CHP300 : Community Health Program-l

1. CHP300: Community Health Program-l Mohamed M. B. Alnoor

2. Content • Scope of EH practice • Definitions • Importance of EH • Traditional and Modern Hazards • EH & ES concerns • Water Supply Sanitation • Waste Disposal • Major global Environmental Problems • Population overgrowth • Air pollution • Ozone depletion/global warming • Water pollution • Challenges and Obstacles

3. DEFINITIONS Environmental Health (EH)? Environmental health is the study and management of environmentalconditions that affect health and well-being of humans

4. DEFINITIONS Pollution The introductionof harmful materials or productionof harmful conditions. Contamination • The introductionof undesirable materials. Polluted environment • Impure, dirty, or otherwise unclean.

5. DEFINITIONS Pollutant a waste material that negatively affects water air, or soil. • Three factors determine the severity of a pollutant: • chemical nature • concentration • persistence

6. DEFINITIONS Pollutants are introduced at: • Point sources: • smokestacks, accidental spills or pipes discharging into waterways. • Area sources, (non point sources): • More diffuse: • Urban and agricultural runoff. • Mobile sources: Automobile exhaust.

7. DEFINITIONS Hazards and Risks: Hazard: Is “a factor or exposure that may adversely affect health”. Risk: Is “the probability that an event will occur.

8. DEFINITIONS Environmental sanitation(ES): Control of environmental factors that form linksintransmission of disease. Subsets of this category are: • solid waste management • treatment of water • treatment of wastewater • industrial-waste treatment .

9. Importance of EH • It helps understand/control/adapt: • Pollution • Natural/technological disasters • Physical hazards • Climatic changes • Food/Nutritional deficiencies • Sanitation

10. Importance of EH • Sanitation is cost-effective: • Interventions yield : • 5.6 billion productive days including: • 2.4 billion healthy infant day • 1.25 billion productive adult days. • 443 million school days economic $3 - $14 • $1 invested return Childhood diarrhoeal deaths 30% • Toilet use reduction

11. Importance of EH • Sanitation can be improved: Success stories • Malaysia and Thailand: • universal coverage over thirty years • The Southern region of Ethiopia: • elimination of open defecation. • Bangladesh: • : “open-defecation-free”.

12. Scope of EH practice Traditional and Modern Hazards: TraditionalHazards Disease Vectors Infectious agents Housing and Shelter hazards Drinking Water & Sanitation hazards Indoor air Pollution Dietary Deficiencies Injury hazards ModernHazards • Tobacco smoking • Alcohol and drugs • Transport hazards • Environmental pollution • Outdoor air pollution • Chemical hazards • Occupational Hazards • Unbalanced Diet • Stress

13. Scope of EH practice Purpose of EH practice • prevention of EHhazards • promotion and protection of : • public health • environment Disciplines of EH: Three basic disciplines: • Environmentalepidemiology : Observational studies • Toxicology : TEAM WORK Animal studies • Exposurescience : Identifying and quantifying exposures.

14. 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

15. Scope of EH practice Water Supply Sanitation: Approved type of water facilities: • Rural areas: • Point Source: (well or spring)  • Communal Faucet • Urban communities : • Waterworks System

16. Scope of EH practice Water Supply Sanitation: Water Treatment : Raw surface groundwater Water Treatment Safe drinking water • Two major processes: • Physical removal of solids • COAGULATION: • SEDIMENTATION : • FILTRATION : • Chemical disinfection • DISINFECTION : • STORAGE :

17. Scope of EH practice Proper Excreta and Sewage Disposal: Approved types • Urban areas: • Water carriage/sewerage • system/ treatment : Removing impurities natural water cycle. Sewage (Treatment) • Separation of solids: Physical processes • Purification: Biological and Chemical processes

18. Scope of EH practice Hospital Waste Disposal: Hospital waste: Biological Non biological • 85% are non-infectious • 10% are infectious • 5% are hazardous

19. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 1- Overpopulation 2- Air pollution: 3- Ozone depletion and global warming: 4- Water pollution:

20. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 1- Overpopulation • Air • Water • Soil • Pollution • Resource depletion • Forests • Fossil fuel • Extinction(52 species) • Mammals • Birds • Amphibians *ESTIMATE

21. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 2- Air pollution: • industrialized and urbanized areas • 75% of children suffer respiratory disease • London fog (1952) killed 4000-8000 (mostly elderly). • The six major air pollutants: • Carbon monoxide (CO) • Nitrogen Oxides (NO, NO2) • particulate matter • sulfur dioxide (SO2) • Hydrocarbons • lead.

22. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS CO2 from fossil fuel 3- Ozone depletion and global warming: plant/ animal ultraviolet rays (skin cancer, cataracts, etc) • Refrigerants :chlorofluorocarbons (CFCs), • 1930: introduced(Freon) • 1976: 750 million lb./year • 1980s: $28 billions/year Keeling Curve

23. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 3- Ozone depletion and global warming: several thousand x the greenhouse potential CFCs CO2 CFCs cooling of the stratosphere accelerates ozone depletion • What can we do? • Reduce home energy usage • Buy cars that are fuel-smart • Transportation alternatives : • mass transit,, bicycling • Insulate your home to save • money and energy • Plant trees • Educate others

24. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS 4- Water pollution: • Causes of water pollution • Population growth. • Outputs (Industrial, agricultural and urban) • Control of water pollution: • Domestic sewage • wastewater • Industrial • Agricultural • stormwater • Construction site • Urban runoff

25. MAJOR GLOBAL ENVIRONMENTAL PROBLEMS Pollutioncontrol: PREVENT most favoured REDUCE option REUSE RECYCLE MITIGATE COMPOST DISPOSE least favoured option

26. CHALLENGES and OBSTACLES to IMPROVED SANITATION • Demographic Issues (more people) • Growth in number • Increase in Consumption • Consumption Patterns: • More wastes • Growth of cities (More • large cities and slums)

27. CHALLENGES and OBSTACLES to IMPROVED SANITATION • Macro Economic Policies • More use and degradation • of resources • Poverty: > 1 billion live below poverty line( $ 1.25/day) • Behavioural and perception barriers: • – low environmental concern • – benefits of improved sanitation not widely understood

28. Pollution affects every organ Cardiac Cardiac

29. The basic requirements for healthy environment • Clean Air • Safe and Sufficient Water • Adequate and Safe Food • Safe and Peaceful Settlements • Stable Global Environment

30. Summary Environmental health is the broadest scope of health problem definition Environmental health studies the impact of the environment on populations It 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