Envhealth
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Environmental Health
Dr. Benjalak Karnchanasest
Institute of Environmental Research
Chulalongkorn University
Benjalak.k@chula.ac.th
02 2188140
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Ideas for the management
Environmental ProblemsObstacles
Influencing Factors
Management
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EXAMPLES OF
ENVIRONMENTAL PROBLEMSthreatening health
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Directly and indirectly affect to the health
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Damage plants, animals and ecosytem
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Toxicants from the discard come back to you through the food chains
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Lack of education and active occupational health
laws, workers are at high risk.
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Typical E-scrapping dismantling operation. 100,000 such migrant workers labor in Guiyu breaking down
imported computers in hundreds of small operations like this one in a 4 village area surrounding the
Lianjiang River. Guiyu, China. December 2001. Copyright Basel Action Network
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Soil samples taken along riverside where circuit boards were treated with acid and burned openly. Massive amounts of dumping of imported computer waste takes place along the riverways. Guiyu, China. December 2001. Copyright Basel Action Network.
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Not realizing the danger of dump site, one of developing countries’ problem.
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Our “home sweet home” is really safe?
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•oven cleaner-toxic, corrosive,
flammable, can become an
irritant and some are strong
sensitizers.
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• Bleach is a chemical that removes color or whitens,
often via oxidation. Common chemical bleaches include
household "chlorine bleach", a solution of approximately
3-6% sodium hypochlorite (NaOCl), and "oxygen bleach",
which contains hydrogen peroxide or a peroxide-
releasing compound such as sodium perborate or sodium
percarbonate. To bleach something is to apply bleach,
sometimes as a preliminary step in the process of dyeing.
Bleaching powder is calcium hypochlorite.
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•Eyes : This substance can cause temporary irritation,
tearing, and blurred vision.
• Skin : This substance may cause burning sensation
on more sensitive areas (face, eyes, and mouth).
•Ingestion : Ingestion can cause stomach irritation resulting
in nausea, cramps, and vomiting. Ingestion of large quantities may
produce nervous system effects such as fatigue, dizziness, and
headache, lack of coordination, tremors, and unconsciousness. •. Inhalation : Excessive inhalation may cause respiratory tract
irritation, nausea, and nervous disorders, such as fatigue, dizziness,
headache, incoordination, tremors, and unconsciousness
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Hydrochloric acid 20.00 %
Ethoxylated nonyl phenol 0.7 %
• To remove hard water deposit such as soap scum,
rust stains, and many other tough stains on the toilet
bowls, bathroom, and many other surfaces
• If irritation occurs upon contact, wash thoroughly
with soap.
• If irritation persists, consider consulting with a
physician.
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•.....using many chemicals leading to deteriorating the
environment due to production of chemicals/products
releasing pollutants to the environment and consuming energy.
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To know influencing factors begins with
understanding basic science of environmental
health which are ..
1. What is Environmental Health
2. Environmental Threats
3. Entry routes
4. Toxicity and Diseases
5. Reducing Toxic Effects
6. Assessment of Risk
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Environmental Health-all aspects of the natural and
built environment that may affect human health
WHO defines: Those aspects of human health and
diseases that are determined by factors in the
environment. It also refers to the theory and practice
of assessing and controlling factors in the environment that can potentially affect health.
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Occupational health or occupational
safety and health (OSH)-foster safe
environment at work and maintain high
degree of physical, mental and social
well-being of workers in all occupants.
Indoor air in some ways similar to the
workplace but not necessarily related to,
usually refers to confined room, building.
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1. What is Environmental Health
Can occur -in your home, workplace
or in the publics
Present in -the air you breathe in
shopping center, on the
street, in the park
-the food you eat
-the products you use.
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2. Environmental Threats
2.1 Sources
2.1.1 Human activities-industry, agricultural, housing, business.. (Chemical/radioactive/heat/noise/light/vibration)
2.1.2 natural toxin2.1.3 Diet2.1.4 Infectious Organisms2.1.5 Terrorism and Biological Warfare2.1.6 New technology: nanotechnology,
GMOs=Genetically modified organisms2.1.7 Accidents
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2.1.2 Natural toxin
Ricin
-a poison found naturally in
castor bean seed, If castor
beans are chewed and
swallowed, the released ricin can cause injury.
-Castor beans are processed
throughout the world to make
castor oil, believed in the ancient
time that could heal diarrhea and cholera.
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See 1 natural toxin
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2.1.3 Diet an unbalanced diet
-weak immune system, often illness, vulnerable to cancer and cardiovascular diseases.
-include a variety of different foods likely providing all essential nutrients (protein, carbohydrates, fat, minerals&vitamins, water and fiber).
-too much fat, salt, etc.
Food additives
-preservatives; sulfite, nitrite, sorbic acid, benzoic acid, radioactive
-flavours: msg, colors, borax,
Foodborne disease
-Ciguatera caused by warm tropical fish; toxic not go away when cooked
-mycotoxin fungus-cereals, nuts, coffee, cocoa, grapes
-E.coli in Nestle cookie dough
-algal toxin in mussels and clams
Food contamination
– Antibiotics, pesticides, heavy metals
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See 2 Fruits & vegie
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2 Environmental Threats
2.1 sources2.1.4 Infectious Organisms
“Great health threats have always been pathogenic
(disease-causing) organisms”
Top 10 causes of death according to WHO
1) Ischaemic heart disease
2) Cerebrovascular disease (Stroke)
3) Lower respiratory infections (e.g. pneumonia)
4) HIV/AIDS
5) Chronic obstructive pulmonary disease
6) Perinatal conditions (childbirth-related conditions, both mothers
and children)
7) Diarrheal diseases
8) Tuberculosis
9) Malaria
10) Cancers of the trachea, bronchus, and lung
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5 basic vaccines: Pertusis (whooping cough), poliomyelitis,diptheria, measles, tetanus kills about 2 million children each year.
Better nutrition, improved sanitation, inexpensive vaccination could have saved their lives.
2 Environmental Threats
2.1 sources 2.1.4 Infectious Organisms
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2.1.4 Infectious Organisms
World population have been facing with…
-Emergent diseases and environmental changes:
“never known before or has been absent at least 20 years”.
-Infectious diseases have appeared in the past, reappear in more violent, more resistant forms.
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2 Environmental Threats
2.1 sources2.1.4 Infectious Organisms
Travelers brought new germs to a naïve population. – Black death, swept through Europe and East Asia during
14th-15th centuries-caused by bacteria infected rat’s flea.Europeans brought small pox, measles, etc to America. - Estimated 90% naïve people perished-caused by virusesRefugees and soldiers returning home
-Great influenza epidemic in 1918, 30-40 million people died.
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Disease 1: SARS
What is SARS?
Severe Acute Respiratory Syndrome (SARS) is
a recent, sometimes deadly, respiratory disease.
been reported mainly in Asia, North America and Europe.
SARS typically affects the lungs, but it may also attack the digestive system.
What causes
A previously unknown virus that belongs to the corona virus family suspected to be the primary cause of SARS.
: currently suspected to be transmitted from a cat-like wildanimal
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See 3. SARS video
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Disease 1: SARS
How do u get SARS
Similar to a common cold, transmitted through direct
person-to-person contact, ex.
– From infected person-sneezes or coughs.
– Transmitted through contact with body fluids of the infected person.
– Spreads through airborne droplets released
For these reasons, SARS has become a serious occupational health disease!
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Disease 2: Avian influenza; H5N1 virus
-the most contagious virus among birds.
-an infection caused by avian (bird) influenza (flu) viruses. -occur naturally among birds, carry in their intestines, not
usually get sick from them.
-can make some domesticated birds very sick and die.
-contact nasal secretion, feces, saliva, dirt, materials contaminated with the viruses.
-The spread from one ill person to another -very rarely and
limited.
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Disease 2: Avian influenza; H5N1 virus
- Some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they
might adapt over time to infect and spread among humans.
all influenza viruses-ability to change, scientists are concerned that
H5N1 virus one day could be able to infect humans and spread easily from one person to another.
Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population.
If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could
occur.
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Disease 2: Avian influenza;
The H5N1 virus that has caused human
illness and death in Asia is resistant to
amantadine and rimantadine, two antiviral medications commonly used for influenza.
Two other antiviral medications, oseltamivir
and zanamivir, would probably work to treat
influenza caused by H5N1 virus, but
additional studies still need to be done to demonstrate their effectiveness.
Huge changes; changes in flu vaccination
research, poultry farming, plan of pandemics
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See 4. avian flu video
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Disease 3: Ebola hemorrhage
The natural reservoir of the Ebola virus - reside in the rain
forests of the African continent and in areas of the Western Pacific .
• transmitted by direct contact with the blood, secretions,
organs or other bodily fluids of infected persons.
•Burial ceremonies where mourners have direct contact.
•Health care workers-frequently been infected while treating Ebola
patients, through close contact without the use of correct infection control precautions and adequate barrier nursing procedures.
•They must be followed up under strict surveillance: body temp, got fever-isolated recommended.
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Ebola
Symptoms include muscle and joint pain, fever, organ failure and heavy bleeding. It is
almost always fatal.
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Disease 3: Ebola
On the African continent, Ebola infections of human cases have
been linked to direct contact with gorillas, chimpanzees,
monkeys, forest antelope and porcupines found dead in the rainforest.
Different hypotheses have been developed to try to explain the
origin of Ebola outbreaks.
Laboratory observation has shown that bats experimentally infected with Ebola do not die, and this
has raised speculation that these mammals may play a role inmaintaining the virus in the tropical forest.
Extensive ecological studies are underway in the Republic of
Congo and Gabon to identify the Ebola's natural reservoir.
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Disease 4: Mad Cow
Mad cow disease: 1990s 125 people in Europe died
and nearly 5 million European cattle and sheep were
slaughtered.
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See 5mad cow video
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Disease 4: Mad Cow
Believed-the cause is that a Phosmet gets into the brain and binds with the normal protein to produce abnormal ones.
Prion-a specific protein thought to be infectious agent.
Prion causes a number of disease in mammals including mad cow disease and CJD in humans.
Phosmet--a combination of an organophosphate pesticides(OP) and thalimide which is used against the warble fly in cattle.
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Disease 4: Mad Cow
could cross the species barrier/ be transmitted to humans or between other animal species.
In humans, there is a disease known as "CJD" which resembles Mad Cow Disease.
The British believe it is caused from eating contaminated beef. CJD
is an extremely rare illness and normally strikes only lder people. More recently -in younger people.
All known prion disease affect the structure of the brain or neural
tissue, currently untreatable and fatal.
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More diseases:-Encephalitis (acute inflammation of the brain):
Virus in Bat first found in Malaysia in 1999. These bats
migrate from Indonesia due to Forest Fire in Indonesia.
Bacteria also does.
-Malaria and Dengue Mosquito has breeding cycle
shorter as a result of higher temperature.
-Leptospirosis cases increase in Thailand due to
flood-caused by bacteria-transmitted by the urine of an infected animal
and is contagious as long as it is still moist. Although rats, mice and voles
are important primary hosts, a wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, raccoons, possums, skunks.
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See 6 leptospirosis video
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Have long been practiced 1000 yrs
Pathogens: smallpox, anthrax
Chemicals: Ricin, Chlorine, Arsenic, Hydrogen cyanide, etc.
Radioactives
2 Environmental Threats
2.1 sources 2.1.5 Terrorism and Biological Warfare
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2.1.5 Terrorism and Biological Warfare
Anthrax
a serious disease caused by Bacillus anthracis, a bacterium that forms spores.
three types of anthrax:
skin (cutaneous)
lungs (inhalation)
digestive (gastrointestinal)
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Anthrax
from animals. Humans can become infected with anthrax by handling products from infected animals or by breathing in anthrax spores from infected animal products (like wool, for example). People also can become infected with gastrointestinal anthrax by eating undercooked meat from infected animals.
as a weapon. This happened in the USA in 2001. Anthrax was deliberately spread through the postal system by sending letters with powder containing anthrax. This caused 22 cases of anthrax infection.
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Anthrax
In most cases, early treatment with antibiotics
can cure cutaneous anthrax. Even if untreated,
80% of people who become infected with cutaneous anthrax do not die.
Gastrointestinal anthrax is more serious because between ¼ and >50% lead to death.
Inhalation anthrax is much more severe. In 2001, about 50% of inhalation anthrax ended in death.
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See 7 anthrax
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2. Environmental Threats
2.1 Sources 2.1.6 New technology
Nanotechnology
-rearrange the atoms, C to diamond, sand to
-size <100 nanometer
-physical chemical properties will change
-likely enhance risk to human
GMOs
-DNA of animals and plants being changed
-Adversely affect to human immune system
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See 8 Nano video
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2.1.6 New technology
GMOs
GM is a special set of technologies that alter the
genetic makeup of such living organisms as animals,
plants, or bacteria. Biotechnology, a more general
term, refers to using living organisms or their
components, such as enzymes, to make products that include wine, cheese, beer, and yogurt.
Combining genes from different organisms is known
as recombinant DNA technology, and the resulting
organism is said to be genetically modified, genetically engineered, or transgenic.
GM products include medicines and vaccines, foods and food ingredients, feeds, and fibers.
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See 9.GMO video
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3. Entry routes
Dermal route
- Chemical property, skin location, concentration, frequency
Oral route
Inhalation route
- Chemical property, form of chemicals, inhalation rate, penetration rate
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Respiratory Effects from Sulfate Particles SO2 reacts with other chemicals in the air to form tiny sulfate
particles. When these are breathed, they gather in the lungs
and are associated with increased respiratory symptoms and disease, difficulty in breathing, and premature death.
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Cancer
Lung cancer
is the most
common
cancer and
the most
common
cause of
cancer deaths
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4. Toxicity and disease
-Hazardous: flammable, explosive, irritant, sensitizer, acidic, caustic,
-Toxic: react with specific cellular components to kill cells
Ricin-200 times more lethal than dioxins
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4. Toxicity and disease
-Allergic:
allergen: substances activate immune
-Neurotoxic: attack nerve cells, most acute & extremely toxic.
-Pb & Hg kill nerve cells
-ether, chloroform, halothane (anesthetic) , DDT, dieldrin, aldrin
distrupt nerve cells.
-malathion,parathion-inhibit acetylcholinesterase
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-Teratogenic: cause abnormalities during embryonic growth and development, e.g. alcohol-lead to fatal alcohol syndrome, rubella virus, syphilis, organic murcury
-Carcinogenic: cause cancer, e.g. PAHs, virus, alflatoxin, asbestos, tobacco, dioxin
-Mutagenic: attack/damage/alter genetic materials
(DNA), eg, UV, radioactive elements
-Endocrine hormone disrupting: disrupt hormone functions, e.g., DDT, PCBs (contained in caulk like silicone, polyurethane), pesticides
(Hormones-chemicals released into blood stream by glands to
regulate development and function of tissues/organs).
4. Toxicity and disease
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See mercury vapour
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Persistence
Stable
Tolerable to biodegradation,
photo-degradation,
hydrolysis
Examples:
asbestos,
CFC-Chlorofluorocarbons,
PVC-Polyvinyl chloride
POP- Persistent Organic
Pollutants
– Aldrin, dieldrin, DDT
– chlordane, mirex,
– PCBs-polychlorinated
biphenly,
– PCDD/Fs-polychlorinated
diphenyl dioxin and furan
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Toxicity
persistence
PBDE-Polybrominated diphenyl ethers
-flame retardation, foam in upholstery, plastic in appliance, computer.
-Found in breast milk in Sweden in 1990
-Laden at ground zero in NY after September 11.
-Banned in European Union
-Toxicity is much like PCBs
CCA-Chromated Copper Arsenate
-rot resistant in lumber, decks, playground
-Arsenic cause loss of muscle function as well as lung, bladder, also endocrine hormone disrupter
-Non arsenic alternative exist but wood treating industry in the US resisted change until 2002, two major manufacturers agreed to begin phase-out
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Toxicity
Persistence
PFOS-Perflurooctane sulfonate
- Major ingredient in stain and repellent.
-Distribute from remote Pacific Island to the Arctic
-long lasting and accumulate
-The manufacturers agreed to phase out in 2000
Atrazine
-Herbicides
-Cause abnormal development and sexual dysfunction in frogs
-Farmers heavily use have high rates of lymphomas.
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4. Toxicity and Diseases “The dose makes the poison” Paracelsus said
Animal testing: -Bell shaped curves
-Dose response curves
-Lethal dose LD50
Toxicity Ratings:
a gram/kg BW=moderate toxic
to make a lethal dose.
Acute Effects: Immediate effects from a single exposure
Chronic Effects: continuous
or repeated sublethal dose
give long lasting effects perhaps years.
Detection Limits:
20 years ago-ppm part per
million .
part per billion, per trillion, quadrillion are now possible.
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4. Toxicity and Diseases
Byssinosis- inflamed lung due to natural fibers: linin, cotton,
Silicosis- inflamed lung due to quartz
Minamata –due to mercury, target organ: CNS
Itai-Itai-due to cadmium-fragile bone, easily broken bone.
Arsenic disease-causing skin and liver cancer
Lead disease-silver line in gum can be seen for serious case
Carbondioxide disease-lack of oxygen in hemoglobin
etc.
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5. Reducing Toxic Effects
Metabolic Degradation and Excretion:
– Enzyme located in the
liver, primary site of
detoxication,
reduce/increase chemical toxicity
– Excretion through feces, urine (kidney), sweat, ..
– Exhalation and lung
Repair Mechanisms:-
-Enzyme repair damage to
DNA, protein in the molecule, tissue, organs,
e.g, skin and lining of
gastrointestinal tract, blood
vessels, lungs have high
cellular reproduction rates to replace injured cells.
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5. Reducing Toxic Effects
Beneficial health effects:
-Fruits, vegetables, whole grains, dietary fibers give beneficial health effects
likely to have reduced risk of chronic diseases, including
stroke and perhaps other cardiovascular diseases, and certain cancers.
-Pectin produced in cruciferous vegetables have anticancer effects.
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anticancer vegetables
>70% ตงโอ ขะแหนง กะหล า (Cauliflower) ตะไคร (Lemon grass) โหระพา (Sweet basil) ใบหย หรา แมงลก (Sweet basil)ถ วลนเตา (Garden peas)
แคบาน (Katuri flower) พรกไทย (Pepper) มะกรด (Kaffir lime) ค นไฉ ใบยอ (Morinda)ใบบวบก (Tiger „s herb) ผกช (Coriander) กระชาย (Galingale) ขา ขงแก
50-70% หวไชเทา (Radish) ฟก สะระแหน (Mint) ขงออน (Young Ginger)
30-50% ผกบง (Morning glory) มะขาม (Tamarind) มะเขอพวง (Devil‟s fig)
มะเขอเทศ (Tomato) มะเขอยาว (Eggplant)
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See 10 fruits &vegie
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5. Reducing Toxic Effects
Sensitivity:
*age, sex, body weight,
nutritional and
immunological status, ability
to deactivate toxins.
determine how react to a given dose.
Chemical reactions:
*Antagonism-interfere with the
effects/breakdown of chemicals, eg. Vit
A, E reduce carcinogen response
*synergism-multiplies the effects of
another, ex. Asbestos increases 20-fold lung cancer and so is smoking
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See 11 bioaccumulation
See 12 food chain
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6. Risk Assessment
Assessing Risks:
1 Hazard identification
2 Exposure assessment
3. Dose Response
Relationships
4. Risk Identification
Accepting Risks:
1 in 1 million is acceptable
for cancinogen
Hazard Index <1 is
acceptable for noncarcinogen
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6. Risk Assessment
Former methods: based on standards
USEPA, Netherlands, Germany
Scientific method to evaluate risk from chemicals
Unit is one or two or etc. per million or per hundred, per thousand
Risk calculated from exposure concentrations, exposure duration, toxicity, and toxicant available in the target organ
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6. Risk Assessment
New trend to evaluate health risk
In the past: physical adverse effects
In the future: should evaluate human soul
Human soul: happiness from helping,
donating, happy for other people.
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Good EH management
- Monitoring station: on footpath in BKK, water quality in main rivers -Health risk assessment for large developing projects- Green label program - Setting up many monitoring program to control hazards from chemicals- Developing occupational course for graduate and postgraduate- Registration on environmental officer for each manufacturer- Setting up standard for physical examination for each disease.-Cooperation and provide information system for safety and occupational -health“CHAMTRACK”
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Good EH Management?
Should pollutants be reduced
-to zero. NO!
-as low as no adverse effect and technological feasible YES!
Pollutants should be set
-as high as amount that does not cause measurable effects. YES!
-set standard of emission so that no one is adversely effected. NO!
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7. Good EH Management?
In setting standards for environmental toxins-Different sensitivities of members of the population
-Some individuals less susceptible to hazards than others
-The sick, the children, the seniors-Effects of both chronic and acute exposure-Mechanisms enable to avoid/repair damages let us withstand some minimal level of exposure without harm
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OBSTACLES
- Heavily use chemicals, available widely, purchase easily- Various standard of analysis among government agencies- Lack of understanding of the hazards from chemicals- Lack of chemical waste management- No collaboration among responsible agencies- non-strict laws/ regulations- No database of chemicals used in each manufactures
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Additional Readings
Botkin D.B. and Keller E.A. (1997) Environmental Science:Earth as a living planet.. John Wiley & Sons. USA
*Cunningham W.P. and Cunningham M.A. (2004) Principles of Environmental Science. Mcgraw-Hill. USA
Louvar J.F. and Louvar B.D.(1998) Health and environmental risk
analysis: Fundamental with applications. Prentice Hall. USA
http://www.environmental-safety.co.uk
http://www.epa.gov
http://www.moph.go.th
http://www.pcd.go.th
http://www.who.int/phe/en/
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Question: What do you think?
The adverse health as a result from the environment can be solved by…..
1. Intellectual only or
2. Moral and social mindset only
How? Why?
Intellectual: a person who uses intelligence (thought and reason) and analytical thinking, either in a professional or a personal capacity.
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Intellectual: a person who uses intelligence (thought and reason) and analytical thinking, either in a professional or a personal capacity.
have knowledge and able to implement those knowledge in daily life. Be able to see the changes in society and environment.
Moral: Be caring, considerate, generous and volunteering in joining social work activities. Believe in goodness. Have the awareness and practicing the concept of virtue and humanism to develop oneself and to create a peaceful society.
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