1 - intro

• The study notes cover environmental and occupational health.

Environmental Health - Definition

• Addresses external physical, chemical, and biological factors impacting behaviors.
• Involves assessing and controlling environmental factors affecting health.
• Aims to prevent diseases by creating health-supportive environments.
• Unlike the clinical approach (disease treatment), environmental health prevents adverse outcomes by intercepting hazards or risks.
• Health-supportive countries use control measures and policies to improve health through environmental approaches. According to the American Public Health Association (APHA)
• Focuses on relationships between people and their physical environments.
• Promotes human health and well-being and fosters healthy, safe communities.
• A key component of any public health system.
• Everyone faces environmental physical, biological, and chemical factors that can cause adverse effects.

Environmental Factors and Health Outcomes

• Environmental health focuses on factors/hazards/pathogens and their transmission.
• Hazards include pollutants in air, water, soil, and food.
• Transmission involves how hazards are introduced, like inhalation, ingestion, absorption, or vertical transmission.
• Exposure through different modes can have wide-ranging adverse health effects.
• Health outcomes are greatly influenced by environmental factors.

Causality Between Health Outcomes and Environmental Factors

• Establishing causality is challenging because health effects may occur over a long period.

Environmental Exposures

• Environmental exposures are generally not genetic, with garbage being an exception.
• Primarily pollution-related rather than lifestyle choices, but physical environment influences behaviours.
• Environmental exposures are commonly passive and external.
• Ambient environment impacts the general population, while the occupational environment focuses on workers.
• Understanding the occupational environment is crucial for students to recognize workplace hazards and address health outcomes.

Burden of Disease

• High disease burden is associated with low-income countries.
• Disease rates attributable to modifiable environmental factors are largely preventable.
• Vulnerable populations such as children and those with low socioeconomic status experience the greatest disease burden.
• 24% of global deaths are linked to environmental factors, which is approximately 13.7 million each year. The Southeast Asia region has 4.1 million deaths relating to health risks and the environment factors.
• The current burden of disease stems from non-communicable diseases, with cardiovascular diseases having the highest rates of morbidity and mortality.
• Global estimates are likely to underestimate the overall burden because of lack of coverage.

Sustainable Development Goals

• Environmental and occupational health are closely tied to Sustainable Development Goal 3 (Good health and well-being).

Diseases, Injuries, and Key Environmental Interventions

• Historically, the greatest disease burden from environmental exposure comes from conditions such as diarrhea, malaria, and lower respiratory infections.
• Diarrhea pathogens may be related to poor water water quality.
• Mosquito vectors can transmit malaria which grows in still waters.
• Lower respiratory infections can be cause by air pollutants.

Specific Environmental Health Threats

Water Quality

• Water is essential for human health and daily activities.
• Microbiological quality can lead to outbreaks without interventions.
• Chemical quality standards, such as those detailed in the Philippine National Standards for Drinking Water, are vital and can cause acute health effects
• Some studies show arsenicosis occurring in Bangladesh.
• Diarrhea is mainly caused by unsafe water and poor sanitation. A study in Bilibid prison, showed drinking water came from a deep well, 1,212 inmates were affected, and 2 died.

Water-Related Diseases

• Water-borne: Via contaminated drinking water and are enteric such as diarrhea.
• Water-washed: Due to limited water; fungal/ophthalmic diseases, infections, scabies, louse-borne typhus
• Water-based: Parasites spending life cycles in water like schistosomiasis.
• Water-vectored: Insects/vectors feeding or living in water bodies; linked to still/standing water; malaria, dengue fever

Sanitation and Hygiene

• 32% of the population worldwide lacks access to improved sanitation.
• 946 million people still defecate in the open.
• Sub-Saharan Africa with 64% and South Asia with 63% still lack proper sanitation.
• 75% out of 2.6 billion people without access, live in Asia.
• Lack of resources and improper practices act as a barrier as well as the low importance that is placed on it.
• Women's health aspects, through fecal transmission relating to water resources, is still big.
• Preventable fecal-oral diseases include cholera, typhoid/paratyphoid fever, salmonellosis, shigellosis, giardiasis, hepatitis.
• 842,000 diarrheal deaths annually could be prevented by improved water, sanitation, and hygiene.

Air Quality

• The WHO states "9 out of 10 people worldwide breathe polluted air."

Indoor Air Pollution (IAP)

• Indoor air quality problems differ strikingly between the developed and developing world.
• People spend 80-90% of their lifetime indoors, making it a significant environmental hazard.

Global Environmental Change

• Large-scale environmental changes amplify existing health risks.

Climate Change and Health

• Human-induced greenhouse gas emissions are related to alteration of the lower atmosphere and change to world world-climate.
• Such change that involves a result in widespread for human health.

Occupational Health - Definition

• According to the WHO/ILO, Occupational health aims to promote and maintain the highest degree of physical, mental, and social well-being of workers in all occupations.
• Focuses are: Preventing departures from health to control risks and adapting work and workers.
• The aims are the prevention of adverse health effects caused by working conditions of workers and risks resulting from factors adverse to health. As well as the placing and maintenance of workers that are adapted to physical and mental needs.

Work and Health

• Work can affect health positively/adversely.

Hazard, Exposure, Risk

• Hazard: Workplace element that can cause harm.
• Exposure: Contact with hazard via inhalation, ingestion, direct contact.
• Risk: Probability of harm.
• Occurrence of risk is realized when both the hazard and exposure are present.

Action Points for Intervention

• Aims to cut the risk of adverse health outcomes from the source and avoid that it spreads.

Intervention Models

• Clinical model: Diagnosis and treatment of sick person.
• Public health intervention model that targets a safe environment.

Strategies to Improve Health

• Includes communication, education, advocacy and research
• Improves healthcare access by applying low strategies and changing harmful consumptions.

Action Points

• Includes reducing occupational exposures and promoting sun-protections and improve sanitation
• Ban smoking to reduce exposure to to secondhand secondhand smoke.
• Apply approaches creating healthier environments and prevention of diseases