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