Impacts of air_&_water_pollution_on_health

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  • 1. Effects of Air and Water Pollution on Health Najibullah Safi, MD, MSc. Health Policy and Management PHC Advisor, WHO Country Office - Afghanistan
  • 2. What is pollution?• It is the introduction of contaminants (pollutant) into an environment that causes instability, disorder, harm or discomfort to the ecosystem i.e. physical systems or living organisms – A pollutant is a waste material that pollutes air, water or soil – Three factors determine the severity of a pollutant: • Its chemical nature • The concentration • The persistenceThursday, July 26, 2012 Afghan Media and Environmental Protection 2
  • 3. Environmental health hazards• Any external factor that negatively affects health can be considered an environmental health “hazard“ – It is a generic term for any situation or state of events which poses a threat to the surrounding environment – Common environmental health hazards include indoor and outdoor air pollution, contaminated food and water – This term incorporates topics like pollution and natural hazards such as storms and earthquakesThursday, July 26, 2012 Afghan Media and Environmental Protection 3
  • 4. Types of environmental hazards• It include: – Chemical – Physical/mechanical – Biological – PsychosocialThursday, July 26, 2012 Afghan Media and Environmental Protection 4
  • 5. Effects of Air Pollution on HealthMore than 3000 people may die in Kabul because of air pollution every year (Press Release - MoPH, January 15, 2009 )Thursday, July 26, 2012 Afghan Media and Environmental Protection 5
  • 6. Comparison of health indicators N Indicator Afghanistan Pakistan O 1 Life expectancy (years) Male: 47, Female: 45 Male: 65.2, Female 65.6 2 Annual growth rate (%)* 2 1.7 3 Dependency ratio (%) 92 88.3 4 Under 5 Mortality Rate (Deaths/1,000 live 191 (165) 90 births) 5 Infant Mortality Rate (Deaths/1,000 live 129 (111) 70.2 births) 6 Total Fertility Rate (Births/Woman) 6.3 4.1 7 Maternal Mortality Ratio (Maternal 1600 (1400) 276 Deaths/100,000 live births)(2000 data) Source: HMIS, MoPH, Afghanistan 2006 Health Survey * Country Health Profile - WHOThursday, July 26, 2012 Afghan Media and Environmental Protection 6
  • 7. Cont. N Indicator Afghanistan Pakistan O 8 Pregnant women who received 1+ ANC visits (%) 30 9 Deliveries attended by skilled health personnel 19 100 (2009) (%) 10 Newborns immunized with BCG 2007 (%) 91 98 11 1-year-olds immunized with 3 doses of DPT 2007 83 98 (%) 12 Children under 2 years immunized with 1 dose of 70 100 measles 2007 (%) 13 Pregnant women immunized with two or more 65 NA doses of tetanus toxoid 2007 (%) 14 Percent of rural population with access to local 66 NA health services Source: HMIS – MoPH WHO, Country profile http://www.emro.who.int/emrinfo/index.asp?Ctry=afgThursday, July 26, 2012 Afghan Media and Environmental Protection 7
  • 8. What is air pollution?• It is the presence of one or more air pollutant in such a quantity and duration sufficient to cause harm to man, plants animals and property• Air pollution is the emission into the air of hazardous substance at a rate that exceed the capacity of natural process in the atmosphere to – Convert them, – Precipitation (rain or snow ) to deposit them or – Of winds and air movement to dilute themThursday, July 26, 2012 Afghan Media and Environmental Protection 8
  • 9. In door air pollution• Indoor air can be defined as any non-industrial indoor space where a person spends a period of an hour or more in any day• This can include the air space in the office, classroom, motor vehicle, shopping centre, hospital and homeThursday, July 26, 2012 Afghan Media and Environmental Protection 9
  • 10. Common indoor air pollutants • Second-hand tobacco • Chemicals released by: smoke • Dry cleaned clothes • Lead-impregnated dust • Cleaning products • Room deodorizers from old paint, • Office supplies cockroach shedding • Paints • Dust mite particles • New furniture and pressed wood • Combustion gases • Personal care products; released by stoves, and heaters, candles and • Pesticides fireplacesThursday, July 26, 2012 Afghan Media and Environmental Protection 10
  • 11. Outdoor air pollutants• Ozone (O3)• Particulate matter• Carbon monoxide (CO)• Nitrogen oxide (Nox)• Sulfur dioxide (SO2)• Lead (Pb)• Volatile organic compounds …Thursday, July 26, 2012 Afghan Media and Environmental Protection 11
  • 12. Sources of air pollution• Transportation (mobile sources ) – Motor vehicles, rail, shipping, aviation• Industry sources – Power stations, petroleum refining, chemical manufacturing• Power plants• Central heating• Incineration of domestic wastesThursday, July 26, 2012 Afghan Media and Environmental Protection 12
  • 13. 13Thursday, July 26, 2012 Afghan Media and Environmental Protection
  • 14. Health effects of air pollution• Irritation of nose, eye, and throat• Respiratory diseases (Bronchitis, Asthma, cough, …etc.)• Cardiovascular diseases• Toxicity (CO)• Decrease of pulmonary function and restricted activities• Cancers (Benzene)• Neurological impairments, such as seizures, mental retardation, and behavioral disorders, learning disabilities, apathy and behavior abnormalities (Pb)• kidney/liver damage, CNS disorders (Arsenic, cadmium, lead, mercury, nickel, and chromium)• Increased hospital admissions and ER visits• Anemia as a complication of chronic lead exposure• Premature deathThursday, July 26, 2012 Afghan Media and Environmental Protection 14
  • 15. Air pollution in KabulThursday, July 26, 2012 Afghan Media and Environmental Protection 15
  • 16. Cont.Thursday, July 26, 2012 Afghan Media and Environmental Protection 16
  • 17. Cont.Thursday, July 26, 2012 Afghan Media and Environmental Protection 17
  • 18. Conti. – High amount of dust and concentration of poly aromatic hydrocarbons (originated from cars)* – A pollutant: Benzo-a-pyrene which increase the risk of lung cancer – Presence of duct increase the potential risks of BP – Combination of drought and loss of vegetation are contributing factors to the increased dust level *Afghanistan post conflict environmental assessment conducted by UNEP in Kabul, Balkh, Herat and Kandahar in 2002Thursday, July 26, 2012 Afghan Media and Environmental Protection 18
  • 19. Control measures• Scientific group studies on the damaging effects on plant, animal, and human life• Legislative bodies to set up the standards and enforce laws to control emission• Health professional and media to educate the population about the health effects of the pollution• Media – advocacy, public awarenessThursday, July 26, 2012 Afghan Media and Environmental Protection 19
  • 20. At the individual level• As transportation is a major source of pollution so – Limit driving – Use public transportation, use carpools, bike – Maintain your car regularly especially the emission control system• Reduction at the emission source is very important in stationary plantsThursday, July 26, 2012 Afghan Media and Environmental Protection 20
  • 21. Community level• They should continue to exert their pressure on the government to carry on ongoing continuous surveillance monitoring for air pollution/ pollutants in order to place more astringent standards when required• To encourage the researches on the subject under studyThursday, July 26, 2012 Afghan Media and Environmental Protection 21
  • 22. Effects of Water Pollution on Health4 billion cases of diarrhea worldwide each year
  • 23. Some facts• Parasites Intestinal Worms infect about 10% of the world population• About 200 million people are affected by schistosomiasis, with 200,000 dying each year• Diarrheal diseases have killed more children in the past ten years than all the people lost to armed conflict since World War II• WHO estimated that 88% of diarrheal disease is caused by unsafe water supply, and inadequate sanitation and hygieneThursday, July 26, 2012 Afghan Media and Environmental Protection 23
  • 24. Cont.• In Afghanistan during 2009 water borne diseases contributed to almost 1/4 of diseases outbreaks which included cholera, Hepatitis A & E and typhoid fever• Water borne diseases are huge burden on already strained health system as almost 1/5 of patients at a health facility are due to diarrheal diseases alone throughout the yearThursday, July 26, 2012 Afghan Media and Environmental Protection 24
  • 25. What is water pollution?• Introduction of harmful substances or products into waterCauses of water pollution• Factors that contribute to water pollution can be categorized into two different groups – Point sources – Non-point sourcesThursday, July 26, 2012 Afghan Media and Environmental Protection 25
  • 26. Point sources• Some point sources of water pollution include – Waste products from factories – Waste from sewage system – Waste from power plants – Waste from underground coalmines – Waste from oil wells …• They are called point sources because they are direct sources of water pollution and can be reduced and monitoredThursday, July 26, 2012 Afghan Media and Environmental Protection 26
  • 27. Non-point sources• The term non-point source encompasses a large range of sources such as: – When rain or snow moves through the ground and picks up pollutants as it moves towards a major body of water – The runoff of fertilizers from farm animals and crop land – Air pollutants getting washed or deposited to earth – Storm water drainage from lawns, parking lots, and streets …Thursday, July 26, 2012 Afghan Media and Environmental Protection 27
  • 28. Water hazardous substances• Heavy metals• Other inorganic elements• Acids/bases• Oxidants• Volatile organic compounds• Hydrophobic organic compounds• Petroleum additives• Pesticides• Micro-organisms• Radioactive … 28Thursday, July 26, 2012 Afghan Media and Environmental Protection 28
  • 29. Harms of water pollution• Virtually all types of water pollution are harmful to the health of humans and animals• Suspended particles in freshwater reduces the quality of drinking water for humans and the aquatic environment for marine life• Heavy metals from industrial processes can accumulate in nearby lakes and rivers. These are toxic to marine life such as fish, and subsequently to the humans who eat them• Industrial waste often contains many toxic compounds that damage the health of aquatic animals and those who eat them• Microbial pollutants from sewage often result in infectious diseases
  • 30. The main water-borne/fecal oral diseases• Typhoid fever• Giardia• Dysentery• Cholera• Diarrhea (caused by a variety of pathogens)• Hepatitis• Polio• WormsThursday, July 26, 2012 Afghan Media and Environmental Protection 30
  • 31. Drinking water quality in Afghanistan• Cross contaminated by sewage*• High level of contamination with Coliform bacteria (18-100 count in 100 ml)• 70% of shallow wells infected by bacteria*Afghanistan post conflict environmental assessment conducted by UNEP in Kabul, Balkh, Herat and Kandahar in 2002Thursday, July 26, 2012 Afghan Media and Environmental Protection 31
  • 32. Water pollution control• Pollution prevention• Minimize pollution – Recycling and re-use; treatment; encourage cleaner production technologies; encourage good housekeeping• Disinfection (Chlorination)• Disposal or discharge of waste water 32Thursday, July 26, 2012 Afghan Media and Environmental Protection 32
  • 33. WHO publication on air pollution and health• WHO air quality Global update 2005: http://whqlibdoc.who.int/hq/2006/WHO_SDE_PHE_OEH_06.02_en g.pdf• WHO indoor air quality: dampness and mould: http://www.euro.who.int/en/what-we-do/health- topics/environmental-health/air- quality/publications/2009/who- guidelines-for-indoor-air-quality-dampness-and-mould• Methodology for assessing the burden of diseases of outdoor air pollution: http://www.who.int/quantifying_ehimpacts/publications/ebd5.pdf• Air quality and health (questions and answers): http://www.who.int/phe/air_quality_q&a.pdfThursday, July 26, 2012 Afghan Media and Environmental Protection 33
  • 34. Thursday, July 26, 2012 Afghan Media and Environmental Protection 34