ENVIRONMENTAL HEALTH

Environment means the condition of object by which one is surrounded. Thus, to total sum of
physical and biological, social factors that directly influences the survival, growth, development
and reproduction of organism is environment. So, every organism of the environment depends up
on each other for their survival.

According to Webster, Environment of is the aggregate of all the external condition and
influences the life and development of an organism. Thus, in the modern concept environment
includes not only the air, water, soil that form our environment but also the social and economic
condition under which we live.

The component or classification of environment in three groups:

Physical environment: it includes water, air, soil, waste, radiation, temperature, humidity’s,
lights etc.

Biological environment: it includes plant, animals, bacteria, virus, protozoa, insects, rodents,
parasites, fungus etc.

Social environment: it includes customs, culture, habit, income, occupation, religion norms,
values, traditions etc.

Definition:

 The comprehensive study management of environmental conditions and principles that

influence the health and well-being of individuals, groups, and communities.

 It is the branch of public health is concerned with all aspects of the natural and built
environment that may affect human health.

Importance

1. To maintain a safe supply of food drinking water and air.

2. To discover mechanism of disease caused by environmental exposure.
3. To treat and dispose of solid, liquid, and hazardous waste.
4. To reduce air, water, food and noise pollution.
5. To control vector borne disease and work place hazards.

Sanitation:

It is the science of safe gardening of health. It is the way of life. And quality of living that is
expressed in clean home, the clean farm, the clean business, the clean neighborhood, and the

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community. Being a way of life, it must come from within the people and it is nourished by
knowledge and growth as an obligation and an ideal in human relations.

National sanitation foundation of USA

“In fact, the term sanitation covers the whole field of controlling the environment with a view to
prevent disease and promote health.”

Environmental sanitation: the control of all the factors in means physical environment which
exercise or may exercise deleterious effect on his physical development, health and survival.
Particularly in the control of air, water, rodents, waste, food housing, insects WHO

Environmental sanitation efforts in Nepal / So, why is this such an issue?

poor sanitation leads to sickness and disease. higher rates of infant mortality and infections,
contributes to malnutrition and generally a weaker human condition. a lack of sanitation limits
economic growth. Without good sanitation, workers are less healthy and therefore less
productive, living shorter lives and saving and investing less. Inadequate sanitation may actually
be the biggest killer of children as 10,500 children die from diarrhea every year in Nepal before
reaching their 5thbirthday. We know that more than 80% of diseases are caused because of unsafe
sanitation facilities and unhygienic practices. We also know that safe sanitation facilities can
prevent diarrhea by 45%.

Chronological History of Sanitation Initiatives in Nepal Major Initiatives Year

• Establishment of the Department of Water Supply and Sewerage (DWSS) 1972

• Janatako Khane Pani Ra Sarasafai Karyakram, (JAKPAS), MPPW/ World Bank (Pilot 1993-
1996) 1993

• Nepal National Sanitation Policy and Guidelines for Planning and Implementation of Sanitation
Program, MPPW

National level/ Regional level/school level

1 Overall coordination with relevant ministries, NPC and donors

2 Capacity building of the districts

3 Media campaigning, advocacy and policy formulation and reformulation

4 National level awards declaration and distribution

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5 Reward and recognition

8 Hygiene and sanitation strategic action plan development

9 Media mobilization and advocacy

10 Campaigning, triggering and awareness raising

11 ODF and post ODF campaigning

11 Toilet, drinking water and hand washing facilities in schools

12 Capacity building (Training to SMC/PTA, teachers, child cubs)

Pollution: any addition to air, water, soil or food (environmental components) that threatens the
health survival or activities of human or other living organism is called pollution.

Environmental pollution: it is the undesirable spread of toxic substances or chemical in to the

aquatic and terrestrial habitats of the world.

Root cause of environmental pollution:

1. Degradation part of earth and life supporting systems

2. Rapid population growth.
3. Widespread use of cheap environmentally damaging fossil fuel.
4. Overuse and degradation of global common property resources which are owned by none
and available for all.
5. Rapid and wasteful use of resources with too little emphasis on pollution prevention and
waste reduction.
6. Industrialization/improper management of waste.
7. Properly exposes the poor to much higher health and environmental risks.

Effects:

1. Damage property
2. Nuisances (noise /unpleasant smell/tastes and sight)
3. Develop and increased life-threatening diseases (CD and NCDs)
4. Disruption of life supporting systems for human and other species.

Relation between environment and health

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Relation of environment and health could be clearly understood through the different etiological
factors of disease such as agent host and environment and the necessity of interaction among
these three factors to produce disease in human. These three factors referred to as
epidemiological triad. Agent

Environment Host
Most disease are either caused or influenced by environmental factors. An understanding of the
way in which specific environmental factors can interfere with health is therefor of crucial
importance for prevention program. In a broad sense every disease is called either by
environmental factors or by genetic factors, the later including natural deterioration of the body
with age.

Environmental factors that may affect health:

1. psychological factors: stress, shift work, human relationship

2. Accidental factors: Hazard situation, speed, influences alcohols and drugs
3. Biological factors: Bacteria, virus, parasites, fungus etc.
4. Chemical factors: chemical, dust, drugs, tobacco, food additives

Agents: It is defined as substances living, non-living or a force, tangible or intangible, the

excessive present or relative lack of which may initiate or perpetuate a disease process.

Classification

1. Biological agents: these are living agents of disease such as bacteria, virus, rickettsia, fungi,
protozoa, parasites, clymedia etc.
2. Nutrient’s agents: these can be protein, carbohydrates, fats, vitamins, minerals, water. Any
excess or deficiency of intake of nutrients elements may results in nutritional disorders such
as PEM, Anemia, goiter, obesity etc.
3. Physical agents: exposure to excessive heat, cold, humidity, pressure, radiation, electricity,
sound, may cause illness.
4. Chemical agents: these are classified in to two groups endogenous and exogenous.
Endogenous: which are produced by the as result of derangement of functions e.g. urea
(uremia), serum bilirubin (jaundice), ketone (Ketosis), uric acid (gout) calcium
carbonate/calcium oxalates/urates (kidney stones)
Exogenous: agents arising outside of human host e.g. allergens, metal, fumes, dust,
gases, and insecticides. These may be acquired by inhalation ingestion or inoculation.
5. Mechanical agents: exposure to chronic friction and other mechanical forces may result in
crushing tearing, sprains, dislocations and even death.

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6. Social agents: it also necessary to consider social agents of disease. These are poverty,
smoking, drug / alcohol abuse, unhealthy life style, social isolation, maternal deprivation etc.
7. Absences or insufficient or excess of factors necessity to health: These may be, Chemical
agents (hormone, enzymes) Nutrients factors, structural abnormality, chromosomal factors.

Host: It is defined as organism which harbors the disease agents. Human host is referred to as
soil and disease agents as seed.

Classification: 1. Demographic characteristics 2. Social and economic characteristics 3.

Biological characteristics 4. lifestyle factors

Demographic characteristics: age factors (> 5 yrs. and < 65yrs age people), Sex: commonest
female, Ethnicity: lower class cast, marginalized or deprived groups etc.

Biological characteristics: genetics factors (genetic diseases), Biological level of blood:

decrease Hb gram% (anemia), decrease platelets. lipedema, increased uric acids level (Gout),
Increased/decreased level of hormones diseases, hypertension, Diabetes and ischemic heart
disease, etc.

Social and economic characteristics:

a. Social status: poor, ethnic group, rich or elite group, marginalized/deprived groups
b. Stress: frustration, mental disorders etc.
c. Occupation: work in poor environmental situation (cottage factories, mines, agricultural
practice, food processing industries, labor groups)
d. Marital status: married / unmarried both conditions may have good host
e. Drug abuse, unsafe sex, alcoholics, and chain smokers etc.
f. Housing Condition: type of land, structure, ventilation, paintings colors in walls and
condition of floor/roof etc.

Environmental hazards

Hazards a factors or exposure that may adversely affects health, synonyms of risks. It is a
generic term for any situation or state of events, which poses a threat to the surrounding
environments, this term incorporated topics like pollution and natural disasters such as storms
and earth quakes.

Basically, hazards have classified in to four groups:

Physical hazards Biological hazards

Cultural hazards Chemical hazards

Physical hazards: It is naturally occurring process that has the potential to create loss or
damage. It includes earth quakes, floods, tornados, tsunamis, landslides etc.

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Cultural hazards: It includes various activities which prevalent in our societies like living
standards, eating habits, working activities, cremation practices in Hindu culture, smoking
behavior, drinking habits, religious practices, customs, social norms, social values, traditional
practices, social taboos etc.

Biological hazards: hazards occurred due to the exposure of various biological components like
bacteria, viruses, parasites, fungus, plants, animals etc. This hazard can be mitigating by proper
handling, packing, cutting, processing, and cooking practices.

Effect of biological hazards:

Long term effects: Different organ cancers, chronic gastritis, peptic ulcer, infertility, sterility,
other chronic Diseases etc.

Short term effects:

viral infection: Hepatitis, rabies, meningitis, jaundice, diarrhea etc.

bacterial infection: Brucellosis, conjunctivitis, food poisoning, typhoid, cholera,

diarrhea, pneumonia etc.

parasitic infection: Helminthiasis, cysticercoids, protozoal infection (amoebiasis),

hydatidosis, etc.

fungus infection: Dermatitis, conjunctivitis, food poisoning, diarrhea, chronic allergies

on GI systems etc.

Chemical hazards: It is hazard caused due to exposure to chemical substances in to the

atmosphere or environment, which cause detrimental effects on environmental components and
living beings.

Types of chemical hazards:

1. In a liquid form like acid/alkali solvent (with or without label)

2. In a vapors or fumes
3. In a flammable/explosive material.

Sources of chemical hazards: Nuclear plant, spraying insecticides, burning fuels, industrial
activities (producing, processing, packing, melting, cooling, grinding, galvanizing, heating etc.)

Effects on human health: different physiological disorders (dizziness, headache, sore throat,
shortness of breath, gastritis, eye allergies/diseases), malignant diseases, mutation, teratogen
effects, genetic disorders, skin allergies/cancer, infertility, irritability, miscarriage, corneal
damage, menstruation irregularities, sleeplessness etc.

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Control of environmental hazards

1. Waste reduction: “3R” concepts, substitution raw materials, change the manufacturing
process.
2. Selected hazardous waste treatment activities: biological treatment, carbon absorption,
incineration etc.
3. Monitoring to reduce adverse effect on health.
4. Public participation to management of waste: access information, allowed participatory,
policy making, and directing.
5. Enforcement of environmental law.
6. Coordination among private NGO, INGOs.
7. Organize awareness programs time to time regularly.