This document provides information about environmental health and related topics. It begins by defining environmental health and its components, including the biological, physical, socio-cultural, economic, and political environments. It then discusses various environmental health issues in more detail, such as pollution, water and sanitation, waste disposal, and the roles of environmental impact assessments and nurses. The document aims to educate students on concepts of environmental health and how to promote health through effective environmental management.
2. MODULE UNITS
Q1. Discuss pollution under the following
sub headings
◦ Define pollution
◦ Types of pollution
◦ Causes of pollution
◦ Effects of pollution
◦ Prevention and control
NB: Group Assignment
3. Unit 1. Concepts of
environmental health
Learning Outcome
The student will acquire knowledge on
environmental health, develop skills and
attitudes to enable her promote health
and prevent illness in the individual,
family and community through effective
environmental management
4. Specific Objectives
Describe environmental health
Describe components of environmental
health
Discuss environmental impact assessment
Describe safe water system
Discuss environmental sanitation
Discuss methods of waste disposal
Discuss food safety and hygiene
Discuss common food borne diseases
Discuss housing and health
5. ENVIRONMENTAL HEALTH
The environment is an important part of
the overall picture of human life and
behavior.
Within the environment are many
influences – biological, physical, social
and economic - all of which have a
bearing on how people live and behave
6. ENVIRONMENTAL MEALTH
CONT…
In turn, the way people live and behave
can determine the diseases from which
they may suffer.
All the environmental influences interact
with each other
7. DO YOU THINK THERE IS
ANYTHING WRONG WITH THE
ENVIRONMENT WE LIVE IN
TODAY?
8. ENVIRONMENTAL HEALTH
DEF OF ENVIRONMENT
Is a the collective term used to describe
all the living and non living things that
make up our surroundings.
Sum total of our surrounding to include
physical, biological, socio-cultural,
economic and political systems
The multiple interactions between people
and their environment is called ecology.
9. DEF OF HEALTH
Health, according to the World Health
Organization, is a state of complete
physical, mental and social well-being and
not merely the absence of disease and
infirmity.
10. Pollution
an undesirable change that can
adversely affect humans or other living
organisms
The 2 main types of pollutants are
Biodegradable pollution is those
which are decomposed by natural
biological agents.
Non- biodegradable pollutants that
do not decompose
12. Environmental health
Environmental health may be defined
also as “the theory and practice of
assessing, correcting, controlling and
preventing factors in the environment”
that negatively affect health
13. Environmental Health
Engineering
• Means modification and enhancing the
quality of the environment to promote
health.
Involves:-
• Protection of people from the effect
of adverse environmental factors
• The protection of the environment
from the potentially causing harm of
human activities.
• The improvement of environmental
quality for human health and well-
being
14. Why Nurses Are Involved With
Environmental Health
1. Nurses provide healing and safe
environments for people.
2. Nurses are trusted sources of information.
3. Nurses are the largest healthcare
occupation.
4. Nurses work with persons from a variety of
cultures.
5. Nurses effect decisions in their own homes,
work settings, and communities.
15. Cont..
6. Nurses are good sources of information
for policy makers.
7. Nurses translate scientific health
literature to make it understandable.
8. Nurses with advanced degrees are
engaged in research about the
environment and health.
9. Health organizations recognize nurses’
roles in environmental health
16. Principles Of Environmental Health
For Nursing
Nurses have a right to work in an
environment that is safe and healthy.
Knowledge of environmental health concepts
is essential to nursing practice
Approaches to promoting a healthy
environment
reflect a respect for the diverse values,
beliefs,
cultures, and circumstances of patients and
their
families.
Nurses participate in assessing the quality of
the
environment in which they practice and live
17. Principles Of Environmental Health
cont..
Nurses participate in research of best
practices that promote a safe and
healthy environment.
Nurses must be supported in
advocating for and implementing
environmental health principles in
nursing practice
21. Plants and influence on health
• Vegetation prevents soil erosion thus
protects water sources....
• Trees act as windbreakers, provide
firewood, charcoal, timber and paper,
influence weather patterns.
• Flowers are a natural beauty
• Plants provide vegetables, fruits, tubers
and seeds as food.
22. Plants and influence on health
cont........
As herbal medicine; muarobaine for
malaria, Garlic for hypertension, aloe
vera for prevention of cancer of the
stomach and healing of wounds.
Some plants may adversely affect
health; pollen grains leading to hay
fever or asthma in allergic pple
Some plants are poisonous eg cactus
23. PEOPLE AND INFLUENCE ON
HEALTH
These influences arise from activities of
man
Urbanization can lead to overcrowding
and slum settlements; promote the
transmission diseases that are spread
through droplets and contact.
Explosions from quarries; noise n dust-
causes respiratory, eye problems n ear
problems.
24. PEOPLE AND INFLUENCE ON
HEALTH cont...
Quarries collect water and become
breeding sites for mosquitoes and risky
places for children.
Felling of trees to provide firewood and
charcoal but, destroys the water sources.
Cultivating along riverbanks may
contaminate the water supply through
seepage of the fertilizers and pesticides
Overgrazing causes soil erosion, destroys
vegetation and contaminates water
sources
25. ANIMALS AND INFLUENCE ON
HEALTH
• Domestic animals source of meat, milk,
hides, wool, manure,
Wildlife is often a tourist attraction
Cats and dogs are kept as pets, but they
can also transmit diseases such rabies
Other hazards include snake and insect
bites leading to....
Houseflies are vectors of dysentery and
other diarrhoeal diseases.
Bacteria, rickettsia and fungi are disease-
causing organisms in man
26. PHYSICAL ENVIRONMENT
Non living part of the environment.
The physical components of the
environment are divided into;
Geographical and
Man-made components.
27. The physical agents
Levels of noise
Levels of heat and humidity
Levels of dust
Vibration
Electricity or lighting
ƒ
Radiation
28.
29. Physical environment cont…
Land is used for settlements,
agriculture
Fertile vs infertile land n effects…..
The type of soil, climate and altitude
determine the type of crops grown
Cold climates encourage respiratory
diseases and joint problems
Warm climates associated with malaria.
Snakes are also common in hot areas
30. Physical environment cont…
Disease outbreaks for cholera, typhoid
common in rainy seasons
Dry seasons--shortage of food--
malnutrition.
Weather pattern Influence clothing.
Dams constructed source of vectors
Industrial wastes that consist of
chemicals and toxic substances, may
pollute environment.
32. Socio-Cultural Environment
Affects food habits and cooking
practices..staple food among different tribes
Food taboos –restrictions in taking food..health
effects
Wife inheritance and polygamy practices -
spreading STI and HIV/AIDS.
Tattoos performed for beautification
Circumcision rites of passage...neg n pos
effects
Female genital mutilation can lead to difficult
deliveries.
Some people discourage breast-feeding
Use of prenatal and delivery services. ...
33. ECONOMIC AND POLITICAL
COMPONENTS
These components include work, money and
government.
Irrigation schemes for growing rice.. income/
disease
People of low economic status...reduced
affordability to health care, access to food
The rich prone to life style diseases.. obesity,
gout, hypertension ...
Government develop policies....
Gvts implement and enforce laws.
Political instability causes unrest, insecurity
and psychological problems.
34. ENVIRONMENTAL IMPACT
ASSESSMENT(EIAs)
Is the study of the effects of a proposed
action on the environment(i.e physical,
biological, economical environments)
Its is based on predictions of the
possible impacts as result of the
proposed action
35. Principles of EIA
Accountability; project officers, gvt and
other stakeholder are held accountable
for the information and decisions they
make
Community participation; adopts open
participatory appproach
GOAL
To ensure that the environment impacts
are accounted for by the key decision
makers throughout the entire life cycle of
the project
36. Objectives of EIA
Identify significant impacts of a project
Predict the extent of environmental
changes as a result of the project
Present information on the impact of
alternative dvpt project plan
Propose appropriate mitigating
measures
Generate baseline data for M&E
mitigation measures
37. Common limitations of EIAs in
developing nations
Lack of guidelines and procedures for
preparing EIAs
Inadequate funds and human resources
No legal requirements to conduct EIAs
Lack of environmental standards
Weak enforcement of existing
environmental standards
Absence of EIAs legislation to ensure
that policy statements are implemented
38. Screening in EIA
Is the process of determining whether or
not a proposal requires detailed
environmental assessment.
Entails carrying out initial environmental
examination to allow categorization of
the proposed project.
39. Categories of projects for
EIAs
Category 1 projects; are project
anticipated to have significant
multifaceted environmental impacts.
Impacts could affect human health, incr
polution, adversely affect endangered
species.
They require a full EIA study
Include industrial project e.g
mining/maufacturing firms and agric firms
like mega dams/airport/sewer lines
40. Categories of projects for EIAs
cont’d
Category 11 projects; hv a potential for
narrower environmental impacts.
• Can be controlled by applying scientific
measures or changes in project design.
• Requires partial EIAs
• Industries and infrastructure…road
rehab/power transm lines; small scale
irrigation
Category 111 projects; are not anticipated
to result in adverse environmental impacts;
• EIAs are often unnecessary.
• Include educational prog, nutritional prog/
family planning
41. WATER AND SANITATION
By the end of this section the learner will
be able to:
Describe the importance of water in
relation to health
Explain different types of waste
Describe various methods of waste
disposal
42. WATER
Water is essential for life.
It is found in every cell in our body
Is necessary for most basic functions of the
body.
More than 50% of human body weight is
made up of water.
Water is thus vital to health and survival
Can be a source of diseases, should be
properly treated and made safe for domestic
use.
43. USES/PURPOSES OF WATER
• Human consumption for body needs e.g...
• Agricultural purposes; Animal watering,
irrigation, sustaining of aquatic life
• Industrial purposes; manufacturing
industries like the iron..and hydroelectric
generation need a lot of water
• Public purposes; recreational activities such
as swimming, fire fighting, public
cleanliness
• Household/domestic purposes like
washing, drinking, cooking, personal
hygiene, flushing latrines
44. REQUIREMENT OF WATER
The consumption depends on;
Climatic conditions
Standard of livings
Habits of individuals
Daily consumption of 50 litres per head
is considered adequate allowance
drinking, bathing, cooking n
sanitation(WHO)
45. Potable/Acceptable water
Water which is physically, chemically and
bacteriologically suitable for drinking
Features of potable water
Free from harmful chemicals
Free from pathogenic agents
Pleasant to taste,
Colourless
Odourless
46. Role Played by Water on the
Transmission of Diseases
Inadequate water supply; poor
sanitation; diseases like scabies, non-
specific diarrhoeas, dysentery and
trachoma spread.
Such diseases are called water-washed
(water scarce) diseases.
Improving the quantity of water can
prevent them.
47. Cont…
When it carries a specific disease-
causing organism.
Examples are typhoid, cholera,
amoebiasis, hepatitis A, or
poliomyelitis.
Such diseases caused by contaminated
water are called water-borne diseases,
Controlled by improving water quality i.e
cleanliness of the water.
48. Cont…
When it is necessary in the life cycle of
a disease vector, for example malaria
and schitosomomiasis.
These diseases are called water-related
diseases.
Other water related diseases include:
onchocerciasis (river blindness) and
dracunculosis (guinea worm).
49. Summary of water associated
disease
Type of
Disease
Cause Example
Water- washed Due to lack of adequate
water
a) For washing hands
,utensils and
vegetables
b) For washing face,
eyes and body
1.Dysentry
2. Diarrhoea
1. Skin disease
2. Eye disease
Water -Borne Due to water containing
disease causing
organism
1.Typhoid 2.Cholera
3.Amoebiasis
4.Hepatits A
Water –related The vector needs water
for its life cycle
1.Malaria
2.Schistosomiasis
50. SOURCES OF WATER
Water does not stay in one place for very
long - it goes round in a cycle.
It evaporates from seas and lakes and
falls back to the earth as rain.
After rainfall, some evaporates and
others drain into streams, rivers, lakes
and ponds.
NB........Draw hydrological cycle
51. Cont…
The most important water for a
community is the water that is held in the
soil, by the roots of the trees in the
forest.
This is a community’s long-term
underground water store.
Therefore communities need to
preserve their forests
52. MAIN SOURCES OF WATER
Rain Water,
Surface Water,
Underground Water And
Sea Water.
53. RAIN WATER
Main source of all water
This water is relatively pure and clean.
Chemically very soft
Its state of cleanliness depends on
levels of atmospheric pollution and how
it is collected(sulphuric and nitric acid)
Disadvantages; difficult to collect from
thatched roofs, tasteless, does not
contain minerals
54. SURFACE WATER
Is the commonest source of water
Includes shallow springs and shallow wells,
streams, rivers, dams, ponds and lakes.
A spring is a natural issue/exit of
underground water.
Water flows freely under natural pressure
Water sinks into the ground until it reaches
the impermeable layer of rock, which it
cannot go through.
All the water above this layer is called
surface water.
55. Cont…
If it finds a point of issue it is called a
shallow spring.
Shallow springs dry up quickly during dry
seasons
If a well is dug into it, it is called a
shallow well, despite its depth.
Water levels vary with season.
Liable to contamination by latrines.
56. Cont….
A river is a large mass of flowing water.
Turbid during rainy seasons
Dry season they are clear.
Has a lot of impurities from..
Provide fresh water
57. Cont…
The quality of water depends on the
location of its sources/catchment.
Forest, hills and valleys,..it is clean;no
human settlement, thus less polluted
Streams, rivers and lakes around or
within towns and villages are likely to be
contaminated by human and animal
waste.
58. Sea Water
Is salty
Requires expensive purification
processes to make it suitable for
drinking.
In Kenya; Lake Magadi, Lake Bogoria
and Lake Elementaita.
There are also the salty waters of the
Indian Ocean.
59. UNDERGROUND WATER
The water that gets under the
impermeable layer of rock is called
underground water.
It is the water between two impermeable
layers of rock
Finds an outlet through a fissure or crack
in the upper layer of the rock.
Is obtained as a deep spring, a well or a
borehole.
60. Underground Water cont...
Wells can be deep or shallow, also can be
dug or tube(consists of a pipe(usually
galvanized iron)
Water plentiful,
Less polluted with pathogenic agents
Does not normally dry off during dry
seasons.
This water is usually salty (calcium and
magnesium)
It also needs to be pumped into tanks or
reservoirs before use which is costy
61. Difference btn shallow and deep
well
Shallow well Deep well
1.Taps the water from
above the first
impervious layer
Taps water from below
the first impervious
layer
2. Moderately hard Much hard
3.Often grossly
contaminated
Taps pure water
4. Usually goes dry in
summer
Provides a source of
constant supply
62. MAIN SOURCES OF WATER
CONTAMINATION
Sewage discharges in water bodies-contain
pathogens and decomposing matters
Industrial effluent-contain toxic substances
such as arsenic materials, sulphur dioxide,
carbon dioxide, lead, mercury
Agricultural pollutants; fertilizers and
pesticides thru seepage and surface run
offs
Physical pollutants to include heat which
cause deoxygenation of water and also
cause thermal pollution. Radioactive
substances—carcinogenic effects
63. Sources of water contamination
cont…
Contaminated collecting surfaces
Use of dirty containers for drawing water
Wells fitted with pumps can be
contaminated by oil from the pump.
Excreta and refuse may contaminate
shallow wells thru surface run offs
Bathing, urinating, defecating in water
64. Cont…
Piped water may get contaminated from
leaks in the pipes.
If it is uncovered or stored for too long
in a pot or cistern.
If it is drunk from dirty or communal
drinking vessels
65. INDICATORS OF WATER
CONTAMINATION
Amt of suspended solids
Biochemical oxygen demand at
20 degrees celcius
Concentration of chloride,
phosphorus, flouride ions
66. WATER ANALYSIS
Three main methods applied are;
◦ Bacteriological analysis e.g for E.
coli indicates contamination wth
excreta
◦ Chemical analysis…levels of cl-,
na+, fl-, nh4-, ca+2; essential
elements, h2o hardness
◦ Physical analysis of water; a
process of determining
substances which affect the
colour, flavour and colour of water
67. Protection of Water
Sources
Rain Water
• Gaseous industrial effluent to be treated
before release to atmosphere,
• Use of clean
energy...hydroelectric/wind/solar
• Use of gutters led by pipes into a small
waste drain tank before a clean closed
tank.
68. Surface Water
• Limit settlement and farming activities
around springs, streams and rivers.
• Water catchments areas, should be free of
human activities.
Springs;
Clear the bush around the site of the
spring.
Put up a fence around the spring.
Dig a drain about 15 metres from the spring
to divert surface water.
Build a strong retaining wall around the
'eyes‘- point from which water flows out
from underground
69. Protection of spring cont’d
Fix the delivery pipe..easy fetching
Build platform on which to place the
containers when collecting waters.
Design an area for washing and for
watering the animals.
Select/hire a caretaker to maintain the
protected springs.
70. Protecting Wells
The site should be at least
100 metres from a pit latrine
The sides of the well should be built with
stones, rocks, or cement
culvert...Seepage
A sloping water-proof area around it to
avoid dirt from getting into to the well.
A strong well cover.
NB;The well should be dug during the dry
season to obtain adequate depth,
filtration and constant water supply.
71. SAFE WATER SYSTEM
The safe water system is a household-
based water quality intervention in
response to the need for inexpensive,
alternative means of water treatment
and storage in the short to medium
terms.
72. SAFE WATER SYSTEM
CONT…
The intervention has three components:
◦ Water treatment in the home
◦ Safe storage
◦ Behaviour change techniques
73. The main goals of safe water
systems
To improve the microbial quality of water
in the home by means of sustainable
technology
To reduce morbidity and mortality of
diarrhoea diseases related to
contaminated water
To improve hygienic behaviour related to
water use
74. PURIFICATION OF WATER
Objective: Remove dissolved and
suspended impurities of H2O to make it
safe and wholesome.
75. SIMPLE WATER PURIFICATION
METHODS
Storage; the three –pot system…24 hr period
storage in pot 1&2
• Storage purify through sedimentation, n death of
bacteria.
• Slowly pour or siphon by a pipe
• Skhistosomia for example die if water is stored for
48hrs, and many bakteria
• Pot 3 contain water for drinking; when used/utized
the process begins; washed n may be scalded by
hot water
Bucket for
fetching
water
POT-2 POT-3
POT- 1
76. At household cont’d
Filtration—ceramic candle water filter/ sieve
Sterilization- chemical by use of chlorination n
iodinisation.
2% iodine tincture; two drops to one litre of water.
1% of chlorine; Minimum contact period of 30
minutes. 3drops to 1L of water
Physical through boiling- bring water to ‘rolling boil’ for
15-20min to give sterilized water;
Kills spores, bacteria, cysts, ova;
Removes temporary hardness of water;
Boil in the container in which it is going to be stored;
Does not offer protection against subsequent microbial
contamination
Flat taste due lost of dissoved gases…co2 n o2..and
other minerals
77. Qualities water disinfectants
Must be capable of destroying
pathogens in water
Products of disinfection reactions should
not make water toxic
Available, affordable and easy to use
Ability to protect against
recontamination, residual value
Amenable to detection by practical and
rapid analytical method
78. PURIFICATION OF WATER IN
LARGE SCALE
Method depends on the nature of raw
water and desired standard of water
quality
Under ground water eg water from wells
and springs(deep)..just disinfection
Surface water e.g river water tend to be
more polluted; extensive treatment
Water purification system comprises of
storage, filtration and disinfection
processes
79. 1. STORAGE
Storage chambers provides reserve for
water, where further contamination is
minimised.
Water is stored for about 10-14 days
Is a natural purification process involving
physical, chemical and biological
processes.
Physical process; 90% of suspended
impurities settle by gravity within 24hrs
of storage;
80. Storage cont…
Chemical process; aerobic bacteria
oxidize organic matter present in water
reducing level of ammonia in water
Biological process; with storage
bacterial counts in water drops due to
cell death
NB: Long period of storage leads to
growth of algae which gives water bad
smell and colour
81. 2. FILTRATION
2nd stage of water purification
Removes 98-99% of bacteria
There are two types of filters(biological/slow
sand filters and mechanical/rapid sand
filters
Biological filters; made up of 4main
elements.
◦ Supernatat/raw water
◦ A bed of graded sand
◦ An under-drainage system
◦ A system of filter control valves
82. A. SUPERNATAT H2O
Above sand bed; depth 1-1.5m; water
settle for 3-12hrs; water get purified
through sedimentation, oxidation
B. SAND BED; 1metre thick; rounded
sand gravel; supported by a layer of
graded gravel; provide a large S/A for
mechanical straining, sedimentation,
adsorption, oxidation; filtration rate---0.1-
0.4m3/hr/m2
83. Cont…..
The surface of sand bed after sometime
gets covered by a slimy growth known
as ‘schmutzdecke’ vital layer, zoogleal
layer or biological layer
The layer is slimy, geletinous consisting
of thread-like algae.
Primary to functioning of sand bed; it
removes organic matter, holds bacteria
and oxidises amnionical nitrogen into
nitrates thus yielding bacteria free water
84. C. UNDER-DRAINAGE
SYSTEM
Consist of porous/perforated pipes; for
outlet of filtered H2O; form base for filter
medium
D. Network of valves and devices;
maintain control rate of filtration
Advantages
Simple to construct and operate
Cheaper to control and maintain
Physical, chemical and bacteriological
quality of filtered H2O is very high
85. MECHANICAL/RAPID SAND
FILTER
Are of 2types; gravity type and pressure
type
Steps in rapid sand filtration
Coagulation ---Raw water Rx with
chemical coagulant e.g alum; dose can
be 5-40mg/litre depending on the
turbidity, temp and PH of water
Rapid mixing---violent agitation for a
few minutes to allow quick and thorough
dissemination of alum throughout the
water
86. Steps in rapid sand filtration
cont…
Flocculation ----slow and gentle stirring of
Rxd water for about 30min in a flocculation
chamber. This process lead to formation of
thick copious flocculent of aluminium
hydroxide which settle down in the chamber
Sedimentation; the coagulated water is
detained in the sedimentation tank for abt
2-6hrs for the flocculent, impurities and
bacteria to settle down
Filtration –partially clear water is passed
through filter beds
87. Advantages of rapid sand
filtration
Can deal with raw water directly no need
for preliminary storage
Filter bed take less space
Filtration is rapid 40-50 times>slow
filtration
More flexible in operation
Washing of the filters is easier
88. 3. Disinfection
Sterilization of water using chlorine or
solar disinfection
Chlorination is the addition of chlorine to
water that has been filtered
In form of gas/tablets/liquid forms
89. PRINCIPLES OF CHLORINATION
The water should be clear i.e free from
turbidity.
Chlorine demand to depend on the level of
contamination
Chlorine should be properly mixed
The contact time 30-60min
The minimum recommended
concentration of free chlorine is 0.5mg/l of
water;
The amount of chlorine should be
proportional to the volume of water.
90. Role of community health
nurses in safe water supply
Survey/ identify water sources
Chlorination of public water supply
sources
Being observant n report; pipes
damage
Educating the public on safe drinking
water
Advising on proper methods of water
storage
Advising methods for water disinfection
Responding during water borne
91. SANITATION AND WASTE
MANAGEMENT
Is defined as systematic method of
applying physical, chemical, biological
and social procedures and measures
aimed at controlling environmental
factors that promote disease
transmission in order to safeguard
human health and the general well-
being of human beings.
92. COMPONENTS OF SANITATION
Practicing personal and food
hygiene
Safe management of solid and
liquid waste
Vector control – control of
insects and rodents that can
spread diseases
93. CONSTRAINTS TO GOOD
SANITATION
Lack of policy guidelines or poor enforcement
Poor community motivation
Cultural, beliefs and taboos
Poor perception of sanitation
Scarcity of resources
Lack of data and information
Lack of effective collaboration and
coordination
Flood prone areas
Difficulty soil conditions
94. STRATEGIES TO IMPROVE
SANITATION
Create demand for sanitation services
at the community level..benefits of Gud
Sani
Develop a comprehensive national
sanitation policy
Mobilize both external and internal
resources towards sanitation
Strengthen the existing sanitation
programs
Research to develop locally feasible
technology options 4sanitation
Raise sanitation profile as a
development agenda…mark of dvmt
Initiate, strengthen n harmonize
existing legislation on sanitation
95. WASTE MANAGEMENT
Undertaken in two ways i.e. solid
waste mgt and liquid waste mgt
Solid waste/refuse
Refers to discarded materials or by
– products of human activities that
are no longer required for further
use by the initial producer.
Does NOT include nightsoil/excreta
96. Liquid waste
Refers to all other wastes in free flowing
liquid form i.e. waste water, soil water
and excreta
Sources:
Municipal waste which includes
domestic and commercial waste water
Industrial waste- from various industrial
processes
97. Objectives of solid waste
management
• To prevent and control refuse related
diseases
• To prevent aesthetic problems
• To prevent obnoxious odors
• To prevent pollution of soil, water
• To prevent physical hazards
• To salvage some materials of economic
value..recycle
• To avoid occupying of space for other
useful purposes
• To create awareness through health
education to the people
98. Types/classes of solid waste
Based on source
Domestic waste
Agricultural waste
Commercial/trade waste
Industrial waste
Hospital waste
etc
99. DOMESTIC WASTE
Refers to all the garbage that emanates
from inside a house e.g food leftovers,
clothes, shoes, broken utensils, bottles
and tins
STREET WASTE
This type of refuse consists of paper,
food and commercial refuse in public
places such as markets and hotels.
Scrap metals included.
100. INDUSTRIAL WASTE
Wastes from industrial processes
The wastes may be toxic, caustic, acidic or
flammable.
Should be processed b4 discharge.
HOSPITAL WASTE
Generated from hospital related activities
Include;
◦ Sharps, that is, needles and syringes-
incinerate
◦ Gauze and cotton wool swabs
◦ Vials and Lotions
◦ Drugs and vaccines
◦ Tubing, gloves and papers
◦ Foetuses---marceration
101. Categories of hospital wastes
Clinical wastes..used gloves, bandages,
dressing materials---yellow liner bag
Pathological wastes; amputation, tooth
extracts..red liner bags
Sharps; needles , scaples; sharp
boxes/jerrican
General wastes; waste papers black liners
Food remains; white liners
NB:Highly infectious/infectious/non
infectious
102. Garden/Agricultural Waste
Agricultural waste from coffee,
sugarcane, sisal, pesticides and
fertilizers.
May result in the pollution of natural
resources such as air, food, and water.
103. PRINCIPLES OF WASTE
MANAGEMENT
Waste segregation/separation
Storage
Collection
Transportation
Disposal
Recycling/refuse
Nb. Considered steps of mgt
105. 1. Dumping
Is where solid waste is deposited in the
sea, river or on low lying areas
This becomes a health hazard and the
littering is unpleasant sight.
2. Burning
For combustible refuse
Can take place in
Simple open air burning
Burning in a trench
Using a simple mud-brick incinerator
• Not effective and pollute environment
106. DISAV
Often leaves tins and broken bottles
littering the surrounding area can cause
accidents,
The smoke and odour contribute to air
pollution.
There is a fire risk
Breeding place for rodents and insect
vectors
107. INCINERATORS
Are an improved way of burning
combustible refuse.
Example; bin incinerator made out of a
drum with fire bars across it and air
holes underneath.
Others are built out of brick and fitted
with chimneys.
Allow more complete combustion and
produce less smoke.
Most hospitals use incinerators
108. 3. COMPOSTING
Composting is a process in which
aerobic micro-organisms break down
organic matter to fairly stable humus.
For biodegradable wastes
Wet and dry refuse is heaped in
alternative layers on to a plot about 2.5
square metres to a depth of about 1.5
square metres.
The refuse is then covered with grass
and earth.
109. CONT…
Compost turning after 30 days then after
60 days.
This turning helps to expose all parts of
the heap to the high temperature of the
interior.
After 90 days the refuse is ready to be
used as manure
Aerobic composting is normally odour
free.
Is cheap, convenient and recommended
110. 4. CONTROLLED TIPPING
• Involves depositing refuse into depressions
or large holes in the ground.
The method consist of three steps:
◦ Deposit refuse
◦ Spread and compact refuse
◦ Cover it with earth and compact earth
cover.
These tips should be situated at;
◦ least 1/2km away from settlement,
◦ Preferably out of sight and down wind.
Effective for hygienic disposal of refuse
Used where sufficient land is available.
111. 5. Recycling
This is a method of re-using non-
biodegradable refuse such as bottles,
plastics, metal cans..
Requires special processes to render
the items suitable for reuse
Should be encouraged.
6. Use of manure pits; in rurals
112. Effects of improper refuse
disposal
It may produce an offensive smell
It attracts vectors; particularly flies,
cockroaches and rats; Spreads diseases
It can cause pollution of air, water or food
It can cause accidents e.g fires, cuts and
falls
113. LIQUID WASTE/WASTE WATER
Refers to all wastes in free flowing liquid
form i.e. waste water and soil water
Objectives of waste water treatment
To kill pathogenic organisms, ova and cysts
To reduce pollution effects of effluent
To render obnoxious materials harmless
Recovery of useful by-products e.g. dry
sludge can be used as fertilizers, effluent
for irrigation.
To reduce cost of treatment of water supply
To avoid nuisance
114. Effects of discharging untreated
wastewaters into water body
Reduction of dissolved oxygen (DO)
levels may cause death of aquatic life.
Setting up septic conditions; health
hazards
Loss of social amenities e.g. swimming
pool
Reduce self-purification capacity of the
H2O
Promote excessive growth of aquatic life.
Aesthetically objectionable – bad odours
115. Human excreta Disposal
In rural areas is a pit latrine, while toilets are
suitable for urban areas.
WHY DISPOSE EXCRETA PROPERLY
To prevent gastro-enteric disease and parasites
To reduce fly and other vermin
Ro reduce smell nuisance
To protect water from contamination
To prevent soil from contamination
To reduce unsightliness
To improve hygiene and promote health
To promote sense of cleanliness
116. Factors affecting sanitary
disposal of human excreta
Knowledge on health danger posed by
human excreta
Affordability of the disposal system
Socio-cultural practices…poor
Attitude of community members
Hydro-geological conditions of an
area..h2o table
Availabilities of practicable technologies
118. WATER CARRIAGE SYSTEM
Excreta are disposed by the use of a
flush toilet, which is also called a water
closet.
The flush toilet is the most permanent
and hygienic method of excreta disposal.
Used where there is a permanent,
continuous and adequate piped water
supply system.
The excreta are carried by water
pressure into a septic tank or sewer line
119. SEWERAGE TREATMENT
Is based on biological principle.
Purification is achieved through the
action of anaerobic, aerobic bacteria n
facultative anaerobes
Conventional stages in sewage
treatment include preliminary treatment,
primary treatment(sedimentation),
secondary rx, and tertiary rx
120. Preliminary treatment
Main aim is to protect the treatment
works/systems
Involves removal of materials such as
grease, grit n logs which may hamper the
system
Screening ; sewage arriving passes thru
network of screens to remove large floating
objects e.g logs, boulders; prevent clogging
of treatment plant
Sewage is then passed thru grit chamber to
remove sand and gravel
121. Primary treatment
Aims to remove settleable solids
Sewage is moved to primary
sedimentation tank, where its retained
for 6-8hrs.
To remove solids which settle under
gravity and coliform organisms
122. Secondary treatment
Is the treatment of effluent from primary
sedimentation tank which still contain a
lot of micro-organism; this effluent has
high oxygen demand; it is subjected to
aerobic oxidation in the aeration tank for
6-8hrs thru mechanical agitation; organic
matter is oxidised into NO3.CO2, H2O
with the help of aerobic bacteria in the
sewage
123. Secondary rx cont’d
The effluent is moved to secondary
sedimentation tank; where oxidised
sludge settle for 2-3hrs to form sludge;
the liquid part is moved to the last tank
awaiting discharge
Sometimes for highly polluted waste
water there is tertiary tx….disinfection
process.. chlorination
124. Fate of Sludge(by-product)
Digestion ; Aerated sludge process
Drying n incineration
Burying
Discharge into existing sewage works
Recycle fertilizer
125. Tests before treated wastewater is
discharged
Biochemical oxygen demand…level of
contamination wth microorganism
Chemical oxygen demand…organic
contamination e.g with petroleum
products
126. NON-WATER CARRIAGE/
CONSERVANCY SYSTEM.
Is where excreta is disposed minus use
of water e.g in a pit latrine.
In its simplest form, the pit latrine
consists of the following:
◦ A hole in the ground
◦ A squatting place for sitting or standing
◦ A hut or shelter for privacy/superstructure
127. The main advantages of a pit
latrine
It does not require piped water supply
It is cheap to construct as materials can
be locally sourced
Employ simple technology in
construction
Easy to use
128. Guidelines for constructing pit
latrines
Pit latrines and cesspools(underground
hole or container for holding liquid
waste) should be at least 2m and 3m
respectively above the water table.
Latrines should be located at least six
metres away from the buildings
129. Guideline cont…
Wells should be located upstream to
avoid contamination of the well by
ground water passing through the pit
latrine or cesspool...atleast 15m away
frm water source if on th same or below
and >30m if above th source
130. Types of pit latrine
The borehole latrine- a hole is bored
into the ground about six metres deep
and four metres in diameter instead of
digging a pit.
Faster to install
Appropriate following disasters where
there is urgent need to install many
latrines.
Has a smaller volume.
Fills up faster than a pit.
131. The trench latrine
Is a latrine where a trench is dug and a
number of holes with dividing partitions
constructed over it.
These types of latrines are used in
temporary work camps.
132. Bucket latrines
Are also known as pail closets and are
used where the water tables are high.
A squatting slab or seat is placed above
the bucket, which is filled within a few
days.
DISADV ; The unpleasant job of
emptying it and the spillage, which
attracts flies.
Composting pit latrine
Is suitable where the water table is too
133. ASSIGNMENT
1. Make short notes on ventilated
improved pit latrines
Definition
Features
Advantages
Disadvantages
134. FOOD SAFETY AND
HYGIENE
Objectives
By the end of this section you will be
able to:
Describe the sources of food
Describe methods of food storage
Describe preparation and preservation of
food
135. INTRODUCTION
Food is essential for growth,
development and in the provision of
energy.
The aim of food hygiene is to prevent
the contamination of food at any stage
processing.
These stages are production,
collection, storage, sale, preparation
and consumption.
136. SOURCES OF FOOD
Reared animals(meat,eggs, milk)
Buying from markets,
Crop production.
NB: Should be safe and free from
contamination
137. FOOD STORAGE
Depends on the type and packaging of the
food.
Dry Foods; include maize, beans, and
wheat (cereals).
Should be stored in dry, airy conditions
in improved granaries
Bagged Foods; should be stored on raised
shelves at least 45cm above the ground
level.
For easy cleaning.
Easy inspection for pest detection.
Prevention of dampness
138. Food storage kont,d
PERISHABLE FOODS
These are foods that go bad within a
short time.
Include dairy products, meat and fish.
Should be refrigerated to inhibit the
multiplication of bacteria
139. FOOD PRESERVATION
Refers to treating food for the purpose of
prolonging its life without appreciable
loss of its quality and appeal.
REASONS FOR PREVERVING FOOD
Increase its shelf-life, for example, canned
foods
Render the food safe for consumption i.e
highly perishable foods like milk
Conserve the food for use during the
periods of scarcity.
Avail seasonal foods, like fruits,
throughout the year
140. PRINCIPLES OF FOOD
PRESERVATION
By Destroying/killing organisms causn spoilage
through heat treatment.
By Inhibiting the micro-organisms through cold
treatment.
AGENTS CAUSING FOOD SPOILAGE
Moulds :Affect foods containing high sugar and
salt and damp ones
Yeasts; Affect foods that have acid or sugar in
high concentration e.g dried fruits, and
concentrated fruit juices.
Bacteria ; Affect foods under various conditions
apart from dry food
Enzymes in food substance
141. METHODS OF FOOD
PRESERVATION
1. Heat Treatment
Are methods which destroy organisms
causing food spoilage.
Cooking
Blanching
Pasteurisation
Sterilization
Canning
142. Cooking
Cooking destroys or reduces micro-
organisms and potential toxins in food.
Cooked food stays longer than raw foods
as long as re-contamination is
minimised.
Cooking also inactivates undesirable
enzymes in food.
May cause loss of nutrients e.g over
cooking vegetables destroys vitamin C.
143. Blanching
This is the process where vegetable
foods are heated at temperatures of 70 -
100°C for 2 - 10 minutes while immersed
boiling water or exposed to steam.
This process inactivates enzymes, drives
out air bubbles trapped in food,
enhances retention of green colours and
reduces micro-organisms.
Blanching is used before freezing,
canning or drying.
144. Pasteurisation
Carried out by heating food (milk)at a
temperature of below 100°C; kills
organisms that cause spoilage
A relatively slow method of heat
treatment.
Sterilisation
• Heat is used to kill all micro-organisms
and their spores at a temperature of
above 100°C.
Sterilised food is stored in an airtight
container to prevent recontamination.
145. Canning
Food is first heated at a temperature that
kills all bacteria and it is then sealed up
in sterile cans or bottles.
Sealing prevents bacteria re entering.
For nuts and fruits
146. Cold Treatment Methods
Freezing: Food must be deep-frozen at
0-4°C to remain palatable.
When properly done, food retains the
colour, texture, flavour and nutritive
value.
147. Salting
This is the saturation of food with salt or sugar,
for example, ham, jam and jelly.
The added solute reduces microbial activity due
to its dehydrating effect.
Smoking and Drying
Drying and smoking makes food unsuitable for
the bacteria to grow and multiply.
The heat will dry the fish or meat
Smoke gets inside the food to act as a
preservative
Fish or meat may be preserved by these
methods.
3.Preservation by preservatives e.g salts,
148. FOOD SAFETY ASPECTS
Food handlers
• Adequate personal hygiene
• Should be healthy; not suffering frm RTI/
typhoid/dysentry/skin eruption/cuts
• Wear clean washable outer
garments/aprons
• Head Covering
• Wash hands before handling the food
• Nails should be kept short and clean.
149. Food
Clean vegetables before preparation for
cooking.
Fruits should be washed before eating.
Utensils be cleaned after use and left to
dry before being stored
Environment
Be dust free; floors and all the surfaces
used for food preparation.
The facility be clean
With adequate ventilation and lighting.
150. Common Food Borne Diseases
and Their Causes
Diseases Causes
Illness affecting
mental function
Some naturally
poisonuos plants
Poisoning Chemical such as lead,
Arsenic
Ascariasis
Taeniasis
Amoebiasis
Parasites such as
Ascaris lumbrecoides
Taenia Solium/Sagnata
Entamoeba histolytica
152. FOOD SAFETY
REGULATIONS
The safety of food is governed by Kenya
Public Health Act cap 242
Is an Act of Parliament to make provision
for securing and maintaining health.
This act is divided into 15 parts.
Each part deals with a specific aspect of
public health
Health officers e.g PHOs are generally
responsible for enforcing these laws.
Agricultural personnel assist them, where
necessary.
153. CONT…
Part X of the Act deals 'with protection of
foodstuffs'.
This part regulates the construction of
buildings used for storage of foodstuffs.
It prohibits residing or sleeping in kitchens or
food stores.
Part (XI) deals with 'milk, meat and other articles
of food'.
This part prohibits the sale of unwholesome
foods.
It gives powers to authorised officers to
inspect and examine food, seize and
recommend disposal at any time.
154. AREAS THAT NEED CLOSE
SUPERVISION.
Slaughterhouses and butcheries..hygiene/
butcher health status/healthy animals
Diaries and shops where milk is sold.. hygiene,
expiry date, integrity of the packets, storage.
Healthy cows/ tb bovine
FARMS; acceptable fertilizers/ pesticides;
harvet when crops are fully ripe to ease
preservation
Markets: should have different stations for
different types of food; clean and proper refuse
disposal; PHOs have the power to close
markets and condemn foods to prevent
disease outbreaks
155. Hotels
Be inspected under hygiene
regulations.
Regular medical examination of food
handlers
Meet Licensing requirements.
Laboratory examinations may be
necessary for food such as pre-cooked
meat.
The use of uniforms, aprons, head
coverings be observed in the hotels.
156. HOUSING
By the end of this section you will be able
to:
Describe the types of houses
Describe the criteria for an adequate
house
Describe a suitable building site
Describe the characteristics of poor
housing
Describe how you would involve the
community in improving housing
157. Introduction
The provision of good housing is an
essential aspect of environmental
health.
Good housing is a requirement for
every human being.
Good housing provides shelter and
protection from environmental
hazards.
158. Types of Housing
A house can be permanent, semi-
permanent or temporary.
Permanent Houses
Has a stone foundation, a cemented floor
and plastered walls.
Roofed with iron sheets, tiles or stones in
the case of flats or maisonettes.
Easy to keep the floor and walls clean.
Floor be dry to avoid accidental falls
Not cheap to construct
159. Semi-Permanent Houses
This is a type of house whereby the floor
is usually cemented but does not
necessarily have a stone foundation.
The walls are made of iron sheets or
sometimes timber.
The house is iron roofed.
It is satisfactory and easy to keep clean.
In some cases mud bricks are used
160. Temporary Houses
The floor is earthen, the walls are made
of cardboard, polythene paper, grass or
mud.
The roof is thatched with the same
material as the walls.
Does not provide for privacy
Can easily catch fire.
Are a health hazard
161. Criteria for an Adequate House
A good house should meet biological,
physical and social criteria.
1. Biological Criteria
Good housing should minimise the risk of
transmission of diseases.
The criteria is met thru;
Good water supply
Good food storage, preservation and
preparation
Adequate facilities for washing utensils
Adequate methods of refuse disposal
162. 2. Physical Criteria
The house should be safe for every
occupant i.e home accidents are
minimised.
3. Social Criteria
Good housing should be designed to
enable the family function effectively in
regard to its cultural background i.e
required privacy for adults should be
catered for.
It should have a suitable setting for
163. Characteristics of Adequate
Housing
Presence of Natural light; the sun provides
natural light; for physical growth, proper vision,
Killn some micro-organisms n keepn away
some insects.
Artificial Lighting...for night vision; sources
are electricity, oil lamps and gas.
Proper Ventilation
Ventilation is the removal of impure air and
pouring in pure air.
Achieved through windows, door (natural
ventilators) and artificial ventilators
Adequate rooms; provide separate
accommodation for adults and children; for
164. Characteristics of good housing
cont…
• Permanent house; cemented
floors/stone F
• Adequate and reliable water supply
• Good latrine and a clean compound.
• Proper methods of refuse disposal
• Satisfactory cooking arrangements
165. Qualities of a Suitable Building
Sites
The soil should be firm
The site should be dry, sunny and
exposed to free air.
The surroundings should be hygienic
Be away from noisy factories, cinema
halls and heavy traffic.
It should be on high ground for good
drainage
166. Characteristics of Poor
Housing
A poor house does not protect its
inhabitants from environmental hazards.
Characteristics
Dampness due to poor drainage.
Overcrowded
Earthen floors and walls; encourage
breeding of fleas and bed bugs
Unscreened windows; encourage entry
of mosquitoes.
167. Characteristics of poor housing
cont…
Unprotected fire places- home accidents
Water supply and storage poor
Poor storage of clean utensils
Poor personal hygiene in the preparation
and serving of food.
Lack a good latrine
Compounds with tall grass, pools of
water
168. Community involvement in
improving housing; steps
1. Meeting the Health Team Members.
To explain the need for community
involvement...outbreak of diseases
Deliberation on the need for community
sensitisation
Identifyin ways of improving housing in the
community.
Team members include PHO/CHN/
169. Steps cont…
2. Sharing Health Messages Daily at the Health
Facility about Improving Housing
3. Meeting the Community Leaders to deliberate
on need for improving housing; both formal and
informal community leaders
Assist them identify and suggest ways of
improvement.
Guide them on the techniques of carrying out
the health activities.
Use clinical records to confirm the health
problem and the need for community
involvement
170. 4. Identifying Ways of
Improvement
Select the best alternative for improving
housing.
Plan and organise their resources, that
is, manpower, money, materials, and
time to carry out the selected activities.
e.g Provision of outreach clinic services.
..to mobilize and share health messages
171. 5. Implementation
Inspect the houses to identify areas
which need improvement.
Organise school health service ;
shared messages passed to parents
Conducts regular supervisory visits to
families and communities
Mobilize resources
Initiate and sustain advocacy
172. 6. Evaluation of Housing
Activities
To Determine level of community
participation and impact of health
activities...conduct special surveys,
determine number of home accidents,
A period of about six months would be
appropriate
173. Control of Vectors and
Pests
Objectives
Describe diseases associated with
vectors and pests
Describe methods of control of vectors
and pests
Describe how you will involve the
community in the control process
174. Diseases Associated With
Vectors
A vector is an organism, usually an
insect, which transmits a pathogen from
a source of infection to a susceptible
host.
175. Ways a vector may transmit
pathogens.
1. Mechanical Transmission
Is where the vector carries the infective
pathogen or agent on its body or limbs.
Or Ingestion of infective agent by the
vector and excreted unchanged in its
faeces where it causes contamination
e.g housefly
176. 2. Biological Transmission
The vector acquires the infective agent
from the blood or skin tissue of the
infected host and the infective organism
undergoes some development in the
vector.
The infective vector then inoculates the
infective agent from its salivary secretion
into a new host to cause disease e.g
mosquito and malaria
177. Ways continued
3. Contamination of Skin or Mucous
Membranes of the host with infective
feaces of the vector e.g in louse borne
relapsing fever
4. Ingestion
The host may acquire infection by
ingesting the vector, for example, guinea
worm.
178.
179. Pest-Related Diseases
A pest is an organism, which in a given
circumstance (when numerous)
adversely affects human health or the
economy.
Rats and mice are pests and they
belong to a group of animals called
rodents.
Insects such as white ants, weevils,
aphids are also pests.
Pests have to be numerous in order to
180.
181. Vectors and Pest Control
Measures
Personal Hygiene
Hand washing
Daily births
Short and clean nails
Wearing of shoes; jiggers and
hookworms.
The hair should be kept short and
clean...lice
The use of shampoo; head lice.
Clothing washed and ironed at least weekly
Bedding cleaned weekly and dried in the
182. Proper Food handling
Food stores, cupboards and tables
should be kept clean... Cockroaches n
rats
All foodstuffs be covered to prevent
flies
All food utensils kept clean and dry.
Environmental Hygiene
Ensure proper water drainage to
destroy all mosquito-breeding sites.
All receptacles likely to retain water,
properly disposed of.
Canalise slow moving streams
Clear bushes
183. Improved Housing
Floors and Walls should be cemented
The floors should be cleaned after
meals.
Crevices and cracks in the walls be
plastered
Beds and Other Furniture-regularly
taken outside in the sun to kill any lice,
mites and bed bugs.
Joineries of furniture with cracks and
crevices should be filled up with plastic
wood filler
184. Buildings and Food Stores
Be Rat proof
Be mosquito proof, with wire gauze to cover all
ventilation openings e.g windows
Regular inspection of buidings for pests.
Use of Chemical Substances such as Pesticides
and Insecticides
The floors and walls of houses be treated with
insecticides regularly.
Mattresses and bedsteads can be treated
Heavily infested buildings be treated with residual
insecticidal sprays.
Kerosene to kill bed bugs and white ants
Insecticides and larvicides sprayed on the water
surface to kill insects in water
185. Community Involvement
CHN and other health workers have to
share health messages with community
members to facilitates community
participation in keeping their
environment free of pests and rodents.
Ensuring clean environment
187. Specific Objectives
Introduce OH; hx, epide oh problems
Describe possible effects of work on health
Describe concepts of occupational health
Describe the aims, objectives, rationale of
occupational health services
Describe occupational health hazards and
their management
Outline characteristics of OD
Describe the concept of OHN
Describe the roles and functions of an
occupational health nurse
Outline advantages of occupational health care
189. Workers spent 1/3 of days in the workplace;
2/3 at home
Working envn can expose to health hazards;
injuries, respiratory diseases, cancer,
musculoskeletal ets…
Workplace fatalities, injuries and illnesses
remain at unacceptably high levels.
Lead to economic loss amounting to 4–5%
of GDP
WHO estimates that there are only 10-15%
of workers who have access to a basic
standard of occupational health services.
T1:INTRODUCTION
190. Intro kont’d
Occupational health and safety issues are
anchored in the ministry of Labour,
department of Occupational Health and
Safety
The factories Act Cap 514 came into
operational on 1st September 1951.
The Act focuses on sanitation of the
factory, safety devices, machine
maintenance, safety precautions in case
of fire, gas explosions, electrical faults,
provisions of protective equipment et….
191. Intro kont’d
It also provides for registration factories
and other workplaces by the Department
of Occupational Health and Safety
In the year 2013 data indicates;
◦ that mining, construction and transport
accounts for 41% of accidents in Kenya,
◦ machine operators and assemblers 28%
◦ other occupations share 31% of
workplace accidents.
192. Intro kont’
In relation to age groups
◦ 44.4% of the injuries occurred in the age
group of 20 to 29 years,
◦ 25% to the age group of 30 to 39 years
and
◦ 24% to the age group below 20 years.
Most of the reported accidents are those
seeking compensation under the
Workman’s Compensation Act.
193. T2: Hxkal background of OH
• The first OHS were started by large companies
for workers in dangerous jobs such as mining,
large tea farms or factories.
• Then it was referred to as industrial medical
services, later industrial hygiene then
occupational health
• Was concerned with the treatment and
prevention of injuries and special diseases, for
workers in mines and factories.
• Gradually it has broadened to cover workers in
all occupations including:
• Agriculture
• Transport
• Commerce ets....
194. CONCEPTS OF OCCUPATIONAL
HEALTH SERVICES
1. OCCUPATIONAL HEALTH --is defined as the
physical, mental and social well being of a
person in relation to their work and working
environment, as well as their adjustment to work
and the adjustment of work to them.
ILO/WHO (1950) defined occupational health
as “The highest degree of physical, mental and
social well-being of workers in all occupations.”
Workers require special health services
The care offered includes promotive, preventive
, curative, rehabilitative services
195. 4/27/2022 195
Concepts kont’d
2. Occupational diseases
◦ Is a disease having a specific or a
strong relation to occupation generally
with only one causal agent and
recognized as such e.g. occupational
dermatitis and respiratory anthrax,
silicosis, lead poisoning.
196. 4/27/2022 196
Concepts kont’d
3. Work-related diseases
◦ Is a disease considered to have multiple
causal agents, and factors in the work
environment could be one of
them…depression, psychosomatic
disorders, HTN, KHD
4. Diseases aggravated by working
conditions
◦ Without causal relationship with work but
which may be aggravated by
occupational hazards to health; bronchial
asthma vs dust exposure; kidney
disease vs mercury exposure
197. 4. OCCUPATIONAL ACCIDENTS
Is an unexpected and unplanned occurrence,
which can lead to bodily injury in occupational
setting
Situations in which accidents occur generally can
be foreseen.
Many accidents can be prevented, before they
occur.
5. OCCUPATIONAL ENVIRONMENT
Is the combined effects of external conditions and
influences which prevail at the place of work and
have a bearing on the health of the working
population.
198. 6. Ergonomics
Is the field of study which deals with
fitting/ matching the job to the worker
e.g work layout, machine designs, to
achieve greater efficiency of man and
machine
Workers placed in jobs they are best
suited for
199. 8. Occupational health team
Include environmental hygienist,
occupational nurse, physician, safety
supervisor, employer, workers
representatives
9. Occupational health hazards
Those harmful condition, material, in the
work place which can have harmful effects
on the health of workers
10. Accident is a sudden event that result
injury, damage or misfortune
200. T3:Effect of Work on People’s
Health
Can have both negative and positive effects on
people’s health.
Q1. State positive effects of work on health
workers
Negative effects of work to health
Physical Injuries
Poor handling tools and machine leading to
cuts crushing injuries; physical injuries can also
be sustained from fumes, dust, noise and
extreme temperatures.
Chemical Injuries
Risk of poisoning from chemicals, for example
pesticides; corrosive effects, suffocation carbon
monoxide
201. Effects kont’d
Diseases
Infections, for example, anthrax due to
poor handling of animals or animal
products.
Other diseases like cancer may result
from exposure to toxic substances.
Emotional Injuries
Stress related effects from work
environment or people; psychosomatic
disorders
202. Characteristics of Occup Dis
1. Many of the symptoms and signs of OD do
not differ from the same diseases when
they occur as a result of a non-occupational
etiology, (Asthma, Lung Cancer).
2. Many times there is no good dose –
response relationship. Some
prone/susceptible individuals will already
react to low levels of exposure.
203. Characteristics of OD (cont’d)
3. Many of OD have a (very) long latency period
exposure latency clinical signs (early)
4. Recall bias – patients / workers tend to “blame”
only recent exposure(s) as casually related to
their symptoms.
204. Characteristics of OD (cont’d)
5. Workers are exposed to many
simultaneous and sequential
exposures in their working career.
Which one should be “blamed”?
6. As a rule, only a small proportion of
the exposed group develop a
clinical disease.
205. Characteristics of OD (cont’d)
6. Sometimes occupational and non
occupational factors interact in the
complex, multi factorial, in the
etiology of the concerned disease.
DM + vibration white
finger(raynaud syndrome)
206. Characteristics of OD (cont’d)
7.Industrial processes and materials
change constantly, it is very hard to
keep record of all materials in use. New
chemicals are introduces daily.
8. No good epidemiological or
toxicological data for many
occupational related diseases and
exposures.
9. Affected by confounders – smoking,
alcohol, diabetes.
207. Importance of early recognizing OD
1. Some OD are “pathognomonic” to specific
exposures:
Asbestos mesothelioma
(signal tumor)
2. When diagnosed early in a particular
individual from a group, intervening early and
protecting the rest possbl.
3. Persons diagnosed with OD are, usually,
entitled for workmen’s compensation.
4. To allow for investigation on cause- effect
relationship
208. T4: Occupational health care
Actors involve in occupational
health programmes
The health team
Employers
The employees
The community’s formal and informal
leaders
209. AREAS OF FOCUS IN OHS
The effect that work may have on health
that is in causing injury or disease
The effect that injury or disease may
have on ability to work
The effect of hazardous industrial fumes
or toxic wastes, which pollute the air,
sewers and rivers.
210. Aims of Occupational Health
Services
The promotion and maintenance of the
highest degree of physical, mental and
social well being in all occupations.
The protection of workers in their
employment from risk resulting from
factors adverse to health.
The placing and maintenance of the
worker in an occupational environment
adapted to their
physiological abilities
211. • The group (workers) conveniently cared for
at a single service point.
• At work, healthy people can be exposed to
health risks.
• The work sites sometime are in isolated
areas where no other health services are
available.
• To easily identify and prevent sickness
caused by certain occupations.
• Illness among workers creates a loss to
both individual and national productivity.
Rationale for occupational
health services
212. Principles of OH
Health education n community participation
Prevention of health hazards from the
source
Team work; dr, nurse, employer, employees/
across sectors
Equity; no discrimination on gender, collar of
the job
Accessibility; in plant services n off plant
facilities
Affordability; services should be within
reach financially; use of simple technology
213. Objectives of Occupational
Health Services
There are three main objectives which
occupational health services are set to
address. These are:
Primary Prevention
Secondary Prevention
Tertiary Prevention
NB: Same with measures for
prevention and kontrol of O hazards
214. a. Primary Prevention
In OH PP refers to anticipating problems
and trying to avoid them before they
occur. Reducing the risk of the disease or
injury occurrence
Primary preventions activities in OHN
include:
• Good construction of machines and
buildings.
• Training of the workforce on how to work
with machines.
• Proper utilisation of protective, safety
equipment and clothing.
215. PP in OH kont’d
• Good personal hygiene and
health.
• Adequate rest when working with
machines
• Substituting more toxic material
with less toxic; zinc-based paints
instead of lead-based paints
• Enclosure or special ventilation to
equipment or industrial process
216. PP in OH kont’d
• Accidents from toxic gases e.g, carbon
monoxide;
– Gas detection warning systems be installed.
– Oxygen cylinders availed, preferably in the
supervisor’s office.
• Risk of liquid or chemical burns; plunge
baths or showers should be sited
alongside the working area.
• Deployment of vulnerable groups, such as
the elderly, hypertensives, diabetics, or
epileptics away from areas where they
can easily injure themselves.
217. PP kont’d
The workplace should have employees who
are ;
◦ trained in first aid and are familiar with the
treatment of such illnesses;
◦ A first-aid box stocked and assigned a
responsible person.
There should be a system in place that
ensures immediate treatment of all injuries
anticipated at the work place and referral for
further management.
Through legislation; public health act, factory
act
218. PP kont’d
Pre- placement medical examination
Good record keeping-easily retrievable
information on the health of the individual and of
groups of workers.
Health education n counselling... hand washing
Mechanization ; 2reduse human contact to
hazardous substances e.g instead of hand
mixing of chemicals special devises should b
used
Controlling dust at points of origin thru wet
drilling of rocks, spraying wood with water before
sawing
Isolation ; dangerous processes done in far from
219. OH MEDICAL EXAMINATIONS
There are two main types of medical
examinations:
• Pre-placement examinations
• Periodic examinations
• Routine and special surveys
220. Pre-placement Examination
This is the medical examination that is done
before a person is employed; include workers
medical, family, occupational & medical hx;
physical examination/lab n radiological exams;
vision testing
Objectives of Pre-placement Examination
Determine suitability of an employee for a
particular job.
Detect untreated pathological conditions and
'asymptomatic' disease.
Provide a baseline record against which any
future findings or routine examinations can be
221. IMPORTANCE OF PRE-PLACEMENT
EXAMS
The results enable OHW to advise the
HRD on the suitability of the applicant
for the particular job.
The applicant is able to discover a
medical condition he was unaware of
and seek early rx
May help to reduce a high labour
turnover, absenteeism, injury and
illness thus
increasing productivity.
222. b. Secondary Prevention
• Accomplished by identifying health
problems before they become clinically
apparent n prompt action
• Entails three types of screening:
• Screening of employees at risk of a particular
hazard.eg measuring blood lead levels in
workers exposed to lead
• Regular screening for non occupational illness
during employment..DM, cancer
• Screening of the working environment to check
that recommended preventive measures are
put in place by employers, n being used by
employees
223. Periodic Medical Examination
• This is an effective method which
enables the occupational health worker
to stay informed about the health of
individuals and groups, and at the same
time detect adverse trends which may
be caused by work.
• Allows for early detection of intoxications
and other effects of occupational
hazards, for early management.
224. KONT….
Ordinarily workers are examined
yearly
Also workers returning to work
after leave
General surveys should be
performed at least once every six
months.
The use of a standardised design
format should assist one to capture
225. c. Tertiary Prevention
Tertiary prevention includes the whole
spectrum of healthcare from first-aid to
treatment and rehabilitation.
The main emphasis is placed on first
aid in order to minimise complications
and disabilities.
E.g treating lead poisoning presenting
with headache, joint pain, kidney
dysfunction by administering chelating
agents
• Assessing workers fitness to return to work.
226. T4:Occupational Hazards
• An occupational hazard is any condition of a
job that can result in illness or injury, a source
of danger, a possibility of incurring a loss or
misfortune.
• The types of occupational hazards are
categorised according to the agents, which
cause the hazard or disease.
• The categories include:
• Physical Hazards
• Chemical Hazards
• Mechanical Hazards
• Biological Hazards
• Psychosocial Hazards
227. 1. Physical Hazards
• Physical hazards are any hazard
associated with a physical harm/injury,
• Includes exposure to excessive levels of
heat, cold, light, noise, vibration and ultra
violet light.
Hot and Cold
The effects of exposure to heat range from
burns, heat stroke, and heat cramps, while
the effects of exposure to the cold include
erthrocyanosis, immersion foot, frost
bite, vasoconstriction and hypothermia.
228. Physical hazard KONT…
Light
The effects of poor illumination result in eye strain,
headache, eye pain, lachrymation congestion
around cornea and eye fatigue, and blurring
of vision; defective illumination in the mines can lead
to miners nystagmus(rapid, involuntary mvt of the
eyes); accidents
Noise Pollution
Auditory effects leading to temporary or permanent
loss of hearing.
Vibration
track drives, miners drilling— pelvic and abdominal
congestion. Segmental vibration may produce
injuries to joints, elbows and shoulders...numbed
hands/ white finger-Raynaud syndrome
229. KONT…
Non-ionizing radiations
• Ultraviolet Radiation
This occurs mainly in welding work causing
intense conjunctivitis and keratitis (welder
flash).
• Infrared radiation; in front of furnaces in
steel mills, glass industry, black smith; to the
eye can cause cataracts; also skin burns; use
special goggles
Ionizing radiation; x-rays n radioactive
isotopes leading to bone marrow suppression
n gene mutation;; reduce time exposure,
distance btn the worker n the source, use of
230. 2. CHEMICAL HAZARDS
• Are harmful kpds in form of dusts, mists, solids,
gases et..
• Exposures may occur in the following ways:
• Contact
• Inhalation
• Ingestion
a. Contact; being in close proximity/ touch
• Toxic chemicals include teratogens, systemic
poisons, mutagens, carcinogens, or behavioural
toxins according to the nature of damage
caused.
231. 2. Chemical hazards kont’d
Frequent skin contact with chemical
substances can lead to occupational
dermatitis, eczema, ulcer, and cancer
232. b. Inhalation
Inhalation of dust is responsible for dust
allergy, anthracocis, silicosis, asbestosis,
cancer of the lung, siderosis.
Inhalation of gases may cause asphyxia
due to carbon monoxide and cyanide gas.
Presence of metal and other components
in air may cause toxic effects to body
organs when inhaled.
233. 3. Biological Hazards
Workers may be exposed to infective
and parasitic agents at the place of
work.
This can result to infection with diseases
such as brucellosis, anthrax,
hydatidosis, tetanus, encephalitis, fungal
injection, and HIV infection
234. 4. Mechanical and Electrical
Hazards
Machinery including its parts, tools,
objects and materials used are often a
source of mechanical hazards leading to
injuries.
Power supply systems, can also create
electrical hazards, leading to severe or
fatal accidents—electrocution
Main causes of accidents in work place
are faulty machines, unsafe acts-poor
handling, unsafe personal factors-
235. 5. Psychosocial Hazards
• Psychological hazards effect the mental and
physical well being of people.
• The most significant psychological hazard in the
workplace is occupational stress which results
from negative harmful stress or distress. ..poor
human rship, lack of job satisfaction, frustrations,
exposure to trauma or violence at work (critical
incident stress).
• Effects; fatigue, PUD, HTN, heart diseases,
absentism
• Occupations that see and work with trauma
include the
– paramedical
– health care professionals,
– community care workers,
– police and prison officers.
236. 6.ERGONOMIK HAZARDS
Related to lifting, holding, pushing,
poorly designed tools, repetitive tasks,,,
can lead to back pains, carpal tunnel
syndrome
237. Common Ways of Dealing with
O Hazards
Depends on the nature of the hazard or
harmful substance and its route of
absorption into the body
Remove the Hazard or Toxic
Substance from the Work Place
The best preventive measure get rid of the
substance, chemical or machine
altogether and, find a less dangerous
alternative
238. Dealing with Hazards KONT….
Reducing Exposure to the Hazard
• Sucking or blowing away the dust or
fumes from the place where they are
produced.
• Wetting a substance that gives off dust
when cut or worked on dry, this is common
in wood industries where there is a lot of
drilling and grinding.
• Carrying out a process entirely in a closed
system of tanks and pipes or in a closed
room or space.
239. Dealing with Hazards KONT….
General Ventilation; The ventilation of
work rooms is improved so that the
atmospheric contaminants and heat are
removed or reduced.
This is mainly achieved by
◦ installing wide windows and ventilators in
areas of work and
◦ ensuring that there is enough operating space
for the workers.
240. Dealing with Hazards KONT….
• General Cleanliness
Good factory cleanliness reduces
exposure, encourages tidiness and safer
methods of working.
• Personal Hygiene
Good washing facilities should be
available so that workers may wash dirt
and chemicals off their hands before
eating.
• Where the work is very dirty, or irritant
chemicals are used, showers should be
241. Dealing with Hazards KONT….
Protective and Safety Equipment
Protective clothing should be worn all the time in
order to protect oneself from health hazards.
Examples of protective clothing include:
• Rubber gloves
• Goggles to protect your eyes and face during
surgical procedures
• Respirator or masks
• Aprons and gumboots
242. OCCUPATIONAL HEALTH
NURSING
Is a specialty nursing practice that
provides for and delivers health care
services to workers and workers
population
It is the synthesis of knowledge gained
from nursing, medicine, OH. Mgt &
social behavior sciences to care for
workers
243. PHILOSOPHY OF OCCUPATIONAL
HEALTH NURSING
• Is based on the belief that the health and
safety of the worker and workforce is the
concern of the employer, employee and
the nation at large. This should be
reflected through:
• The promotion and protection of workers
throughout the working community
• Respect for workers’ rights and adherence.
• Non discrimination in the receipt of quality
healthcare.
• Employee confidentiality
244. Philosophy statements Kont…
• Dynamics of the work environment and
diversity of the workers population
• Employer and employee responsibility for
health and safety
• The benefits of the occupational health
services to the worker population and
company
• Collaborative multidisciplinary relationships
that support and enhance worker’s health
and safety
• The relationship of the occupational health
and the community
246. 1. Professional role
Entails assessing for evidence of
both OD & nOD/injuries / doing
physical examination/ follow-up/
emergency care/ prevention of
injury & OD/ select, train n
supervise auxiliary nursing
personnel in matters OHN
247. 2. Environmental Role
• An occupational environment is the combined
effects of external conditions and influences
which prevail at the place of work and have a
bearing on the health of the working
population.
• For example in industry, the worker interacts
with three different types of agents:
• Physical, chemical and biological agents e.g
Physical - heat, cold, radiation
Chemical - toxic dust liquids and gases
Biological - viral, bacteriological, rickettsia
• Machines and electricity
248. EVI ROLE KTN’D
Periodically assess the work environment
to detect and appraise health hazards;
lighting, ventilation, temperature, humidity
and cleanliness
249. ENVIR KTD’
• To provide a safe environment in the
occupational setting, particularly in industrial
setting, it is recommended that:
– Working hours should be organised in such a way
that they allow the worker to have breaks in
between.
– Periodic inspection of the plant be carried out to
check on ventilation, cleanliness, dust gases, light,
sanitary facilities.
– Periodic medical checks up of the workers be
undertaken to detect any signs of sickness.
– Precaution be taken to prevent accidents by the
workers
– The management to supply of protective devices
250. ENVI Kont’d
• Adequate lighting and ventilation to avoid
hazards like eye defects, accidents, b
provided
• There should be proper washing facilities
to maintain cleanliness and prevent
infection.
• Workers be given HE on safety, prevention
of health hazards and need for regular
medical check up.
• Measures to promote mental health and
prevention of mental illness be in place.
251. 3.Managerial Role
• Reports and give recommendations on
hazardous conditions and health condition of
employees.
• Manage interaction between the industry and
other systems e.g social, health, or welfare
systems, to meet the overall health needs of
the workers.
• Involved in setting up a referral system to
arrange care for workers and their families
• Involve compiling data on absenteeism owing
to illness to be used in calculating illness
rates among workers
• Taking part in planning, formulation and
implementation of policies related to the
252. 4. Educational Role
• HE is essential for the promotion of optimal health
for workers and their community.
• The OHN should plan, organise, and implement
health education programmes for the workers and
their community members.
• The topics for health education talk during
occupational health services:
• The effects of work on health and vice versa.
• Importance of periodic examinations related to
identified risk.
• Monitoring of the environment and development of
control methods.
• Disaster planning.
• Health supervision of welfare facilities.
• Rehabilitation and resettlement.
254. Responsibilities of an
Occupational Health Nurse
• Participating in the health assessment
program; pre-placement and routine medical
examination of workers.
• Keeping a continuous watch on working
conditions, equipment and materials for
safety precautions and possible dangers.
• Counselling workers regarding personal and
family health problem.
• Cooperating with management in the
application, enforcement and training on the
use of protective measures.
255. Responsibilities of OHN
Giving advice on environmental sanitation
and safety education activities.
Carrying out nursing administrative duties,
which assure the efficient management of
the occupation health services.
Maintaining simple records on which to
base surveillance, prevention and control
of occupational illness or accidents.
Evaluating health programme and
activities
256. 4/27/2022 256
Advantages of Occupational
Health Care
Investigates and assesses
health hazards in the
working environment and
gives expert assistance
for eliminating them
257. 4/27/2022 257
Advantages of Occupational Health
Care
Estimates employees’ working ability and
monitors their health condition
Its knowledge and skills supports action for
maintaining working ability in the
development of individuals, working
environment and working community
Prevents occupational diseases and other
work-related illnesses
258. 4/27/2022 258
Advantages of Occupational Health Care
Prevents premature incapacity for work,
reduces pension costs
Reduces absenteeism due to sickness
Can make calculations of the profitability of
occupational safety and health and
occupational health care.
259. 4/27/2022 259
Are we an occupational health
conscious community / country
or do we always have to wait
for disasters to revive us from
our coma?
262. ENVIRONMENTAL IMPACT
ASSESSMENT
Define
Formal study process used to predict
environmental consequences of
proposed major developments.
Aim
To ensure that potential problems are
fore seen and arrested at an early stage
in the projects planning and design
stages
Function- ensure that decisions on
proposed projects take the environment
into account.
263. EIA AIMS
Ensure potential problems are detected
Process of EIA
Project concept i.e site selection,
screening, initial assessment, scope of
significant issues
Pre- feasibility study
Feasibility
Design and engineering
Implementation, monitoring and post
auditing
Evaluation
264. WHO ARE INVOLVED IN EIA
Developers
Investors
Competent authorities i.e NEMA
Other Govt authorities
Regulation
Regional planner
The community
Politicians
265. PROJECTS THAT NEED EIA
Urban development projects
Transportation i.e pipeline, road,
railways etc
Mining activities including quarrying,
open cast extraction, oil exploration
Waste disposal-sewage
Nuclear reactors
Dams, rivers and water resources
266. EIA OFFENCES
An offence is act that contravenes the
provisions of a given Act
General Offence- offence for which
there are no specified penalties
267. Offences cont’d
A person commits an offence if;
1. They do not conduct EIA
2. Fails to submit project report as per
the requirements
3. Fails to prepare EIA report in
accordance to the requirement
4. Knowingly give false information in
EIA report
268. MISCONCEPTIONS ABOUT EIA
THAT EIA IS:
Antidevelopment
Too expensive and a waste of money
A waste of time
Ineffective
269. Levels of environmental quality
Bare survival – control of major epidemics
of disease and violent death, minimum food
and water
Control of disease and injury – control of
endemic and dietary disease and
accidental injury
Efficient performance –adequate and
proper diet, safe and clean environment
Comfort – stimulating environment,
aesthetic satisfactions, comfort control.
270. SOLID WASTE DISPOSAL
Refuse in towns should be stored in proper
containers.
These containers should be:
Watertight plastic or metal with a tight-fitting
lid or polythene bags
Rust resistant
Easily filled, emptied and cleaned
Have side handles
Rest on a concrete slab to ensure
cleanliness of adjacent ground