Environmental Health
PARVEEN
ASSISTANT PROF.
DEPARTMENT OF COMMUNITY MEDICINE
& PUBLIC HEALTH SCIENCES LUMHS
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Objectives
• Discuss what is environmental health
• Discuss water, air and noise pollution
• Enlist the strategies for environmental
health
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Environmental Health
What is the environment?
The trees, air, &
soil around us
ALL the places we
live, work & play
Our fields,
farms & the
food we grow
Our oceans, lakes,
and rivers
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Environmental Links to Health
Concerns
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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.
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.
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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.
Sources Water pollution
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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.
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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
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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
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
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WHO Criteria for water Quality
A. Acceptability Aspects
B. Microbiological Aspects
C. Chemical Aspects
D. 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 factors
 Turbidity
 Colour
 Taste and odour
 Total 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:
detectable taste
Fluoride
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)
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
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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 temperature
Increase humidity
decrease air movement
addition 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
Indicators of air pollution
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Sulphur dioxide
Carbon monoxide
Lead
Carbon dioxide
Hydrocarbons
Nitrogen dioxide
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Diseases
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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
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life and discoloration
of houses
STRATEGIE
• Based on scientific knowledge
• Using best available, quality-controlled realworld data
1. Forestation & Plantation & green belts
2. 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
NOISE POLLUTION
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Definition
Unwanted 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
Sources of noise
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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 dB
On the decibel scale, the smallest audible
sound is 0dB
Bed room. 253dB
Normal conversation
60-65dB
Class room 30-40dB
Hospital word 20-35dB
Well tolerated 85dB
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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 effects
T dafness
Permanent dafness
Tympanic membrane perforation
Non auditory effects
High blood pressure
Speech interference
Sleep Disruption
Depression
Increase intracranial pressure
Decrease 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
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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 :
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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.
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• http://www.who.int/water_sanitation_heal
th/WHS_WWD2010_guidelines_2010_6_en
.pdf?ua=1
• http://apps.who.int/bookorders/anglais/de
tart1.jsp?sesslan=1&codlan=1&codcol=15
&codcch=810
Any Questions
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