CHAPTER 1

Introduction to Environmental
Health
 Learning Objective
•  Describe relationship between human & environment

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 Health & Environment

Environmental health
Public Health

Occupational Health

Family Health

Personal
Health

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 Definition of Environment
•  Natural environment
–  Physical, chemical, biological factors & processes external to
people
•  Built environment
–  Human made settings – buildings, housing, sanitation,
transportation systems – all settings
•  Social environment
–  Conditions w/in which people live, shaped by cultural, social,
economic, political relations & factors

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 Environmental Exposure
•  Natural exposures
–  Seasonal, latitudinal, altitudinal gradients in solar irradiation
–  Extremes of hot/cold weather
–  Physical disasters
–  Local micronutrient deficiencies in soil
•  Human interventions
–  Chemical contaminants → air, water, soil, food, work place
–  Physical hazards: ionizing radiation, urban noise, road trauma

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Forces Driving Global Economy
–  Industrial & agricultural production
–  Resource exploitation & contamination
–  Energy extraction & use
–  Transportation & building patterns
–  Militarism
–  Market driven consumption patterns

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 Global Environmental Change &
Population Health
•  Climate Change
•  Stratospheric Ozone depletion
•  Biodiversity: Losses & Invasions
•  Land Degradation, food & Malnutrition
•  Persistent Organic Pollutants
•  Exporting Hazards

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 Magnitude of environmental
change
•  During the 20th century we humans
–  ↑2x our average life expectancy
–  ↑4x the size of our population
–  ↑ x 6 the global food yield & water consumption
–  ↑ x 12 the production of carbon dioxide
–  ↑ x 20 overall level of economic activity

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 Environmental Threats
•  Household Exposures •  Community level Exposure
–  Sanitation & clean –  Outdoor air quality
drinking water –  Traffic & transport
–  Solid household fuels –  Industry & manufacturing
–  Housing quality –  Waste management
•  Workplace Environment –  Microbial & chemical
–  Agriculture contamination or water & food
–  Mining & Extraction –  Urbanization
–  Construction •  Regional Exposures:
–  Manufacturing Transboundary
–  Service Occupations –  Atmospheric dispersion of
contaminants
–  Land use & water Engineering
 World Health report
•  Global level risks (climate change)
–  Highest in poor countries
–  Greenhouse gases emitting activities in rich countries→
–  “environmental risk transition”
•  MDG monitoring by WHO
–  on health & environment related indicator
–  →Global & national time trend analyses for certain
environmental health hazards
eg: # proportion of population access to clean water&
sanitization, use solid fuels etc.
–  Global statistical data is Increasingly ambitious & sophisticated &
multidisciplinary

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 World Health report
•  Low & middle income countries
–  Largest environmental health burden
•  Significant household level risks, ↓ w/ development
•  Young children particularly affected
•  Community level environmental risks (urban air pollution) ↑
w/ development, then ↓
•  Rich countries
–  Environment least important factor in illness
–  Behavioral risks dominate (smoking, diet, physical activity, etc)

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 Environmental Risk Transition
•  Risks in low & middle income societies
–  Dominated by poor food, water, & air quality
–  Household level
–  Poor sanitation, contaminated water, low quality fuels
–  Activities that solve these problems→ Community problems
•  urban air pollution, hazardous waste, chemical pollution
•  Industrialized societies
–  Household and community problems have come under control
–  Problems → Global scale
•  Greenhouse gas emissions

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 Characteristics of Environmental
Risk Transition
•  Economic Development
→Environmental Risk Transitions
→Epidemiological transition (shift in diseases)

•  Shift in Temporal Scale: Latency

→Infectious diseases (short period btw exposure & disease)
→Cancer, chronic non infectious diseases (long)

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 Scale & Distribution of
Environmental Risks to Health
•  Relative importance of environmental exposure as cause of
human disease & premature death remains contentious
–  Knowledge of disease etiology incomplete
–  Statistic is moving target
–  Latency period (for non-acute outcomes)
–  Past exposures that have changed/ceased

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 Scale & Distribution of
Environmental Risks to Health
•  Complex bidirectional relationships
–  Environmental conditions, socioeconomic circumstances,
demographic change & human health
–  Difficulty estimating the environmental contribution to disease
burden

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 Interdisciplinary roles in
Environmental Health
•  To implement the systematic approach, role players are needed
•  3 major classes of role players are:
1.  Environmental health problem investigators
2.  Environmental problem responders
3.  Health problem responders

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1. Environmental Health problem
investigators
•  monitors populations to identify health trends
•  measures the range of effects of health trends- to
characterize degrees of adverse intensity
•  identify potential hazards, potential pathways of hazards, and
populations susceptible to hazards

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 Related Disciplines

Epidemiologists Risk Assessors Biostatisticians

Health Service
Toxicologists Microbiologists Administrators

Behavioral Public Health

Social Workers Psychologists Educators
2. Environmental problem
responders
–  focus on the health hazard that has been identified and
characterized
–  analyze the environment of the exposed population to see what
controls are needed and what controls can be implemented to
minimize risk of recurrence and risk of future occurrence
–  where means of control does not exist, it may be necessary to
invent

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Related Disciplines

Engineers Risk Assessors Biostatisticians

Toxicologists Chemists Biologists/

Microbiologists

Physicists Mathematicians Educators

3. Health problem responders
–  focus on populations of individuals
–  attempt to identify how health is adversely affected
–  classify severity of effect as either injury or deleterious
–  attempt to restore compromised health to a ‘normal’ functional
state

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 Related Disciplines

Medical Doctors/
Surgeons Dentists Biostatisticians
Psychologists/
Nutritionists Psychiatrists Nurses

Epidemiologist Social Workers Clinicians

Biologists/
Toxicologists Pharmacists Microbiologists

Physiologists Mathematicians Educators

 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
individual within populations
•  Problem definition and potential resolution is possible
through the implementation of a systematic approach

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End of Chapter 1

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