Overcrowding and poor living conditions

1. Issue Identification
A number of health hazards can be associated with poor living conditions and overcrowding in
inner city apartments. These are physical, psychological, social and environmental factors all of
which can be interlinked and intertwined in many ways. The environmental factors include that
various parts of the natural environment such as air quality, water quality, food availability and
other physical environmental factors like traffic and housing. The social factors include income,
work and other social inequalities that effect health.
A lot of research has been carried out on the relationship between physical and mental health and
the quality of housing. The relation between poor health and poor housing becomes self-evident
with time. The poor housing quality is directly associated with a number of other hardships such
as poor sanitation, poor nutrition, lack of personal freedom etc.
A person spends most hours of his life in his house and any such issues can lead to severe and
long term health problems. These can become more prominent in children and women and lead
to severe illness and in some extreme cases to disability. Any health issue not properly treated
can lead to death of the individual as well.
Similarly, overcrowding is recognized as a root cause of many such health hazards. Poor living
conditions in addition to overcrowding are an icing on the cake. Any infections or diseases that
outbreak spread much quicker uncontrollably and becomes difficult to control.
In this part I will look at three health hazards that are associated with overcrowding and poor
living conditions in inner city apartments. These two hazards are air pollution and

2. Air Pollution
Air pollution is becoming a great issue in many major cities of the world. There are many factors
that are affecting it. It becomes more severe when the locality is more crowded and the living
conditions are poor. The impacts of air pollution are more severe for already non-healthy people
but are also affecting healthy people as well. These include respiratory irritation during any
outdoor activities. Immediate health problems due to air pollution are aggravated respiratory
illness and cardiovascular issues, increased stress on lungs and the heart to supply proper oxygen
to the body and damages to the respiratory organs and cells. These issues if continue to persist
lead to many long term illnesses such as accelerated aging of the lungs, loss of lung function and
lung capacity, development of diseases such as bronchitis, asthma etc and overall shortened life
of the individual. Easily affected are children, pregnant women, athletes and those who stay
outdoor for longer durations.
This air pollution may be due to many sources such as fuel burning at homes, automobiles,
industrial wastes, animal waste, waste mismanagement etc. As inner city apartments become
crowded and living conditions deteriorate, the various waste management systems become
overloaded leading to leakages that cause air pollution of very harmful gases. Also there is
decreased air ventilation. Similarly, any smoke developed cannot escape leading to increased
concentrations of carbon monoxide and particulate matter that then gets deposited in the lungs
causing severe damages. Due to poor air circulations, the levels of oxygen decrease and over
crowdedness adds to that. The residents feel greater levels of suffocation and soon health hazards
start to become visible. (Sacramento Metropolitan Air Quality Management District , 2017)

3. Infection Risk
Second important health hazard is the risk of becoming infected by a viral or any other infectious
disease due to overcrowding and poor living conditions. Housing conditions are used as socio-
economic indicators of well being and health. Overcrowding and poor housing quality lead to
increased susceptibility to diseases.
One of the major causes of this is the poor and inadequate ventilation and the presence of
infectious agents such as mold and smoke add to the poor respiratory health. One of the most
infectious diseases in these circumstances is tuberculosis. It easily spreads as a result of sneezing
or coughing of a TB patient. Increased head count leads to increased probability of becoming
infected. The air circulation and ventilation is poor in such areas. This leads to lower chances of
fresh air moving in and infectious agents moving out. Thus the residents become more prone to
the infectious agents.
Inadequate sanitation, contaminated water, poverty and poor nutrition are the main issues of poor
living conditions and overcrowding that lead to various infection risks. These infections also
include gastric issues, diarrhea, flu, fever, malaria, measles etc.
Fire Risk
Fire risks are directly related to the quality of a neighborhood. It in turn is related to the quality
of housing in the area. A overcrowded area itself is a huge fire risk. Suppose a fire breaks out,
everyone will begin to panic creating it very difficult to escape for anyone. Rescue services that
will arrive will also face a challenging time in attempting to help the residents of the apartments
escape and the put out the fire. It will take greater time leading to more property and health loss.

4. Poor living conditions also mean poor ventilation. Due to delay in being able to leave the fire
area, the accumulated smoke begins to enter the lungs of those inhaling it causes severe damage.
Children in such areas are even more at risk. They panic more easily and their lungs are more
affected by inhaling the smoke. (Crawford, 2005)
Another reason for the great fire risk is the use of portable heating devices by residents of such
apartments. These residential areas usually do not have a central heating system. Thus the
residents use portable heating devices. These devices can easily lead to fire if left near any
combustible material. Also if the device is electrical, then any such devices plugged into an
overloaded electrical outlet or left unattended, can be dangerous. (Chandler et al., 1984)
Such overcrowded and poor living conditions in inner city apartments are easy fire risks. These
places usually do not have proper fire safety and alarm mechanisms in place. As a result, any fire
will not easily be noted and will cause plenty of damage before it even becomes visible. Thus,
making such places a huge fire risk.

5. Hazard and Exposure Assessment
For the three issues identified in the last section related to overcrowding and poor living
conditions in inner-city apartments, following are how they impact the health of the residents:
Infection Risk
The strongest infections include those caused by hepatitis C virus, hepatitis B virus, human
immunodeficiency virus, influenza virus, tuberculosis and rhino virus. These all are the most
deadly of the viruses possessing the greatest risks of fatal infections and if not treated properly or
timely, death of the infected individual. (Kwong, 2012). Other diseases include pneumonia,
gastric problems, skin infections, lung infections and so on. Poor living standards, lack of
adequate health care, air pollution and damp environment make a person more prone to such
infections. These hazards directly attack the human body and render it infected. E.g. many of the
above mentioned health hazards are caused by viruses and they directly attack the immune
system of particular organs of the body making its functions abnormal. These viruses, bacteria or
other agents enter the human body from the air, eating contaminated food, using unsanitary
washrooms or living in unsanitary conditions. Once they are inside the body, they can easily
infect organs, multiply in number and then require proper medical care to be fully treated. Low
socio economic groups, children and senior citizens are prone to such viral outbreaks. Similarly
people with a weak immune system can easily become infected (WHO, 2011). Such infections
are very less in the rich as their living conditions are very clean and they are less likely to come
into contact with such bacteria or viruses.

6. Air Pollution
There are mainly four agents that are a part of air pollution and cause health related problems.
First is particulate matter that causes increased mortality. They directly impact the lungs if
breathed in and a number of particulate matters also affect the skin. Second is the Ozone in the
air, it can lead to breathing problems, reduce lung functions, trigger asthma and cause lung
diseases. Third is nitrogen Oxides which increases the probability of bronchitis in asthmatic
children and reduced lung function. Last is Sulphur dioxide. It can directly affect the functions of
the lungs and the respiratory system and cause irritation of the eyes. The inflammation of the
respiratory tract causes mucus secretion, coughing, chronic bronchitis and aggravation of asthma.
(WHO, 2016).
All of these air pollution components have only one mechanism of causing health problems.
They enter the human body through the process of breathing and land directly in the lungs.
Children and older adults become easily affected by air pollution. Similarly people with weak
immune system are more susceptible. Particle pollutants cause more than half a million deaths
worldwide annually. (Nel, 2005)
Fire Risk
Fire risk has multiple impacts. It impacts a person’s health as well as causes financial and
physical loss. Fire has three main health impacts: burning, smoke inhalation and exposure to high
temperatures. Direct contact with fire can cause severe burns on the skin and damage internal
organs and prolonged contact can lead to death. Inhalation of smoke along with fine particles
associated with it, penetrate deep into the lungs, cause burning of the eyes and lead to aggravated
chronic heart and lung disorders. Exposure to high temperatures can also cause skin burns. Worst

7. of these and the factor usually known to be the prime risk in case of fires is smoke inhalation. As
buildings consist of a variety of synthetic materials, the risks of fire are significantly higher.
(Stefanidou et al., 2008).
Fire risk is also different for various people. People with heart or lung diseases, older adults,
young kids, diabetics and pregnant women are more at risk. (US Environmental Protection
Agency, 2017). Similarly, people living in congested and overcrowded apartments are more at
risk as the smoke of the fire rises up it affects everyone. The chances of escaping are very limited
and due to poor ventilation, the smoke cannot escape the building properly. Thus the chances of
smoke inhalation become much more significant for the residents of the apartments. Also poor
living conditions lead to enhanced fire risks due to less protection systems in place, improper
wiring etc.

8. Risk Characterization
The final step in the assessment of risk in any health project is the characterization of risk. Any
party that is seeking information regarding the characterization of risk will take the information
from the exposure and the assessment stage.
Elements of Risk Characterization
There are four elements related to risk characterization. In the following lines, I will elaborate
each of them one by one.
Quantitative Estimates of Risk:
As discussed earlier, we are considering infection risk, air pollution and fire risk in the above
lines. We will address the same issues in this section.
Air pollution:
In case of air pollution, we have to consider who is affected by this issue. The answer to this
question will decide whether the researcher will have to consider some sub populations within
the main population. The next aspect relates to the adverse affects that air pollution is having on
the population. This includes the extent of the affect as well. It relates to the fact whether the
people have to be hospitalized due to the pollution or at the extreme level, is it resulting in
mortality of the people. The next part is concerned with the major parts of the pollutants. This
may include sulphur dioxide and carbon monoxide. The next step includes that the space to be
considered is defined. In our scenario, it is the city of Melbourne. This study within the city of
Melbourne is restricted to the present era. The impact of air pollution will be severe and will
cause many diseases including the lungs diseases and asthma.

9. Infection Risk
Risk for an infection is also very high along with other environmental health hazards.
Due to poor living conditions and overcrowding, development and accumulation of viruses and
bacteria becomes very likely. Also humid warm environments favor their growth. And in case an
infection does develop in some individuals, it becomes very difficult in controlling and getting
rid of it due to lack of proper healthcare. Other infection control risks include lack of hand
hygiene, unsafe use of injections, poor cleaning and disinfection and inadequate environment
cleaning. The risk is very adverse at the population level. It has direct impact on the health of the
residents of the population as the likelihood is very high. Such poor living conditions are usually
associated with lack of cleaning and fresh air. These two factors lead to greater risk of becoming
an attack of infections.
Fire risk
In the characterization of fire risk, event tree and fire tree approaches have been consistently
used. The invention of latest technology and methods has not decreased the impact of these two
methods on the fire risk assessment procedure. The event tree represents all the possible events
that can happen within a given organization. The more number of events are depicted as
increased number of branches in the diagram. (Hadjisophocleous & Fu, 2004). It is not easy
perform an assessment of fire risk on health basis. It is more feasible to do it on financial basis.
However, its main loss is in the form of human Life. The likelihood of health risks is very high.
As overcrowded places and poor living conditions suggest lack of fire escapes, alarm systems,
adequate ventilation, water sprinklers and even hydrants, making the fire risk extremely high.
Once a fire starts it will have a high level of impact on the health at the population level. It will

10. create panic, smoke will start accumulating leading to smoke inhalation and lack of fire escapes
means difficulty in escaping to open area in such an event. Thus severity of health impacts is
very high for a fire risk.
Thus any sort of environmental hazard be it an infection risk, air pollution, noise pollution, fire
risk or any other hazard, all of them posses a certain level of health hazard for the population.
Their likelihood being higher and the severity very impactful.

11. Risk Management Plan
The above parts of the report have defined in detailed various issues that are related with
overcrowding and poor living conditions in inner city apartments, their prime causes and the
health hazards associated with these hazards as well. Now I will outline some recommendations
for various authoritative bodies for intervention. There are various methods for monitoring and
control of environmental hazards that the government and other stakeholders can put into action
to reduce or remove the impact of environmental hazards. Following are some of the
recommendations and how they can be implemented for the benefit of the population:
 The quality of the water delivered to homes needs to be monitored at various points along
its distribution route up to the house tap. Its pH, microorganisms, chlorination by-
products, salts, dissolved contents, organic matters and metalloids need to be checked by
taking regular samples. This is the responsibility of the local municipal authority. Also
awareness through community involvement needs to be spread to highlight the
importance of clean drinking water.
 The local authorities be required under law to regularly review and assess the current and
possible future air quality in the area. Other measures may include vehicle emission
reductions, better local traffic management, promoting green belts and plantation of trees,
encouraging people to utilize cleaner and more sustainable methods of travelling such as
cycling and walking and so on. All of these require dissemination of information to the
local residents encouraging them to realize the importance of clean air. The landlords be
forced to design proper ventilation in the residential buildings, plant more trees around
the buildings and ensure routine remove of trash.

12.  To minimize fire risk, both the local city authority and landlords to ensure strict
implementation of fire prevention policies in residential constructions. Each residential
construction should have a escape routes, fire-resistant construction material, fire-fighting
basic equipment, fire alarms, emergency lighting, posters and other materials highlighting
various aspects for fire safety and so on. There are policies in place but its negligence that
is usually the cause of greater losses in the case of fires. Also importance of fire risks and
drills needs to be carried out in corporation with local fire authority to ensure that the
residents are well aware of what to do in case of a real fire.
 The City of Melbourne needs to ensure that the defined capacity of residents in an
apartment building does not exceed its limit. This will lead to avoidance of
overcrowding. Residents can be provided awareness regarding the drawbacks of
overcrowding.
 To handle infection risks, local authority needs to ensure that the trash of the residential
areas is picked up on time, streets are cleaned, any leakage of sewerage and water lines is
immediately fixed, no main holes are left open, proper drainage of rain water etc. The
landlord can also play his role to remind the local authority to play their part if there is
any negligence. Local residents also need to be encouraged to deposit their trash at the
proper points, avoid water spillage, and ensure routine cleanliness of their homes and so
on. All of these measures will minimize the risk of infectious problems.
 The residential areas need to be properly heated and cooled to ensure the residents do not
have to face extreme temperatures. This is the responsibility of the landlord to ensure
installation of central heating systems in building and also of the City of Melbourne to
put a check and balance system in place for such systems.

13. Above are some of the recommendations that if implemented with the help of various
stakeholders and the awareness of the population, will lead to significant benefits and removal of
a number of environmental hazards. Also issues such as overcrowding and poor living conditions
will be removed.

14. References
Chandler, S.E., Chapman, A. & Hollington, S.J., 1984. Fire incidents, housing and social
conditions—the urban situation in Britian. Fire Prevention, 172, pp.15-20.
Crawford, B.A., 2005. REDUCING FIRE RISKS FOR THE POOR. [Online] Available at:
http://www.fireengineering.com/articles/print/volume-158/issue-1/features/reducing-fire-risks-
for-the-poor.html [Accessed 18 May 2017].
Hadjisophocleous, G.V. & Fu, Z., 2004. LITERATURE REVIEW OF FIRE RISK
ASSESSMENT METHODOLOGIES. International Journal on Engineering Performance-
Based Fire Codes, 6(1), pp.28-45.
Kwong, J.C., 2012. The Impact of Infection on Population Health: Results of the Ontario Burden
of Infectious Diseases Study. PLoS ONE, 7(9).
Nel, A., 2005. Air Pollution-Related Illness: Effects of Particles. Science, 308(5723), pp.804-06.
Sacramento Metropolitan Air Quality Management District , 2017. Air Quality Information.
[Online] Available at: http://www.sparetheair.com/health.cfm?page=healthoverall [Accessed 18
May 2017].
Stefanidou, S., Athanaselis, S. & Spiliopoulou, C., 2008. Health Impacts of Fire Smoke
Inhalation. Inhalation Toxicology, 20(8), pp.761-66.
US Environmental Protection Agency, 2017. How Smoke from Fires Can Affect Your Health.
[Online] Available at: https://www.airnow.gov/index.cfm?action=smoke.index [Accessed 18
May 2017].
WHO, 2011. The burden of health care-associated infection worldwide. [Online] Available at:
http://www.who.int/gpsc/country_work/burden_hcai/en/ [Accessed 18 May 2017].
WHO, 2016. Ambient (outdoor) air quality and health. [Online] Available at:
http://www.who.int/mediacentre/factsheets/fs313/en/ [Accessed 18 May 2017].