Nature of Environmental

Health Hazards
Titik Respati
UNISBA

OBJECTIVE:
To describe the difference between hazard & risk
To explain the logic of the various methods of classifying
environmental hazards
To describe a scheme for identifying the level of hazard &
toxicity
To explain why knowledge of the toxicology, microbiology, or
physical properties of an environmental hazard is essential to
determining the most appropriate approach to its risk assessment
To identify different experimental investigative methods
To explain the biological significance of bio-transformation
process
To list the basic characteristics of chemical, physical, biological,
mechanical, & psychosocial hazards

 Required Reading
Yassi A, Kjellstrm T, de Kok T,
Guidotti TL. Basic
Environmental Health. Chapter
2: Nature of Environmental Health
Hazards. New York: Oxford
University Press, 2001

Menuurt sbeauh penilitean di Cmabrigde

Uinervtisy, tiadk meajndi malsaah
bgaiamnaa uratun hruuf-hruuf di daalm
seubah ktaa. Ynag pailng pnetnig
adlaah leatk hruuf peratma Dan terkahir
itu beanr. Sisnaya daapt breatnakan
smaa seakli Dan kmau maish dpaat
meaambcnya dgaen bnaer.

Definition

Hazard
a factor or exposure that may adversely affect
health (Last, 1995)
a source of danger
a qualitative term expressing the potential of an
environmental agent to harm the health of certain
individuals if the exposure level is high enough
&/or if other conditions apply

Definition (contd)
Risk
the probability that an event will occur, e.g. that an
individual will become ill or die within a stated
period of time or before a given age; the probability
of a (generally) unfavorable outcome (Last, 1995)
the quantitative probability that a health effect will
occur after an individual has been exposed to a
specified amount of a hazard

Types of EH Hazards
Biological hazards
e.g. bacteria, viruses, parasites

Chemical hazards
e.g. toxic metals, air pollutants, solvents, pesticides

Physical hazards
e.g. radiation, temperature, noise

Mechanical hazards
e.g. motor vehicle, sports, home, agriculture, & workplace
injury hazards

Psychosocial hazards
e.g. stress, lifestyle disruption, workplace discrimination,
effects of social change, marginalization, unemployment

Types of EH Hazards (contd)

Classified according to:
nature
natural vs anthropogenic
traditional vs modern
route of exposure
setting

Traditional Hazards

Disease vectors
Infectious agents
Inadequate housing
& shelter
Poor-quality
drinking water &
sanitation
Indoor air pollution
from cooking
Dietary deficiencies
Hazards of child
birth
Wildlife & domestic
animals
Injury hazards in
agriculture

Modern Hazards
Tobacco smoking
Transport
hazards
Pollution from
sewage &
industry
Outdoor air
pollution from
industry &
motorcars
Overuse or
misuse of
chemicals
Industrial
machinery

Biological, chemical & physical hazards

by routes of exposure
Biological

Chemical

Physical

AIR
Agent/source

Microorganisms

Fumes, dust, particles

Radiation, heat, noise

Vectorial factors

Coughing, exhalations

Contaminated air

Climate, unguarded
exposures

Routes

Inhalation, contact

Inhalation, contact

Inhalation, direct
penetration

Agent/source

Microorganisms, decayed
organic material

Discharges, teaching,
dumping

Radiation, heat in power

station cooling water

Vectorial factors

Insects, rodents, snails,

animal excreta, food
chain

Contaminated food &

water

Accidents, contaminated
food & water

Routes

Bites, ingestion, contact

Ingestion, contact

Ingestion, contact

WATER

BIOLOGICAL HAZARDS
Include all of the forms of life (as well as the
nonliving products they produce)
plants, insects, rodents, other animals, fungi, bacterial,
viruses, protozoa, a wide variety of toxins & allergens; &
prion

Routes of exposure:
Air
Water
Food
Direct penetration
Biting
Person exposed the agent distributed via blood,
lymph, or other body fluids to the parts of the body
most favorable for it to grow

Prions (proteinaceous infectious particles)

Infectious agents (not organisms) made of protein (yet to be
fully characterized)
Multiply by converting normal protein molecules into
dangerous ones by changing their shapes
Responsible for the various forms of spongiform
encephalopathy, e.g.:
- bovine spongiform encephalopathy (BSE) or mad-cow
disease)
- Creutzfeldt-Jakob disease (CJD)
- kuru (transmitted by ritual handling of bodies & brains
of the dead)
Symptoms of the human prion diseases: dementia,
loss of coordination

Viruses
a piece of nucleic acid (either DNA or RNA), which makes
its progeny by orchestrating the production of virus
particles by a cell
viruses that lack a lipoprotein envelope (e.g. hepatitis A,
gastroenteritis viruses) can grow in the human gut & be
spread by food & water
viruses with a lipoprotein envelope have limited survival
outside a host & so are spread in aerosols or inoculations
of body fluids from person to person (e.g. measles)
reproduces only inside a host cell
viral diseases do not respond to antibiotics, but some
respond to specific antivirals

Bacteria
most have sufficient energy supply to reproduce outside a
cell
have genetic material but no nucleus
divide by splitting in half
exist singly or in short chains of two or more
classified by shape, oxygen requirement & ability to take
up a special stain

Fungi
simple plant plant organisms that lack the chlorophyll
needed to use carbon dioxide & sunlight to build sugars &
structural molecules
classified into yeast (single-celled) or moulds, which grow
as branching filaments called hyphae
yeast reproduce by budding, moulds by branching &
longitudinal growth of hyphae, as well as by producing
sexual spores

Protozoa
the simplest class of animal & consisting of a single
nucleated cell
each cells has organelles that carry on such functions as
locomotion, nutrition, excretion, respiration
e.g. : plasmodium, cryptosporidium, giardia
Arthropods
the large phylum of animal life that includes insects,
spiders, mites & ticks (as well as crabs & lobsters)
some of these creatures bite, sting, cause allergic
reactions, and may serve as vectors for viruses & other
infectious agents

Pathway

Disease

Inadequate sanitation, the dumping of

untreated sewage into surface water, cholera, typhoid fever, dysentry, other
diarrheal diseases, hepatitis A,
poor hygienic practices water
schistosomiasis
polluted by human excreta
Overcrowding, poorly ventilated
housing airborne transmission

tuberculosis, measles, influenza,

pneumonia, pertussis, cerebrospinal
meningitis

Unhygienic animal husbandry

zoonoses transmission

plague & hydatids diseases

Stagnant waters, unsanitary housing,

refuse dumping vector-borne
transmission

malaria, trachoma, schistosomiasis,

filariasis, yellow fever, plague, typhus,
trypanosomiasis

Growth of biological agents are

slowed down or stopped by:
defense mechanisms of the body
drugs

CHEMICAL HAZARDS
Inorganic Substances
- halogens (e.g. fluorine, chlorine, bromine, iodine)
- alkaline compounds (e.g. NH3, Ca(OH)2, KOH, NaOH
- ozone (O3)
- NOx and SOx
- metals (e.g. cadmium, chromium, copper, lead, manganese,
mercury, nickel, arsenic)

Organic Compounds
- aliphatic hydrocarbons (e.g. methane, ethane, propane,
butane, pentane, hexane, heptane, octane)
- alicyclic hydrocarbons (e.g. cyclohexane,
methylcyclohexane, turpentine)
- aromatic hydrocarbons (e.g. benzene, toluene, styrene,
naphthalene)
- halogenated hydrocarbons (e.g. chloromethane,
dichloromethane, chloroform, carbon tetrachloride,
trichloroethyene, polyviyl chloride)
- alcohols (e.g. methanol, ethanol, propanol)

Route of exposures
Source:
natural events
man-made: industrial, agricultural, commercial,
domestic, manufacturing wastes
Exposure:
-

inhalation
- breastfeeding
oral ingestion
- placental transfer
absorption via the skin - inoculation & direct penetration
absorption via the eyes

Air, water,
dirt, etc

Exposure
Media

inhalation

Major uptake
pathways

Food, water,
drugs

Air

exhalation

Respiratory
tract

Skin

GI-tract
bile

exfoliation

Transport &
distribution

ingestion

Other
organs

Blood

Liver

Kidney

Major
excretory
pathways

Sweat

Hair

external contamination

Urine

Faeces

Biotransformation
Hydrophobic or lipophilic hydrophilic
Phase I : - the molecule is altered by the introduction
of electrostatically charged (polar) groups
- result of oxidation, reduction, or hydrolysis
Phase II: substances are combined w/ hydrophilic
endogenous compounds

Bioactivation of Benzene
Phase II

Phase I
O

OH
Benzene
(the original chemical)

Benzene epoxide
(a dangerously toxic
product)

Phenol
(an intermediate that
the body can handle)

Gluc
Phenylglucuronide
(hydrophilic; easily
excreted)

xenobiotics
highly lipophilic
metabolically stable

lipophilic

polar

hydrophilic

accumulation in body fat

phase I
(bioactivation or inactivation)
oxidation, reduction, hydrolysis
polar
phase II
(bioinactivation) conjugation
hydrophilic

extracellular mobilization
plasma circulation
biliary excretion

renal excretion

secretion

Toxicity
any harmful effect of a chemical or a drug on a
target organ

Systemic toxicity
Liver toxicity
Kidney toxicity
Skin toxicity
Neurotoxicity
Immunotoxicity

Biological agents
Chemical agents

DNA

Physical agents

Alteration of genetic
codes & information:
- gene mutation
- chromosomal alteration
- gene rearrangements

Gene mutation:
the result of single or multiple base pair changes (substitutions, deletions, insertions)
in the DNA. Normally, the cell defense mechanisms can repair DNA damages, recreating
the original structures. Repair can be faulty, leading to heritable changes

Chromosomal alterations
via damage by genotoxic agents, leading to structural aberrations (breaks, deletions, translocations), &
via loss or gain of one or more chromosomes & sometimes changes in the number of chromosomes

Gene rearrangements:
characterized by altered gene expression (gene amplification, loss of activity). The underlying causes
might be translocations or inversions of large parts of chromosomes

Multistage process of carcinogenesis:

Initiation

Promotion

Progression

Toxicity Testing
Acute toxicity studies
to predict human effects of short-term, high-level exposures; can provide a
measure of the toxic potential of different compounds
ED50 : dose that would cause the effect in half of the test population
LD50 : dose that would kill half of the test population
LC50 : concentration of gas or vapor that kills half the test population
LD50 & LC50 : crude indices of toxicity

Sub-chronic tests
animals exposed repeatedly to a given chemical over a relatively long period (28
days or longer), normally 10% of the lifetime of the selected animals

Chronic toxicity testing

performed by exposing animals to the chemical being tested for the whole of the
animals lifetime

Reproductive studies
on parents & offspring

Toxicity Testing (contd)

Genotoxic short-term tests
short-term tests for gene mutation & chromosome alterations
both in vitro & in vivo

Human studies
clinical or epidemiological studies

Structure-activity relationships
Right-to-know legislation hazard identification & control

PHYSICAL HAZARDS
Forms of potentially harmful energy in the environment that
can result in either immediate or gradually acquired damage
when transferred in sufficient quantities to exposed
individuals
e.g.: sound waves, radiation, light energy, thermal energy,
electrical energy

Noise
Noise: an unwanted sound
Sound intensity: measured in decibels (dB)
Risk of incurring hearing loss begins w/
prolonged exposure to sound of + 75 dB(A)
Rule of thumb:
if a loud voice is not understandable at a distance
of 1 m b/c of excessive background noise, the
background noise level is above 85 dB & likely to be
dangerous

Hearing conservation program

Regular monitoring of the workplace
Baseline & annual audiograms (for all exposed
workers)
In-service & pre-service (worker) education
Systematic record keeping
Worker notification
Provision of hearing protection

Other physical hazards:

vibration, radiation, light, lasers, pressure,
temperatures
What are potential health effects of such
hazards?

Mechanical Hazards
those posed by the transfer of mechanical or
kinetic energy (the energy of motion)
Injury, trauma, accidents
Vulnerable groups:
children, the elderly, & disadvantaged groups

The Haddon Matrix

Factors
Phases
Pre-injury
Injury
Post-injury

Human

Vehicle

Environment

Psychosocial Hazards
Potential sources of work-related
psychosocial stress:
- factors intrinsic to the job
- the role of the worker in the organization
- career development
- interpersonal relationships at work
- organizational structure & climate

Thank you