ENVIRONMENT AND HEALTH

Dr.Shahid MahmoodAssistant Professor

Department of Community Medicine

Fatima Jinnah Medical College Lahore

Lecture 1

ACKNOWLEDGEMENT

Park K. Textbook of Preventive and Social Medicine

Dr.Ejaz Qureshi. Institute of Public Health Lahore

Maxcy- Rosenau-Last. Public health and Preventive Medicine

o Gupta & Mahajan . Textbook of preventive and Social Medicine

o Illiyas -Shah- Ansari . Public Health and Community Medicine

o World Health Organization (WHO)o Pakistan Environmental Protection Agency

(EPA)

LEARNING OBJECTIVES At the end of this session, students will be able to:

1. Define basic terms in Environmental Health

2. Illustrate the types of environments and its role in influencing health and disease.

3. Describe current environmental health issues

4. Appreciate how environmental degradation would lead to various emergencies and disasters.

ENVIRONMENT All the external factors Living and non

living Material and Non-

material

Surrounding and affecting a given organism

Environment

Physical

WaterAirSoil

HousingWastes

Radiation

Biologic

PlantsAnimalsBacteriaVirusesInsects

Rodents

Social

ValuesCustomsCulture

OccupationReligion

PHYSICAL ENVIRONMENT AND HEALTH

Physical Environm

ent

Air

Water

Soil

Housing Radiat

ion

Climate

NoiseLight

WasteDiarrheaDysenteryHepatitis Amoebiasis

Respiratory tract infections, cancers

Lead Poisoning,Mercury poisoning, Leukemia, skin problems

Respiratory infections, skin infections, accidents

Heat cramps, Frostbite, Respiratory problems

Leukemia, mutations

Deafness,Fatigue,Annoyance,Psychological effect, Blindness (light)

Chemical poisoning,Radioactive hazards,Skin problems, GI problems

BIOLOGICAL ENVIRONMENT AND HEALTH

Biological Environment

Bacteria

Viruses

Arthropods

Plants and Eukaryotic organisms

Animals

Cholera, Typhoid, TB

ChickenpoxPoliomyelitisMeaslesInfluenza

Malaria (parasite)Dengue (viruses)

Zoonoses * Rabies * Yellow fever* Plague

Fungal infection, Poisoning

Social Environment

Values/ Culture/ Socio-economic

Conditions/ Employment/

Poverty /Education/Polit

ics/Religion/

Technology/ Urbanization

Social Problems

• Poverty•

Unemployment

• Corruption• Hunger• Drug

Addiction• Alcoholism• Bullying• Gambling• Prostitution• Underage

marriages• Inequality of

wealth• Gender

inequality

Inequitable health care

Malnutrition Depression/ Anxiety Mental stress Accidents Poor dental hygiene reduce life

expectancy Hygiene related

diseases like scabies, fungal infections

Poor environmental sanitation diseases

ECOSYSTEM

An ecosystem is a biological environment consisting of all the organisms living in a particular area, as well as all the nonliving (abiotic), physical components of the environment with which the organisms interact, such as air, soil, water and sunlight.

ECOLOGY The scientific study of interactions of

organisms with one another and with the physical and chemical environment.

SANITATION (A WAY OF LIFE)

Science of safe guarding health

“ Quality of living expressed in clean home, clean workplace, clean neighborhood and clean community…” National Sanitation Foundation , USA

ENVIRONMENTAL SANITATION

“ The Control of all those factors in man’s physical environment which exercise or may exercise a deleterious effect on his physical environment, health and survival ”

World Health Organization (WHO)

HEALTH “ State of physical , mental and social

wellbeing and not merely an absence of disease or infirmity ” World Health Organization

It is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health.

Other terms refer to the discipline of environmental health include

Environmental public health and Environmental health and protection.

Environmental Health

ENVIRONMENTAL HEALTH

It Comprises the aspects of human

health that are determined by physical, chemical, biological, and psychosocial factors in the environment.

It also concerns with assessing, correcting, controlling and preventing factors in the environment that can potentially affect adversely the health of present and future generations”

University of California, USA

DEFINITION OF ENVIRONMENTAL HEALTH – WHO

Environmental health is defined by the World Health Organization as:

“ Those aspects of the human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and controlling factors in the environment that can potentially affect health”.

Environmental Health (Themes of the definition)

Study of all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours.

Assessment and control of those environmental factors that can potentially affect health.

Targeted towards preventing disease and creating health-supportive environments.

(World Health Organization)

ENVIRONMENTAL HEALTH SERVICES

Those services which implement environmental health policies through monitoring and control activities.

Carry out that role by promoting the improvement of environmental parameters and by encouraging the use of environmentally friendly and healthy technologies and behaviors.

They also have a leading role in developing and suggesting new policy areas.

DISCIPLINES OF ENVIRONMENTAL HEALTH

Three basic disciplines generally contribute to the field of environmental health:

1. Environmental Epidemiology2. Toxicology3. Exposure science.

Each of these disciplines contributes different information to describe problems in environmental health, but there is some overlap among them.

ENVIRONMENTAL STUDY TO HEALTH POLICY DECISIONS

Information from these three disciplines can be combined to conduct a risk assessment for specific chemicals or mixtures of chemicals to determine whether an exposure poses significant risk to human health. This can in turn be used to develop and implement environmental health policy that, for example, regulates chemical emissions, or imposes standards for proper sanitation.

ENVIRONMENTAL HEALTH TEAM

It comprises of :

1. Public health practitioner2. Epidemiologist 3. Economist 4. Public Health Engineer 5. Town Planner 6. Clinician7. Sociologist 8. Health Inspector

ENVIRONMENTAL HEALTH PRACTITIONERS

1. Environmental health officers 2. Public Health Inspectors 3. Sanitarians

WHAT ENVIRONMENTAL HEALTH PRACTITIONERS DO? Promoting healthy environments and managing

environmental factors that affect human health. Issues that practitioners deal with include:

1. Environmental degradation2. Climate change3. Contaminated food and water4. Waste management5. Disaster management6. Dangerous goods, chemicals and drug

safety management.

Environmental Health Issues

Indoor Air Pollution

Improper Solid waste Disposal

Outdoor Air Pollution

Water Pollution Poor Housing

POPULATION GROWTH AND URBANIZATION

ENVIRONMENTAL HEALTH ISSUES

Industrial Waste causing water pollution

Nuclear and electromagnetic hazards in Environment

WHY STUDY ENVIRONMENTAL HEALTH ?

Environmental hazards are responsible for as much as 23% the total burden of disease world-wide, and more than one-third of the disease burden among children.

The disease burden is much higher in the

developing world

Most Common problems related to environment include:

o Diarrheao Respiratory tract infectionso Unintentional injuries o Malaria and Dengue

Every year, the lives of four million children under 5 years – mostly in developing countries – could be saved by preventing environmental risks such as unsafe water and polluted air

For many poor people, household waste can become the source of their income.

proximity to livestock and garbage poses multiple risks to the health of such workers.

88%of the diarrheal deaths are due to unsafe water, inappropriate sanitation and lack of hygiene.

Indoor air pollution due to cooking fuels is estimated to cause approximately 2 million premature deaths mostly in developing countries. Almost half of these deaths are due to pneumonia in children under 5 years of age.

Urban outdoor air pollution is estimated to

cause 1.3 million deaths worldwide per year.

IMPORTANCE OF STUDYING ENVIRONMENTAL HEALTH

Worldwide, as many as 13 million deaths could be prevented every year by making our environments healthier.

Health impacts of environmental hazards run across more than 80 diseases and types of injury.

The global warming that has occurred since the 1970s was causing over 140 000 excess deaths annually by the year 2004.

IMPORTANCE OF ENVIRONMENTAL HEALTH

The electromagnetic fields produced by mobile phones are classified by the International Agency for Research on Cancer as possibly carcinogenic to humans.

Climate change affects the

fundamental requirements for health – clean air, safe drinking water, sufficient food and secure shelter.

IMPORTANCE OF ENVIRONMENTAL HEALTH

Many of the major killers such as diarrhoeal diseases, malnutrition, malaria and dengue are highly climate-sensitive and are expected to worsen as the climate changes

Reducing emissions of greenhouse gases through better transport, food and energy-use choices can result in improved health.

Healthier environments could significantly reduce the incidence of cancers, cardiovascular diseases, asthma, lower respiratory infections, musculoskeletal diseases, road traffic injuries, poisoning, and drowning.

DEVELOPING COUNTRIES

In developing countries, the main environmentally caused diseases are diarrhoeal disease, lower respiratory infections, unintentional injuries, and malaria.

Better environmental management could prevent 40% of deaths from malaria, 41% of deaths from lower respiratory infections, and 94% of deaths from diarrhoeal disease – three of the world's biggest childhood killers.

ENVIRONMENTAL ISSUES IN PAKISTAN

Improper disposal of both solid and liquid waste.Unsafe drinking water

AIR POLLUTION IN PAKISTAN

NOISE POLLUTION IN PAKISTAN

POOR HOUSING IN PAKISTAN

ENVIRONMENTAL HEALTH STATISTICS PAKISTAN

The WHO reports that 25-30% of all hospital admissions are connected to water borne bacterial and parasitic conditions, with 60% of infant deaths caused by water infections.

Annual deaths in Pakistan due to respiratory diseases have not been well-documented Total Annual deaths attributed to indoor pollution in Pakistan are 70700.

COMPARISON OF SAFE WATER AND SANITATION – SOUTH EAST ASIAN COUNTRIES

Indi

a

Bhuta

n

Bangl

ades

h

Indo

nesia

Maldi

ves

Myanm

ar

Nepal

Sri l

anka

Thai

land

Paki

stan

0

10

20

30

40

50

60

70

80

90

100

Safe Water Adequate Sanitation

CURRENT ENVIRONMENTAL HEALTH CONCERNS

Air Quality

Climate Change/ Global

Warming

Food Safety

Water protectio

nBody Art Safety

Housing Standards

Chemical, Medical and liquid waste

Management

Toxicity in air water, soil

10 MOST POLLUTED CITIES IN WORLD

1.Maputo Mozambique2.Moscow – Russia 3.Brunei Dar- Islam 4.Baghdad - Iraq 5.Mumbai India 6.New Delhi India7.Mexico city Maxico8.Dhaka Bangladesh 9.Karachi Pakistan10. Lagos Nigeria

Leaking Iranian tanker spilt 60,000 tones of crude oil into Moroccan sea ,threatening aquatic life in early 90’s

Burning of Oil wells in Kuwait During Gulf crisis caused atmospheric and Marine Pollution, killed thousands of birds

Effects of Environmental Degradation

An estimated 2000 tons of dead fish was found floating in the marine beach of Karachi possibly due to chemicals effluents from Industries.

The Tsunami Flood in Asian countries caused a devastation with several thousand killed and houses destroyed

IN THIS LECTURE, What is environment , its different types and

relevance to human Health?

How Environmental factors influence our living?

Why it is essential to study Environmental factors?

What are various environmental concerns today?