of other sciences
(d) Application of ideas and methods of science
15. The amount of hazard that enters the body is termed as:
(a) Exposure
(b) Dose
(c) Effect
(d) Hazard
16. The frequency measure which is usually expressed as a percentage is:
(a) Proportion
(b) Rate
(c) Ratio
(d) None of the above
17. …………………………………….. is a survey of population at a single point in time.
(a) Prevalence study

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 (b) Cross-sectional study
(c) Case control study
(d) Longitudinal Study
18. Features of a study that produce systematic errors are generally referred to as:
(a) Cofounding
(b) Bias
(c) Randomization
(d) None of the above
19. Herd Immunity describes:
(a) Form of immunity that occurs when the vaccination of a significant portion of
the population provides a measure of protection for the individuals who have
not developed immunity
(b) Form of immunity that occurs when the vaccination of a small portion of the
population provides a measure of protection for the individuals who have not
developed immunity
(c) Form of immunity that occurs when the vaccination of a significant portion of
the population provides no protection for the individuals who have not
developed immunity
(d) Form of immunity that does not occur when the vaccination of a significant
portion of the population provide a measure of protection for the individuals
who have not developed immunity
20. Specificity is defined as:
(a) The proportion of patients who do not have the disease who will test negative
(b) The proportion of patients who have the disease who will test positive
(c) The proportion of patients who do not have the disease who will test positive
(d) The proportion of patients who have the disease who will test negative
21. For any potential environmental hazard one of the main principle for monitoring and
controlling is:
(a) To identify the critical agents, pathways and the population at risk
(b) For the agents to be classified correctly in that field
(c) To have the correct measurements of the concentrates of the pollutants in the
environment
(d) None of the above.

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22. The substance used as indicator of a biologic state in monitoring and controlling of
environmental hazards is called:
(a) Ionizer
(b) Biomarker
(c) Biomonitor
(d) Hazard analyser
23. Confounding is:
(a) When a separate factor influences the risk of developing a disease other than a
risk factor being studied
(b) When controls are matched to cases at the start of the study in order to see
what happens in the development of disease.
(c) When the subjects are divided into groups at the analysis stage in order to see
those that are at risk
(d) When factors influencing the development of disease are easily identified in
the study conducted.
24. Risk period is:
(a) From the time one is exposed to a risk up to the time the agent starts to
multiply
(b) The total time during which one gets infected to the time they start to suffer
from a disease of interest
(c) The total time during which one is at the danger of developing an outcome of
interest
(d) The total time during which the agent is in the incubation period
25. The proportion of immune individuals in a population above which the disease may
no longer persist is called:
(a) Herd immunity
(b) Herd immunity threshold
(c) Herd immunity maximization
(d) Herd immunity control.
26. Health risk assessment has:
(a) Six steps
(b) Five steps
(c) Four steps
(d) Three steps

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27. All are done in risk characterization except:
(a) Integrating and summarizing the hazard
(b) Develop public risk estimate
(c) Develop a framework to define the significance of the risk
(d) Change the levels of causes of disease that associated with the risk
28. Cohort studies are sometime called:
(a) Snapshot studies
(b) Retrospective studies
(c) Prospective studies
(d) None of the above
29. Crude mortality rate is:
(a) Death tempo from a specified cause for a population during a specified time
period
(b) Death tempo from all causes of death for a population during a specified time
period
(c) Death tempo from all hospitals during a specified time period
(d) None of the above
30. If a person works in an area that may have ionizing radiation, they are supposed to:
(a) Continue working even when the personal dose limit is reached as long as they
feel health
(b) Go for radiation tests every two years
(c) Wear radiation budges to monitor personal exposure to radiation
(d) None of the above
31. The fifth most frequent cause of mortality and leading causes of injury related deaths
are
a) Smoking
b) Motor vehicle related, fire arm or poisoning
c) Flying
d) Swimming
32. Give an example of an airborne illness
a) Spores in the air
b) An air viral carrier
c) Contaminated objects and are nonmoving
d) None of the above

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 33. Which research study method is used for ongoing surveillance or to measure trends in
disease rates over many years in a defined population.

a) Cross-sectional survey
b) Cross-sectional ecologic survey
c) Longitudinal ecologic studies
d) Case control studies
34. The traditional black box epidemiology is defined as
a) The measurement of media use and video games
b) How much a plane can go for without crashing
c) An uncovered association between risk and disease without knowing why
d) All of the above
35. Which of the following is NOT an observational design for generating hypotheses?
a) Cross-sectional survey
b) Cross-sectional ecologic survey
c) Longitudinal ecologic studies
d) Case control studies
36. If there has been a food borne outbreak of disease, the investigator assembles the persons
who have the disease and a sample of the persons who ate at the same at the time of
exposure but did not have the disease. This describes which kind of study?
a) Cross-sectional survey
b) Cross-sectional ecologic studies
c) Longitudinal ecologic studies
d) Case-control studies
37. A Classical epidemiology is a study which is population oriented and looks at the all the
aspects listed below except for………….?
a) The environment
b) The nutrition
c) Human behavior
d) Care for patients in hospitals
38. An indirect mean of transmission may be anything other than
a) Person to animal
b) Person to person
c) Object to person

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 d) None of the above
39. Define a host
a) With the presence of, excessive presence, or lack of is essential for the
occurrence of a disease
b) This is the domain in which disease causing agents may exist, survive or come
from
c) Is the person or animal that provides abstinence for an infectious agent under
natural conditions
d) All of the above
40. Autism is defined as
a) A condition that impairs functioning in the social, communicative and
behavioural domains
b) Cognitive functioning
c) Mental retardation
d) None of the above

SECTION B: TRUE OR FALSE QUESTIONS

 Answer ALL questions in this section
 Each question carries one (1) mark
 Indicate your answer either TRUE or FALSE in the answer booklet

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 (Total marks = 10)
1. To calculate a rate, we must have an estimate of the population at risk during a specified
period for the denominatorTrue or False
2. People who previously had an infectious disease and develop immunity against re-
infection are at risk when there is an outbreak of that disease. True or False
3. A prevalence study is also prospective study True or False
4. Direct contact transmission occurs when there is physical contact between an infected
person and a susceptible personTrue or False
5. Source population is a group of people at risk which the study population will be
sampled
True or False
6. Relative risk is at times called odds ratio True or False
7. The process of releasing the pollutants into the environment is called dilution True or
FalseSurveillance is an ongoing examination to detect the trends or distribution of
disease in order to initiate monitoring of a disease True or False Incidence rate is the
measure of disease occurrence per unit time True or False
8. Risk period is quantified as the person-time at risk because it incorporates both the
number of individuals not at risk and the amount of time each individual is at risk. True
or False
9. Vaccination acts as a firewall in the spread of disease. True or False
10. There are three kinds of frequency measures that are used with two category
variablesTrue or False

SECTION C: CROSS MATCHING QUESTIONS

 Answer ALL questions in this section
 Each question carries one (1) mark
 (Total marks = 10)

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S/N D E S C R I P T I O N E L E M E N T
1 Protection gained from a person to person transaction C hi ku ng un y a
2 ….is defined as the resistance of a population to the introduction and spread of an infectious agent, based on the immunity of a high proportion of individual members of the population Epidemi c
3 Example of an Arboviral dis eas e may include : V e h i c l e
4 The group of people in the general population who could develop the disease of interest Climate, terrain, and pollution
5 The occurrence in the community of a number of cases of disease that is usually large or unexpected is known as: Community resistance
6 Physical environmental factors under the epidemiological triangle include P o p u l a t i o n a t r i s k
7 The mode of transport of an infectious agent through the environment to a susceptible host is called a: S el ec ti v e s c re en in g
8 The time from when the agent first invaded up to the time the first symptoms manifest Food Safety
9 All conditions and measures necessary to ensure the safety and suitability of food at all stages of the food chain Incubation period
1 0 This is the ability of a test to identify only those non diseased individuals who actually do not have the disease Passive immunity

SECTION D: FILLING BLANKS QUESTIONS

 Answer ALL questions in this section
 Each question carries one (1) mark
 (Total marks = 10)
1. A hazard can be defined as "a property or situation that in particular circumstances
could lead to ......death /njury .......................
2. Risk......assessment .......................... is the procedure in which the risks posed by
inherent hazards involved in processes or situations are estimated either quantitatively
or qualitatively.
3. .......suspectibilty .................................Stage by which the presence of factors that favour
the occurrence of disease.
4. Risk ....analysis ............................. involves people's beliefs, attitudes, judgements and
feelings, as well as the wider social or cultural values that people adopt towards hazards
and their benefits.
5. Range of values surrounding the estimate which has a specified probability of including
the true population values is called standard.......variation ......................
6. Epidemiology is mainly a......................................science.
7. The...................... in the infectious process range from viral particles to complex multi-cellular
organisms

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 8. Risk.....................................is the process of integrating exposure and effects data and
evaluating any associated uncertainties.
9. The amount of hazard that enters the body is termed as...........dose ..............................
10. Diseases that are always present in a community, usually at a low, more or less constant,
frequency are classified as having an...............................................pattern

SECTION E: SHORT ANSWER QUESTIONS

 There are six (6) questions in this section
 Answer all questions in this section
 (Total marks = 30)
1. When discussing bias, one may talk of selection bias. Discuss three kinds of selection
bias (5 marks)
2. In the definition of epidemiology, one of the concepts discussed is pattern. Discuss
three issues that are related to this concept (5 marks)
3. Discus the best ways that can be used to deal with possible confounding factors in
order to eliminate its effects from the study. (5 marks)
4. Habbanyuka Hachivwalala, an EHT third year was asked to write the advantages and
disadvantages of cohort studies. Write three advantages and three disadvantages
which he wrote? (5 marks)
5. In evaluating the accuracy of screening tests, what should one take into account? (5
marks) (5 marks)
6. What are the four levels of scientific approach that can be used in the study of disease
(5 marks)

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SECTION F: ESSAY QUESTIONS
 There are THREE (03) questions in this section.
 Answer two (2) questions only from this section
 (Total marks = 20)
1. Discuss Environmental risk assessment. (10 marks)
2. Seven cases of hepatitis A occurred among 70 children who were attending child care
centre in Namulonga. Each infected child came from a different family. The total
number of children affected in the 7 families was 32. After a while, 5 family members
of the 7 infected children also developed hepatitis A.
a. Calculate the attack rate (3 marks)
b. Calculate the secondary attack rate (4 marks)
c. Interpret the results for (a) and (b) (3 marks)
3. Discuss the best method that can be used to deal with possible confounding factors in
order to eliminate its effects on the study. (10 marks)

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