CHP310:

Community Health Program-l

Mohamed M. B. Alnoor

• Definitions• Importance of EH

Population overgrowth Air pollution Ozone depletion/global warming Water pollution

• Major global Environmental Problems

• Challenges and Obstacles

• Scope of EH practice Traditional and Modern Hazards EH & ES concerns Water Supply Sanitation Waste Disposal

Environmental health is the

Environmental Health (EH)?

study and management

of environmental conditionsthat

affect health and well-being of humans

Contamination The introduction of undesirable

materials.

The introduction of harmful materials or production of harmful conditions.

Pollution

Impure, dirty, or otherwise unclean .Polluted environment

Pollutant

a waste material that negatively affects

Three factors determine the severity of a pollutant:

• chemical nature• concentration • persistence

air,

water or soil.

• Point sources:smokestacks, accidental spills or pipes discharging into waterways.

• Area sources, (non point sources):More diffuse:

Pollutants are introduced at:

Urban and agricultural runoff.Mobile sources: Automobile exhaust.

Is “a factor or exposure that may adversely affect health”.

Is “the probability that an event will occur.

Risk:

Hazard:Hazards and Risks:

Control of environmental factors that form links in transmission of disease.

Environmental sanitation(ES):

• solid waste management• treatment of water• treatment of wastewater• industrial-waste

treatment .

Subsets of this category are:

It helps understand/control/adapt:

Importance of EH

• Pollution

• Natural/technological disasters

• Physical hazards

• Climatic changes

• Food/Nutritional deficiencies

• Sanitation

Importance of EH

5.6 billion productive days including:

$3 - $14economic return

• Interventions yield :

o 443 million school days

o 2.4 billion healthy infant day

o 1.25 billion productive adult days.

Sanitation is cost-effective:

• $1 invested

Childhooddiarrhoeal deaths

30% reduction • Toilet use

Importance of EH

Sanitation can be improved:

• Malaysia and Thailand:

universal coverage over thirty years

• The Southern region of Ethiopia:

elimination of open defecation.

• Bangladesh:

: “open-defecation-free”.

Success stories

Traditional Hazards•Disease Vectors •Infectious agents•Housing and Shelter hazards•Drinking Water & Sanitation hazards•Indoor air Pollution•Dietary Deficiencies•Injury hazards

Modern Hazards• Tobacco smoking• Alcohol and drugs• Transport hazards• Environmental pollution• Outdoor air pollution• Chemical hazards• Occupational Hazards• Unbalanced Diet• Stress

Traditional and Modern Hazards:

Scope of EH practice

• Environmental epidemiology :

• Toxicology :

• Exposure science :

Three basic disciplines:

Identifying and quantifying exposures.

Observational studies

Animal studies

Disciplines of EH:

Purpose of EH practice• prevention of EH hazards

• promotion and protection of : public health

environment

TEAM WORK

Scope of EH practice

EH and ES concerns :

• Air, water and soil: - Quality - Pollution• Waste and toxic substances.• Climate and Disaster : - Preparedness & Management • Occupational Health & Safety• Behaviour

Scope of EH practice

Scope of EH practiceWater Supply Sanitation:Approved type of water

facilities:

Point Source: (well or spring) 

Communal Faucet

Rural areas:

Urban communities : Waterworks System

Scope of EH practiceWater Supply Sanitation:Water

Treatment :Raw surface groundwater

Safe drinking water Water

Treatment

Two major processes:• Physical removal of solids

• Chemical disinfection

COAGULATION: SEDIMENTATION : FILTRATION :

DISINFECTION : STORAGE :

Scope of EH practiceProper Excreta and Sewage Disposal:Approved

types Urban areas:

Water carriage/sewerage system/ treatment :

natural water cycle.

Sewage Removing impurities (Treatment)

Separation of solids: Physical processes Purification: Biological and Chemical

processes

Scope of EH practiceHospital Waste Disposal:

Hospital waste:

• 85% are non-infectious85% are non-infectious• 10% are infectious10% are infectious• 5% are hazardous5% are hazardous

Biological Non biological

MAJOR GLOBALENVIRONMENTAL PROBLEMS

1- Overpopulation2- Air pollution:3- Ozone depletion and global warming:

4- Water pollution:

MAJOR GLOBALENVIRONMENTAL PROBLEMS

YEAR BILLION

1804 11927 21959 31974 41987 51999 62011 72050* 9

1- Overpopulation

• Pollution

*ESTIMATE

Air Water Soil

• Resource depletion Forests Fossil fuel

• Extinction(52 species) Mammals Birds Amphibians

MAJOR GLOBALENVIRONMENTAL PROBLEMS

2- Air pollution:• industrialized and urbanized

areas• 75% of children suffer respiratory disease

• The six major air pollutants:

• London fog (1952) killed 4000-8000 (mostly elderly).

Carbon monoxide (CO) Nitrogen Oxides (NO, NO2) particulate matter sulfur dioxide (SO2) Hydrocarbons lead.

MAJOR GLOBALENVIRONMENTAL PROBLEMS

3- Ozone depletion and global warming:

plant/ animal ultraviolet rays

(skin cancer, cataracts, etc)

• 1930: introduced(Freon)

• 1976: 750 million lb./year

• 1980s: $28 billions/year CO2 from fossil fuel

Refrigerants :chlorofluorocarbons (CFCs),

Keeling Curve

MAJOR GLOBALENVIRONMENTAL PROBLEMS

3- Ozone depletion and global warming:CFCs

CFCs cooling of the stratosphere accelerates ozone depletion

several thousand x the

greenhouse potential CO2

• Reduce home energy usage• Buy cars that are fuel-smart• Transportation

alternatives : mass transit,, bicycling• Plant trees • Educate others

What can we do?

MAJOR GLOBALENVIRONMENTAL PROBLEMS

4- Water pollution:• Population growth.• Outputs (Industrial, agricultural and

urban)

Causes of water pollution

Control of water pollution:• Domestic sewage

Industrial

Construction site

Agricultural

• wastewater

• stormwater

Urban runoff

MAJOR GLOBALENVIRONMENTAL PROBLEMS

Pollution control : PREVENT

REDUCEREUSE

RECYCLEMITIGATE

COMPOSTDISPOSE

most favoure

d option

least favoured option

to IMPROVED SANITATIONCHALLENGES and OBSTACLES

Demographic Issues (more people)

Consumption Patterns: More wastes

Growth of cities (More large cities and slums)

• Growth in number • Increase in Consumption

to IMPROVED SANITATIONCHALLENGES and OBSTACLES

Poverty: > 1 billion live below poverty line( $ 1.25/day)

Behavioural and perception barriers:

– low environmental concern

– benefits of improved sanitation not widely understood

Macro Economic Policies

• More use and degradation of resources

CardiacCardiac

Pollution affects every organ

The basic requirements for

Clean Air

Safe and Sufficient Water

Adequate and Safe Food

Safe and Peaceful Settlements

Stable Global Environment

healthy environment

SummaryEnvironmental health is the broadest scope

of health problem definitionEnvironmental health studies the impact of

the environment on populationsIt is a population based science that can be

scaled to study individuals within populations

Problem definition and potential resolution is possible through the implementation of a

systematic approach