Impacts of air_&_water_pollution_on_health

Effects of Air and Water Pollution on Health

Najibullah Safi, MD, MSc. Health Policy and Management
PHC Advisor, WHO Country Office - Afghanistan

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 persistence

Tuesday, March 12, 2013 Afghan Media and Environmental Protection 2

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 earthquakes


Types of environmental hazards

• It include:
– Chemical
– Physical/mechanical
– Biological
– Psychosocial


Effects of Air Pollution on Health

More than 3000 people may die in Kabul because of air pollution
every year (Press Release - MoPH, January 15, 2009 )

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 - WHO


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=afg

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 them


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 home


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
fireplaces


Outdoor air pollutants

• Ozone (O3)
• Particulate matter
• Carbon monoxide (CO)
• Nitrogen oxide (Nox)
• Sulfur dioxide (SO2)
• Lead (Pb)
• Volatile organic compounds …


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 wastes


13
Tuesday, March 12, 2013 Afghan Media and Environmental Protection

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 death

Air pollution in Kabul


Cont.


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 2002


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 awareness


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 plants


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
study


Effects of Water Pollution on Health

4 billion cases of diarrhea worldwide each year

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 hygiene


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 year


What is water pollution?

• Introduction of harmful substances or products into
water

Causes of water pollution
• Factors that contribute to water pollution can be
categorized into two different groups
– Point sources
– Non-point sources


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
monitored


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
…


Water hazardous substances

• Heavy metals
• Other inorganic elements
• Acids/bases
• Oxidants
• Volatile organic compounds
• Hydrophobic organic compounds
• Petroleum additives
• Pesticides
• Micro-organisms
• Radioactive … 28


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

The main water-borne/fecal oral diseases

• Typhoid fever
• Giardia
• Dysentery
• Cholera
• Diarrhea (caused by a variety of pathogens)
• Hepatitis
• Polio
• Worms


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 2002

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

32


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.pdf


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