Human Health and Environment

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Human Health and Environment


In order to protect equality between present and future generations, the current generation is protected from violations of planetary boundaries (such as climate change and biodiversity loss).

Primary prevention of damage) is essential to prevent disease, injury and death for future generations.


Human beings are components of an intricate web of life. Because of the ongoing interactions between humans and the environment, our health is largely determined by the quality of the ecosystems in which we live. The functioning of ecosystems is also determined in large part by human activity. In short, there is a close relationship between environment and health.

In this module we have given some examples of ways in which human health is determined by the natural environment and given examples of causes of disease related to environment and how it can be controlled at primary, secondary and tertiary levels. We have also considered how to reduce

Unequal distribution of the environmental burden of disease. While the task may seem daunting, especially given the growing global impacts of anthropogenic environmental change, it is important to remember that there are many solutions within reach. We can address the drivers of environmental change by redefining prosperity to focus on health and well-being for all, by sustainable and equitable patterns of consumption, and by respecting the integrity of natural systems.


In 1800, the average life expectancy globally was about 30 years; Two centuries later it was 66 years. In the same period, the global population increased from one billion to seven billion.

Much progress in population health stems from technological mastery of the relationship between humans and the natural environment. For example, with technology and fossil fuels we have created an infrastructure to bring clean drinking water to billions of people, systems to water, fertilize, harvest and transport food to feed them, and vector-borne transmission Chemical pesticides have been invented to reduce. Disease.

However, technological advances have also created new threats to human health, including chemical pollution, nuclear radiation, and climate change. The health burden of these hazards is distributed unequally between and within populations. In this module we will explore the physical, chemical and biological components of environmental health and the evidence linking human health directly and indirectly to the natural environment.



environmental determinants of health



There are many factors that together determine the health of individuals and communities. For the most part, whether a person will live a long and healthy life, or suffer early illness, disability, or death, is determined by their genetic makeup and their environment.


Our genetic makeup, our age and our sex are relatively fixed. However, where we live, the state of our environment, our income and education levels, and our relationships with friends and family have a substantial impact on health, and are largely the result of policies or practices that modify can go. These are called ‘social’ determinants of health.


The diagram below depicts the social determinants of health. The center of the circle represents non-modifiable determinants of health such as genetics, age and gender. Each ring outside the center represents a type of social, or transformative, aspect of health. Lifestyle choices include a person’s diet, exercise, smoking and drinking habits. Big issues include the types of jobs available and how socially integrated we are. But the widest range of factors are environmental, ranging from unsafe drinking water and poor sanitation or hygiene to indoor and outdoor pollution, workplace hazards, industrial accidents, automobile accidents, or poor natural resource management.


Surprisingly, access to health care services often has less impact on health than the environment. For this reason, a well-developed system of health care has less impact on human health, longevity, and well-being than a robust, resilient natural and physical environment. The health of our natural environment, and the quality of the larger ecosystem that supports all life, determines how healthy we can be.

Traditionally, environmental hazards to human health have been classified as biological (eg germs, malaria), chemical (eg toxic substances) or physical (eg radiation).


Physical hazards are naturally occurring processes that pose a threat to human health. Examples include ultraviolet radiation (sunlight) that damages DNA, or natural events such as volcanoes, earthquakes, tornadoes, landslides, or droughts.


Biological hazards are interactions between organisms, including the transfer or transmission of viruses, bacteria, or parasites that cause disease. These are also natural processes.


Chemical hazards may be naturally occurring (i.e. heavy metals such as lead or mercury are compounds in foods that cause allergic reactions in humans) or may be man-made. As chemical use has increased in industrialized societies, so have chemical-related diseases, including cancer, asthma, birth defects, developmental disabilities, autism, endometriosis, and infertility.


Children are especially sensitive to biological, chemical and physical hazards.

are sensitive; The World Health Organization estimates that about a third of the 6.6 million deaths in children under the age of 5 each year are linked to environmental causes, including diarrheal disease and malaria. release of thousands of new

The amicals have coincided with rapidly increasing incidences of childhood asthma, obesity, diabetes, attention deficit hyperactive disorder (ADHD) and birth defects since the 1950s. Rowing scientific evidence links the incidence of these diseases to environmental toxins. Even at low levels, chemicals can disrupt bodily systems and cause disease: disrupt hormones or sexual development and cause cancer.


The short film Environment, Health and You presents a historical overview of environmental health and the interrelationships between air, water, soil, food production and distribution, chemicals, population, climate change and policy. Although the United States

The main sources of mercury pollution include coal emissions from plant emissions, mercury cell chlor-alkali processing facilities, artisanal and industrial gold mining.

The dumped mercury pollutes the global environment, affecting water bodies and the organisms living in them. The mercury contaminating water and moist soil will turn into highly toxic organic mercury. Even small amounts of this substance will damage the brain and the rest of the nervous system. Organic mercury also accumulates in the bodies of exposed animals.


Health care is a major source of mercury pollution. fluorescent lamp, thermometer, dental filling; waste treatment and incineration of mercury-containing products; and cremation. Many instruments used in hospitals, health care facilities, and laboratories contain mercury. The substance is commonly found in thermometers and blood pressure measuring instruments. tools used

There may also be mercury in construction and in household items such as thermostats, pressure gauges, and switches. Mercury can escape from these and other similar products, as no device is 100% fail-proof. Mercury can be added intentionally in substances such as fixatives, preservatives, lab chemicals, cleaners, and other products. When disposed inappropriately, mercury always contaminates the environment. Significant amounts of mercury can turn into a gas at room temperature.

Reducing methyl mercury accumulation in the global environment is a global priority. Fortunately, there are safe, cost-effective non-mercury alternatives for nearly all healthcare procedures that use it. Most mercury based thermometers and


Everyday products such as batteries, lighting fixtures, electrical and electronic equipment, dental products, and measuring and control equipment.

The municipal government of Delhi is developing a plan to phase out mercury-based medical devices (PDF) in hospitals under its jurisdiction.

As more and more wealthy countries pass laws banning mercury products, stocks are usually sold to Asian countries. This practice is likely to pose challenges to mercury reduction programs in the region. This is an alarming trend, and calls for greater control over trade, including export and import restrictions on mercury.

Earth has several mechanisms to maintain the balance of its biosphere and there is now scientific consensus that humans have significantly altered the balance of the biosphere. Over the past several hundred years, human activity has caused far-reaching changes in the structure and function of Earth’s natural systems. There are substantial health impacts from anthropogenic degradation of nature’s life support systems. 

Several recent reports explore the health impacts of global climate change in great detail. The 2015 Lancet Commission on Climate Change and Health explores the health effects of climate change and fossil fuel combustion. WHO Conference on the Status of Biodiversity Knowledge Review on Biodiversity and Health. The Rockefeller Foundation-Lancet Commission

On Planetary Health situates these both in the wider context of anthropogenic impacts on the environment and the social and political failures responsible for these damages. The figure below takes a detailed view. It describes the limits of essential Earth-system processes that make the planet hospitable to human life. Four of these have been violated: climate change, loss of biodiversity and disruption of the nitrogen cycle and ocean acidification,. In other areas (chemical pollution, land degradation, freshwater use, and ozone depletion) threshold limits have not yet been determined (Rockstrom et al., 2009).


It also shows how close we are getting to those limits, which would mean exceeding the Earth’s carrying capacity in those areas. Breaking these limits would undermine the ecosystem processes needed to support our population of 7 billion people.




Some scientists have suggested that our current geological epoch should be titled ‘The Anthropocene’ to recognize it as the time when human activities began to have a pronounced global impact on Earth’s systems.



Biodiversity – the diversity of life – is often referred to as ‘ecological

It is discussed in terms of ‘system services’, the functions that ecology performs in human societies. Examples of ‘services’ provided by ecosystems to humanity include ‘products’ such as clean water, flood regulation, SNF disease control. Forest and wetland systems filter and purify water. Woodlands stabilize soil saturation on steep surfaces, preventing landslides and floods. Plants reduce air pollution by absorbing carbon and other gaseous and particulate pollutants.


Biodiversity ecosystems help control infectious disease and are important for medical research. More than half of all drugs registered with the US Food and Drug Administration in 1981–2010 were derived from natural sources. But deforestation threatens the extinction of tree frog species whose venoms underpin our understanding of anesthetic agents. Climate change and ocean acidification have decimated coral reefs and species of snail whose venom is used to develop new painkillers. Melting artificial ice deprives us of the ability to study how polar bears avoid kidney failure, diabetes and osteoporosis under conditions that cause them in other mammals like us.


Biodiverse systems are also resilient, able to mitigate disruptions, recover from shocks and stresses, and adapt and grow from them. Systems with low biodiversity are susceptible to collapse when faced with new pathogens, but biodiverse ecosystems are robust – that is, they have the adaptive capacity to remain stable in the face of external disturbances and are protective against a range of infectious diseases. There are



The effects of climate change threaten to undermine the past half-century’s gains in development and global health. The effects are already being felt, and future projections represent a high and potentially catastrophic risk to human health. (See Module X Climate Change and Health for more details).




Health inequality is the systematic and avoidable difference in life expectancy and health status between groups of people. Many aspects of policy or social practice affect the environment in ways that can increase health inequality. Development and planning policies often locate a disproportionate number of polluting industries, power plants or waste disposal areas near low income or communities. Transportation and housing practices also affect the distribution of environmental pollutants. The principle of environmental justice recognizes that all people have a right to equal protection from environmental burdens.







preventing health disparities


Imagine that you are standing on the bank of a fast flowing river and you hear the sound of a drowning man. You jump into the cool water, fight against the strong current and make your way to man. You hold on tight to him and slowly swim back to shore. You drag him to the bank and start CPR. As he begins to revive, you hear another cry for help. You jump back in the water. You struggle against the current and finally reach a drowning woman. You eventually get her to shore, lift her to the shore next to the man and begin resuscitating her. As she begins to breathe, you hear another cry for help. Dazed, tired and overwhelmed, you return to the cool water and make your way to a desperate child.


Although the child weighs very little, a lot of effort is required to bring it to the shore, to put it on the shore and to revive it. Near exhaustion, it occurs to you that you are so busy rescuing people that you don’t have time to see what is happening upstream that caused them to fall into the river. Why are people falling? Is the bridge broken? Are they unaware of the danger of crossing the river at that point? Should warning signs be posted? Do I need to learn swimming? Has a particular cultural practice resulted in an increased risk of falls?


The story is an allegory of the ways in which we can choose to prevent ill health and death. Drowning people represent people who have become ill and need treatment in the health care system. Curative treatment is costly, labor- and resource-intensive. In contrast, identifying and preventing upstream, or ‘root’ causes of injury and disease (preventing people from falling into a river) is a powerful way of reducing inequalities in health.


There are three types of interventions that can reduce risks or hazards to health. Primary prevention is preventive. The aim is to prevent disease or injury before it occurs. th

This is done by preventing exposure to hazards that cause disease or injury, or by altering behaviors that may lead to disease or injury, or by increasing resistance to disease or injury when exposure occurs. These include legislation (and enforcement) to control the use of hazardous products (such as asbestos), education about safe practices (such as reducing occupational exposure to health hazards),

  1. do) and vaccination against infectious diseases.


Secondary prevention is protective. It aims to reduce the effects of a disease or injury by detecting and treating the disease or injury as early as possible, preventing or slowing its progression and the progression of long-term problems. Examples include: screening tests to detect disease at an early stage (for example) and modified work so that injured or ill workers can safely return to their jobs.


Tertiary prevention is curative. It helps people manage long-term health problems or injuries in order to maintain their ability to work, their quality of life and their life expectancy for as long as possible. Examples include management (eg) and vocational rehabilitation programs to retrain employees for new jobs when they are unable to recover their previous work.


Take the example of a polluted river that causes illness in the surrounding community.


  • Primary prevention action: Contact the company discharging industrial chemicals into the river (eliminate exposure completely).


  • Secondary prevention action: Advise local residents to avoid certain uses of the river, identify symptoms of disease, or initiate a screening program to treat poisoning or infection early.


  • Tertiary Prevention Action: Teach people how to reduce the effects of their condition.


In environmental health issues, a combination of primary, secondary and tertiary interventions is needed to achieve a meaningful degree of prevention and protection. However, further


“Upstream” from a disease and injury is the likelihood that an intervention will be effective and reduce health inequality.


Another reason to focus on source or primary level prevention of environmental health hazards is that healthcare organizations themselves are major contributors to environmental pollution, resource depletion, climate change, and biodiversity loss. A large private hospital can produce up to a ton of general waste every day, along with a range of chemical, pharmaceutical and radioactive wastes requiring special handling. Burning medical waste produces large amounts of airborne dioxins, mercury and other pollutants that can drift for thousands of miles, and the ash from incineration can spread disease.



Our discussion of health equity includes considerations of the distribution of resources for health and justice within nations and among groups of people. It believes that greater equality can be achieved through policy and practice. But it only considers people of the same generation. In a world of global environmental changes, a similar idea needs to be created inter-generationally. In many ways, the economic, development gains in the health gains of the last century have been achieved at the expense of the health of future generations.






humans and their ecosystems





Thinking about health and well-being in the context of development requires a comprehensive multi-disciplinary understanding of the interactions between humans and their ecosystems. Events in the last few decades have brought to the fore the need to understand the relationship between the environment we live in and the potential threats to our health. On December 4, 1984, over 40 tons of methyl isocyanate gas leaked from a pesticide plant in Bhopal, India, killing nearly 4,000 people instantly and causing significant morbidity and premature death for thousands more. The leak was caused by a large multinational conglomerate, which was able to insulate itself from disaster for the most part due to weak laws related to environmental protection, indicating a need to strengthen such laws and provisions.


Nearly three decades later, India again faced an environmental disaster: floods in the state of Uttarakhand in 2013 killed more than 6,000 people. This was attributed to climate change and poorly managed development projects: unseasonal monsoon rains, along with the premature melting of Himalayan glaciers, triggered widespread landslides and floods. The situation was worsened by numerous dams, random diversion of rivers and illegal tourist and other development along the river banks. The need of the hour is to create legal and policy frameworks to understand and manage environmental risks for morbidity and mortality, and to safeguard against large-scale violations of environmental safeguards.

There is clear evidence that the environment and health are closely related. Data from the World Health Organization (WHO) show that environmental factors are responsible for 24% of the world’s disease burden, 35% in regions such as sub-Saharan Africa, and 23% of all deaths. Environmental changes are largely attributable to human activities and the resulting driving forces and pressures; Increasing global warming is increasing the risk factors affecting human health.







Climate change was among 26 environmental, behavioral and occupational risk factors assessed by the World Health Organization as part of a comparative assessment of global and regional causes.

Burden of disease for the year 2000.3 Ta

Lika 1 shows that climate change is causing an enormous burden of disease in the developing world. India is also facing similar challenges from rising rates of water-related diseases such as diarrhoea, vector-borne infections such as malaria and the double burden of malnutrition. climate

Between 2030 and 2050, malaria, diarrhea, heat stress and malnutrition are projected to cause an additional 250,000 deaths per year. Children, women and the poor in developing countries will be the most vulnerable. The Health and Environment Linkage Initiative (HELI) recommends that policy should address the root causes of climate change; and adapt to a changing climate through actions that immediately improve the health of the poorest communities and reduce their vulnerability to future climate change impacts5.

At the national level, there are several programs that address issues related to disease control, better availability of water, sanitation and hygiene, malnutrition such as the National Vector Borne Disease Control Program, WASH, ICDS/Kindergarten Nutrition Program, Mid Day Meal, etc.



RBSKY, Prevention and control of non-communicable diseases etc. The draft National Health Policy 2015 also talks about some of the areas mentioned above. However, progress has been slow in implementing the provisions of policies and programs available to reduce environmental risks to health; And more focused research is needed on the relationship between environmental health hazards and its impact on human health in order to respond effectively as we move forward.

A World Bank study (2001) on the contribution of environmental factors to ill health concluded that a fifth of the total burden of ill health in Andhra Pradesh may be attributable to environmental causes. The study states that morbidity and mortality due to major environmental exposures account for about 20% of the total burden of disease across India; Second only to malnutrition and ahead of all other preventable risk factors. World Health Organization (WHO, 2009) Estimates – Based on Comparative Risk Assessment, Evidence Synthesis and Expert Assessment for Regional Risk and WHO Country Health Statistics 2004 –


  World Bank (2001). Environmental health in India: priorities in Andhra Pradesh. Environment and Social Development Unit, South Asia Region; World Bank, New Delhi.


that the annual environmental burden of the diseases was 65 DALYs per 1000 population. Globally, this ranges from a low of 13 to a high of 289 per 1,000 DALYs; And in India, this translates to about 2.7 million deaths annually, which accounts for 24% of all deaths worldwide. The same report indicates environmental burden for disease status in India



Risk Factors/Environmental Hazards: Generally, environmental hazards are classified as follows:

(i) biological hazards such as bacteria, viruses, parasites, protozoa and fungi; (ii) chemical hazards from harmful chemicals in air, water, soil, food and man-made products; (iii) natural hazards such as fire, earthquake, volcanic eruption, flood and storm; (iv) cultural hazards, such as unsafe working conditions, unsafe highways, criminal assault and poverty; and (v) lifestyle choices such as smoking, poor food choices, alcohol and unprotected sex.



Disability-adjusted life-years are a standard measure of the burden of disease. The DALY concept combines the fraction of life-years lost due to premature death and years of healthy life as a result of disease or disability. A weighting function that includes discounting is used for the years of life lost at each age, reflecting the different social weights that are typically assigned to disease and premature mortality at different ages. . The combination of discounting and age weighting produces a pattern of DALYs lost from one death at each age. For example, the death of a girl child represents a loss of 32.5 DALYs, while the death of a woman at age 60 represents a death of 12 DALYs (the value for men is slightly lower due to their lower life expectancy). . Source: Murray and Lopez, 1996.



(i) traditional risks associated with poverty and under-development, including unsafe water, poor sanitation and waste disposal, indoor air pollution and vector-borne diseases (such as malaria and dengue); And

(ii) New risks due to ‘development’ projects that lack adequate environmental safeguards, urban air pollution and exposure to agro-industrial chemicals and wastes.



A report released by the Ministry of Environment and Forests unpacks these categories, taking stock of the status, risks and challenges of environmental health.








There is an accompanying ‘vision’ document which takes a comprehensive approach to the issue. 10 The report acknowledges that the environment we live in has a great impact on our health, and identifies the following specific household, workplace, outdoor and indoor factors that play an important role in determining human health:

(i) Water: About 75-80% of water pollution is due to domestic sewage, and the rest is due to industrial waste water which can be highly toxic. Major industries which cause pollution at the place of production: Distillery, Sugar, Textile, Electroplay

ting, insecticides, pharmaceuticals, pulp and paper mills, tannery, dye and dye intermediates, petro-chemicals, steel plants, etc.

ting, insecticides, pharmaceuticals, pulp and paper mills, tannery, dye and dye intermediates, petro-chemicals, steel plants, etc.

ting, pesticides, pharmaceuticals, pulp and paper mills, tannery, dye and dye intermediates, petro-chemical, steel plants, etc.

There are other sources of pollution as well. Those that are ‘nonpoint’, such as agricultural fertilizer and pesticide runoff in rural areas. Unsafe water, consumption of contaminants and poor sanitation are linked to infectious diarrhea

EA, cholera, jaundice and other gastrointestinal tract infections which together cause significant levels of morbidity and mortality.


The environmental effects of poor water quality on human health are causing increasing casualties among the world’s poor, especially in developing countries including India. Globally, more than 1 billion people do not have access to a safe drinking water supply, while 2.6 billion lack adequate sanitation; Diseases related to unsafe water, sanitation and hygiene account for an estimated 1.7 million deaths every year.11 In India, contamination of a water source (such as water taps, hand pumps, wells etc.) can result from a number of factors: Open Defecation, improper drainage system, monsoon floods, land irrigation and fertilizers used in agriculture.


Of the 692 million people in South Asia who practice open defecation, 90 per cent are in India. Water stored in containers within homes also presents a risk due to a variety of unhygienic practices. Diarrheal infection caused by consumption of dirty water is one of the major causes of death of many poor children. A World Bank study on environmental health in India suggests that “most of the health benefits come from improving access to water in rural areas”.


Sanitation in both rural and urban areas is a public benefit that accrues to the local community through the reduction of health risks for all households, rather than private benefits that accrue primarily or exclusively to those households. who install water connections or toilets.’13

(ii) Ground water pollution: Industrial waste contaminates ground water sources; The heavy metals and toxic compounds contained in these effluents pose significant health risks. Several incidents of ground water pollution have been reported due to industrial clusters especially electroplating units, 4 tanneries, dyeing and printing units etc.

(iii) Air pollution: The biggest contributors to air pollution are industries, vehicles and to some extent domestic sources. Urban air pollution resulting largely from the combustion of fossil fuels causes a wide range of acute and chronic conditions such as asthma and, in the case of suspended particulate matter, lung cancer. Other components of air pollution, such as lead and ozone, have also been associated with serious health effects. Industries that contribute significantly to air pollution include: thermal power plants, iron and steel plants, smelters, foundries, stone crushers, cement, refineries, lime kilns, chemical and petro-chemical plants, etc.

(iv) Indoor air pollution: Indoor cooking with solid fuels such as cow dung, wood, agricultural residues or coal releases a large number of pollutants including carbon monoxide, nitrogen and sulfur oxides. Indoor air pollution is closely related to poverty, as it is largely the poor who cook indoors with unprocessed fuels and use challahs or chulhas that are not energy efficient. This results in the emission of carbon monoxide, hydrocarbons, suspended particulate matter and polycyclic aromatic hydrocarbons (PAH) etc., which cause respiratory diseases such as cough, dyspnoea and abnormal lung function. The most affected by household air pollution are women and children. The use of biomass fuels (such as wood), and is responsible for an estimated 1.6 million deaths annually. More than half of these deaths occur in children under the age of five.14 Biomass fuel is recognized as one of the major social determinants of child malnutrition in India. Upgrading to cleaner and more cost-effective energy technologies such as LPG, biogas or solar power will significantly reduce the effects of indoor air pollution, especially in rural areas; as also



Improved design of stoves and ventilation systems and increased awareness of health risks among the public.

(v) Biological hazards: Infectious diseases spread by biological means constitute a significant burden of disease, especially in developing countries. Diseases like Tuberculosis, Influenza, Malaria and Measles are examples of diseases spread by bacteria. Viruses are smaller than bacteria but just as dangerous, causing diseases such as influenza and HIV/AIDS; the latter can be tray

Mother to child was passed even further. Biological hazards can be contagious, spreading through air, water, food, and body fluids. A large-scale outbreak is called a pandemic, and sometimes such an epidemic can be global, as in the case of avian flu or HIV/AIDS.

(vi) Climate change and allergies: Climate change may put humans at risk for extreme weather or seasonal disasters. Changes in weather conditions can alter the dynamics of disease vectors (such as malaria and dengue); It can alter the yield of agricultural crops, affecting nutritional outcomes; resurgence of pests and pathogens; and due to the depleting natural resources and degradation of the natural environment.

A range of effects on human health.

(vii) Chemical pollutants: The Indian economy is heavily dependent on agriculture. There is an increasing reliance on the use of pesticides to avoid and reduce environmental risks in agriculture. “Long-term exposure to pesticides may increase the risk of developing developmental and reproductive disorders, immune-system disruption, endocrine disruption, impaired nervous-system function, and certain cancers. Children are at greater risk from exposure than adults.” Is.”


  Thus, it is an important environmental health issue in India and must be addressed through policy and programs. The World Health Organization recommends a multi-pronged approach to mitigate the effects of changing agricultural practices: (i) at the policy level, better regulation and control of the sale, distribution and use of pesticides; (ii) systems for identifying, treating and monitoring cases of pesticide poisoning, at the health system level; and (iii) educating well designed people


Zoonotic Transmission: A recent study by the International Livestock Research Institute (ILRI), UK found a huge burden of disease that is transmitted from animals to humans – ‘zoonose’. The study found that 13 zoonoses are responsible for 2.4 billion cases of human illness and approximately 2.2 million deaths each year. most of them have


in middle- and low-income countries.19 While zoonoses can be transmitted to people by wild or domesticated animals, most human infections are acquired from the world’s 24 billion livestock, including pigs, poultry, cattle, goats, sheep and camels Huh.

Figure 2: Global spread of zoonotic disease


  • What kinds of health problems can be caused by environmental stressors such as chemicals and radiation?
  • What health problems are people likely to experience when exposed to different levels of environmental stressors?
  • Is there a level below which some chemicals do not pose a risk to human health?


  • What environmental stressors are people exposed to and at what level and for how long?


  • Are some people more likely to be vulnerable to environmental stressors because of factors such as age, genetics, pre-existing health conditions, ethnic practices, gender, etc.?
  • Are some people more likely to be exposed to environmental stressors because of factors such as where they work, where they play, what they eat, etc.?

Environmental risks are usually expressed as probabilities. Risk is the possibility of being harmed by a hazard that can cause injury, illness, death, economic loss or damage. Risk is expressed as a mathematical statement of the probability that an individual will be harmed by exposure to a particular hazard. So, for example, the chance of developing lung cancer by smoking a pack of cigarettes a day is 1 in 250. This means that one in every 250 people who smoke a pack of cigarettes every day is likely to develop lung cancer in their lifetime.

Risk assessment is the process of using statistical methods to estimate how much of a risk a particular environmental hazard poses to human health, and to develop an appropriate risk assessment.



Any specific risk can be mitigated.




A detailed internal review of Canadian risk management strategies adopted by a range of public agencies in the face of different types of environmental risks (food safety, prescription drug use, contaminated sites, etc.) was published in 2003, with the following principles: Was recommended: Risk assessment, management and communication: 21

Table 3: Principles and ethical concerns of decision making in risk management


decision making theory ethical concern

Do more good than harm: prevent or reduce risk and ‘do good;

As much as possible Gratitude/Non-


Reasonable process of decision-making: should be as fair, fair and objective as possible taking into account the circumstances of each

positional fairness/natural justice



Ensure equitable distribution of risk: must ensure fair outcomes and equal treatment for all concerned through equitable distribution of benefits and burdens Equity/distributive justice

Seek optimal use of limited risk management resources: use resources where they will have maximum risk reduction benefits

Promise risk management more than it can deliver: a clear public accounting of what is known and what is not, what can and cannot be done Integrity

Don’t take more risk than you can tolerate yourself: Understand

Influencers’ Attitudes ‘The Golden Rule’

Be cautious in times of uncertainty, as evidence can be uncertain ‘Better safe than sorry’

Promote informed risk decision making among all stakeholders, with full and honest disclosure of all information necessary for informed decision autonomy

Risk management processes should be flexible and open to the development of new knowledge, iterative

Risk is pervasive and cannot be completely eliminated. Life is not risk free.





  environmental health protection policies


Policy Framework for Addressing the Health Effects of Environmental Issues

is limited. One of the earliest efforts to address the issue was the Stockholm Convention (2001), ratified by 50 countries, which restricts or eliminates the production and use of 12 chemical substances: 8 pesticides, 2 industrial pollutants and 2 organic pollutants. The Convention was widely praised for protecting the public from DDT and for outlawing an entire class of chemicals generally because of their harmful health effects.


  In fact, the Convention substantially widened the scope of such legislation by stating that absolute scientific certainty was not a precondition for proposing to ban a chemical.22 Earlier, the United Nations Framework on Climate Change Convention (1992), and later the UN Framework Convention on Climate Change (1992) Kyoto Protocol (1997) called for the reduction of greenhouse gas emissions, which are known to have harmful effects on health. Agenda 21 of the Rio Declaration is often cited as an important international provision that ‘with an emphasis on meeting the needs of primary health care—control of communicable diseases, especially in rural areas, protecting human health and Provides the boost it needs. Health of Vulnerable Groups, Addressing the Urban Health Challenge and Reducing Health Risks from Environmental Pollution


  More recently, the Sustainable Development Goals, which seek to revisit and build on the Rio Declaration, have adopted health as an explicit concern of sustainable development, reflected in Goal 5 and a number of specific targets. ; They advance the agenda of the Millennium Development Goals by specifically recognizing the impact of the environment on health outcomes. However, it is generally recognized that enforcement of such treaties has been weak.


In India, the National Environment Policy (NEP) formulated by the Ministry of Environment and Forests in 2006 aimed to emphasize the environmental impacts of all developmental activities, including conservation of resources. The main objective of this policy is that while conservation of environmental resources is necessary to secure the livelihood and well-being of all, the surest basis for conservation is to ensure that people dependent on particular resources derive better livelihoods from the environment.

The fact of conservation rather than depletion of resource. The NEP viewed human health as an entity with “incomparable value” that could adversely affect the environment and pose significant risks to human health.

The NEP argued that environmental degradation often leads to poverty and poor health outcomes.

including malnutrition, lack of access to clean energy and safe drinking water. Recognized that rapid industrialization based on poor assessment of environmental impacts results in further poverty of the rural poor as they are largely dependent on natural resources for their livelihoods; And groundwater contamination can cause serious hardship in rural areas as it is the only source of drinking water in many places. In urban areas, the NEP identified the lack of (or improper) wastewater treatment and sanitation, industry and transport-related pollution, which adversely affect air, water and soil quality, as threats to health.


These environmental risks were seen to negatively affect the ability of the urban poor, especially to seek and maintain employment, attend school, and exacerbate gender inequalities. The NEP emphasized the importance of reducing indoor air pollution, protecting sources of safe drinking water, protecting soil from contamination, better sanitation measures, and better public health governance to reduce the incidence of many serious health problems.





The National Health Policy 2002 reiterated the effects of environmental change on health.25 It also emphasized the importance of environmental policies in India to address the effects of environmental change on human health. For example, unsafe drinking water, poor sanitation and air pollution contribute significantly to the burden of disease, especially in urban settings. The draft National Health Policy 2015 also addresses the impact of climate change on health. For example, it emphasizes measures to reduce air pollution, better management of solid waste, and to improve water quality, especially in urban areas. In addition, the Government of India has launched a program to address the issues of water and sanitation – the Swachh Bharat Abhiyan – with an emphasis on behavior change, building modern technologies (clean technologies) for public services and regulatory measures. As supplements that address each of these. These urban health determinants.

Recently, the National Policy on Safety, Health and Environment at Work Place was announced in 2009. The policy sets out a set of goals with a view to building and maintaining a national preventive safety and health culture and improving safety, health and the environment. at the workplace. It identifies eight specific work areas including enforcement, national standards, compliance, awareness, research and development, occupational safety and health skills development and data collection.

Is. The policy is envisaged to be reviewed at least every five years, after an initial review to ascertain the status of safety, health and environment at the workplace


Environmental health has become one of the major public health issues, which must be tackled by building resilience in an equitable manner, taking into account inequalities and vulnerabilities.

Equality is the absence of avoidable or treatable differences between groups of people, whether those groups are defined socially, economically, demographically, or geographically.

Vulnerability is the degree to which a population, individual or organization is unable to anticipate, prepare for, resist and recover from the effects of disasters.


Resilience is essentially the flip side of vulnerability. It is “the ability to survive, overcome and thrive.

The impact of environmental risks largely falls on the poor and marginalised. The extreme poverty rate has gradually declined from 52% in 1981 to 21% in 2010, according to World Bank estimates; An estimated 1.2 billion people are living on less than $1.25 a day. The average income of the extreme poor in the developing world was 87 cents per person per day, up from 74 cents in 1981. Women represent nearly 70% of the world’s 1.3 billion people currently living in extreme poverty, and are disproportionately affected by climate. change 31

Environmental risks, especially those linked to climate change, make the poor poorer or push individuals into poverty

Directly through rising food prices and agricultural production channels, or indirectly through vulnerabilities to livelihoods. 32 In the understanding of vulnerability and risks, the natural hazards literature in geography and White, 33 Burton et al. 34 and others are theoretical contributions on hazard characterization.


Climate change therefore directly affects health, undermines the social determinants of health, and threatens the viability of many environmental services provided by natural systems. 36 The IPCC Report on Risk Management to Advance Climate Change Adaptation Extreme events and disasters define vulnerability as the propensity for individuals and households to be adversely affected by climate and other environmental shocks and stressors – this vulnerability It is defined in terms of both risk and social determinants. Both of these aspects are seen to increase susceptibility to damage and reduce




Marginalized groups are at high risk of being harmed by social vulnerability due to various dimensions of poverty such as uncertain income, limited assets and resources, poor knowledge and adaptive capacity, no alternatives. Livelihood alternatives and social exclusion.

In operational terms, pursuing equity in health means addressing health inequities that are systematically underlying social disadvantage or marginalization – both of which are influenced by environmental factors. 38 Eliminating systematic health disparities between social groups requires addressing their root causes and reducing their negatives. health effect. 39,40 Both equality and human rights principles strive for equal opportunity for health—by providing care to improve the health of the poor, but also by helping to change the conditions that lead to, exacerbate, and perpetuate poverty and marginalization. Let’s help. 41 It argues for proactive policy and program interventions to address issues of water quality, sanitation, vector-borne diseases, indoor and ambient air pollution – all of which disproportionately impact the rural and urban poor.

“Physical health and psychological dimensions of poverty may also play a role in influencing both the vulnerability to climate change and the resilience of poor populations. While the term resilience has various meanings in the climate change literature, in the context of poverty, resilience is understood to refer to poor individuals. and the ability of poor communities to recover or ‘bounce-back’ from climate shocks and stresses. The poor often experience high levels of illness, mental stress, stigma, shame, humiliation and other burdens that exacerbate monetary losses and hinder their ability to escape poverty, respond to external shocks, or plan for the future.”42,43 Poverty alleviation is one of the most important strategies for mitigating the impacts of climate change on the poor. one of; and to reduce inequalities in social and


Environmental determinants of health. Strengthening public health systems to expand services to hard-to-reach populations is therefore critical to protecting the health of the poor from climate change, in particular. These broad-based responses enhance an individual’s and community’s own capacity to respond to a changing climate, and improve their ability to respond to social and environmental shocks.


On the other hand, it is not easy to measure the resilience or adaptive capacity of a society. Early literature on the subject often assumed that wealthy, industrialized countries would be able to adapt, while poorer, less industrialized countries would not. The IPCC’s Third Assessment Report identified five characteristics that contribute to the adaptive capacity of communities

: (i) economic condition; (ii) available technologies, information and skills; (iii) infrastructure status;

(iv) institutional framework and governance; and (v) equity. Therefore building resilience to climate risks and adapting to environmental risks should be part of a broader effort to improve and maintain the social and environmental determinants of health. In India, at the national level, environmental health and climate change policies are included in its economic, industrial and human development policies, which come first. Environmental health and climate change policy has been reactive rather than proactive and focused mainly on the energy sector.46

Sixth. Role of different actors in response to environmental health challenges


Laurie Garrant, in her best-selling book, The Coming Plague, extensively researched a series of global health disasters that have been the result of a ‘world out of balance’. The spread of old diseases and the emergence of new ones due to changing environmental and social conditions present a frightening scenario of global pandemics with the potential for serious loss of life. She recommends that humans must learn to live together while addressing the environmental threats we face by investing in better research, technologies and systems that help us address the challenges of increasing disease.


  Others have recommended that the burden of climate change on health can be avoided for the next 2–3 decades through environmental and social determinants of climate-sensitive diseases, strengthening climate resilience of both preventive and curative aspects of health systems. and adapt to changing climatic conditions.47

Over the past 3 decades, WHO has enhanced its program with a focus on working with national health ministries and other partners to support and guide the implementation of protective measures. The main strategy to build resilience to climate change and adapt to climate change is through improving and maintaining the social and environmental determinants of health. They recommend the following actions: 48

– The health department should work with other departments to address the issue of climate change and adopt a “health in all” approach;

– Regular impact assessments of key areas for vulnerable populations such as employment, health, energy, small-scale farming, migration, gender and children;

– promoting inter-ministerial policy dialogue;

– ensuring policies are socially inclusive and ensuring that new infrastructure and budget prioritization do not exacerbate social inequality;

– taking into account the specific needs of vulnerable populations through meaningful community engagement;

– use of environmentally friendly technologies, environmental determinants of health for example regulations on air, water, food quality, housing safety and waste management; And

Emergency preparedness and disaster risk management and funding must also be taken into account.

Most members of the WHO European Region are engaged in strengthening their health systems: in particular infectious disease surveillance, environmental health services, early warning for extreme events and disaster response, international health regulations, and the integration of climate change into public health policy. on plan






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