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PARVEENASSISTANT PROF.DEPARTMENT OF COMMUNITY MEDICINE & PUBLIC HEALTH SCIENCES LUMHS

Environmental Health

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Objectives

• Discuss what is environmental health• Discuss water, air and noise pollution• Enlist the strategies for

environmental health

Environmental Health

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What is the environment?What is the

environment?The trees, air, & soil around us

Our fields, farms & the food we grow

Our oceans, lakes, and rivers

ALL the places we live, work & play

Environmental Links to Health Concerns

• Drinking Water

• Food• Land• Buildings• Indoor Air• Out door air• Emergencies

Introduction• The environment in which we live

greatly affects our health. Household, workplace, outdoor and transportation.

• pose risks to the health in a number of ways from the poor quality of air that many people breathe, to hazards related to unsafe water, poor sanitation and hygiene.

Environmental Health• To control the environment with a view

to prevent from disease and promote and maintain health.

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Environment & public health• More than 7 million people – one in eight of

total global deaths – are due to indoor or outdoor air pollution exposure.

• 4.3 million people worldwide die every year from household air pollution.

• 24% of the global disease burden is due to environmental factors.

• About 36% of this burden affects children from 0 to 14 years of age

(12 November 2014)

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World Health Organization

• 3 billion people, in low- and middle-income countries still rely on solid fuels (wood, animal dung, & coal) burned in inefficiently & highly polluting stoves for cooking & heating.

• In 2012, 4.3 million children & adults

died due to household air pollution. 

Together with widespread use of kerosene stoves, heaters and lamps, these practices also result in many serious injuries & deaths

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WATER POLLUTION

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UNICEF • 1.1 billion people in the world still

do not have access to safe water. This is nearly 15-20% of the population.

• 20-40 percent of the hospital beds in Pakistan are occupied by patients suffering from water-related diseases.

• In terms of financial loss, the country is bearing Rs.112 billion per year as water, sanitation and hygiene-related diseases.

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Facts about Pakistan• 62 percent of Pakistan’s urban and 84

percent of its rural population do not treat their water, resulting in 100 million cases of diarrheal diseases registered in hospitals,

• 40 % of deaths due to drinking polluted water.

• Estimated 250,000 child deaths occur every year in Pakistan due to water-borne diseases.

• More than 1.6 million DALYs (Disability Adjusted Life Years) are lost annually due to diarrhea and almost 90,000 as a result of typhoid.

Burden

• Poor water quality is responsible for death of 5 million children in developing countries.

In Pakistan poor water quality is responsible – 30% of all diseases –40% of all deaths–Every 5th citizen suffers from the

illness and disease caused by polluted water

Water safety and human health

• The quality of drinking-water is a powerful environmental determinant of health.

• Drinking-water quality management has been a key pillar of primary prevention for over one-and-a-half centuries and it continues to be the foundation for the prevention and control of waterborne diseases.

Water to drink• 66% of the human body is made up

of water.• By just 2% dehydration, your

performance decreases by around 20%.

• We should drink at least 1½ litres of water a day.

Clean water

• The number of people with access of clean water has doubled in the last 20 year.

The UN estimates that by 2025, 75% of the world population won’t have reliable, clean water.

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Sources Water pollution

• Dissolved gasses & impurities• Industrial wastes• Agricultural pollutants such as

fertilizers• Sewage • Dumping of waste• Water is contaminated by human or

animal faeces.• water within the distribution system

through leaky pipes or of stored household water as a result of unhygienic handling.

Safe & Wholesome water

• Drinking water should be safe as well as wholesome.

• Water is termed safe when it does not harm the consumer even when ingested over prolonged periods.

• Safe and wholesome water thus, must be:

(a) Free of pathogenic organisms(b) Free from harmful chemical substances(c) Acceptable to taste and appearance(d) Usable for domestic purposes

How do we know drinking water is safe

or unsafe• Through water quality testing• •Ensure safe drinking water• •Identify problems• •Adopt precautionary measures• •Raise awareness• •Determine the effectiveness of

water treatment technologies• •Select an appropriate water source• •Influence policies to supply safe

water

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WHO standard for safe water

• Through out the year 95% of sample should not contain any coliform organisms in 100 ml.

• No sample should contain E. coli in 100 ml.

• No sample should contain coliform in 100ml

WHO Criteria for water Quality

A. Acceptability AspectsB.Microbiological AspectsC. Chemical AspectsD.Radiological Aspects

Acceptability Aspects

• The drinking water should not only be safe but also pleasent in appearance, taste and colour.

• water is determined by the following factorsTurbidityColourTaste and odourTotal dissolved salts (TDS).

The palatability of waters with TDS levels below 600 mg/litre is considered to be good

Acceptability Aspects – pH

• The guideline value for pH of water is 6.5 to 8.5.

• Water with pH levels below this range may increased levels of certain chemical substances, such as lead, in water.

• At pH levels above this range, the efficiency of the disinfectant action of chlorine is reduced.

Ammonia in water is an indicator of possible bacterial, sewage and animal waste pollution.

• The guideline value is 1.5 mg/litre

Acceptability Aspects• Dissolve O2: Not less than 5 mg /

L• Chlorides : Standard is 250 mg /

L• Hardness: for domestic use, the

amount of hardness should not be more than 300 ppm. (Parts per million) caco2

Microbiological aspect• Primary indicator coliform• Faecal streptococci conform recent

faecal pollution.• Clostridium perfringens indicate remote

contamination.

HEALTH IMPACTS pH values (below 4 or above 10)

irritation to the eye, skin .

TDS: unpalatability, and corrosion may occur. ( incidence of ca, and cardiovascular disease.)

Arsenic skin cancer digestive problems

Chloride:

Fluoride

detectable taste

Excess (Dental, Skeletal Fluorosis), Deficit (Dental caries)

Coli forms water-borne disease.

. Preventive measures• 1. Preventive measures must be taken

at all levels to prevent water contamination.

• 2. Protection of water sources• 3. All water distributing agencies must

be supplied standards water.• All personnel responsible for educate

monitoring the quality of water & provided in-service training on a regular basis.

• Public awareness• In this view low cost measures to be

applied at a household level (chlorination 0.5 mg/L for 1 hour)

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Air Pollution

• Contamination of the air by noxious gases and minute particles of solid and liquid matter (particulates) in concentrations that endanger health

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Air Pollution

• Dust and smoke particles in Pakistan are generally twice the world average and five times higher than the developed world. Therefore increasing rate of Air Pollution in Pakistan is significantly high. Though some pollution comes from the natural sources, but most pollution is the result of human activities. 

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WORLD BANK REPORT

• More than 22,600 adult deaths in 2005 were caused by urban air pollution.

• Outdoor air pollution alone causes more than 80,000 hospital admissions per year; nearly 8,000 cases of chronic bronchitis, &

• five million cases of lower respiratory cases in children under the age of five.

• The number of vehicles in Pakistan has increased from around 2 million to 10.6 million over the last 20 years

Sources of indoor Air Pollution

• Respiration chemical(15-18/mint

gives 500cc of air at each breath & added/hour 0.6-0.7sft)

• Physical. Changes are Increase temperatureIncrease humiditydecrease air movementaddition of body odours addition of bacteria & viruses

• Smoke

Sources of Outside Air Pollution

• Combustion of gasoline and other fuels in cars, trucks, and airplanes

• Burning of fossil fuels (oil, coal)

• Insecticides• Herbicides• Everyday radioactive • Dust from fertilizers• Mining operation

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Indicators of air pollution

• Sulphur dioxide• Carbon monoxide• Lead • Carbon dioxide• Hydrocarbons• Nitrogen dioxide

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Diseases • Respiratory tract infections• Lung cancer• Cough• Asthma• COPDs• Physical effects nausea, vomiting

headache• Global effects

– Ozone depletion – Green houses effects– Acidic rain

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Ozone depletion• It present at the distance 15- 50 Km

from earth. & protect us from ultraviolet radiation

• Ozone layer is depleted by aerosol sprays, air conditions & refrigerators & also causes skin cancer.

Green houses effects• Increases sea level, global worming &

flood– Decrease industrial smoke & unfit automobiles

Acidic rain. Fuel combustion & organic

decomposition causes acidic rain that damage crops, marine life and discoloration of houses

STRATEGIE

• Based on scientific knowledge• Using best available, quality-controlled

real-world data1. Forestation & Plantation & green belts2. Project future emissions and air quality

resulting from full implementation of current legislation

3. Replacement burning of wood with electricity

4. Use cost-effective policy 5. Ventilation (comfort zone 69 f) 6. increase political will

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NOISE POLLUTION

DefinitionUnwanted Sound when it interferes with normal activities, or disrupts or diminishes one’s quality of life.Man is living in increasingly noisy environment.20th century is a century of

Noise

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Sources of noise

• Automobile• Industries• Factories• Air craft• Radio, TV

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Decibel scale (dB)The unit used to measure the intensity of a sound is dBOn the decibel scale, the smallest audible sound is 0dBBed room. 253dBNormal conversation

60-65dBClass room 30-40dBHospital word 20-35dBWell tolerated 85dB

Noise-Related Illnesses

Noise pollution adversely affects the lives of millions of people.Studies have shown that there are direct links between noise and health.Auditory effectsT dafnessPermanent dafnessTympanic membrane perforation

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Non auditory effects

High blood pressureSpeech interferenceSleep DisruptionDepressionIncrease intracranial pressureDecrease efficiency

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Noise control

• Control at source. Industrial noise can be reduced by installing noise barriers in the workplace

• Control transmission. – Use absorbing material

• Protection of expose person• Health education• Carry out investigations and studies

on noise and its effect on the public health and welfare.

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Housing

• a physical structure should be comfortable mentally, physically and socially.

WHO criteria• Provide physical protection• Provide adequate space for eating,

cooking & washing• Protect from communicable diseases • promote relation ship & community

development.

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Effect of poor housing on health

• Respiratory infection• Skin diseases• Psychological effects• Injuries truama

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Land pollution

• Land pollution is caused on the earth’s surface by industrial, commercial, domestic and agricultural activities.

• The most common sources of land pollution include toxic waste residues, chemical and nuclear plants, oil refineries, mining, littering and deforestation.

• It has hazardous effects on our health and lifestyle.

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Strategies

• Use natural fertilizers.• Avoid all chemical use, pesticides,

herbicides, fungicides• Preserve forests and promote

reforestation.• Plant trees

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Solid waste

• The unwanted or discarded waste material from houses, street, industries & agriculture.

Health hazard• Breeding of flies, rodents & mosquito

that causes :– Cholera, diarrhea – Typhoid– Viral hepatitis– Water pollution, . Air pollution & soil pollution

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Solid waste

• Always practice the three R’s; recycle, reduce, reuse.

• Eliminate plastic use• Reduce general household waste.• Purchase products with minimal

packaging.• Enforce and obey EP laws.

• http://www.who.int/water_sanitation_health/WHS_WWD2010_guidelines_2010_6_en.pdf?ua=1

• http://apps.who.int/bookorders/anglais/detart1.jsp?sesslan=1&codlan=1&codcol=15&codcch=810

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Any Questions