Impacts of air_&_water_pollution_on_health

Effects of Air and Water Pollution on Health

Najibullah Safi, MD, MSc. Health Policy and Management PHC Advisor, WHO Country Office - Afghanistan

What is pollution?

• It is the introduction of contaminants (pollutant) into an environment that causes instability, disorder, harm or discomfort to the ecosystem i.e. physical systems or living organisms– A pollutant is a waste material that pollutes air, water or

soil– Three factors determine the severity of a pollutant:

• Its chemical nature• The concentration • The persistence

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Environmental health hazards

• Any external factor that negatively affects health can be considered an environmental health “hazard“– It is a generic term for any situation or state of events

which poses a threat to the surrounding environment– Common environmental health hazards include indoor and

outdoor air pollution, contaminated food and water – This term incorporates topics like pollution and natural

hazards such as storms and earthquakes


Types of environmental hazards

• It include:– Chemical – Physical/mechanical – Biological – Psychosocial


Effects of Air Pollution on Health

More than 3000 people may die in Kabul because of air pollution every year (Press Release - MoPH, January 15, 2009 )


Comparison of health indicators

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NO

Indicator Afghanistan Pakistan

1 Life expectancy (years) Male: 47, Female: 45 Male: 65.2, Female 65.6

2 Annual growth rate (%)* 2 1.7

3 Dependency ratio (%) 92 88.3

4 Under 5 Mortality Rate (Deaths/1,000 live births)

191 (165) 90

5 Infant Mortality Rate (Deaths/1,000 livebirths)

129 (111) 70.2

6 Total Fertility Rate (Births/Woman) 6.3 4.1

7 Maternal Mortality Ratio (MaternalDeaths/100,000 live births)(2000 data)

1600 (1400) 276

Source: HMIS, MoPH, Afghanistan 2006 Health Survey* Country Health Profile - WHO

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Cont.

7

NO

Indicator Afghanistan Pakistan

8 Pregnant women who received 1+ ANC visits (%) 30

9 Deliveries attended by skilled health personnel (%)

19 100 (2009)

10 Newborns immunized with BCG 2007 (%) 91 98

11 1-year-olds immunized with 3 doses of DPT 2007 (%)

83 98

12 Children under 2 years immunized with 1 dose of measles 2007 (%)

70 100

13 Pregnant women immunized with two or more doses of tetanus toxoid 2007 (%)

65 NA

14 Percent of rural population with access to local health services

66 NA

Source: HMIS – MoPH WHO, Country profile http://www.emro.who.int/emrinfo/index.asp?Ctry=afg

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What is air pollution?

• It is the presence of one or more air pollutant in such a quantity and duration sufficient to cause harm to man, plants animals and property

• Air pollution is the emission into the air of hazardous substance at a rate that exceed the capacity of natural process in the atmosphere to – Convert them, – Precipitation (rain or snow ) to deposit them or – Of winds and air movement to dilute them


In door air pollution

• Indoor air can be defined as any non-industrial indoor space where a person spends a period of an hour or more in any day

• This can include the air space in the office, classroom, motor vehicle, shopping centre, hospital and home


Common indoor air pollutants

• Second-hand tobacco smoke

• Lead-impregnated dust from old paint, cockroach shedding

• Dust mite particles• Combustion gases

released by stoves, heaters, candles and fireplaces


• Chemicals released by:• Dry cleaned clothes• Cleaning products• Room deodorizers• Office supplies• Paints• New furniture and

pressed wood• Personal care products;

and• Pesticides

Outdoor air pollutants

• Ozone (O3) • Particulate matter• Carbon monoxide (CO) • Nitrogen oxide (Nox)• Sulfur dioxide (SO2)• Lead (Pb)• Volatile organic compounds …


Sources of air pollution

• Transportation (mobile sources )– Motor vehicles, rail, shipping, aviation

• Industry sources– Power stations, petroleum refining, chemical

manufacturing• Power plants• Central heating • Incineration of domestic wastes


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Afghan Media and Environmental Protection

Health effects of air pollution • Irritation of nose, eye, and throat• Respiratory diseases (Bronchitis, Asthma, cough, …etc.)• Cardiovascular diseases• Toxicity (CO)• Decrease of pulmonary function and restricted activities• Cancers (Benzene)• Neurological impairments, such as seizures, mental

retardation, and behavioral disorders, learning disabilities, apathy and behavior abnormalities (Pb)

• kidney/liver damage, CNS disorders (Arsenic, cadmium, lead, mercury, nickel, and chromium)

• Increased hospital admissions and ER visits• Anemia as a complication of chronic lead exposure• Premature death Tuesday, April 11, 2023 14Afghan Media and Environmental Protection

Air pollution in Kabul

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Cont.


Conti.

– High amount of dust and concentration of poly aromatic hydrocarbons (originated from cars)*

– A pollutant: Benzo-a-pyrene which increase the risk of lung cancer

– Presence of duct increase the potential risks of BP– Combination of drought and loss of vegetation are

contributing factors to the increased dust level

*Afghanistan post conflict environmental assessment conducted by UNEP in Kabul, Balkh, Herat and Kandahar in 2002


Control measures

• Scientific group studies on the damaging effects on plant, animal, and human life• Legislative bodies to set up the standards and

enforce laws to control emission• Health professional and media to educate the

population about the health effects of the pollution• Media – advocacy, public awareness


At the individual level

• As transportation is a major source of pollution so– Limit driving – Use public transportation, use carpools, bike– Maintain your car regularly especially the emission control

system

• Reduction at the emission source is very important in stationary plants


Community level

• They should continue to exert their pressure on the government to carry on ongoing continuous surveillance monitoring for air pollution/ pollutants in order to place more astringent standards when required

• To encourage the researches on the subject under study


Effects of Water Pollution on Health

4 billion cases of diarrhea worldwide each year

Some facts

• Parasites Intestinal Worms infect about 10% of the world population

• About 200 million people are affected by schistosomiasis, with 200,000 dying each year

• Diarrheal diseases have killed more children in the past ten years than all the people lost to armed conflict since World War II

• WHO estimated that 88% of diarrheal disease is caused by unsafe water supply, and inadequate sanitation and hygiene


Cont.

• In Afghanistan during 2009 water borne diseases contributed to almost 1/4 of diseases outbreaks which included cholera, Hepatitis A & E and typhoid fever

• Water borne diseases are huge burden on already strained health system as almost 1/5 of patients at a health facility are due to diarrheal diseases alone throughout the year


What is water pollution?

• Introduction of harmful substances or products into water

Causes of water pollution• Factors that contribute to water pollution can be

categorized into two different groups– Point sources– Non-point sources


Point sources

• Some point sources of water pollution include– Waste products from factories– Waste from sewage system– Waste from power plants– Waste from underground coalmines– Waste from oil wells …

• They are called point sources because they are direct sources of water pollution and can be reduced and monitored


Non-point sources

• The term non-point source encompasses a large range of sources such as:– When rain or snow moves through the ground and picks

up pollutants as it moves towards a major body of water– The runoff of fertilizers from farm animals and crop land – Air pollutants getting washed or deposited to earth – Storm water drainage from lawns, parking lots, and streets

…


Water hazardous substances

• Heavy metals• Other inorganic elements• Acids/bases• Oxidants• Volatile organic compounds• Hydrophobic organic compounds• Petroleum additives• Pesticides• Micro-organisms • Radioactive …

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Harms of water pollution

• Virtually all types of water pollution are harmful to the health of humans and animals

• Suspended particles in freshwater reduces the quality of drinking water for humans and the aquatic environment for marine life

• Heavy metals from industrial processes can accumulate in nearby lakes and rivers. These are toxic to marine life such as fish, and subsequently to the humans who eat them

• Industrial waste often contains many toxic compounds that damage the health of aquatic animals and those who eat them

• Microbial pollutants from sewage often result in infectious diseases

The main water-borne/fecal oral diseases

• Typhoid fever • Giardia • Dysentery • Cholera • Diarrhea (caused by a variety of pathogens) • Hepatitis • Polio • Worms


Drinking water quality in Afghanistan

• Cross contaminated by sewage*• High level of contamination with Coliform bacteria

(18-100 count in 100 ml)• 70% of shallow wells infected by bacteria

*Afghanistan post conflict environmental assessment conducted by UNEP in Kabul, Balkh, Herat and Kandahar in 2002


Water pollution control

• Pollution prevention• Minimize pollution

– Recycling and re-use; treatment; encourage cleaner production technologies; encourage good housekeeping

• Disinfection (Chlorination)• Disposal or discharge of waste water

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WHO publication on air pollution and health

• WHO air quality Global update 2005: http://whqlibdoc.who.int/hq/2006/WHO_SDE_PHE_OEH_06.02_eng.pdf

• WHO indoor air quality: dampness and mould: http://www.euro.who.int/en/what-we-do/health-topics/environmental-health/air- quality/publications/2009/who-guidelines-for-indoor-air-quality-dampness-and-mould

• Methodology for assessing the burden of diseases of outdoor air pollution: http://www.who.int/quantifying_ehimpacts/publications/ebd5.pdf

• Air quality and health (questions and answers): http://www.who.int/phe/air_quality_q&a.pdf


Impacts of air_&_water_pollution_on_health

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