Chapter 8Environmental and Occupational Health- Environment’s role in etiology (how disease happens)- Germ theory of disease widely accepted in late 1800s- Public health efforts in 19th century focused primarily on environmental sanitation- Miasma theory of disease- Most medical scientists had shifted their efforts from the identification of social and environmental risk factors for disease to the identification of specific infectious agents and genes- Scientists, health professionals and health consumers agree there are many social, behavioral, environmental and biological contributors to disease- Modern environmental health scientists access the impact of people on their environment and the impact of environment on human health- Environmental health looks at all aspects of physical environment- Physical environment impacts health behavior- Environmental health researchers focus on issues related to geography, geology, and climate- Health risks are often tied to local climate, types of vegetation and animals- Most environmental health experts focus on aspects of health related to the home, workplace or community Home Environment- Environmental health is also concerned with the health and safety of the home environment- Most building have potential health hazards- Conditions may be potentially hazardous but in some ways it is a luxury to be able to worry about these household threats- Contaminated water, poor sanitation and hygiene, and inadequate management of humanand animal waste are all associated with increased risk of diarrheal diseases and other infections- Air pollution including the indoor air pollution is associated with respiratory infections, chronic diseases- Increasing access to healthy housing improved healthDrinking Water- Everyone needs access to an adequate supply of clean water- Increased access to water is associated with improved health- When water sources are far from home women spend a lot of time getting it- Five key aspects of water accesso Quality: water must be clean enough to drink safelyo Quantity: must be available so people can stay hydrated and cleano Reliability: the water source must be available and functioning at all times Appropriate technology: simple enough that if broken it can be repaired by local residents cheaply and quicklyo Cost: water must be affordable- Access to water is requirement for lifeSanitation- Sanitation is disposal of human excreta- Several types of sanitation facilities that can be used for safe waste disposal- Simple pit latrine: hole in ground covered buy an outhouse or enriched by privacy blind- Septic tanks and sewer connections are more advanced sanitation technologies- Advanced sanitation facilities are common in north America and Europe- About half of the people who live in developing countries do not have access even to simplelest improved sanitation facility- Must practice open defecation- Some people may be able to go to defecation site away from home- People who do not have improved sanitation system are at increased risk for infectious diseases- Six Fso Feces are not exposed properly; they can contaminate fields, and fluids. Fecal matter can then get onto hands and fingers and transport it to foods. Flies can spread it to foods too.- Presence of feces near homes significantly increases the risk of bacterial, viral and protzoal diarrheal diseases and helminthic (worm) infectionsFuel and Indoor Air Quality- Energy is necessary for at least 3 important purposes: cooking food and boiling water for safe consumption, providing a source of heat when outdoor temperatures are low and providing source of light at night- Households without electricity usually rely on sold fuels- All fuels that are burned for energy release air pollutions- Solid fuels used in homes are particularly unhealthy- Use of solid fuels can have other negative health effects – risk for burns, susceptible to injuries- Several ways people can reduce exposure to indoor air pollutiono Improved cooking deviceso Increase ventilation or move the kitchen to the outsideo Change behaviorWork Environment- Occupational health was one of the first public health specialty fields- Every worker may face a particular mix of biological, chemical, physical, mechanical andpsychosocial challenges at workToxicology- Toxicology: study of harmful effects that chemicals and other environmental hazards likeradiation can have on living things- Variations in exposure frequency, duration, dose, various exposure routes and how it influences health- Carcinogens: cause genetic mutations that lead to cancer- Teratogens: cause birth defects- Ecotoxicology: examines impact of toxic exposure on populations, communities and ecosystems- Air pollution is a widespread environmental damage caused by humans- Many countries have passed occupational and environmental health and safety lawsCommunities and environmental health- Everyone who lives or works in a community share the same air, water and environmental exposure- WHO endorses the use of indoor residual spraying (IRS) for mosquito control in areas that have endemic or epidemic malaria transmissionChapter 14 347-357Disasters and Health- Both natural and human generated disasters lead to urgent humanitarian situations- Critical needso Watero Foodo Sheltero Essential health services- Crisis: small scale event that can be addressed locally- Emergency: larger event that stresses local resources but can be managed locally- Disaster: occurs when need exceed local capacity- Catastrophe: overwhelms the local response network and requires extensive outside assistance- Attention must be paid to protecting the civil, political, economic, social and cultural rights of affected persons- Nonderogable right: human right that is irrevocable- If rights are derogated during or immediately after critical incident the new rules must notbe discriminatory and full rights should be restored as soon as possibleCivil Conflict and War- Complex humanitarian emergency: occurs when civil conflict or war cause mass migration of civilian populations, food insecurity, and long term public health concerns- International humanitarian laws are supposed to provide protection to civilians and armedforces- Malnutrition is primary concern during conflicts- Outbreaks of communicable diseases also often occur during complex emergenciesRefugees and Internally Displaced People- Refugee: person who has been forced to involuntarily move because security concerns o