Introduction Environmental health course

for 2nd year Midwifery students

• Course Title: Introduction to Environmental health
• Total Cr.Hr: 2ECTS (32 hrs.)

1
 Course objective
 To understand and discuss the environmental health concepts and
components
 Discuss the association between the human and environment.
 Describe the importance of the environmental health in preventing
the disease and promoting the health
 Identify chemical, physical, and biological agents that originate in
the environment and can impact human health

2
 Conti
 Describe policies that have been developed to manage health risks
associated with exposures to environmental hazards
 Describe specific applications of environmental health concepts to
fields such as water quality control, food safety, occupational health,
and injury prevention etc.
 Describe the healthcare waste management and its implication

3
 Course contents
• Chapter 1 • Introduction

• Chapter 2 • Community Water Supply

• Chapter 3 • Community Waste Management

• Chapter 4 • Food Hygiene and Safety

• Chapter 5 • Housing & Institutional Health

• Chapter 6 • Vector & Rodent Control

• Chapter 7 • Occupational Health & Safety

4
 Chapter 1: Introduction
• Health services can be categorized in to two
1. Preventive
2. Curative
• Curative health care oriented towards seeking
a cure for an existent disease or medical condition.
• Preventive preventing the appearance of diseases
through immunization, exercise, environmental
sanitation, proper eating habits and other life
style issues
• what is health mean ?

5
 Health
• WHO definition states:

“Health is a state of complete physical, mental,

and social well-being and not merely the absence
of disease or infirmity and the ability to lead a
productive life in society ”.

6
While the WHO definition has been widely accepted,
• Indicators of “complete physical, mental, and social well-being”
have not been developed to the same degree as indicators of
disease.

• Thus, in practice, there continues to be reference to those things,

which are indicators of disease.

• So that any impairment of physiological and mental functioning or

physical and mental growth and development would be considered
to be ill health or disease.

7
Definition of Public Health

• Public health is the science and the art of preventing

disease, prolonging life and promoting health and
efficiency through organized community efforts.

8
These efforts should deal with:

– Sanitation of the environment

– The control of communicable diseases

– The education of individuals about personal hygiene

– The organization of medical and nursing services for the

early diagnosis and preventive treatment of diseases

9
• The success of public health work is dependent upon
the simultaneous development of all the disciplines of
public health, with the sanitation of the environment
as the first endeavor.

• Environmental sanitation is one of the major

disciplines of public health.

10
Environment
– It is the sum of all external conditions and influences
(biological, chemical, physical and socio-economic)
affecting the life and development of an organism,
human behavior or society.

– Those are factors outside the human body

11
Sanitation
• Derived from the Latin word “Sanitas”, meaning
health

– Is the establishment of environmental conditions

favorable to health.

– It is the prevention of diseases by eliminating/

controlling the environmental factors which form
links in the chain of disease transmission.

12
 Environmental factors that could influence health
• Life support: Food, Water, Air etc

• Physical factors: Climate, Rain fall

• Biological factors: Microorganisms, Toxins, Biological waste,

• Psycho-social and economic: Crowding, Income level, Access

to health care

• Chemical factors: Industrial wastes, Agricultural wastes, Air

pollution, etc

13
Environmental health / Environmental sanitation
• Is the prevention of diseases and promotion of health by
eliminating/controlling the environmental factors, which form
links in the chain of disease transmission.

• Is the control of all those factors in man’s physical environment,

which exercise or may exercise a deleterious effect on his
physical, mental or social well-being (WHO).

14
Why do we concern on Environmental health?
I. Global situation: basic sanitation provision
• In 2020, just over half (54%) of the world population had access to
safely managed sanitation. It is shocking that nearly one-in-two don't.

• In developing countries 1.1 billion people lack access to safe drinking

water. 2.6 billion people lack adequate sanitation. 1.8 million people
die every year from diarrheal diseases (among this 90 % of children
under 5).

• 25% of world’s population and 60% population in developing

countries lack basic housing sanitation;

15
 Why do we concern on Environmental health?...Conti

• 80% of health problems in developing countries is due to lack of

safe water and basic sanitation

• In Ethiopia: (EDHS, 2019)

• In Ethiopia, 69% of households have access to an improved source

of drinking water

• Overall, 20% of Ethiopian households use improved toilet facilities

16
 Determinant of health
Hereditary or biological factors such as

 Diabetes, mental retardation, lack of resistance to disease, etc

Medical care such as
 Technology and interest in medical self-help-
Life style such as
 Lack of sleep and rest, foods, poor exercise, bad behaviors etc..
Environment such as
 The place we live, the water we drink, the food we eat, the air we
breathe etc.

17
• Man- Environment relationship

• This interacting system may be depicted as follows:

• Man Environment

• This latter concept could be extended to include ecological and

aesthetic values, as well as health in a strict sense.

18
Three kinds of Human-environment outcomes/
interactions:
• Man can affect the environment: deforestation, fire, air
pollution, noise pollution, waste dumping, radiation
pollution, etc.
– This is due human activities for land search,
industrialization, urbanization, population explosion,
migration, war, etc.
• Man can be affected by the environment: flooding,
draught, famine, disease, earthquakes, lighting etc
because of the various disturbances in the environment.
• Man can maintain environment: afforestation, pollution
reduction, disarmament, international conventions and
legislations on environment, etc.

19
• The quality of life is directly related to the quality of
the environment.

• Concepts of “pure” water, “wholesome food,” Clean”

air, and” clean” neighborhood reflected the newer
concepts of health as meaning more than the absence
of disease.

20
 The role of environmental health in public health

• The role of environmental sanitation is to break the chain of

disease transmission

How?

• To answer this question it is essential that we understand the

mechanism of disease transmission.

21
For the development of the infectious process, six factors are
essential:

1. Etiological or a causative agent

2. A reservoir or source of infection of the causative agent

3. A mode of escape from the reservoir

4. A mode of transmission from the reservoir to new host

5. A mode of entry into the new host

6. A susceptible host

22
• These represent a logical sequence of factors or links of
a chain, all of which are essential to the development of
the infectious diseases.

• If any one of these links is lacking, disease will not

ensue even though the remaining five factors may be
present.

23
• Expressed in simple terms, it means that for a person to get sick
from a germ, three conditions must exist simultaneously:

a. There must be an a etiologic agent (a germ which causes the

disease)

b. There must be a victim (man) sensitive or susceptible to that

disease

c. There must be a mode of transmission through which the a

etiologic agent gets into the man (the pathway of the agent,
i.e. the environment).

24
.

25
• Therefore, to stop the spread of a communicable
disease, attacking the agent, protecting the host or
changing the environment can break the chain.

• The environment also plays an important role in the

control of other non-communicable disease, such as
chemical poisoning of the air, land and water,
occupational disease, etc.

26
• In many instances of the prevention or control measures for
many of the communicable diseases, the attack at the
environmental part of the disease cycle has been the most
feasible and vulnerable of the three components: agent-host-
environment.

i.e. it is more practicable, and comparatively more economical,

to control the mode of transmission (the pathway of the
germs) from the reservoir to the potential new host.

• Thus the role of environmental sanitation in breaking the chain of

disease transmission must be clearly understood.

27
• In general environmental sanitation breaks the chain of disease
transmission through three basic strategies:

1. Promotion: targeted to behavioral changes mainly through;

housing improvement, basic sanitary provisions.

2. Prevention of communicable diseases before it happens:

safe water, safe food, latrine provisions, personal hygiene, proper

solid waste management, vector control, occupational health and
safety etc.

1. Control of communicable diseases through various

environmental interventions.

28
 The Scientific Bases for the Practice of Environmental Health

• As a scientific discipline, environmental health begun with

attempts to prevent and control communicable disease, which
were believed to be caused by environmental factors such as
impure water and unhygienic disposal of sewage (excreta).
• Since then, it has continuously widened in scope.
• It now embraces the total environment, from the individual
dwelling to the entire biosphere and seeks to maintain the
ecological balance of nature and the well-being of man not only
physically but mentally and socially too.

29
• All living organisms are the product of their heredity and
environment, and the interaction between these two.

• Certain diseases are hereditary (e.g. hemophilia (a bleeding

disease), albinism,etc).

• So far very little progress has been achieved to prevent or

control hereditary diseases.
• The important deciding factor between health and disease is
the environment.

• It plays a major role, except in the rare hereditary cases.

30
• The environment exposes us to disease-causing agents
such as parasitic worms, protozoa, and microorganisms
such as bacteria, rickettsia and viruses, all of which play
a very vital role in infections of all types, such as
bubonic plague, smallpox, cholera, typhus, typhoid,
malaria to minor illnesses like the common cold.

• These disease agents are transmitted through soil, water,

food, air and through specific insect-vectors.

31
• Influence of the environment is not only limited to only
biological, but also includes influences of other physical,
chemical and social effects (such as effects of radiation,
noise, light, heat, stress, etc).
• These are only a few examples of harmful influences of our
environment.
• In brief, our survival is dependent upon our
environment.
• Where a man lives and how he lives have a greater effect on
his health and well-being
32
 The scope of environmental health
 The objective of Environmental Health is to create and
maintain conditions in the environment that will promote
health and prevent diseases.
• Man’s external environment contains elements, which are
essential for life and for the maintenance of good health.
• In addition, the environment contains potential hazards.
 The field of activities of environmental health is very broad
and complex, covering the entire field of control of the
environment.
 Environmental health (sanitation) is the process of taming the
environment so that it no longer constitutes a hazard to man.

33
 In general the scope of environmental health….
No Description Concerns
1 Personal hygiene Hygiene of body and clothing.
2 Water supply Adequacy, safety (chemical, bacteriological, physical) for domestic,
drinking, and recreational use
3 Human waste disposal Proper excreta disposal & liquid waste management
4 Solid waste management Proper application of storage, collection, disposal: Waste recycling
and generation analysis
5 Vector control Control of disease transmitting and harmful arthropods and animals

6 Food hygiene Food safety and wholesomeness in its production, storage,

preparation, distribution, sale, until consumption
7 Occupational hygiene Occupational health service, sanitation, safety in working settings

8 Housing sanitation Physiological needs, protection against disease and accidents,

psychological, and social comforts in residential and recreational
areas
9 Institutional hygiene Communal hygiene in schools, prisons, health facilities, refugee
camp, Detention homes, Settlement areas
10 Radiation hygiene Protection of workers and the community from internal and external
radiation
11 Hygiene and quarantine Hygiene provisions in international ports: air, train, bus
service
12 Disinfectionand Control of disease causing organisms in omits, utensils, equipment,
sterilization foods, etc.
13 Specialized field Mental hygiene, oral hygiene, adolescent hygiene
34
14 Air pollution Nature of atmosphere, pollution sources, global warming, etc.
 .
Any question?

35