1. Introduction to Environmental Health
KEMU
2014

2. Overview Birth, Life, Death and Environment
- First appearance of humans Life Expectancy years
- To survive the first humans had to cope with
. The constant search for food and drinking water
. Avoid natural toxins , infections and parasites
. Injuries from falls, fires and animal attacks
. Cold and hot temperatures, rain, snow , natural disasters and other adverse conditions

3. Traditional Hazards vs Modern hazards
Increase in LE due to environmental quality , better nutrition and medical care
Some points to ponder
- how many children are born in our country every year and how many of them die?
- Are there any environmental factors behind these deaths?
- what will be the main health problems in next years for adults in our country?
- Will any of these be related to environment?

4. Health and Environment
Environment : All which is external to the individual human host, Can be divided into Physical, biological , social , cultural etc., any or all of which can influence the health status of a population (1995)
Environmental Health : comprises those aspects of human health including quality of life that are determined by physical , social , biological and psychological factors in the environment. It also refers to the theory and practice of assesssing , correcting , controlling and preventing those factors in the environment that can potentially effect adversely the health of present and future generations (WHO )

5. Basic Requirements for a Healthy Environment
Clean Air
Safe and Sufficient Water
Adequate and Safe food
Safe and peaceful settlements
Stable global environment

6. Link b/w Environmental and Occupational Health
100 million workforce injuries and occupational deaths are reported in addition to millions of cases of illnesses due to chronic exposure to Noise , Infectious agents , Biochemical hazards, and toxic chemicals (ILO Encyclopedia of Occupational health and safety)
Link b/w environment and occupational health
- Source of hazard is often the same
Environmentally inappropriate substitutes eg. Chlourofluoro carbons instead of ammonia in refrigerators

7. LINK contd. OHE has been used to calculate the risk to wider community
- Lead , mercury , asbestos, arsenic and nickel
( WHO set criteria for Air quality in work place and General environment ) lead exposure 8 hrs. mean ug/m3 , mercury 50, NO2 900
- 1942, Cadmium in french alkaline batteries, lead to osteomalacia and multiple fractures in factory workers
- Itai- Itai disease in Japan ( Osteo malacia + renal pathology )
Increased lead levls in workers of a lead foundry in Brazil led to investigation for lead in blood of children in nearby residential areas.

8. Contributors to the environment
Chemical
- air pollutants, toxic wastes, pesticides
Biologic
- disease organisms present in food, water and air
Physical
- noise, ionizing and non ionizing radiation
Socioeconomic
- socioeconomic status, ethnicity

9. Facets of Environmental Health
Environmental Epidemiology
- association between exposure to environmental agents and subsequent development of disease
Environmental Toxicology
- causal mechanisms between exposure and subsequent development of disease
Environmental Engineering
- factors that govern and reduce exposure

10. Preventive Medicine
- factors that govern and reduce disease development
Law
- development of appropriate legislation to protect public health

11. Qs
Do you think that environmental issues are among the top three public health issues in this country?

12. The ‘Right’ first Qs
what criteria do you use to identify an important public health issue?
Health Status
- Mortality
- Morbidity
- Life Expectancy
- Functional status and capacity
- Quality of life

13. Health indicator:
A variable that is susceptible to direct measurement , that reflects the state of health of persons in a community
- examples: Infant mortality rates, incidence rates based on notifiable cases of disease, disability days
Incidence and Prevalence
- Incidence: no. of new cases/ persons at risk
- Prevalence: no. of cases present/ total population

14. Choices for Metric for life
Mortality Rate
- fraction of deaths in a population
Years of potential life lost:
- difference bw expected age of death and actual age of death, summed across all deaths