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Faculty of Medicine
Family and Community Medicine
كلية الطب
قسم طب العائلة والمجتمع
جامعة الملك سعود
Introduction to
ENVIRONMENTAL AND
OCCUPATIONAL HEALTH
YEAR
1431-1432 Hajji
2010 - 2011 Gregorian
April and May 2011
session
Description
Topics covered
4/3/2011
Environmental & Occupational health
1.
2.
3.
4.
5.
6.
Concepts of environment and health
Environmental hazards
Control of environmental hazards
Mass gathering and health
Principals of occupational health
Examples of occupational diseases
Introduction to Environmental & Occupation Health
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Faculty of Medicine
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كلية الطب
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part
1
Environmental Health
1.1. Environment:
1.2. Pollution:
1.3. Environmental health
1.4. Concepts of Environment and health
EXAMPLE I: Air quality
EXAMPLE II: WATER Pollution
EXAMPLE III: Water Disinfection
1.5. Epidemiologic Triangle
Exercises:
1. Pandemic (H1N1) 2009
2. Giardia lamblia
3. Escherichia coli
1.6. Risk Assessment
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1.1. Environment:
In general, environment
refers to the
surroundings of an
object
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1.2. Pollution:
Pollution is the introduction of contaminants
into a natural environment that causes
instability, disorder, harm or discomfort to the
ecosystem i.e. physical systems or living
organisms.
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Pollution can take the form of chemical substances
or energy, such as noise, heat, or light.
Pollutants, the elements of pollution, can be
foreign substances or energies, or naturally
occurring;
When naturally occurring, they are considered
contaminants when they exceed natural levels.
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1.3. Environmental health
Environmental health is the branch of public
health that is concerned with all aspects of the
natural and built environment that may affect
human health.
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Environmental health: Those aspects of the
human health and disease 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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1.4. Concepts of Environment and health
•Air quality, including both ambient outdoor air
and indoor air quality, which also comprises
concerns about environmental tobacco smoke.
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•Climate change and its effects on health.
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•Disaster preparedness and response.
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•Food safety,
including in agriculture,
transportation, food
processing, wholesale and
retail distribution and sale.
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•Hazardous materials management, including
hazardous waste management, contaminated
site remediation, the prevention of leaks from
underground storage tanks and the prevention
of hazardous materials releases to the
environment and responses to emergency
situations resulting from such releases.
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•Housing, including substandard housing
abatement
•Childhood lead poisoning prevention.
• Land use planning, including smart growth.
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•Liquid waste disposal, including city
wastewater treatment plants and onsite waste water disposal systems,
such as septic tank systems and
chemical toilets.
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•Medical waste management and disposal.
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•Noise pollution control.
•Occupational health and industrial hygiene.
•Radiological health, including exposure to
ionizing radiation from X-rays or radioactive
isotopes.
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•Recreational water illness prevention,
including from swimming pools, spas and
ocean and freshwater bathing places.
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•Safe drinking water.
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Solid waste management, including
landfills, recycling facilities, composting
and solid waste transfer stations
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•Toxic chemical exposure whether in consumer
products, housing, workplaces, air, water or soil.
•Vector control, including the control of
mosquitoes, rodents, flies, cockroaches and
other animals that may transmit pathogens.
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•Sulphur oxides (SOx) - especially sulphur dioxide, a chemical compound with the formula SO2.
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EXAMPLE I: Air quality
primary pollutants include
•Nitrogen oxides (NOx) - especially nitrogen
Carbon monoxide - is a colourless, odorless, nonirritating but very poisonous gas
•Carbon dioxide (CO2) - a colourless, odorless,
non-toxic greenhouse gas associated with ocean
acidification, emitted from sources such as
combustion, cement production, and respiration
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•Particulate matter - Particulates, alternatively
referred to as particulate matter (PM) or fine
particles, are tiny particles of solid or liquid
suspended in a gas.
•Toxic metals, such as lead, cadmium and copper.
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•Chlorofluorocarbons (CFCs) - harmful to
the ozone layer emitted from products
currently banned from use.
•Ammonia (NH3) - emitted from
agricultural processes.
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Secondary pollutants are not emitted directly.
Rather, they form in the air when primary
pollutants react or interact.
include:
•Particulate matter formed from gaseous primary
pollutants and compounds in photochemical
smog.
•Ground level ozone (O3) formed from NOx and
VOCs. Ozone (O3) is a key constituent of the
troposphere.
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EXAMPLE II: WATER:
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•Evaporation and Transpiration
•Condensation and Precipitation
•Runoff and infiltration
•Streams
•Groundwater – held in aquifers
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Sources of Pollution & Causes of Contamination
Improper Waste Disposal
Improper Well Construction
Poor Site Selection
Wells Not Properly Abandoned
Improper Waste Storage
Lack of Information on Hazardous Sites or
Activities
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Water Disinfection
1. Chlorination. using chlorine
2. Ozonization. using ozone
3. Bromination. using bromine.
4. Iodination. using iodine.
5. Exposure to Ultra Violet Rays using UV Rays.
6. Heating. By boiling
7. Addition of lime. using lime.
8. Exposure to Ultra Sonic Waves.
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Chlorination is the most common method for ease
of control and low cost in addition to its
effectively.
Applying Chlorination in rural areas:
This could be carried out with any powder or solution
containing Cl2 as:
a. Chlorinated lime = Bleaching powder, 25-35% Cl2
b. HTH = High test hypochlorite powder, 70-75% CI2.
c. Sodium hypochlorite solution, 15% Cl2
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Ex. Water quantity
Residual Cl2 required
Cl2 demand
Cl2 dose
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= 100 m3/day.
= 0.5 ppm
= 0.6 ppm
= 1.1 ppm
So every 1 m3 needs 1.1 gm CI2
100 m3 need 100 x 1.1 = 110 gm Cl2/day
for one month 110 x 30 = 3300 gm Cl2
Every 1 gm of HTH contains 0.75 gm CI2
100x1.1x30
So amount of HTH needed = --------------= 4400 gm HTH / month
0.75
= 4.4 Kg HTH / month
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1.5. Epidemiologic Triangle
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•Pandemic (H1N1) 2009
Virus Viewed from an
Epidemiological Triangle
Model
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Risk Assessment
Potential for risk
HAZARD
E. Coli
0157
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EVENT
CONSEQUENCE
Chlorinator
fails
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People are
Sick
(some die)
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For each event:
• How severe would the public health consequences be?
[Severity]
• How likely is the event to happen ? [Frequency]
Importance = Severity X Frequency
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Risk scoring matrix
Likelihood
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Severity of Consequences
Insignificant
Minor
Moderate
Major
Catastrophic
Almost
certain
Likely
Possible
-
Unlikely
-
-
Rare
-
-
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part
SAFE AND HEALTHY MASS
2
GATHERINGS
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Mass gatherings are events
attended by a sufficient
number of people to strain the
planning and response
resources of the host
community, state/province/,
nation, or region where it is
being held.
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APPROVAL FOR EVENT
Event organizers usually must gain approval
from local, and sometimes state, authorities to
hold public events. Information on the
approval process should be obtained
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LEGAL ISSUES
There is usually some form of legislation
which governs or restricts public events or
aspects thereof.
In some cases, particularly for extremely
large or high impact events, special State or
local legislation for the event may required.
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VENUE
It may be necessary to consider a number
of alternative venues for the event.
Emergency managers may be able to
recommend appropriate venues based on
health and safety considerations.
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Hazards
•Power lines which could be brought down by
a severe storm;
• Water ways that may be prone to flooding;
• bush fires;
• High winds;
• Extremes of temperature; and
• Pests, large animals, pollens and poisonous
plants.
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Access and Outlet of Health
and Emergency Services
Planning should ensure that emergency
services personnel have access to all
subsections of the venue, including
performance, spectator and parking
areas.
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PUBLIC HEALTH
•safe and adequate water supply;
•food safety;
•sanitation requirements and waste management;
•water and swimming pool safety;
•pest/vector control;
•infectious diseases prevention and investigation;
•standards for activities involving skin penetration, such
as tattooing and body piercing;
• building safety;
•noise and other nuisance issues; and
•public health emergency management/planning.
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MEDICAL CARE
Suitable medical facilities,
such as a first aid room, tent,
or vehicle, should be on-site.
It should be clearly identified
and easily accessible.
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MEDICAL CARE
Ambulances
The relevant ambulance
service must be consulted to
determine ambulance
requirements for the event.
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Medical Logistics
There are many medical logistic issues to
be considered in the planning of an event
including:
•Will medical staff operate in a facility to which the injured must
make their way, or will clearly identified medical teams patrol
spectator areas?
•Will there be vehicles to transport spectators to the medical
facility?
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Medical Logistics
•Will medical vehicles be appropriate to the
terrain? For example, four-wheel-drive vehicles
may be required for off-road areas, and golf carts
or similar vehicles for high-density spectator
areas.
•Where an ambulance is not required, will a
’chauffeur system’ be provided to transport
persons from the medical facility to their own
transport?
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Medical Logistics
•How will medical staff be notified of or summoned to
spectators requiring assistance in widespread spectator
areas?
•What means of communication will be available for
attending medical personnel to communicate with off-site
medical staff, event organisers, security and other support
staff?
•Are there any sponsorship conflicts between the event
sponsor and any medical service sponsors?
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