Introduction to Environmental Health

Allison Robinson

University of Pittsburgh

Pittsburgh, Pennsylvania

November 2001

Learning Objectives

• Define fundamental terms

• Explain the basic relationship between the environment and health

• Explain impact of environmental factors on health

• Explain role of environmental health professionals

Performance Objectives

• Understand what is environmental health

• Understand scope of problem definition

• Understand means of addressing defined problem

• Understand the role players involved in problem solving

Outline

• Definition of Environmental Health• Interdependent Relations• Environmental Effects on Health• Systematic Approach • Interdisciplinary Roles

Definition: ‘Health …’• ‘…is a state of complete physical, mental

and social well-being and not merely the absence of disease or infirmity’(WHO, 1948)

• ‘Health is only possible where resources are available to meet human needs and where the living and working environment is protected from life-threatening and health threatening pollutants, pathogens and physical hazards’(Who, 1992a)

Definition: ‘Environment’

• ‘…[All] that which is external to individual human host. [It] can be divided into physical, biological, social cultural any or all of which can influence health status in populations.’ (WHO, 1995)

Definition: ‘Environmental Health’

• ‘…comprises those aspects of human health, including quality of life, that are determined by physical, biological, social and psychosocial factors in the environment. It also, refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations’ (WHO, 1993a)

Definition: ‘Health Effect…’

• ‘…is the specific damage to health that an environmental hazard can cause an individual person. Often the same hazard can cause a range of different effects of different severity.’ (Yassi et al., 2001)

Interdependence• Health depends on resources. • Good health depends on accessibility

to sustainable resources. • Bad health results from

inaccessibility to sustainable resources or exposure to a hazard.

• Sustainable resources and hazards exist in the environment.

• Therefore, quality of health depends on the environment

Interdependent Environments

• A relational definition of environment is a function of scale, boundaries, spatial proximity and recipient populations

• When considering a global scale, focus is on the effect of an unbounded environment, e.g. air, on all populations anywhere

Interdependent Environments

• When considering local scale, focus is on effect of both a bounded and an unbounded environment, e.g. water and air, on a subpopulation closest to the exposure event

• The local scale is a subpart of the global scale

Population Perspective of Relations

Individual

Family

Community, nation

Human population

All populations

Health and Environment Perspective of Relations

PersonalHealth

Family Health

Occupational Health

Public Health

Environmental health

Environmental Effects on Health

• The indicators of beneficial environmental effects are longevity and sustained functionality.

• Two degrees of adverse environmental effects are: injury (syn. include: debilitating, dysfunctional, lame) with decreased longevity or death (syn. include: life-threatening, terminal, deleterious)

Environmental Effects on Health

• Injury does not prematurely end life, but can hinder the capacity to function to the fullest potential

• Death does end life and is the most extreme adverse state of health

• This means of classification is simple and rigorous

Environmental Effects on Health

• An individual’s response to an environmental effect is a function of their physical environment, their health state, and their culture.

Systematic Approach

• In the absence of a universal definition of ‘good health’, at least a universal concept of adverse health effect, e.g. sick, illness, dysfunctional, ‘not normal’ or ‘not well’, must exist such that understanding the concept results in a response

Systematic Approach• In order to identify and investigate

adverse states of health, a fundamental systematic approach of health problem identification and characterization must exist and be implemented

• This approach is summarized as follows:

Systematic Approach

• Determine the source and nature of hazards

• Determine the exposure pathway• Measure the effects• Apply controls however possible

(Moeller, 1992)

Interdisciplinary Roles

• To implement the systematic approach, role players are needed

• Three major classes of role players are: the environmental health problem investigators, the environmental problem responders and the health problem responders

Interdisciplinary Roles• Health problem investigators:

– monitors populations to identify health trends, in an attempt to distinguish that which is harmful from that which is harmless

– measures the range of effects of health trends to characterize degrees of adverse intensity

– identify potential hazards, potential pathways of hazards, and populations susceptible to hazards

Related Disciplines

Epidemiologists Risk Assessors Biostatisticians

Toxicologists Microbiologists

Health Service

Administrators

Social Workers

Behavioral Psychologists

Public Health Educators

Interdisciplinary Roles• Environmental problem responders:

– focus on the health hazard that has been identified and characterized

– analyze the environment of the exposed population to see what controls are needed and what controls can be implemented to minimize risk of recurrence and risk of future occurrence

– where means of control does not exist, it may be necessary to invent

Related Disciplines

Engineers Risk Assessors Biostatisticians

Toxicologists Chemists Biologists/

Microbiologists

Physicists Mathematicians

Educators

Interdisciplinary Roles

• Health problem responders:– focus on populations of individuals

– attempt to identify how health is adversely affected

– classify severity of effect as either injury or deleterious

– attempt to restore compromised health to a ‘normal’ functional state

Related DisciplinesMedical

Doctors/Surgeons Dentists Biostatisticians

NutritionistsPsychologists/ Psychiatrists Nurses

Epidemiologist Social Workers Clinicians

Toxicologists PharmacistsBiologists/

Microbiologists

Physiologists Mathematicians

Educators

Summary• Environmental health is the broadest

scope of health problem definition• Environmental health studies the impact

of the environment on populations• It is a population based science that can

be scaled to study individual within populations

• Problem definition and potential resolution is possible through the implementation of a systematic approach

About the Lecturer

Allison Robinson is a teaching assistant in the Environmental and Occupational Health Department at the University of Pittsburgh’s Graduate School of Public Health in Pittsburgh Pennsylvania. Currently, she is earning on her doctorate degree in Environmental Health. She has a Master’s of Environmental Science and Management.