Environmental health

Conceptual map illustrating the connections among nonhuman nature, ecosystem services, environmental ethics, environmental justice, and public health

Environmental health indicator (2016). It consists of three categories: health impacts, air quality, and water and sanitation. The health impacts category includes the environmental risk exposure indicator.

Environmental health is the branch of public health concerned with all aspects of the natural and built environment affecting human health. Its study determines the requirements for a healthy environment, with the goal of effective control over the factors that affect health.<ref>Template:Citation</ref> The major sub-disciplines of environmental health are environmental science, toxicology, environmental epidemiology, and environmental and occupational medicine.<ref>Template:Cite journal</ref>

Definitions

WHO definitions

Environmental health was defined in a 1989 document by the World Health Organization (WHO) as: Those aspects of human health and disease that are determined by factors in the environment.<ref>Template:Cite web</ref> It is also referred to as the theory and practice of accessing and controlling factors in the environment that can potentially affect health.<ref>Template:Cite book</ref>

Template:As of, the WHO website on environmental health states that "Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behaviour not related to environment, as well as behaviour related to the social and cultural environment, as well as genetics."<ref>Template:Cite web</ref><ref>Template:Cite journal</ref><ref name="i386">Template:Cite journal</ref>

Other considerations

The term environmental medicine may be seen as a medical specialty, or branch of the broader field of environmental health.<ref>Template:Cite web</ref><ref>Template:Cite journal</ref> Terminology is not fully established, and in many European countries they are used interchangeably.<ref>Template:Cite web</ref>

Other terms referring to or concerning environmental health include environmental public health and health protection.<ref>Template:Citation</ref>

Disciplines

Five basic disciplines generally contribute to the field of environmental health, with some overlap between them:

• Environmental epidemiology studies the relationship between environmental exposures (including exposure to chemicals, radiation, microbiological agents, etc.) and human health. Observational studies, which simply observe exposures that people have already experienced, are common in environmental epidemiology because humans cannot ethically be exposed to agents that are known or suspected to cause disease. While the inability to use experimental study designs is a limitation of environmental epidemiology, this discipline directly observes effects on human health rather than estimating effects from animal studies.<ref>Template:Cite book</ref> Environmental epidemiology is the study of the effect on human health of physical, biologic, and chemical factors in the external environment, broadly conceived. Also, examining specific populations or communities exposed to different ambient environments, Epidemiology in our environment aims to clarify the relationship that exist between physical, biologic or chemical factors and human health.<ref>Template:Cite book</ref>
• Toxicology studies how environmental exposures lead to specific health outcomes, generally in animals, as a means to understand possible health outcomes in humans. Toxicology has the advantage of being able to conduct randomized controlled trials and other experimental studies because they can use animal subjects. However, there are many differences in animal and human biology, and there can be a lot of uncertainty when interpreting the results of animal studies for their implications for human health.<ref>Template:Cite web</ref>
• Exposure science studies human exposure to environmental contaminants by both identifying and quantifying exposures. Exposure science can be used to support environmental epidemiology by better describing environmental exposures that may lead to a particular health outcome, identify common exposures whose health outcomes may be better understood through a toxicology study, or can be used in a risk assessment to determine whether current levels of exposure might exceed recommended levels. Exposure science has the advantage of being able to very accurately quantify exposures to specific chemicals, but it does not generate any information about health outcomes like environmental epidemiology or toxicology.<ref>Template:Cite web</ref>
• Environmental engineering applies scientific and engineering principles for protection of human populations from the effects of adverse environmental factors; protection of environments from potentially deleterious effects of natural and human activities; and general improvement of environmental quality.<ref>Template:Cite web</ref>
• Environmental law includes the network of treaties, statutes, regulations, common and customary laws addressing the effects of human activity on the natural environment.<ref>Template:Cite web</ref><ref>Template:Cite web</ref>

Information from epidemiology, toxicology, and exposure science can be combined to conduct a risk assessment for specific chemicals, mixtures of chemicals or other risk factors to determine whether an exposure poses significant risk to human health (exposure would likely result in the development of pollution-related diseases). This can in turn be used to develop and implement environmental health policy that, for example, regulates chemical emissions, or imposes standards for proper sanitation.<ref>Template:Cite book</ref> Actions of engineering and law can be combined to provide risk management to minimize, monitor, and otherwise manage the impact of exposure to protect human health to achieve the objectives of environmental health policy.

Pediatric environmental health

Children's environmental health is the academic discipline that studies how environmental exposures in early life—chemical, biological, nutritional, and social—influence health and development in childhood and across the entire human life span.<ref>Template:Cite book</ref> Pediatric environmental health is based on the recognition that children are not "little adults." Infants and children have unique patterns of exposure and vulnerabilities. Environmental risks of infants and children are qualitatively and quantitatively different from those of adults. Pediatric environmental health is highly interdisciplinary. It spans and brings together general pediatrics and numerous pediatric subspecialties as well as epidemiology, occupational and environmental medicine, medical toxicology, industrial hygiene, and exposure science.

Concerns

Overview of main health effects on humans from some common types of pollution<ref>Template:Cite web</ref><ref>Template:Cite web</ref><ref>Template:Cite web</ref>

FEMA/EPA Hazardous Materials Team removing hazards left in the wake of Hurricane Katrina, 2005

File:How is our sick planet making us sick.webm Environmental health concerns include:

• Biosafety.
• Disaster preparedness and response.
• Food safety, including in agriculture, transportation, food processing, wholesale and retail distribution and sale.
• Housing, including substandard housing abatement and the inspection of jails and prisons.
• Childhood lead poisoning prevention.
• Land use planning, including smart growth.
• Liquid waste disposal, including city waste water treatment plants and on-site waste water disposal systems, such as septic tank systems and chemical toilets.
• Medical waste management and disposal.
• Occupational health and industrial hygiene.
• Radiological health, including exposure to ionizing radiation from X-rays or radioactive isotopes.
• Recreational water illness prevention, including from swimming pools, spas and ocean and freshwater bathing places.
• Solid waste management, including landfills, recycling facilities, composting and solid waste transfer stations.
• Toxic chemical exposure whether in consumer products, housing, workplaces, air, water or soil.
• Toxins from molds and algal blooms.
• Vector control, including the control of mosquitoes, rodents, flies, cockroaches and other animals that may transmit pathogens.

According to recent estimates in Europe, about 5 to 10% of disability-adjusted life years (DALYs) lost are due to environmental causes. By far the most important factor is fine particulate matter pollution in urban air.<ref>Template:Cite web</ref> Similarly, environmental exposures have been estimated to contribute to 4.9 million (8.7%) deaths and 86 million (5.7%) DALYs globally.<ref name="y052">Template:Cite journal</ref> In the United States, Superfund sites created by various companies have been found to be hazardous to human and environmental health in nearby communities. It was this perceived threat, raising the specter of miscarriages, mutations, birth defects, and cancers that most frightened the public.<ref>Template:Cite book</ref>

Air quality

Air quality includes ambient outdoor air quality and indoor air quality. Large concerns about air quality include environmental tobacco smoke, air pollution by forms of chemical waste, and other concerns.

Outdoor air quality

Air pollution is globally responsible for over 6.5 million deaths each year, as of 2022.<ref name="h352">Template:Cite journal</ref><ref>Template:Cite web</ref> Air pollution is often a risk-factor for diseases like lung cancer, respiratory infections, asthma, heart disease, and other forms of respiratory-related illnesses.<ref>Template:Cite web</ref> Reducing air pollution, and thus developing air quality, has been found to decrease adult mortality.<ref name="c579">Template:Cite journal</ref>

A Mumbai factory releasing air pollution.

Common products responsible for emissions include road traffic, energy production, household combustion, aviation and motor vehicles, and other forms of pollutants.<ref>Template:Cite report</ref><ref>Template:Cite web</ref> These pollutants are responsible for the burning of fuel, which can release harmful particles into the air that humans and other living organisms can inhale or ingest.<ref>Template:Cite web</ref>

Air pollution is associated with adverse health effects like respiratory and cardiovascular diseases, cancer, related illnesses, and even death.<ref name="p599">Template:Cite journal</ref> The risk of air pollution is determined by the pollutant's hazard and the amount of exposure that affects a person.<ref name=":0">Template:Cite book</ref> For example, a child who plays outdoor sports will have a higher likelihood of outdoor air pollution exposure than an adult who tends to spend more time indoors, whether at work or elsewhere.<ref name=":0" /> Environmental health officials work to detect individuals who are at higher risks of consuming air pollution, detect risk factors present in communities, work to decrease overall community exposure.<ref>Template:Cite journal</ref>

Indoor air quality

Household air pollution contributes to diseases that kill almost 4.3 million people every year, as of 2014.<ref name=":1">Template:Cite journal</ref> Indoor air pollution contributes to risk factors for diseases like heart disease, pulmonary disease, stroke, pneumonia, and other associated illnesses.<ref name=":1" /> For vulnerable populations, such as children and elderly populations, who spend large amounts of their time indoors, poor indoor air quality can be dangerous.<ref>Template:Cite journal</ref>

Burning fuels like coal or kerosene inside homes can cause dangerous chemicals to be released into the air.<ref name=":1" /> Dampness and mold in houses can cause diseases, but few studies have been performed on mold in schools and workplaces.<ref name="s217">Template:Cite journal</ref> Environmental tobacco smoke is considered to be a leading contributor to indoor air pollution since exposure to second and third-hand smoke is a common risk factor.<ref name="p775">Template:Cite journal</ref> Tobacco smoke contains over 60 carcinogens, where 18% are known human carcinogens.<ref>Template:Cite book</ref> Exposure to these chemicals can lead to exacerbation of asthma, the development of cardiovascular diseases and cardiopulmonary diseases, and an increase in the likelihood of cancer development.<ref>Template:Cite journal</ref>

Climate change and its effects on health

Climate change, in addition to its other effects, makes extreme weather events more likely, including ozone smog events, dust storms, and elevated aerosol levels, all due to extreme heat, drought, winds, and rainfall.<ref name="d657">Template:Cite journal</ref><ref name="m357">Template:Cite journal</ref> These extreme weather events can increase the likelihood of undernutrition, mortality, food insecurity, and climate-sensitive infectious diseases in vulnerable populations.<ref name="f669">Template:Cite journal</ref> The effects of climate change are felt by the whole world, but disproportionately affect disadvantaged populations who are subject to climate change vulnerability.<ref name="Toll M 2023">Template:Cite journal</ref>

Water runoff in Maryland, USA.

Climate impacts can affect exposure to water-borne pathogens through increased rates of runoff, frequent heavy rains, and the effects of severe storms.<ref name=":2">Template:Cite web</ref> Extreme weather events and storm surges can also exceed the capacity of water infrastructure, which can increase the likelihood that populations will be exposed to these contaminants.<ref name=":2" /><ref name="h670">Template:Cite report</ref> Exposure to these contaminants are more likely in low-income communities, where they have inadequate infrastructure to respond to climate disasters and are less likely to recover from infrastructure damage as quickly.<ref name=":6">Template:Cite web</ref>

Problems like the loss of homes, loved ones, and previous ways of life, are often what people face after a climate disaster occurs. These events can lead to vulnerability in the form of housing affordability stress, lower household income, lack of community attachment, grief, and anxiety around another disaster occurring.<ref name="Toll M 2023" />

Environmental racism

Template:Further Certain groups of people can be put at a higher risk for environmental hazards like air, soil and water pollution. This often happens due to marginalization, economic and political processes, and racism. Environmental racism uniquely affects different groups globally, however generally the most marginalized groups of any region are most affected. These marginalized groups are frequently put next to pollution sources like major roadways, toxic waste sites, landfills, and chemical plants.<ref>Template:Cite journal</ref> In a 2021 study, it was found that racial and ethnic minority groups in the United States are exposed to disproportionately high levels of particulate air pollution.<ref name=":8">Template:Cite journal</ref> Racial housing policies that exist in the United States continue to exacerbate racial minority exposure to air pollution at a disproportionate rate, even as overall pollution levels have declined.<ref name=":8" /> Likewise, in a 2022 study, it was shown that implementing policy changes that favor wealth redistribution could double as climate change mitigation measures.<ref name=":9">Template:Cite journal</ref> For populations who are not subject to wealth redistribution measures, this means more money will flow into their communities while climate effects are mitigated.<ref name=":8" /><ref name=":9" />

Noise pollution

Airplane flying over a residential district.

Noise pollution is usually environmental, machine-created sound that can disrupt activities or communication between humans and other forms of life.Template:Citation needed Exposure to persistent noise pollution can cause numerous ailments like hearing impairment, sleep disturbances, cardiovascular problems, annoyance, problems with communication and other diseases.<ref name="pmid24183105">Template:Cite journal</ref> For American minorities that live in neighborhoods of low socioeconomic status, they often experience higher levels of noise pollution compared to their higher socioeconomic counterparts.<ref name=":3">Template:Cite web</ref>

Noise pollution can cause or exacerbate cardiovascular diseases, which can further attribute to a larger range of diseases, increase stress levels, and cause sleep disturbances.<ref name=":3" /> Noise pollution is also responsible for many reported cases of hearing loss, tinnitus, and other forms of hypersensitivity(stress/irritability) or lack thereof to sound(present or subconscious from continuous exposure).<ref name=":3" /> These conditions can be dangerous to children and young adults who consistently experience noise pollution, as many of these conditions can develop into long-term problems, including physical and mental health issues.<ref name=":3" />

Children who attend school in noisy traffic zones have shown to have 15% lower memory development compared to other students who attended schools in quiet traffic zones, according to a Barcelona study.<ref name="g811">Template:Cite journal</ref> This is consistent with research that suggests that children who are exposed to regular aircraft noise "have inadequate performance on standardised achievement tests."<ref>Template:Cite journal</ref>

Exposure to persistent noise pollution can cause one to develop hearing impairments, like tinnitus or impaired speech discrimination.<ref>Template:Cite journal</ref> One of the largest factors in worsened mental health due to noise pollution is annoyance.<ref name="v911">Template:Cite journal</ref><ref name=":4">Template:Cite journal</ref> Annoyance due to environmental factors has been found to increase stress reactions and overall feelings of stress among adults.<ref name=pmid24183105/> The level of annoyance felt by an individual varies, but contributes to worsened mental health significantly.<ref name=":4" />

Noise exposure also contributes to sleep disturbances, which can cause daytime sleepiness and an overall lack of sleep, which contributes to worsened health.<ref name=":4" /> Daytime sleepiness has been linked to several reports of declining mental health and other health issues, job insecurities and further social and environmental factors declining.

Safe drinking water

Well installation for safe drinking water.

Access to safe drinking water is considered a "basic human need for health and well-being" by the United Nations.<ref>Template:Cite web</ref> According to their reports, over 2 billion people worldwide live without access to safe drinking water.<ref>Template:Cite web</ref> In 2017, almost 22 million Americans drank from water systems that were in violation of public health standards.<ref>Template:Cite web</ref> Globally, over 2 billion people drink feces-contaminated water, which poses the greatest threat to drinking water safety.<ref name=":5">Template:Cite web</ref> Contaminated drinking water could transmit diseases like cholera, dysentery, typhoid, diarrhea and polio.<ref name=":5" />

Harmful chemicals in drinking water can negatively affect health. Unsafe water management practices can increase the prevalence of water-borne diseases and sanitation-related illnesses.<ref name="t860">Template:Cite journal</ref><ref>Template:Cite journal</ref> Inadequate disinfecting of wastewater in industrial and agricultural centers can also infect hundreds of millions of people with contaminated water.<ref name=":5" /> Chemicals like fluoride and arsenic can benefit humans when the levels of these chemicals are controlled;but other, more dangerous chemicals like lead and metals can be harmful to humans.<ref name=":5" />

In America, communities of color can be subject to poor-quality water.<ref name=":7">Template:Cite journal</ref> In communities in America with large Hispanic and black populations, there is a correlated rise in SDWA health violations.<ref name=":7" /> Populations who have experienced lack of safe drinking water, like populations in Flint, Michigan, are more likely to distrust tap water in their communities.<ref name=":6" /> Populations to experience this are commonly low-income, communities of color.<ref name="d572">Template:Cite journal</ref>

Hazardous materials management

Hazardous materials management, including hazardous waste management, contaminated site remediation, the prevention of leaks from underground storage tanks and the prevention of hazardous materials releases to the environment and responses to emergency situations resulting from such releases. When hazardous materials are not managed properly, waste can pollute nearby water sources and reduce air quality.<ref name="u773">Template:Cite journal</ref>

According to a study done in Austria, people who live near industrial sites are "more often unemployed, have lower educations levels, and are twice as likely to be immigrants.<ref>Template:Cite journal</ref> With the interest of environmental health in mind, the Resource Conservation and Recovery Act was passed in the United States in 1976 that covered how to properly manage hazardous waste.<ref>Template:Cite web</ref>

There are a variety of occupations that work with hazardous materials and help manage them so that everything is disposed of correctly. These professionals work in various sectors, including government agencies, private industry, consulting firms, and non-profit organizations, all with the common goal of ensuring the safe handling of hazardous materials and waste. These positions include but are not limited to Environmental Health and Safety Specialists, Waste collectors, Medical Professionals, and Emergency Responders.<ref>Template:Cite journal</ref> Handling waste, especially hazardous materials is considered one of the most dangerous occupations in the world.<ref>Template:Cite journal</ref> Often, these workers may not have all of information about the specific hazardous materials they encounter, making their jobs even more dangerous. The sudden exposure to materials they are not properly prepared to handle can lead to severe consequences.<ref>Template:Cite journal</ref> This emphasizes the importance of training, safety protocols, and the use of personal protective equipment for those working with hazardous waste.

Information and mapping

The Toxicology and Environmental Health Information Program (TEHIP)<ref>Template:Cite web</ref> is a comprehensive toxicology and environmental health web site that includes open access to resources produced by US government agencies and organizations, maintained under the umbrella of the Specialized Information Service at the United States National Library of Medicine. TEHIP was responsible for the Toxicology Data Network (TOXNET),<ref>Template:Cite web</ref> an integrated system of toxicology and environmental health databases including the Hazardous Substances Data Bank, that was open access. TOXNET was retired in 2019.<ref>Template:Cite web</ref>

There are many environmental health mapping tools. TOXMAP is a geographic information system (GIS) from the Division of Specialized Information Services<ref>Template:Cite web</ref> of the United States National Library of Medicine (NLM) that uses maps of the United States to help users visually explore data from the United States Environmental Protection Agency's (EPA) Toxics Release Inventory and Superfund Basic Research Programs. TOXMAP is a resource funded by the US federal government. TOXMAP's chemical and environmental health information is taken from the NLM's Toxicology Data Network (TOXNET)<ref>Template:Cite web</ref> and PubMed, and from other authoritative sources.

Environmental health profession

Environmental health professionals may be known as environmental health officers, public health inspectors, environmental health specialists or environmental health practitioners. Researchers and policy-makers also play important roles in how environmental health is practiced in the field. In many European countries, physicians and veterinarians are involved in environmental health.<ref>Template:Cite journal</ref> Many countries require graduate degrees and professional licenses to practice environmental health.<ref>Template:Citation</ref>

The environmental health profession had its modern-day roots in the sanitary and public health movement of the United Kingdom. This was epitomized by Sir Edwin Chadwick, who was instrumental in the repeal of the poor laws, and in 1884 was the founding president of the Association of Public Sanitary Inspectors, now called the Chartered Institute of Environmental Health.<ref>Template:Cite web</ref>

See also

• EcoHealth
• Environmental disease
• Environmental medicine
• Environmental toxicology
• Epigenetics
• Exposure science
• Healing environments
• Health effects from noise
• Heavy metals
• Indoor air quality
• Industrial and organizational psychology
• Livability
• NIEHS
• Nightingale's environmental theory
• One Health
• Pollution
• Volatile organic compound

Journals:

• List of environmental health journals

Further reading

• Template:Cite book
• Template:Cite book
• Template:Cite book
• Template:Cite web
• Template:Cite web
• Patrick Sogno, Claudia Traidl-Hoffmann, Claudia Kuenzer: Earth Observation Data Supporting Non-Communicable Disease Research: A Review. Remote Sensing (12), 2020, P. 1-34. doi: 10.3390/rs12162541. ISSN 2072-4292.

External links

• NIEHS