This document discusses environmental and nutritional diseases. It notes that environmental diseases are caused by exposure to chemical or physical agents in the environment, including diseases of nutritional origin. It then discusses the global burden of disease, noting that undernutrition is the leading global cause of health loss and that coronary and cerebrovascular diseases are leading causes of death in developed countries. Infections constitute a significant global health burden and malnutrition increases infection risk. Climate change is expected to amplify cardiovascular and respiratory diseases via heat waves and pollution and increase malnutrition as crop productivity declines.

1. Environmental and Nutritional
Diseases

2. Environmental Diseases
• Conditions caused by exposure to chemical or
physical agents in the ambient, workplace or
personal environment, including diseases of
nutritional origin

3. The Global Burden of Disease
• DALY (Disability-adjusted life year) metric =
years lost to premature mortality + years lived
with illness and disability
• Undernutrition is the single leading global
cause of health loss
• Coronary and cerebrovascular diseases are the
leading causes of death in developed
countries (obesity, smoking, high cholesterol)

5. • Infections constitute a significant global health
burden
• Malnutrition increases the risk of infection
• Drug resistant pathogens (due to clinical and
agricultural antibiotic use) are the most
important group of pathogens
• Vector borne diseases constitute almost a 3rd
of newly emerging infections and linked to
global warming

7. Health Effects of Climate Change
• Cardiovascular and respiratory diseases will be
amplified by heat waves and air pollution
• Gastroenteritis and infection epidemics will be
affected by water and food contamination
following flooding and other environmental
disruptions

8. • Vector-borne infectious diseases are expected
to increase as vector numbers and geographic
distributions are altered
• Malnutrition will increase as crop productivity
wanes

10. Toxicity of Chemical and Physical
Agents
• Toxicity depends on the structural properties
of the compound
• A lipophilic compound will have increased
blood transport
• Compounds may be excreted in urine, feces or
expired air or accumulate in bone fat, brain or
other tissues

11. • Metabolizing enzymes
phase I – hydrolysis, oxidation, reduction
cytochrome P-450
phase II – glucoronidation, sulfation,
methylation
increase water solubility and
hence excretion

12. Environmental Pollution
• Air pollution
outdoor (sulfur dioxide, soot, CO)
indoor (wood smoke, bioaerosol, radon,
formaldehyde)
• Metal Environmental pollutants
Lead, mercury, arsenic,
cadmium

13. •
•
•
•
Occupational health risks
Tobacco
Alcohol
Therapeutic drugs and drug abuse
hormonal replacement therapy
anabolic steroids
acetaminophen
aspirin
regulated or prohibited drugs

14. Nutritional Disorders
• Dietary insufficiency
• Protein-Energy Malnutrition (PEM)
marasmus
kwashiorkor
cachexia (PEM in chronically ill patients)
• Anorexia nervosa and Bulimia

15. marasmus
kwashiorkor

16. Anorexia nervosa
Bulimia nervosa

17. •
•
•
•
Vitamin deficiencies
Obesity
Diet and cancer
Diet and atherosclerosis
• Further readings:
Groysman, Robert. (2001). Pathology. USA:
Lange Medical Books/McGraw Hill.
Chapter 14. pp 289- 298