Post on 16-Apr-2017
INTRODUCTION TO ENVIRONMENTAL
HEALTHDr.Qomariyatus Sholihah,Amd.hyp,ST.MKesUniversity of Lambung Mangkurat Banjarbaru, South KalimantanFeb 2014
Outline Definition of Environmental
Health Interdependent Relations Environmental Effects on
Health Systematic Approach Interdisciplinary Roles
Definition: ‘Health …’
• ‘…is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’(WHO, 1948)
• ‘Health is only possible where resources are available to meet human needs and where the living and working environment is protected from life-threatening and health threatening pollutants, pathogens and physical hazards’(Who, 1992a)
Definition: ‘Environment’
• ‘…[All] that which is external to individual human host. [It] can be divided into physical, biological, social cultural any or all of which can influence health status in populations.’ (WHO, 1995)
Definition: ‘Environmental Health’
‘…comprises those aspects of human health, including quality of life, that are determined by physical, biological, social and psychosocial factors in the environment. It also, refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations’ (WHO, 1993a)
Definition: ‘Health Effect…’
• ‘…is the specific damage to health that an environmental hazard can cause an individual person. Often the same hazard can cause a range of different effects of different severity.’ (Yassi et al., 2001)
Interdependence Health depends on resources. Good health depends on
accessibility to sustainable resources.
Bad health results from inaccessibility to sustainable resources or exposure to a hazard.
Sustainable resources and hazards exist in the environment.
Therefore, quality of health depends on the environment
Interdependent Environments
A relational definition of environment is a function of scale, boundaries, spatial proximity and recipient populations
When considering a global scale, focus is on the effect of an unbounded environment, e.g. air, on all populations anywhere
Interdependent Environments When considering local scale,
focus is on effect of both a bounded and an unbounded environment, e.g. water and air, on a subpopulation closest to the exposure event
The local scale is a subpart of the global scale
Population Perspective of Relations
Individual
Family
Community, nation
Human population
All populations
Health and Environment Perspective of Relations
PersonalHealth
Family Health
Occupational Health
Public Health
Environmental health
Environmental Effects on Health
The indicators of beneficial environmental effects are longevity and sustained functionality.
Two degrees of adverse environmental effects are: injury (syn. include: debilitating, dysfunctional, lame) with decreased longevity or death (syn. include: life-threatening, terminal, deleterious)
Environmental Effects on Health
Injury does not prematurely end life, but can hinder the capacity to function to the fullest potential
Death does end life and is the most extreme adverse state of health
This means of classification is simple and rigorous
Environmental Effects on Health
An individual’s response to an environmental effect is a function of their physical environment, their health state, and their culture.
Systematic Approach In the absence of a universal
definition of ‘good health’, at least a universal concept of adverse health effect, e.g. sick, illness, dysfunctional, ‘not normal’ or ‘not well’, must exist such that understanding the concept results in a response
Systematic Approach In order to identify and
investigate adverse states of health, a fundamental systematic approach of health problem identification and characterization must exist and be implemented
This approach is summarized as follows:
Systematic Approach Determine the source and
nature of hazards Determine the exposure
pathway Measure the effects Apply controls however
possible(Moeller, 1992)
Interdisciplinary Roles To implement the systematic
approach, role players are needed
Three major classes of role players are: the environmental health problem investigators, the environmental problem responders and the health problem responders
Interdisciplinary Roles
Health problem investigators: monitors populations to identify health trends, in an attempt to distinguish that which is harmful from that which is harmless
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
Related Disciplines
Epidemiologists Risk Assessors Biostatisticians
Toxicologists MicrobiologistsHealth ServiceAdministrators
Social WorkersBehavioral
PsychologistsPublic Health
Educators
Interdisciplinary Roles
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
Related Disciplines
Engineers Risk Assessors Biostatisticians
Toxicologists Chemists Biologists/Microbiologists
Physicists Mathematicians
Educators
Interdisciplinary Roles 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
Related DisciplinesMedical
Doctors/Surgeons Dentists Biostatisticians
NutritionistsPsychologists/ Psychiatrists Nurses
Epidemiologist Social Workers Clinicians
Toxicologists PharmacistsBiologists/
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