Environmental

Health

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Dr. rer. med. H. Hamzah Hasyim, S.K.M, M.K.M.
 What is Public Health?
the American Public Health Association
"Public health promotes and protects the health of people and the communities where they
live, learn, work and play."

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"Public Health is the science and the art of preventing disease, prolonging life, and

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promoting physical health and efficiency through organized community efforts for the

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sanitation of the environment, the control of community infections, the education of the
individual in principles of personal hygiene, the organization of medical and nursing
services for the early diagnosis and preventive treatment of disease, and the development
of the social machinery which will ensure to every individual in the community a standard
of living adequate for the maintenance of health.“
https://guides.lib.berkeley.edu/publichealth/whatisph
The Ten Essential Public Health Services
Equity is at the Heart of the 10 Essential Public Health Services (Revised, 2020)

•Assess and monitor population health status, factors that influence health, and community needs and
assets
•Investigate, diagnose, and address health problems and hazards affecting the population
•Communicate effectively to inform and educate people about health, factors that influence it, and

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how to improve it

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•Strengthen, support, and mobilize communities and partnerships to improve health
•Create, champion, and implement policies, plans, and laws that impact health
•Utilize legal and regulatory actions designed to improve and protect the public's health
•Assure an effective system that enables equitable access to the individual services and care needed to
be healthy
•Build and support a diverse and skilled public health workforce
•Improve and innovate public health functions through ongoing evaluation, research, and continuous
quality improvement
•Build and maintain a strong organizational infrastructure for public health
 The Future of Public Health
Report (IOM 1988)
The committee defines the mission of public
health as fulfilling society's interest in assuring
conditions in which people can be healthy. Its
aim is to generate organized community effort to

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address the public interest in health by applying

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scientific and technical knowledge to prevent

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disease and promote health.

The mission of public health is addressed by

private organizations and individuals as well as by
public agencies. But the governmental public
health agency has a unique function: to see to it
that vital elements are in place and that the
mission is adequately addressed.
Institute of Medicine (US) Committee for the Study of the Future of Public Health.
The Future of Public Health. Washington (DC): National Academies Press (US); 1988. Summary and Recommendations. 4
Available from: https://www.ncbi.nlm.nih.gov/books/NBK218215/
 • ‘…is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity’(WHO,
1948)
Definition: • ‘Health is only possible where resources

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are available to meet human needs and

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‘Health …’

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where the living and working

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environment is protected from life-
threatening and health threatening
pollutants, pathogens and physical
hazards’(Who, 1992a)

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Definition:
‘Environment’
• ‘…[All] that which is
external to individual

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human host.

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• [It] can be divided into

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physical, biological, social
cultural any or all of
which can influence health
status in populations.’
(WHO, 1995)

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Environmental Health is the branch of public
health concerned with all aspects of
the natural and built environment affecting human
health. Environmental health focuses on the natural
and built environments for the benefit of human
health.

The major subdisciplines of environmental health

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are:

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environmental science; environmental and

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occupational medicine, toxicology and environmental
epidemiology.

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.
• Those aspects of the human health and disease
that are determined by factors in the
Definition: environment. environmental health (WHO),
‘Environmental

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1989

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Health’

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• It also, refers to the theory and practice of

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assessing, correcting, controlling, and
preventing those factors in the environment
that can potentially affect adversely the health
of present and future generations’ (WHO,
1993a)

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Environmental health addresses
all the physical, chemical, and
biological factors external to a
person, and all the related
factors impacting behaviours.

It encompasses the assessment

and control of those
environmental factors that can
potentially affect health. It is
targeted towards preventing
disease and creating health-
supportive environments. This

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definition excludes behaviour not

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related to environment, as well

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as behaviour related to the
social and cultural environment,
as well as genetics
environmental health (WHO), 2016
Those services which implement
environmental health policies through
monitoring and control activities.

They also carry out that role by

promoting the improvement of
environmental parameters and by
encouraging the use of
environmentally friendly and healthy
technologies and behaviors. They
also have a leading role in developing

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and suggesting new policy areas

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environmental health (WHO)
Conceptual map
illustrating the
connections among
nonhuman nature,
ecosystem
services, environmental

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ethics, environmental

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justice, and public
health
 Environmental health addresses all human-health-
related aspects of the natural environment and
the built environment.
Concerns : Air quality, Biosafety Disaster preparedness and response.
Climate change and its effects on health. Environmental racism Food
safety, including in agriculture, transportation, food
processing, Hazardous materials Housing, Childhood lead
poisoning prevention. Medical waste management and disposal.

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Noise pollution control. Occupational health and industrial hygiene.

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Radiological health, including exposure to ionizing radiation from X-

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rays or radioactive isotopes. Recreational water illness prevention,
including from swimming pools, spas
and ocean and freshwater bathing places.

Safe drinking water. Solid waste management,

including landfills, recycling facilities, composting and solid waste
transfer stations. Toxic chemical exposure whether in consumer
products, housing, workplaces, air, water or soil. Vector control,
including the control of mosquitoes, rodents, flies, cockroaches and
other animals that may transmit pathogens.
Environmental
health indicator
(2016).

It consists of 3 categories:

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health impacts, air quality, and

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water and sanitation.

The health impacts category

includes the environmental risk
exposure indicator.
 24% of
all global deaths
are linked to the
environment, which
is roughly 13.7 million
deaths a year.

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2.1 billion people lack

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safe drinking water at

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home, more than
twice as many lack
safe sanitation

https://www.who.int/publications/i/item/9789241565196
https://www.who.int/news/item/12-07-2017-2-1-billion-people-lack-
safe-drinking-water-at-home-more-than-twice-as-many-lack-safe-
sanitation
⚫ Dalam diagram yang
diusun oleh H.L
Bloom Peran
Lingkungan faktor
yang terbesar
mempengaruhi
Kesehatan
Masyarakat.

⚫ Peran dari kesehatan

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lingkungan adalah

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mencegah :

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⚫ Water borne disease
⚫ Air borne disease
⚫ Vector borne disease
Typhoid Fever

Although rare in industrialized countries, typhoid fever is

WATERBORNE DISEASES
well-known in extremely poor parts of developing nations;
it’s estimated that up to 20 million people worldwide
suffer from the illness each year. It’s spread through
contaminated food, unsafe water, and poor sanitation,
and it is highly contagious.
2.Cholera

Cholera is commonly found in humanitarian emergencies

or marginalized villages where poverty and poor
sanitation are rampant. The disease is spread through
contaminated water and causes severe dehydration and
diarrhea. Cholera can be fatal within days or even hours
of exposure to the bacteria, but only 1 in 10 people will
develop life-threatening symptoms.

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3.Giardia

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This waterborne disease is shared through contaminated

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water, most often in ponds and streams, but it can also

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be found in a town’s water supply, swimming pools, and

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more. The infection is caused by a parasite and typically
clears up after a few weeks. However, it’s possible for
those who have been exposed will experience intestinal
problems for years to come.
4. Dysentery

An intestinal infection, dysentery is a waterborne disease

characterized by severe diarrhea as well as blood or
mucus in the stool. Dysentery is good reason to always
wash your hands, as the disease is spread mainly
through poor hygiene. It can be caused by bacteria,
viruses, or parasites in unsafe food and water and by
people coming in contact with fecal matter. If someone
experiencing dysentery cannot replace fluids quickly
enough, their life could be at risk.

https://lifewater.org/blog/7-most-common-waterborne-diseases-and-how-to-prevent-them/
8/14/2021 16
 seven waterborne diseases and help prevent them today.
WATERBORNE DISEASES
5.Escherichia Coli (E. coli)
E. coli is a bacteria with various strains, some dangerous and some beneficial. For
example, E. coli bacteria is important in creating a healthy intestinal tract.
6.Hepatitis A
Hepatitis A is a liver infection caused by consuming contaminated food and water or
by coming in close contact with someone who has the infection. People who travel in
developing countries often or work in rural communities with poor sanitation and
hygiene management are most exposed to the disease.
7. Salmonella

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Most cases of salmonella come from ingesting food or water contaminated with

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feces. Undercooked meat, egg products, fruits, and vegetables can also carry the

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disease. Most people don’t develop complications, but children, pregnant women,

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older adults, and people with weakened immune systems are most at risk

Prevent Waterborne Diseases for Good: Give with Lifewater

There are many parts in the world where waterborne diseases are rampant, deadly,
and knowledge about prevention is not widely available. For over 40 years, Lifewater
has sought out these places, working with communities to teach vital sanitation and
health practices and constructing custom water technologies in places where water
access is most difficult.
Over and over again, cholera is prevented and typhoid eradicated. Children no longer
battle waterborne illness, and parents go back to work.

https://lifewater.org/blog/7-most-common-waterborne-diseases-and-how-to-prevent-them/
8/14/2021 17
Airborne diseases :
are bacteria or viruses that are
most commonly transmitted
through small respiratory droplets.

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These droplets are expelled when

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someone with the airborne disease
sneezes, coughs, laughs, or
otherwise exhales in some way.
Vector-Borne Disease:
Disease that results from an infection transmitted to
humans and other animals by blood-feeding anthropods,
such as mosquitoes, ticks, and fleas. Examples of vector-
borne diseases include Dengue fever, West Nile Virus,
Lyme disease, and malaria.
•Chikungunya
•Dengue Fever
•Lyme Disease
•Malaria
•Plague *

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•Relapsing Fever

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•Rocky Mountain Spotted Fever

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•Tularemia * (Rabbit Fever)
•Typhus * (Flea-Borne, Endemic)
•West Nile Virus
•Zika Virus Disease
Zoonotic Disease:
A disease that can be transmitted from animals to people
or, more specifically, a disease that normally exists in
animals but that can infect humans. There are multitudes
of zoonotic diseases.
A zoonosis (zoonotic disease or zoonoses -plural) is an infectious http://publichealth.lacounty.gov/acd/Vector.htm#:
https://abhipedia.abhimanu.com/Article/
disease that is transmitted between species from animals to
https://www.frontiersin.org/articles/10.3389/fvets.2020.58
humans (or from humans to animals). 2743/full
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https://www.rural21.com/english/home.html
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 The Ten Main Causes of Air
Pollution
The Burning of Industrial Indoor Air
Fossil Fuels Emission Pollution

Microbial

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Wildfires Decaying Transportation

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Process

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Open Burning of Construction Agricultural
Garbage Waste and Demolition Activities

Use of chemical
and synthetic
products

https://www.aqi.in/blog/here-are-the-10-main-causes-of-air-pollution/
 Types of Sources
There are four main types of air pollution
sources:

1. Mobile sources – such as cars, buses,

planes, trucks, and trains

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2. Stationary sources – such as power

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plants, oil refineries, industrial

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facilities, and factories
3. Area sources – such as agricultural
areas, cities, and wood-burning
fireplaces
4. Natural sources – such as wind-blown
dust, wildfires, and volcanoes

https://youtu.be/r2BLGWPAEiE
https://www.nps.gov/subjects/air/sources.htm
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Apakah anda masih menggunakan jamban ini …???

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DINAMIKA KESEHATAN LINGKUNGAN
(TEORI SIMPUL)
Pengukuran parameter kesehatan
lingkungan

⚫ Pada simpul A: pengukuran pada

sumbernya (pengukuran emisi)

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⚫ Pada simpul B: pengukuran

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komponen penyebab sakit
pada ambient

⚫ Pada simpul C: pengukuran pada

spesimen tubuh manusia (biomarker
atau bioindikator)
⚫ Pada simpul D: sudah terjadi outcome
berupa kejadian penyakit, misal jumlah
penderita keracunan
Ruang Lingkup
Kesehatan Lingkungan

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⚫

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Penyediaan air

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⚫ Pengelolaan limbah

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⚫ Sanitasi makanan
⚫ Sanitasi pemukiman dan TTU
⚫ Pencemaran lingkungan
⚫ Pengendalian vektor & rodent
⚫ dll
• Moeller, Dade W. “Environmental Health.” Harvard University
Press, Cambridge Massachusetts. 1992
• Integrated Environmental Health Middle School Project
University of Washington © 2005
• Yassi, A., Kjellstrom, T., de Kok, T., and Guidotti, T. “Basic

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Environmental Health.” Oxford University Press for the World

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Health Organization. 2001.

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8/14/2021 Vielen Dank für Ihre Aufmerksamkeit 29