2ASAP
esyim
the_environment_and_health.pptxGlobal Health
Chapter 7
The Environment and Health
Overview
What are the most important environmental threats to health in low- and middle-income countries?
What are the burdens of disease and consequences related to these threats?
What can be done in cost-effective ways to reduce the global burden of these threats?
Key Links between Environmental Health and the MDGs
The Importance of Environmental Health
Environmental risk factors account for 25-33% of global burden of disease
Leading causes of death in low- and middle-income countries:
3rd: Chronic obstructive pulmonary disease (COPD)
4th: Lower respiratory infections
5th: Diarrheal diseases
Central to achievement of MDGs
Key Concepts
Environment - “external physical, chemical, and microbiological exposures and processes that impinge upon individuals and groups and are beyond the immediate control of individuals”
Key Concepts
Environmental health - efforts that are “concerned with preventing disease, death, and disability by reducing exposure to adverse environmental conditions and promoting behavior change.”
Typical Environmental Health Issues
Key Environmental Health Burdens
Household Air Pollution
3 billion people in the world depend on solid fuel for cooking and heating
Poorer populations more susceptible
Short-term problems: conjunctivitis, upper respiratory infection, acute respiratory infection, and carbon monoxide poisoning
Long-term associations: cardiovascular disease, chronic obstructive pulmonary disease, and cancer
Key Environmental Health Burdens
Ambient Air Pollution
Common effects are respiratory symptoms, including cough, irritation of the nose and throat, and shortness of breath
Older and younger people tend to be more susceptible
Common Air Pollutants and their Health Effects
Key Environmental Health Burdens
Water, Sanitation, and Hygiene
Failure to properly dispose of human waste associated with increase in transmission of pathogens through oral-fecal route, spread of parasitic worms, and trachoma
Waterborne pathogens are associated with diarrhea and other gastrointestinal problems
Selected Waterborne Pathogens
Examples of Water-related Infections
Waterborne – cholera, amebiasis
Water-washed or water scarce – scabies, trachoma
Water-based – schistosomiasis, Guinea worm
Water-related – malaria, yellow fever, dengue, Zika
Burden of Environmentally Related Diseases
Household Air Pollution
3.5 million deaths and 4.3% of total DALYs in 2010
4th most important risk factor in high mortality low- and middle-income countries
41% of all deaths attributable to indoor air pollution are among females
Burden of Environmentally Related Diseases
Ambient Air Pollution
3.1 million deaths and 3.1% of global DALYs in 2010
53% of deaths among men, 44% among women, and 3 % children under five
India and China have major burdens of disease, along with other countries in Asia and Eastern Europe
Burden of Environmentally Related Diseases
Sanitation, Water, and Hygiene
0.3 million deaths and 0.9% of DALYs in 2010
Burden falls primarily on children and the poor and less well-educated people in the poorer countries of South Asia and sub-Saharan Africa
Unsafe sanitation, unsafe water, poor hygienic practices and burden of diarrheal disease are closely linked
The Costs and Consequences of Key Environmental Health Problems
Because of the high burden, social and economic consequences are enormous
Burden falls disproportionately on relatively poor people
Negative consequences on productivity
Reducing the Burden of Disease
Ambient Air Pollution
Introduction of unleaded gasoline
Low-smoke lubricant for or banning of two-stroke engines
Shifting to natural gas to fuel public vehicles
Tightening emissions inspections
Reducing the burning of garbage
Reducing the Burden of Disease
Household Air Pollution
Improved cooking devices
Use of less polluting fuels
Reducing need for fuels by using solar cooking and heating
Mechanisms for venting smoke
Using dried fuels for cooking
Keeping children away from cooking area
Reducing the Burden of Disease
Sanitation
Simple methods of sanitation and excreta disposal are low-cost and relatively effective
Barriers include lack of knowledge, cost, construction, and local laws
Government subsidies and regulations for installing latrines
Promotion through public-private partnerships headed by NGOs
Selected Sanitation Technologies
Reducing the Burden of Disease
Water Supply
Improved water sources:
House connection
Standpost
Borehole
Dug well
Rainwater collection
Investments in water alone do not have greatest impact on reductions in diarrheal morbidity
Hygiene investments are critical to realizing water and sanitation benefits
Reducing the Burden of Disease
Reducing the Burden of Disease
Hygiene
Hygiene promotion can lead to a 33% reduction in diarrhea morbidity
Focus should be on simple messages about handwashing and enabling handwashing
Handwashing associated with significant reductions in acute respiratory infections
Reducing the Burden of Disease
Integrating Investment Choices about Water, Sanitation and Hygiene
In order of priority:
1) Hygiene - important for its own sake and to maximize effect of other investments
2) Sanitation - government promotion of low-cost sanitation schemes
3) Water - development of low-cost water supply schemes
Cost per DALY Averted of Selected Investments in Water, Sanitation, and Hygiene
Future Challenges
Population growth
Pollution management
Community-based approaches to reach rural populations
Better information
Engaging sectors beyond health
Further Exploration
Arsenic mitigation in Bangladesh
http ://www.unicef.org/bangladesh/ Arsenic.pdf
Climate change and health
http://www.who.int/mediacentre/factsheets/fs266/en/
Videos
WHO Calls Air Pollution in Chinese Cities a Crisis-BBC (2:11min)
Pro-World Improved Stove (4:27 min)
AID Africa Build Clean Rocket Stoves (3:00 min)
Why Care About Water? Nat’l Geo. (2:30 min)
Water & Public Health - Water for People (3:31 min)
Ethiopia Daily Struggle for Clean Water-PBS (6:47 min)
WASH Building Latrines – (4:39 min)
Young People Help to Improve Sanitation in Haiti- UNICEF- (3:25 min)
