the environment and health

Mata Kuliah Kesehatan Global Fakultas Kesehatan Masyarakat Universitas Indonesia

THE HEALTH SYSTEM– SESI 4

Reference : Global Health 101 2nd Edition, Richard Skolnik, 2012

Mata Kuliah Kesehatan Global Fakultas Kesehatan Masyarakat Universitas Indonesia

THE ENVIRONMENT AND HEALTH– SESI 6


Click icon to add picture

MK: Kesehatan Global Fakultas Kesehatan Masyarakat Universitas Indonesia

Learning Objectives

1

2

3

4

5

Discuss the most important environmental threats to health in low- and middle-income

Review the burden of disease from indoor and outdoor air pollution and unsafe water and sanitationExamine the contribution of personal hygiene to reducing the burden of environmentally related health problems

Comments on the costs and consequences of the environmental burdens

Describe some of the most cost-effective ways of reducing the global burden of environmental health-problems


1. Rashmi lived in the eastern part of Nepal in a modest home. She had difficulty breathing, that linked to the way Rashmi cooked with a stove inside the house that not vented outside. She used cow dung or wood as fuel, when cooked she often held her new baby on her back. She lacked the money to buy a new stove or to fuel it with kerosene.

2. Sunisa was young mother lived in northern Laos. she collected the water from the stream about half a mile from her house. Sunisa was not educated woman and did nothing purify the water. The two daughters regularly had bouts of diarrhea partly the result of drinking unsafe water.

Vignettes


OUTLINE

1

2

3

4

5

6

Environment Threats in Low- and Middle-Income

Indoor & Outdoor Air Pollution, Unsafe Water & Sanitation

Personal Hygiene to Reducing the Burden of Environmentally Related Health Problems

Costs and Consequences of the Environmental Burdens

Cost-effective Ways of Reducing The Global Burden of Environmental Health-Problems

Future Challenge


1. ENVIRONMENT THREATS IN LOW- AND MIDDLE-INCOME


1. Environment Threats in Low- and Middle-Income

8.4% of the total burden of disease because environmental condition :a. Unsafe water, Hygiene, and Excreta disposalb. Urban air pollutionc. Indoor smoke from household use of solid fuels

25-33 % of the global burden of disease can be attributed to environmental risk factors.

Causing death : a. Lower respiratory infectionsb. Chronic obstructive pulmonary diseasec. Diarrheal disease


2. INDOOR & OUTDOOR AIR POLLUTION, UNSAFE WATER & SANITATION


2. Indoor & Outdoor Air Pollution, Unsafe Water & Sanitation

Indoor smoke from

household use of solid fuels

House not vented outside

Conjunctivitis, upper

respiration irritation, and

acute respiratory infection

1. Indoor air pollution


2. Outdoor air pollutionTable 1. Common Air Pollutants and their Health

EffectName of Pollutant Example Sulfur of Source Health Effects

Carbon monoxide Combustion of gasoline and fossil fuels, cars Reduction in oxygen-carrying capacity of the blood

Lead Leaded gasoline, paint, batteries Brain/CNS damage, digestive problem

Nitrogen dioxide, nitrogen oxides

Combustion of gasoline and fossil fuels, cars Damage to lungs and respiratory system

Ozone Variety of oxygen formed by chemical reaction of pollutants

Breathing impairment, eye irritation

Particulate matter Burning of wood and diesel fuels Respiratory irritation, lung damage

Smog Mixture of pollutants, esp. ozone, originates from petroleum-based fuels

Irritation of respiratory system, eyes

Sulfur dioxide Burning of coal and oil Breathing problems, lung damage

Volatile organic compounds (VOCs)

Burning fuels, released from certain chemicals

Acute effect similar to those of smog, possible carcinogen



More than 1 billion people (mostly in low- and middle-income) lack access to safe water sources

It estimated 400 million children lack access to safe water Waterborne disease and spread parasitic worms such ascaris and

hookworm Burden of disease : diarrhea and worm infections

3. Unsafe water and sanitation



3. PERSONAL HYGIENE TO REDUCING THE BURDEN OF ENVIRONMENTALLY RELATED HEALTH PROBLEMS


3 .Personal Hygiene to Reducing the Burden of Environmentally Related Health Problems

The Environment

Burden of Disease

Indoor Air pollution

Outdoor Air Pollution

Unsafe Water, sanitation, and

Hygiene

Personal Hygiene promotion led to a 33%

reduction in diarrhea and studies about hand-

washing was associated with a significant reduction

in acute respiratory infection


4. COSTS AND CONSEQUENCES OF THE ENVIRONMENTAL BURDENS


4. Costs and Consequences of the Environmental Burdens

8.4% of the total deaths in low- and middle-income countries and 7.2% of

their total burden of disease

The burden of these causes falls disproportionately on relatively poorer

people

Environmental health burdens have very negative consequences on productivity


5. COST-EFFECTIVE WAYS OF REDUCING THE GLOBAL BURDEN OF ENVIRONMENTAL HEALTH-PROBLEMS


5. Cost-effective Ways of Reducing the Global Burden of Environmental Health-Problems

Outdoor air pollution

Indoor air pollution

Sanitation

Water supply

Hygiene

The Burden of Diseases



Outdoor Air pollution

a) The introduction of unleaded gasoline

b) Low-smoke lubricant for two-stroke engines

c) The banning of two-stroke enginesd) Shifting to natural gas to fuel

public vehiclese) Tightening emissions inspections

on vehiclesf) Reducing the burning of garbage

Indoor air pollution

a) Involve end users, especially women, in helping to asses needs and design approaches

b) Promote demand for better stoves and fuels to encourage the development of competitive suppliers and market choice

c) Consider subsidies and microcredit for selected intervention

d) establish national and local policies that encourages the needed changes in stoves and fuels



Constraints in sanitation

a) Lack of knowledge optionb) Costc) Constructiond) Local laws

Solution

a) Built low cost-cost sanitation systemb) Public or private partnership with NGOsTwo most successful cases of improving low-cost sanitation were led by NGOs in Zimbabwe and Bangladesh



Water supply

Improved water sources by: a) House connection b) Standpost c) Borehole d) Dug well e) Rainwater collection

Hygiene

Hygiene promotion

Low cost hygiene scheme promotion by

government

Plan of water supply with low-cost

Reduction : diarrhea and acute respiratory

infections


6. FUTURE CHALLENGE


6. Future Challenge

Population grow in many developing country and urbanization

Burden of disease related to hygiene, water supply, and sanitation; indoor and outdoor air

pollution

Economic grow in low- and middle-income (related with pollution, using energy, etc)

Action outside health sector, climate change


Learning Objectives Accomplished

Discuss the most important environmental threats to health in low- and middle-income

Review the burden of disease from indoor and outdoor air pollution and unsafe water and sanitation

Examine the contribution of personal hygiene to reducing the burden of environmentally related health problems

Comments on the costs and consequences of the environmental burdens

Describe some of the most cost-effective ways of reducing the global burden of environmental health-problems


THANK YOU



Health & Medicine

the environment and health