Transcript Introduction to Environmental Health Allison Robinson University of Pittsburgh

Introduction to
Environmental Health
Allison Robinson
University of Pittsburgh
Pittsburgh, Pennsylvania
November 2001
Learning Objectives
• Define fundamental terms
• Explain the basic relationship
between the environment and health
• Explain impact of environmental
factors on health
• Explain role of environmental health
professionals
Performance Objectives
• Understand what is environmental
health
• Understand scope of problem
definition
• Understand means of addressing
defined problem
• Understand the role players involved
in problem solving
Outline
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Definition of Environmental Health
Interdependent Relations
Environmental Effects on Health
Systematic Approach
Interdisciplinary Roles
Definition: ‘Health …’
• ‘…is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity’(WHO,
1948)
• ‘Health is only possible where resources are
available to meet human needs and where
the living and working environment is
protected from life-threatening and health
threatening pollutants, pathogens and
physical hazards’(Who, 1992a)
Definition: ‘Environment’
• ‘…[All] that which is external to
individual human host. [It] can be
divided into physical, biological,
social cultural any or all of which
can influence health status in
populations.’ (WHO, 1995)
Definition: ‘Environmental Health’
• ‘…comprises those aspects of human
health, including quality of life, that are
determined by physical, biological, social
and psychosocial factors in the
environment. It also, refers to the theory
and practice of assessing, correcting,
controlling, and preventing those factors
in the environment that can potentially
affect adversely the health of present and
future generations’ (WHO, 1993a)
Definition:
‘Health Effect…’
• ‘…is the specific damage to health
that an environmental hazard can
cause an individual person. Often
the same hazard can cause a range
of different effects of different
severity.’ (Yassi et al., 2001)
Interdependence
• Health depends on resources.
• Good health depends on accessibility
to sustainable resources.
• Bad health results from
inaccessibility to sustainable
resources or exposure to a hazard.
• Sustainable resources and hazards
exist in the environment.
• Therefore, quality of health depends
on the environment
Interdependent Environments
• A relational definition of
environment is a function of scale,
boundaries, spatial proximity and
recipient populations
• When considering a global scale,
focus is on the effect of an
unbounded environment, e.g. air, on
all populations anywhere
Interdependent Environments
• When considering local scale, focus
is on effect of both a bounded and an
unbounded environment, e.g. water
and air, on a subpopulation closest to
the exposure event
• The local scale is a subpart of the
global scale
Population Perspective of Relations
All populations
Human population
Community, nation
Family
Individual
Health and Environment
Perspective of Relations
Environmental health
Public Health
Occupational Health
Family Health
Personal
Health
Environmental Effects on Health
• The indicators of beneficial
environmental effects are longevity
and sustained functionality.
• Two degrees of adverse environmental
effects are: injury (syn. include:
debilitating, dysfunctional, lame) with
decreased longevity or death (syn.
include: life-threatening, terminal,
deleterious)
Environmental Effects on Health
• Injury does not prematurely end life,
but can hinder the capacity to
function to the fullest potential
• Death does end life and is the most
extreme adverse state of health
• This means of classification is simple
and rigorous
Environmental Effects on Health
• An individual’s response to an
environmental effect is a function of
their physical environment, their
health state, and their culture.
Systematic Approach
• In the absence of a universal
definition of ‘good health’, at least a
universal concept of adverse health
effect, e.g. sick, illness, dysfunctional,
‘not normal’ or ‘not well’, must
exist such that understanding the
concept results in a response
Systematic Approach
• In order to identify and investigate
adverse states of health, a
fundamental systematic approach of
health problem identification and
characterization must exist and be
implemented
• This approach is summarized as
follows:
Systematic Approach
• Determine the source and nature of
hazards
• Determine the exposure pathway
• Measure the effects
• Apply controls however possible
(Moeller, 1992)
Interdisciplinary Roles
• To implement the systematic
approach, role players are needed
• Three major classes of role players
are: the environmental health
problem investigators, the
environmental problem responders
and the health problem responders
Interdisciplinary Roles
• Health problem investigators:
– monitors populations to identify health
trends, in an attempt to distinguish that
which is harmful from that which is harmless
– measures the range of effects of health trends
to characterize degrees of adverse intensity
– identify potential hazards, potential pathways
of hazards, and populations susceptible to
hazards
Related Disciplines
Epidemiologists
Risk Assessors
Biostatisticians
Toxicologists
Microbiologists
Health Service
Administrators
Social Workers
Behavioral
Psychologists
Public Health
Educators
Interdisciplinary Roles
• Environmental problem responders:
– focus on the health hazard that has been
identified and characterized
– analyze the environment of the exposed
population to see what controls are needed
and what controls can be implemented to
minimize risk of recurrence and risk of
future occurrence
– where means of control does not exist, it
may be necessary to invent
Related Disciplines
Engineers
Risk Assessors
Biostatisticians
Toxicologists
Chemists
Biologists/
Microbiologists
Physicists
Mathematicians
Educators
Interdisciplinary Roles
• Health problem responders:
– focus on populations of individuals
– attempt to identify how health is
adversely affected
– classify severity of effect as either injury
or deleterious
– attempt to restore compromised health to
a ‘normal’ functional state
Related Disciplines
Medical
Doctors/Surgeons
Dentists
Biostatisticians
Nutritionists
Psychologists/
Psychiatrists
Nurses
Epidemiologist
Social Workers
Clinicians
Toxicologists
Pharmacists
Biologists/
Microbiologists
Physiologists
Mathematicians
Educators
Summary
• Environmental health is the broadest
scope of health problem definition
• Environmental health studies the impact
of the environment on populations
• It is a population based science that can
be scaled to study individual within
populations
• Problem definition and potential
resolution is possible through the
implementation of a systematic approach
About the Lecturer
Allison Robinson is a teaching assistant in the
Environmental and Occupational Health
Department at the University of Pittsburgh’s
Graduate School of Public Health in
Pittsburgh Pennsylvania. Currently, she is
earning on her doctorate degree in
Environmental Health. She has a Master’s of
Environmental Science and Management.