Environmental Health/OCH

Environmental Health

General objectives:

At the end of the subjects Environmental Health students will able to:

▪ define the terms related to environmental and occupational health

▪ describe sources of water, air and noise pollution and their preventive
measures
▪ enumerate the methods of waste disposal, sanitary measures for camp, mela
and during disaster, criteria of healthful housing

List of Competencies
▪ Assess physical quality of water
▪ Perform water examination by field kit for arsenic, iron. fluoride, salinity
▪ Assess physically the sources of pollution of ambient air and indoor air
▪ Perform sound level measurement
▪ Organize and advice of proper waste collection, transportation and disposal
▪ Assess occupational hazards using inspection format /checklist
▪ Perform light, humidity and sound measurement in workplace
▪ Perform BOC/COD measurement in industrial effluent by field kit
▪ Organize and advice proper technique of using pesticides
 Environmental Health

Table of Content
Unit Lesson Topic Page
1 Introduction to Environmental Health
I • Definition of Environment
• Classification of Environment
• Role of Environmental in the causation of disease
II • Définition of Environnemental Heath
• Pollution and Polluant in différent Environnemental Medias,
• Diseases due to Environmental pollution
2 Water
I • Introduction to water
• Uses and Sources of water
• Define Safe water
• Quality of Water- Physical,
Chemical and
Biological water quality
II • Hardness of water
• Water pollution and Sources of water pollution
• Classification of water pollution,
• Chemical Pollutant
Fluoride,
III • Diseases due to water pollution
Biological water borne diseases
Chemical toxicity
IV • Water purification - Boiling,
Domestic Filter,
• Disinfection of Water – Chlorination
3 Air
I • Introduction and Composition of air
• Define Air pollution, Sources of air pollution
• Air Pollution in brick field, motor vehicle, industrial emission
II • Diseases due to air pollution,
• Prevention of air pollution
III • Define indoor pollution,
Sources of indoor pollution in rural and urban area
Health effects due to indoor Pollutant
IV • Smokeless cooking,
Cooking with improved stove,
Biomass fuel
4 Solid Wastes
I • Introduction and definition of solid waste
• Types of solid waste
Properties of hazardous waste
Composition of hospital waste
• Risk of poor management of wastes
 • Health effects due to poor management of wastes
II • Safe Management wastes- color coding of waste
collection of waste, and
transportation of waste
final disposal of wastes
• Recycle, Reuse and Reduce wastes
• Use of PPE and maintenance of Personal hygiene
III • Environnemental pollution due unsanitary waste disposal,
• List of health effects due to poor management of wastes
5 Sanitation
I • Introduction, Hygiene, Sanitation, Environmental Sanitation
• Sanitation barrier
II • Rural sanitation- water seal latrine
bore hole latrine
trench latrine
III • Sanitation of public places
Market Place- Waste collection, transportation, Excreta disposal,
cleaning, water supply
Hospital- collection and segregation of wastes, using color code,
transportation of wastes
IV • Air port and Sea port safe water supply
wastes collection and transportation
cleaning
quarantine
disinfection of air craft and de- ratification and cargo
V • Sanitation in Disaster
Water supply, waste disposal and Excreta Disposal
6 Noise
I Definition of Noise, Noise Pollution Sources of Noise pollution
II • Health Effects of Noise
• Noise Assessment
7 Housing
I • Introduction, Definition of housing
• Criteria of Good housing,
• Characteristics of poor housing,
II • Effects of poor housing condition
• Housing in rural area
 Introduction to Environmental Health
Learning Objectives

At the end of the session the students will be able to

• Define Environment, Environmental Health,
• Define Pollution and Pollutant
• Classify Pollutant,
• List common diseases due to pollution

Introduction and Basic Concepts on Environmental Health

What is Environment?
• Everything surrounds us may collectively be termed as the environment
• All elements of nature including those man made, make the environment
• The aggregate of all-external conditions and influences affecting the life and
development of an organism, human behaviour or society is known as Environment.
It is a state where and with what an organism live in. The health of an individual, a
community or a nation is determined by two factors:
a) The internal environment of the human being - Organ, Organ system, tissue etc. of the body
b) The external environment that surrounds him.

Classification of Environment: Environment has three components

a. Physical- . water, air, soil, climate, heat, light etc.
b. Biological - microorganisms, insects, rodents, animals including man, plant etc.
c. Psycho-Social - education, religion, culture, believes etc.

Environmental Health: It was Hippocrates who first related health with environment i.e
air, water and soil. Our living environment is composed of home, work and recreational
centres etc. where people spend their time. Water, air and food are our concern. The
provision of environmental health extends to all these aspects of our lives. The interaction
between these environments and human activities results in various types of hazards that
may adversely affect human health.
Environmental Health involves studying the environmental factors that affect health. It
encompasses hygiene, sanitation, and many other aspects of environment like global
warming, climate change, gene technology, flooding and natural disaster, green house
gases effects, etc.
Factors included in the definition of Environment
The definition of ‘environment’ includes only part of natural environment that are
modifiable. Following factors are included in our definition of environment:
- UV and ionizing radiation
- Noise, electromagnetic fields
- Occupational links
- Built environments including housing, land use pattern, roads
- Agricultural methods, irrigation scheme
- Man-made climate change, ecosystem change
- Behavior related to availability to safe water and sanitation facilities such as
washing hands and contaminating food with unsafe water or unclear hands.
WHO definition of environmental health:
“Environmental health comprises those aspects of human health, including quality of life,
that are determined by physical, chemical, 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 1993
Simplified definition:
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.
Contents of Environmental Health:
• Environmental health addresses all the physical chemical, and biological factors
external to a person, and all the related factors impacting behaviors.
• 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.
• It excludes behavior not related to environment as well as behavior related to the
social cultural environment, and agencies.
Health and Disease
A disease is contributed by three ecological factors where environment plays pivotal role
a) Agent
b) Host
c) Environment
Health is a dynamic equilibrium between man and his environment. Disease develops
when the balance between man and his environment is disrupted

The environment is all the physical, chemical, and biological, factors

external to the persons and all the related behaviors.
Health is a dynamic equilibrium between man and his environment.
Disease develops when the balance between man and his environment is

Definition of Pollution: Presence of harmful substances in the environment. Air is the

disrupted.
immediate environment of mankind and other creation on earth. Air pollution means
presence of chemical elements or compounds in sufficient quantity in air to cause injury
to health or life over short or long term.
Pollutant: Chemical, physical, biological and other factors or substances those are
responsible for pollution of environment. The major identified sources of pollution are:
a) Air pollution
b) Industrial effluents and emissions
c) Global warming
d) Solid/Human waste
e) Hospital Waste
f) Noise pollution
g) Radiation
h) Arsenic
i) Water and sanitation
j) Deforestation
k) Biodiversity
l) Pesticide and fertilizer
Classification of pollutants:
a) Solid pollutants e.g. different types of solid wastes
b) Liquid pollutants e.g. contaminated water
c) Gaseous pollutants e.g. air pollution, industrious effluents
d) Chemical pollution e.g. pesticide, arsenic
e) Biodiversity and deforestation
f) Radiation
g) Noise pollution

Environmental health comprises physical, chemical, biological, social

and psychosocial factors that influence the human health, including
quality of life.
Pollution is the presence of harmful chemical, physical, biological and
other factors or substances in the environment which may cause disease
or injury to human health

Questions:
• What is Environment?
• What is Environmental Health?
• What are the factors of Environmental Health?
• What is Pollution and Pollutant?
• Classify Pollutant with example
• List common diseases due to pollution
 Water

Learning Objectives

At the end of the session the students will be able to

• Define safe water, water pollution,
• Classify water pollution
• Illustrate the sources of water
• List common water and chemical borne diseases
• Assess physical quality of water
• Perform proper chlorination
• Identify arsenicosis patient

Introduction
▪ The water on earth now is about the same amount as it was during Jurassic period
(about 100 million years ago)
▪ Water covers 70% of the Earth's surface. Over 97% water is saline water and
2.5% is fresh water
▪ Less than 1% of the world's fresh water (or about 0.007% of all water on earth) is
readily accessible for direct human uses.
▪ Fresh water is defined as water with a salinity of less than 0.35% of the oceans
▪ Only 37,000 cubic kilometers of water for distribution to the Earth's population,
but not evenly distributed around the Earth' surface
▪ If all the earth's water fit in a gallon jug, available fresh water would equal just
over a tablespoon.
▪ Presently, 1.1 billion people lack access to improved water supply and 2.4 billion
to improved sanitation Unless action is stepped up, the number of people who
lack access to improved water supply could increase to 2.3 billion by 2025
▪ Every year the use of water increases 6%
▪ More than 2.2 million people died in 2000 from diseases related to the
consumption of contaminated water.
▪ A child dies every 15 seconds from easily preventable water-related diseases

Water covers 70% of the Earth's surface but less than 1% of the world's
fresh water is readily accessible for direct human use.
Once 97% of the population of Bangladesh had access to safe water
interms of tubeweill water use
Uses of Water
• Drinking
• Agriculture
• Industrial applications
• As a solvent
• As a thermal transfer agent
• Recreation
• Food processing.
• Power generation
Sources of Water
Rain Water- purest water in nature and soft water
Surface Water- Rivers, Ponds, Reservoirs, Tanks, Lakes- mostly polluted water
Ground Water- Water colleted through shallow wells, deep wells and water of
springs, usually safe
• Shallow wells or Shallow tubewell water is collected from above first impervious
layer
• Deep wells or Deep tubewell water is collected from below 1st impervious layer.

Safe Water
Free from pathogenic agents
Free from harmful chemical substances
Pleasant to taste, free from colour and odour
Useable for domestic use
Free from sedimentation
Safe water is one that cannot harm the consumer even when ingested over
prolonged periods. It may not be pleasant in taste, smell and appearance
Quality of Water
1) Acceptability aspects - physical or chemical parameters
2) Microbial aspects
 3) Chemical aspects
4) Radiological aspects
Acceptability aspects - physical or chemical parameters
Turbidity < 5 NTU (Nephelometric turbidity Unit)
Colour < 15 TCU ( True Colour Unit)
Taste & Odour- No unusual taste or odour
Temperature Cool water is more platable
Bacteriological Quality of Water:
▪ Ideally drinking water should not contain any pathogenic microorganism
▪ Bacteriological indicator
1) Coliform organism-
- faecal group of organism e.g E coli
- non-faecal group organism e.g Klebsiella aerogens
- E-coli must not be detectable in any 100 ml sample of drinking water
- Total Coliform bacteria must not present in 95 % of samples
taken through out any 12 month period
2) Faecal streptococci
- in doubtful cases the finding of Faecal streptococci in water is
regarded as confirmatory evidence of recent faecal pollution
3) Cl. perfringes:
- presence of spores Cl. perfringes in water indicative of faecal
contamination and in the absence of the coliform organism it presence
indicates faecal contamination in some remote time
Chemical Quality
Chemical Parameters
Indicator WHO Bangladesh
Chlorides or salinity- 200 - 500mg/l 150-600 mg/l
Hardness 100 – 300 mg/l 200-500 mg/l
Ammonia <0.2 mg/l 0.5 mg/l
pH 6.5 –8.5 6.5 –8.5
Hydrogen Sulphide 0.1 mg/l
Iron 0.3 mg/l 0.3 - 1mg/l
Sodium <200 mg/l 200 mg/l
Sulphate <250 mg/l 400 mg/l
Total dissolved Solid <1000 mg/l 1000 mg/l
Zinc < 3mg/l 5 mg/l
Manganese < 0.1 mg/l 0.1 mg/l
Copper < 1 mg/l 1 mg/l
Aluminium < 0.2 mg/l 0.2 mg/l
 Safe Water must be free from pathogenic agents, harmful chemical
substances, and sedimentation. Safe water is one that cannot harm the
consumer even when ingested over prolonged periods.
Ideally drinking water should not contain any pathogenic microorganism

Hardness of Water
- Hardness is defined as soap destroying power of water. Requires considerable
amount of soap to produce a foam or lather and that also produce scale in heaters,
boilers, hot water pipes
- Surface waters are softer than ground water. Hardness reflects the nature of the
geological formations with which it has been contact. It is derived largely from
contact with soil and rock.
- Rain water as it falls upon the earth is soft water
- Drinking water should be moderately hard
- Softening of water required when hardness exceeds 300mg/l
Hardness is caused by mainly four compounds:
1) Calcium bicarbonate 2) Calcium sulfate
3) Magnesium bicarbonate 4) Magnesium sulfate
Hardness is classified as:
1) Carbonate or temporary hardness 2) Non-carbonate or Permanent hardness
Hardness in water is Classified in terms of presence of Ca CO3 as follows:
1) Soft water < 50mg/l
2) Moderately Hard 50 – 150mg/l
3) Hard Water 150-300 mg/l
4) Very Hard Water > 300mg/l
Disadvantages of Hard water
1) Consumes more soap and detergents
 2) Scaling boilers water heater etc.
3) Adversely affects cooking and
4) Shortens the life of fabrics
5) Shortens the life of industrial machineries pipes and fixtures
• Advantage- inverse association with occurrence of cardiovascular diseases
Removal of Hardness:
Temporary:1) Boiling, \2) Addition of lime.

Permanent:1) Addition of sodium carbonate 2) Permutit process or Base exchange

Water pollution:
Water is never pure in chemical sense. It contains impurities of various kinds both
dissolved and suspended impurities.
a. Dissolved:
• dissolved gases dissolved minerals
b. Suspended impurities:
• clay, silt, sand mud
• Microscopic organisms, plants and animal
Presence of nitrite in water also indication of recent pollution and nitrate is old
contamination.
Principal water pollutants are:
a) Organic wastes
b) Micro organisms
c) Nutrients of plants, algae, fungi etc.
d) Organic synthetic matters
e) Inorganic chemicals
f) Suspended mud, clay etc.
g) Radio activity substances
h) Thermal Pollution-hot water discharged by the industries
i) Discarded oil and oil substances
Sources of Water Pollution
The sources of contamination natural water are classified as:
 • Natural
• Industrial Effluents
• Agricultural / Farm wastes
• Sewage / Municipal wastes
• Mining
Natural:
- Soil, silt and other substances washed out from the land by rail fall
- Leachates from animal excreta, decaying bodies of plants and animal
- Aerial contamination like gases dusts contaminate water bodies through rain fall
Industrial Effluents:
Industries activities generates a wide variety of waste which are generally
discharged into water bodies and maybe organic and inorganic contaminants
such as acids, alkalis, dyes, soaps, waxes, suspended matter, oil, toxic metals,
pesticides including radioactive materials. Biological pollutants include bacteria,
viruses, plants, and animals
Agricultural / Farm wastes:
Fertilizers, Pesticides washed out of the soil by rain. Wastes and waste water from
cattle shed, poultry farms
Sewage / Municipal wastes:
Discharge of sewage and municipal wastes into water bodies which includes
discharges from toilets, wash rooms, kitchens etc from dwellings, institutions and
commercial buildings. The principal pollutants are pathogenic bacteria, suspended
solids and oxygen consuming organic matter.
Mining:
During mining ore washings or leachates are disposed of into water bodies or
natural stream. In addition during mining operations suspended substances, toxic
materials washed out or discharged through drain into stream or water bodies

Water is never pure in chemical sense. It contains impurities of various kinds

both dissolved and suspended impurities including pathogenic microorganism
Impact of Water Pollution
In addition to biological and chemical pollution Alterations of taste and odour due to
presence of many organic and inorganic substance
Chronic effects caused by long term low level exposure to organic and inorganic
pollutants; Acute effect usually causes bacteria, virus and parasitic water borne Diseases

a) Water Borne Diseases-Biological

1) Diseases caused by presence of an infective agent
a) Viral Viral hepatitis A, Hepatitis E, Poliomyelitis, Rota virus
diarrhoea in infants
b) bactrial Typhoid and Paratyphoid, Bacillary dysentery, Esch
coli diarrhoea, Cholera
c) Protozoal Amoebiasis, Giardiasis
d) Helminthic Roundworm, Threadworm, Hydatid diasease
2) Diseases due to the presence of aquatic host
a) Snail Schistosomiasis,
b) Cyclop Gunieaworm, Fish tapeworm

b) Toxic effects due to chemical pollution

Some of the toxic metals which in chronic exposure may cause toxic effects on
human health
Chemical Pollutant Diseases
Mercury (methyl mercury) Minamata disease
Cadmium Itai Itai disease
Lead Plumbism
Chromium (hexavalent) Cancer
Arsenic Arsenicosis
Fluoride in access Fluorosis
Fluoride in low level Dental carries
Cyanide Thyroid toxic and Neurotoxic
Nitrate Methaemoglobin – acute toxicity
Selenium Toxic effect on liver and hair

Acute illnesses caused by water usually due to presence of pathogenic

microorganism in the water.
Chronic effects usually caused by long term low level exposure to
organic and inorganic chemical pollutants in the water
Fluoride
Fluoride is identified as one of the major inorganic chemical contaminants found in
drinking water in many countries of the world. In Bangladesh also fluoride contamination
in tubewell has been reported A guideline value of 1.5 mg/L is recommended by WHO as
a permissible level. Excess fluoride in drinking water may cause Dental fluorosis, in
bones it can cause a crippling bone disease called skeletal fluorosis. Low fluoride content
in drinking water may cause dental caries
Water Purification

Community Purpose: Principle of purification

Storage
Filtration- Rapid sand and Slow sand filtration Disinfection
a) Rapid sand filtration-comprise of Raw water
Coagulation, mixing, flocculation, sedimentation
Filter beds, filtration
Back washing
b) Slow sand filtration- supernatant (raw) water
a bed of graded sand- vital layer
an under drainage system
system of filter control valves
c) Pond sand filtration
Water Purification (Microbial)
Disinfection
Chlorination
Ozonation
Ultraviolet irradiation
Household Purpose:
• Boling
• Chemical – Chlorine, Halogen tab, Potash, Fitcary
• Domestic Filter
Disinfection by Water-Chlorination
 Water disinfection by adding chlorine is still widely practiced throughout the world.
Chlorine is applied in water either in the form of chlorine gas, chlorine tablet,
bleaching powder, or chlorine solution. Criteria for proper chlorination of water.
1) Water to be chlorinated should be clear and free from turbidity. Turbidity impedes
proper chlorination
2) Chlorine demand of the water is to be estimated. Chlorine demand is the
difference between chlorine added to the water and the amount of residual
chlorine remaining at the end of a specific period of time (usually 60 minutes). It
is the amount of chlorine that is needed to destroy bacteria and to oxidize all the
organic matter
3) The pH of the water should be 5.5 - 7.5
4) The contact period- the contact period of free residual chlorine must be at least
one hour to kill the bacteria and viruses.
5) Minimum concentration of free residual chlorine is 0,5mg/L for one hour.
6) The correct dose of chlorine is sum of the chlorine demand plus free residual
chlorine (0.5 mg/L).
Roughly to disinfect 1000 liters of water (1 cubic meter of water) 2.5 grams of good
quality bleaching powder is required. One chlorine tablet of 0.5 gm is required to
disinfect 20 liters of water.
Boiling:
Boiling water is the safest and effective method of purification. Before purifying water,
it needs to check whether it is cloudy first. Cloudy water needs to be filtered before
boiling. To filter the water, Water should be boiled at boiling stage (roaring) stage for 5-
20 miniutes. Giardia lambila, Cryptosporidium and microorganisms that cause disease are
killed by boiling water.

• Water should boiled at least for 20 minutes for purification.

• Disinfection of water by chlorine is still widely practiced throughout the world
• Domestic filter must be cleaned and maintained regularly according to
manufacturer instructions
• Rain water is the pure water in nature, if it is collected properly
Questions:
• What are sources of Water in Bangladesh?
• Define safe water
• What is water pollution?
• List the water pollutant
• What are the sources of water pollutant?
• What is the bacteriological quality of drinking water?
• Assess physical quality of water
• List common water and chemical borne diseases
• How you will perform proper chlorination?
• How you will identify an arsenicosis patient?
 Air-Pollution

Learning Objectives
At the end of the session the students will be able to
• Define air pollution
• Enumerate the sources of air pollution.
• Illustrate Air pollutant from brick field, motor vehicle, industrial pollution,
• List diseases due to air pollution,
• Organize preventive measures against air pollution
• Explain indoor pollution
• Enumerate the sources of indoor pollution in rural and urban area,
• List the disease due to indoor pollutant
• Illustrate the pollution due to biomass fuel,
• Explain and organize smokeless cooking or cooking with improved stove,

Introduction to Air
Air supplies life-giving oxygen for all forms of life. Every human being has an inborn
right to clean fresh air. Air is a mechanical mixture of gases. The normal composition of
air by volume is as follows.
• Nitrogen: 78.1%
• Oxygen: 20.93%
• Carbon dioxide: 0.03%
• Other gases e.g. argon, helium, neon in traces
Water vapor, dust, bacteria, spores, vegetables debris, etc. in negligible amount
Definition of air pollution: Air pollution may be stated as substances put into air by the
activity of mankind in concentration sufficient to cause harmful effects to his health,
vegetable, property or to interfere with the enjoyment of his property. The best air
pollutant indicators are:
• SO2
• Smoke
• Methane
• Oxides of Nitrogen
• Suspended Particulate Matter (PM10 and PM2.5)
• Others- CO, Lead, CO2, Hydrocarbon, CFC,
• Ozone, H2S, etc
 Air is essential for all forms of life
Air pollution is usually occurred by the activity of mankind in the concentration
sufficient to cause harmful effects to his health.

Sources of air pollution:

• Motor vehicular exhaust
• Industries and factories
• Brickfields
• Combustion (biomass fuel, tobacco smoke, coals, gases)
• Dust particles
• Population density
• Deforestation and encroachment of rivers, lakes, trees and parks
• Others like solid, hospital and industrial wastes, furnishing and
construction materials that release organic gases and vapors, and nuclear
energy program
Motor vehicular exhaust: The main pollutants from gasoline –carbon monoxide,
hydrocarbons, nitrogen oxides, sulfur dioxides, particulates of lead components and
unburned carbon particles (soot).

The reason for poisonous air pollution from motor vehicles are, very old and expired
engines, less capacity to burn fuel efficiently, use of sub-standard fuel, non use of
adequate and qualitative lubricants, carrying extra loads, etc. Absence of catalytic
converter in motor vehicle, which is essential for minimizing the VOCs in the exhaust.

Growing number of vehicle, narrow roads, traffic congestion, poor quality of fuel and
improper traffic management are further aggravating the air pollution in urban areas.

Industries and factories: Industries such as textile and dying, tanneries, pulp and paper,
cement, metal and fertilizer are important sources of air pollution.
Textile and dying:
Gaseous emission, noxious vapors from printing and dying and inadequate ventilation
affects the health of workers. The mills dump wastes indiscriminately and often burn
their solid wastes in open air.
Tanneries:
Foul odor from putrefying raw hides and solid wastes are the cause of air pollution.
Liquid and solid waste spills into nearby rivers and cause environmental pollution.
Pulp and paper mills:
Sulfur dioxide, total reduced sulfur compounds and particulate matter, hydrogen sulfide
and methyl’s are the dangerous emissions from paper and pulp mills. These are highly
malodorous.
Cement factories:
Emissions generated by various operations
Source Emissions
Raw materials grinding, handling Particulate dust
Kiln operation and clinker cooling Particulate dust, CO, HC, SO2, NO2
Product grinding, handling, packing, Particulate dust
shipping

Fertilizer Industries:
A number of metals and surface may results from ammonia leakage during production of
nitrogen fertilizer. Phosphate fertilizer generates dust while phosphate rock is being
ground. The acidulation process may produce fluorine. Specific air pollution problems
are caused by Triple Super Phosphate (TSP) production.
Brickfields:
The brickfields discharge a lot of black smoke, dust and ashes which spread out around a
large area near the fields.
Dust:
Dust particles are produced due to various construction processes of the roads and high
ways, building construction, brickfields and agricultural activities.
Population density, deforestation and park encroachment:
Overpopulation is an important cause of public health problem. Majority of the
respiratory pathogens are transmitted by the droplet infection from person to person.
Trees are the natural reservoir of oxygen. Therefore deforestation and encroachment of
parks, lakes and rivers adds to air pollution.
Industrial Gaseous Emissions:
Industrial emissions may be classified as
• Power plant (SPM, Sox, CO, VOC)
• Tannery (Odor)
• Fertilizer Industries (dust, NH2)
• Brick manufacturing (soot)
• Textile processing (VOC)
• Paper and pulp industries (odor, Sox, SPM)
• Cement industries (dust)
Industrial solid wastes:
Industrial solid wastes may be classified as
• Organic (biodegradable)
• Other organic (usable as fuel, e.g. wood and paper)
• Inter waste (often recyclable, eg. Metal, plastic, glass)
• Hazardous waste (e.g. heavy metals, pesticides, chemical residuals)
• Waste water treatment sludge (often containing hazardous substances)

In city area motor-vehicular emission, constructions, industry are the common

sources of air pollution.
Amongst the industries, brickfields discharge a lot of black smoke, dust and
ashes which spread out around a large area near the fields.

Diseases Due to Air Pollution

Immediate effects:
Sudden increase in air pollution has often been associated with immediate
increase in the mortality and morbidity especially due to respiratory diseases.
Delayed effects:
• Cardio-pulmonary effects
 • Neuro-developmental effects
• Symptomatic exacerbations
• Nutritional and other effects
• Bronchial Asthma ,Chronic bronchitis,
• Emphysema, COPD,
• Pneumonia, Acute RTI
• Sinusitis, Otitis
• Conjunctivitis, irritation to eyes,
• Dermatitis
• Lung cancer
Immune System and Allergies
• Allergic Asthma, Allergic Rhinoconjunctivitis
• Extrinsic Allergic Alveolitis / Hypersensitivity
• Central Nervous System
• Toxic Damage of Nerve Cells
• Mental retardation
• Carcinogenic Effects
• Lung Cancer, Leukemia
• Reproductive effects
• Infant mortality, Low weight birth

Air pollution may cause both acute and chronic effect.

Sudden increase in air pollution may cause immediate increase in the
mortality and morbidity especially due to respiratory diseases and
cardiovascular diseases.
PREVENTIVE MEASURES OF AIR POLLUTION
Any activity, which reduces the burden of mortality or morbidity from disease, is
considered as preventive measures. This takes place at primary, secondary and tertiary
prevention levels.
• Modification of industrial process, whenever possible to minimize air pollution by
less harmful chemicals.
• Use of electricity and natural gas in place of fire-wood, coal and oil in houses and
factories as fuels whenever possible.
• Reduction of pollution from automobiles by proper maintenance.
• Health education to the public regarding harmful effects of pollution and its control.
• Establishment of green-belts/green-space: In the cities, between industrial and
residential areas.
• Air pollution warning system during excessive pollution in the air so that individual
protection can be ensured.
• Cautious use of insecticides/pesticides.
• Control of dusts by spraying water on the road, wet mopping of the floor, hospital
wards, house floors etc.
• Proper disposal of excreta and waste
• International Action
• Proper Legislation
• Commitment

Indoor Air Pollution:

Indoor can be defined as any non-industrial indoor space where a person spends a period
of an hour or more in any day. This can include the space in the office, classroom, motor
vehicle, shopping centre, hospital and home.
The quality of indoor air is influenced by two major factors:
– amount and quality of outdoor air getting in (ventilation rates, deposition
and chemical decay)
– indoor sources of emissions of air pollutants
Definition: Indoor air pollution is defined as the presence of physical, chemical or
biological contaminants in high quantities in the air of confined environments, which are
not naturally present in the external air of the ecological systems.
• Indoor air quality may vary a great deal from one house to another depending on
the structural components, internal fittings, biomass combustion sources, cooking
fuel, cooking practice and the rate of natural and artificial ventilation and for the
activities of the occupants.
Sources of Biomass fuel:
• Agricultural and forestry residues
• Municipal solid waste
• Industrial waste
• Specifically grown bio energy crops.
Source of IAP:
• Kitchen
• Tobacco Smoke
• Pollen
• Dust
• Radon
• Cleaning products
• Beauty Products
• Building Materials
• Carpets
• Furniture
• Air Fresheners
• Pesticides
Kitchen
• Use of traditional fuels for cooking, such as, fire wood, animal dung, coal, gas etc.
Artificial building materials and poor ventilation:
• Hazardous building materials and reduced ventilation
 • Formaldehyde in building materials such as particleboard, plywood etc.
Construction Materials:
• Construction materials like rock, sand, bricks, concrete plaster, limestone,
marble, wood, asbestos etc.
Diffusion of gaseous:
• Emissions from construction materials.
Office machines and domestic air cleaners:
• electrical engine and equipments are the sources of indoor ozone
Biogenic Particles:
• bacteria, fungi, viruses, amoebae and pollen grains
Tobacco Smoke:
• tobacco smoke contains a great variety of potentially hazardous materials
Other Sources:
• emissions from ammoniated cleaning compounds and germicidal cleaners
• furnishing, adhesive and paints are also sources of pollutants
In the urban setting:
• Use of diesel generator for electricity production,
• Use of mosquito coils and chemical repellants,
• Use of electrical appliances and equipment's like Computer, TV, refrigerator,
photocopier etc,
• Increased use of synthetic building materials and furnishings like particle boards
and ply woods,
• Substantial use of chemically formulated personal care products, pesticides and
in-house cleaning items are some of the potential pollutants.
In the rural areas:
• During winter, there is a common practice of using wood and crops waste to
generate heat from fire, which also contribute to indoor pollution.
• There is a custom and culture in our rural community to use smoke during sun-set
time to drive away the mosquito from inside the house, which has some
contribution to the indoor pollution as well.
Indoor Pollutants:
Combustion Generated Pollutants – (Stoves, Space Heaters, Furnaces, Fireplaces)-
Carbon monoxide (CO) toxicity
- manifestations are headache, dizziness, loss of motor control and coma
- reduce the exercise capacity and aggravate the myocardial ischaemia
- forming carboxy-haemoglobin (COHb) and disrupting oxygen transport
- the elderly, the infants, and persons with cardiovascular and pulmonary diseases are
particularly sensitive
Nitrous dioxide (NO2)
- irritates the mucus membranes in the eye, nose and throat
- causes shortness of breath after exposure to high concentrations
- exposure to low levels of nitrogen dioxides increases the risk of respiratory infection
- gas stoves and kerosene heater can raise NO2 levels to 20-40 PPM inside the homes.
Sulfur dioxides (SO2)
– extremely irritating to the eyes and upper respiratory tract
– concentrations above 6 PPM produces mucus membrane irritation
– chronic exposure to SO2 is associated with increased respiratory symptoms
– acute SO2 exposure causes bronchial constriction
Wood Smoke
– complex mixture of NO2, Particulate, Polycyclic Aromatic Hydrocarbons
– increase respiratory infection among the children
Volatile Organic Compounds, Formaldehyde, Pesticides, Solvents, Cleaning Agents
– exposure may cause eye and upper respiratory tract irritation, rhinitis, nasal
congestion, rash, pruritis, headache, nausea, vomiting, dysponea etc.
– Formaldehyde is a probable human carcinogen, irritant to conjunctivitis and upper
and lower respiratory tract
– symptoms include chest tightness and wheezing
– formaldehyde vapor may cause- epistaxsis
Pesticides
– exposure via inhalation of spray mists and contaminated dust
– symptoms may include headache, dizziness, muscular weakness, and nausea.
Other Pollutants
Lead- (toxicity may present as acute illness)
– signs and symptoms in children may include irritability, abdominal pain, emesis,
marked ataxia, and seizers or loss of consciousness.
– diffuse complaints include headache, nausea, anorexia and weight loss, constipation,
fatigue, personality changes, and hearing loss
Asbestos-
- in the lungs may results in asbestosis, lung cancer and plural or peritoneal cancer or
mesothelioma
Radon-
Naturally occurring radioactive gas resulting from the decay of uranium widely
distributed in soil, emit alpha radiation and cause lung cancer

• Indoor air pollution is more dangerous than ambient air pollution,

because people are more exposed to indoor pollution.
• The common sources of indoor air pollution is cooking,
• Cooking gas may emit hydrocarbon which is a carcinogen

Prevention of indoor air pollution

a) Interventions to reduce indoor air pollution e.g.

• Gas stove should be fired only during cooking other time the stove should completely
switched off, so that there would be no leakage of gas.
• Changes to the source like improved stoves,
• Cleaner fuels,
• These can be delivered through policies operating at national level (supply and
distribution of improved stoves/cleaner fuels) and local level (through community
development).
b) Feasible, low-cost measures that could reduce exposure to indoor biomass smoke:
• Cooking outdoors
• Cooking in rotations and for shorter time periods
• Keeping children, especially infants, away from cooking areas as much as possible
• Having women or older children who are not involved in cooking assume temporary
childcare duties
• Improving cross ventilation by adding more windows around cooking areas or by
building chimneys over stoves
• Improving stove construction
• Using cleaner burning, low-smoke fuels such as liquid petroleum gas, kerosene,
ethanol, or biogas; or ideally switching to solar-powered stoves
• Educating women regarding the health risks of biomass smoke inhalation,
• Improving the overall status of women by enhancing their access to capital, political,
and legal representation

• Care should be taken so that there would be no leakage of non-burnt or

incomplete burnt gas and other fuel used for cooking .
• During cooking children particularly infant should not be near to the
cooking areas
i ares
Improved stoves:
An improved stove is a cooking stove which has been especially/specifically designed to
use less fuel, cook food more quickly and produce less smoke.
– Expert cooks know exactly how to set the fire to burn hot enough to avoid making a
lot of smoke,
– how to feed wood to the fire to avoid using more fuel than necessary and
– how to place the pot to get the most heat from the fire.
Some or all of the following design features help make a stove more efficient and
lowering adverse health impact:
– Chimney or vent - to remove smoke to outdoors and improve airflow through the fire.
– Controllable air inflow - requires the fire to be in an enclosure with an adjustable inlet
- allows reduction of burning rate to match needs.
– Use of a material with good insulating properties, for the inside walls of the stove -
usually ceramic.
– Afterburning - mixing the flue (exhaust gas) with a small amount of new air, to allow
the last remaining hydrocarbons and carbon monoxide to burn without a flame.
• To stir a thick material, well supported base is needed to keep the cooker stable.
 • There is an optimal separation between the pot and the cooker to allow for the
airflow to escape.
• In densely populated areas such as refugee camps, multiple households will want
to share the stoves, so it is needed to consider about insulated handles.
• Many societies cook only a few types of food and it is designed to meet their
specific needs.
• As always with appropriate technology, the stoves should be locally constructed
with local materials, using local techniques.
Advantages:
• Improved stoves reduces smoke in the kitchen
• Smokeless stoves also reduce the consumption of firewood to the extent of 30-
40% and reduces the burden of women with this regard to time taken for
collecting firewood
• Reduction in respiratory infections, watering of eyes and other health problems
• Reduction in periodical white washing of the kitchen
• Easy and fast cooking
• Financial support through subsidy in project villages is an added advantage for
poorer sections of the population to install smokeless stoves.
• Reduction in internal air pollution

An improved cooking stove produces less smoke, cook food more

quickly, and use less fuel, by which there will less indoor air pollutant. It
is better to avoid cooking with biomass fuel.

Questions:
• Define air pollution
• List the sources of air pollution.
• List the air pollutant from brick field, motor vehicle, industrial sources
• List the diseases due to air pollution,
• What are the preventive measures against air pollution?
• What is indoor pollution?
• What are the sources of indoor pollution?
• List the disease due to indoor pollutant
• What are the pollutants emitted from biomass fuel burning?
• What is improved stove?
• What are the advantages of improved stove?
 Solid Wastes

Learning Objectives

At the end of the session the students will be able to

• Define solid wastes;
• Recognize different type of wastes including hazardous wastes.
• Illustrate different color coding for collection wastes
• State the methods for final disposal of different type of wastes.
• Organize recycle, reuse and reutilization of wastes
• Advice for PPE use and maintenance of personal hygiene
• Explain environmental pollution due to poor disposal of wastes

Introduction

Solid Waste: useless, unwanted or discarded material from houses, street sweeping,
commercial, industrial and agricultural operation, arising from man's activities.
Solid wastes by products of anthropogenic activities. It may be house hold wastes,
industrial wastes, medical wastes, agricultural waste, etc.
Types of wastes: Considering the origin of product solid wastes may be categorized as
a) Industrial wastes
b) House hold wastes
c) Medical wastes
d) Agricultural wastes
Some solid wastes are dangerous and may cause serious harm to human health. A large
amount of Health Care Wastes are categorized under this group.
Definition of Health Care Waste (HCW): Health Care Waste is defined as the total
amount of wastes that is produced during health care services. In other words HCW is a
byproduct of health care services.
According to WHO ‘Health Care Waste’ is a by-product of healthcare that includes
sharps, non-sharps, blood, body parts, chemicals, pharmaceuticals, medical devices and
radioactive materials. Health Care Wastes may be classified in two major groups:
a) General waste or non-infectious wastes
b) Hazardous wastes or infectious wastes
Hazardous wastes are again grouped as follows:
– Infecting organism
 – Corrosive agent
– Explosive agent
– Radioactive agent
– Carcinogenic agent
– Sharp agent etc
Risks associated with poor management of HCW: Hepatitis B, hepatitis C and HIV
infection may be the cause of accidental stick with infectious needle.
Occupational risks are associated with handling of infectious wastes. Unprotected pits
increase risks to health care workers, of waste handlers and the community to needle
stick injury. The re-use of infectious syringes is a major threat to public health.
Risk for environment: Health care wastes can adversely impact on human health by
contaminating water bodies during dumping and by polluting the air during incineration.
When wastes are disposed of in a pit close to water sources, the water bodies may
become contaminated. Burning of HCW may produce toxic air pollutants (dioxin, furans
and other toxic gases).
Health effects due to poor management of HCW:
• AIDS
• Hepatitis B and C
• Gastroenteric infections
• Respiratory infections
• Blood stream infections
• Skin infections
• Effects of radioactive substances
• Intoxication
Use of PPE: The waste handlers, nurses, doctors and other health professionals must use
PPE. Wastes should be segregated at the point of waste production. Sharp needles must
be collected in protective container and handle with caution. The waste handlers must use
PPE like gloves, mask, apron etc. while handling with wastes. They must clean hand and
mouth with proper disinfection substances and proper personal hygiene.

Useless, unwanted or discarded material arising from man's activities is

known as Solid waste. Solid waste may contain a small proportion of
hazardous wastes, but is enough to make whole wastes hazardous.
Management of HCW: Poor management of healthcare waste exposes healthcare
workers, waste handlers and the community to infections, toxic effects and injuries.
Main dangers of infection from HCW are through ingestion, broken mucous membrane
and puncture by sharp waste.
– Particular concern about HIV, HBV,HCV
– New concern about SARS virus.
– Persistence of pathogens registrant to antibiotic & disinfectant, specially E.Coli.
– Priority on Needle sticks injury.

Basic elements for safe management of HCW:

Selection of options: National HCW legislation should keep in consideration. Select
sustainable, locally available and acceptable, cost effective and efficient, affordable,
environment friendly options. Prevent the re-use of disposable medical equipment (e.g.
syringe). Involve key stakeholders, e.g. Environmentalist, municipalities and private
sectors.
Awareness and training: Arrange training program waste handlers, nurses, doctors and
other persons involved in the HCW management process. Training content should
include a. risk related sharp and other infected wastes, b. Segregation process, b. Safe
handling, storage, operations and maintenance of treatment technologies.
Implementation: Assessment of current HCW system and joint development of sound
HCW management system. Following point should be considered
• Resource allocation and assignment of responsibilities
• Waste minimization including purchasing policy, segregation of wastes,
implementation of safe handling, tracking of waste production and waste
destination
• Evaluation of the HCW system
Segregation of wastes: Health care wastes must be segmented at the place of generation.
There should be provision of adequate number bins. Waste must me disposes in specified
colour coded bins. Bins must be replaced immediately after re-filling.
Colour code:
Red coloured bin: for sharp wastes such as needles, blades etc.
Blue coloured bins: for liquids wastes such as chemicals
Yellow coloured bins: for infectious wastes such as gauge, bandage, body tissue etc.
Black cloured bins: for general wastes such as paper, wastes fruits etc.
Silver coloured bins: for Radioactive wastes such as x-ray related wastes
Green cloured bins: for reusable wastes such as paper, bottle, pot etc.
Handling and Storage of Health Care Waste
1) Waste segregation and packaging
2) Collection of waste
3) Storage of waste
4) Transportation of Health Care waste
5) Preparation for transportation
6) Transportation of vehicles or containers
7) Treatment and final disposal
Collection of Waste
• Establish a routine programme for collection
• Waste should be collected daily
• Waste bags should be sealed
• Transported to the designated central storage site.
• No bags should be removed unless they are labeled with their point of
production and contents.
• The bags or containers should be replaced immediately with new ones of
the same type.
Storage of Health Care Waste
• The storage area should have an impermeable, hard standing floor with
good drainage; it should be easy to clean and disinfect
• Should have water supply for cleaning purposes
 • Should have easy access for staff in charge of handling wastes
• Easy access to waste-collection vehicles
• Storage area should be inaccessible for animals, insects, and birds
• A supply of cleaning equipment, protective clothing, and waste bags or
containers should be located conveniently close to the storage area
Transportation of Health Care Waste
• On-site transportation of waste
➢ wheeled trolleys
➢ Containers
➢ Should not be used for any other purpose
• Off-site transportation of wastes
➢ shipped abroad for treatment
Transportation of Vehicles or Containers
• The body of the vehicle should be of a suitable size
• There should be suitable systems for securing the load during transport
• Empty plastic bags, suitable protective clothing, cleaning equipment, tools, and
disinfectant, together with special kits for dealing with liquid spills, should be
carried in a separate compartment in the vehicle
• The international hazard sign should be displayed on the vehicle or container, as
well as an emergency telephone number
Treatment and Disposal
Treatment modifies the characteristics of waste. The main aim of treatment is to reduce
the dangers of direct exposure to humans at recovering recyclable materials and at
protecting the environment. Disinfection reduces the pathogenic organisms. Minimization
cuts down the requirements for storage and transportation. Make recyclable items
unusable to prevent re-use of the used items. Following options should be used for HCW
treatment:
• Shredding or removal of needles from the syringe (after disinfection)
• Encapsulation
• Disinfection
1) Steam/thermal
 2) Microwave
3) Chemical
• Incineration
1) Uncontrolled incineration should be avoided
2) Open pit
3) Burning
• Controlled small and large incineration
Final disposal of wastes:
There is no method of waste disposal, which is equally suitable in all circumstances.
Improper disposal wastes causes air, water and soil pollution by burning of wastes, air
borne dust from open dumping, gas emission from landfill, leachate from landfill etc.
Wastes Disposal Methods :
• Open dumping
• Sanitary landfill
• Incineration
• Manure pits or Composting
• Burial
• Sea or ocean disposal
• Deep well dumping
Composting is the decomposition of materials that originated from animals and plants.
These organic materials can be things such as plant trimmings, vegetable cuttings,
eggshells and teabags. The composting process produces a dark, crumbly matter that can
be used as fertilizer in garden soil. The whole process usually takes about 3 – 9 months,
and results in a nutrient-rich fertilizer to use in garden.

Disposal of wastes by Recycle, Re-use and Reduce (3R):

Recycling : Use of wastes as raw materials
Recovery : Waste can be used again as the same materials. Waste paper to make pulp
for new paper.
Reuse / utilisation: Many solid wastes can be utilised again. Refilling of soft drinks
bottle .
Examples of Recycle Re-use and Reduce:
✓ Recycling old or damaged pallets prevents unnecessary landfill and reduces the need
to chop down trees for new wood to make new pallets.

✓ Up to 80% of a vehicle can be recycled. Sell unwanted vehicles.

✓ Glass is 100% recyclable and can be used again and again. Glass will never
decompose. Reuse glass whenever possible. Jars can be used as small containers and
bottles can be used as vases.

✓ Recycled paper produces 73% less air pollution than if it was made from raw materials

✓ Plastic bottles etc. can be recycled for several times to manufacture new plastic
product. Plastic can take up to 500 years to decompose

✓ Waste batteries are classified as hazardous waste and recycling is always the best
option. Batteries should be returned to manufacturer for disposal or recycled to
produce new battery.

✓ Rechargeable batteries are the most environmental friendly option as can last for up to
several hundred charging cycles resulting in less waste being produced.

✓ Many building materials can be reused, such as bricks and wood. Metal is usually
separated into 2 groups: aluminum and steel.

✓ Mobile phone can be recycled or donated. Many manufacturers take back old mobile
phones for recycling.

✓ Whenever possible, engine oil should be recycled correctly as even a small amount of
oil can cause damage to the environment.

✓ Reduce paper waste by cancelling unwanted deliveries. Reuse paper around the home
as scrap paper or packing material. Envelopes can also be reused. Set your printer to
print on both sides of the paper. Buy recycled paper whenever possible.

✓ Clinical wastes have the potential to be infectious, must be disposed of using special
methods. Be very careful when disposing of needles and syringes.
✓ Recycling printer cartridges is worthwhile as remanufactured printer cartridges can
cost as little as 10% of what original cartridges do. It also reduces environmental
pollution.

✓ Old clothes can be used to make other textile items, such as cushion covers.

Recycle, Re-use and Reduce is the best method for waste management
and are excellent way of saving energy and conserving the environment.
Medical wastes must be disposed according to colour code
Improper disposal of wastes causes air, water and soil pollution

Questions:
.
• What is solid wastes?
• What are the types of wastes?
• What is health care wastes?
• What is hazardous wastes? Give some examples
• What are the types of color coding for collection of different type of wastes?
• What are the basic elements of management health care wastes?
• What is composting?
• What is 3R? Give the examples of 3R
 Sanitation
Learning Objectives

At the end of the session, the students will be able to

• Defline environnemental sanitation.

• Explain sanitation barrier,
• List the merits and demerits of water seal latrine
• Organize proper sanitary measures during fair and festivals
• Organize and advice for proper collection, transportation and disposal of wastes from
market place, hospital
• Perform proper disinfection in air-craft and ship and cargo
• Organize safe water supply, waste disposal and excreta disposal in Disaster

Introduction

Hygiene generally refers to the set of practices associated with the preservation of health
and healthy living. The focus is mainly on personal hygiene that looks at cleanliness of
the hair, body, hands, fingers, feet and clothing, and menstrual hygiene.
Safe hygiene practice includes a broad range of healthy behaviours, such as hand washing
before eating and after cleaning a child’s bottom, and safe faeces disposal. The aim of
hygiene education and promotion is to help people to change their behaviour to use
better hygiene practices.
Sanitation is promoting health through the prevention of human contact with the hazards
associated with the lack of healthy food, clean water and healthful housing, the control
of vectors, and a clean environment.
Hazards can be physical, microbiological, biological or chemical agents of disease.
The word 'sanitation' also refers to the maintenance of hygienic conditions, through
prevention of human contact with hazards of wastes such as human and animal faeces,
solid wastes, domestic wastewater, industrial wastes, wastewater and agricultural wastes
which may cause health problem
Improved sanitation - refers to the management of human faeces at the household level.
This terminology is the indicator used to describe the target of the Millennium
Development Goal on sanitation. The Joint Monitoring Programme for Water Supply and
Sanitation of WHO and UNICEF has defined improved sanitation as follows:
• Flush toilet- connection to a piped sewer system or connection to a septic system
• Flush / pour-flush to a pit latrine
• Ventilated improved pit (VIP) latrine[
• Pit latrine with slab[
• Composting toilet
• Some special cases[
There are different types of sanitation relating to particular situations, such as:
• Basic sanitation: refers to the management of human faeces at the household level.
It means access to a toilet or latrine.
• Onsite sanitation: the collection and treatment of waste at the place where it is
deposited.
• Food sanitation: refers to the hygienic measures for ensuring food safety. Food
hygiene is similar to food sanitation.
• Housing sanitation: refers to safeguarding the home environment (the dwelling
and its immediate environment).
• Environmental sanitation: the control of environmental factors that form links in
disease transmission. This category includes solid waste management, water and
wastewater treatment, industrial waste treatment and noise and pollution control.
• Ecological sanitation: the concept of recycling the nutrients from human and
animal wastes to the environment.

Hygiene includes the practices which are associated with the

preservation of health and healthy living.
Sanitation includes the prevention of human contact with the hazards
for promoting health
.

Sanitation Barrier

The source of diarrhoeal diseases is the agent or carrier who discharges infected faeces to
the environment. To remember the possible pathways we can use the six ‘F’s:
1. Faeces: resulting from defecation.
2. Fluids: through contaminated water and other contaminated liquids.
3. Fingers: contaminated fingers transmit diseases.
4. Flies: all sorts of animals such as flies can carry and transmit diseases.
 5. Fomites or fields: fomites are inanimate objects that carry the infectious agent
(e.g.dishes, cups and other contaminated surfaces in contact with food or water).
6. Food: infected by fluids, flies, fingers or fomites and then eaten.

Sanitation barrier refers to segregation of excreta in such a way as to break the

disease transmission cycle particularly faeco-oral transmission(i.e.fecal borne diseases).

Sanitation Barrier

The barrier approach to sanitation prevents disease agents in faeces from gaining access
to new host through various channel (5 F) such as fingers, flies, fields and fluids.
Through them pathogen are transmitted from faeces to food or directly to humans. This
transmission can be prevented by using a sanitary latrine with proper waste disposal and
proper hand washing after defecation and before taking food.

Sanitation barrier is the approach to prevents exposure to disease agents by

preventing transmission of disease agents in faeces through using water-seal
latrine and proper hand washing after defecation and before taking food

Rural sanitation-water sealed latrine:

Water sealed latrine: A water sealed latrine is water-flushed toilet in which water is
poured to flush urine and fecal material from a toilet bowl either directly into a pit or
through a pipe to a pit or septic tank. The important part of this latrine include a trap
(bent pipe) which forms a water seal. The water seal prevent access to fly and cockroach
into latrine. This latrine is a suitable latrine for sanitary disposal of human excreta in rural
area
Advantages: Water-seal toilets are cheap, easy to use and keep clean; they are highly
popular, and they remove fecal material from the household environment. The water
seal prevents flies and smells from entering the house through the waste pipe.
Disadvantages:
➢ Pit requires a strong infrastructure to avoid contamination of soil and ground
water table.
➢ Untreated wastewater can pose dangers to health if the outflow discharge directly
into open field
➢ Sometimes need large volume water to clean the faecal matter from pan
➢ It cannot be constructed if ground water table is high.
Technical requirements:
➢ Water- seal toilets require a bowl or pan,
➢ Water- seal created by placing a ‘U’ bend beneath the bowl.
➢ The bowl is fitted to a squatting plate.
➢ Conventional toilets use a 50mm deep water- seal.
➢ To reduce the amount of flush water required, some designs reduce this to around
25mm.
➢ Wastewater from water-seal toilets may be discharged either locally to a leach pit,
a septic tank and soak away.
Borehole latrines- Borehole latrines have a hole instead of a dug pit. May be sunk to a
depth of 10 m or more ( 4-6 m is usual). The life of the pit is very short. For example, a 5
m deep hole will serve a family of five people for about two years.
The small diameter of the hole may be blocked quickly. If the depth of the hole increases
the danger of groundwater contamination. The sides of the hole become soiled near the
top making fly infestation. Borehole latrines are for emergency or short-term use.
Trench Latrine:This latrine is simply a trench. The trench should be no more than six
inches deep and narrow enough to straddle. Make sure you dig at least 100 yards away
from any water source like a river or pond. During digging the trench the earth should be
piled by the side of the trench. After every use the faeces should be covered with piled
earth. This will keep away flies and disease

Water-seal latrines are cheap, easy to use and keep clean,

and are suitable latrine for sanitary disposal of human excreta
in rural area.

Sanitation of public places site selection:

The public places like school, bus/train station, festival and fairs, camps, etc. have a
greater risk of the spread of faecal borne diseases such as cholera, hepatitis A, typhoid
and diarrhoeal diseases. Therefore special attention should be paid to the adequacy of
facilities, their availability to the public and sanitary disposal of excreta. There are
several basic rules for sanitation in public places:
Site selection for proper excreta disposal:
• There should be sufficient toilet facilities for the maximum number of people. This
normally means one toilet compartment for every 25 users. There should be separate
blocks for men and women. The men's toilet block should have urinals and toilet
compartments; the women's block toilet compartments only.
• Toilet facilities should not be near to kitchens. It is important that people using the
toilet facilities cannot pass directly through the kitchen.
• There must be a hand washing basin with clean water and soap close to the toilet
facilities. There should be separate, similar facilities near to kitchens or where food is
handled.
• There must be a clean and reliable water supply for hand-washing, personal hygiene
and flushing of toilet facilities. The water supply should meet quality standards and be
regularly tested.
Cleaning of toilet facilities:
Responsibilities for cleaning sanitation facilities should be very clearly defined to every
user. Set a good example for cleaning to users. Information about cleaning and other
health message should be displayed in an eye-catching, simple and accurate way. These
messages should include the promotion of
• Care for cleaning toilet
• Hand washing.
• Use of refuse bins.
• Protection of water supplies.
• Local school children and college students can be involved in preparing educational
posters and notices for public places and awareness programme.
Proper waste collection:
Refuse must be disposed of properly and not allowed to build up. The wastes need
individual collection bins and contracts. It is important to have the proper collection bins
placed strategically at all facilities and to ensure collection contracts are in place for the
proper removal and disposal of collected waste.
Transportation and disposal of waste
Vehicles used to collect and or transport waste shall:
• Be suitably designed and covered to ensure that waste does not escape during
transportation.
• Open topped vehicles shall be covered with appropriate material such as nets, tarpaulin
or any other material during transportation of waste.
• Automatic offloading systems should be encouraged.
• During transportation mixing of different waste streams is discouraged. Transported of
waste shall be deposited only at a facility that has been designed and licensed to accept
that type of waste. Transporters shall not accept untreated medical waste and
containers of medical waste and hazardous waste, which are leaking or damaged
Food and cooking arrangement in fair and festival:
Only foods that are not potentially hazardous may be sold. Hazardous foods include
foods that contain meat, poultry, fish or uncooked or partially cooked eggs (such as
mayonnaise or custard, quiche, etc.) or any foods that are required to be heated or cooled.
Allergen warnings must be provided on all foods with potential allergens.
If hot food is purchased from a restaurant, the food should ideally be served within two
hours of preparation. It must be discarded after four (4) hours. Temperature is critical for
food safety. The same rules apply to "open and hold cold" foods. Organizers of large
events should identify the 4 hour cut-off for each dish at the food service station.
Risk Factors means improper practices or procedures which is the most prevalent
contributing factors of food borne injury or illness. Risk factors include:
• Poor personal hygiene
• Food from unsafe sources
• Inadequate cooking
• Improper cooking temperatures
• Contaminated equipment
Catering personals are expected to follow reasonable food safety practices when
preparing food in fair and festival.
• All persons handling food should completely wash their hands (rub using soap and
water for at least 20 seconds before rinsing thoroughly) before handling any food.
Ingredients should be fresh and have been properly stored.
• Use thermometers to check oven and food temperatures to ensure adequate cooking
and proper cooking temperatures.
• Do not attempt to cook food in equipment that is inadequate for the task. Make sure
all equipment is clean and sanitary before using it.
• Have appropriate materials on hand to package the food. Small zip-lock type bags
or plastic food wrap for individual portions is sufficient.
Proper waste collection- The designated government/municipality authority is
responsible to collect and dispose the market place wastes. It is the responsibility of
waste generator to segregate waste at production site and dispose those to respective bins.
Recycleable waste should be send to respective section. Food and abandoned fruits and
vegetables may be used for animal feeding purpose.
Waste Management at Market places
Waste materials that are organic in nature, such as food scraps, plant material, and paper
products, can be recycled using biological composting and digestion processes. The
resulting organic material is then recycled as compost for agricultural. The intention of
biological processing in waste management is to control and accelerate the natural
process of decomposition of organic matter. There is a large variety of composting and
digestion methods and technologies varying in complexity from simple home compost
heaps, to small town scale batch digesters, industrial-scale enclosed-vessel digestion of
mixed domestic waste.
Cleaning of market places- It is the responsibility of individual shop owners to keep
their premise neat and clean. Wastes should be disposed of in to the specified bins. Keep
the shop dust free by regular mop up of floor and furniture. There should be an appointed
cleaner to clean the market after closure of shops. Special attention should be given to on
cleanliness of fish and vegetable markets. Sufficient water supply should be ensured to
wash the ‘Katcha Bazar’. Abandoned animal part, fish other rubbish must be cleaned
properly. Insecticide may be sprayed at night.
Collection of Waste
• Establish a routine programme for collection of wastes
• Waste should be collected daily
• Waste bags should be sealed
• Transported to the designated central storage site.
• No bags should be removed unless they are labeled with their point of production and
contents.
• The bags or containers should be replaced immediately with new ones of the same
type.
Segregattion of wastes: Health care wastes must be segmented at the place of generation.
There should be provision of adequate number bins. Waste must me disposes in specified
colour coded bins. Bins must be replaced immediately after re-filling.
Colour coding of waste- Red coloured bin for sharp wastes like needle, blades etc., Blue
coloured bins for liquid wastes, Yellow for infectious gauge, bandage etc. and black for
general wastes. Silver colour bin is for radioactive wastes.
Steps of handling and storage of Hospital Waste
• Waste segregation and packaging
• Collection of waste
• Storage of waste
• Transportation of Health Care waste
• Preparation for transportation
• Transportation of vehicles or containers
• Treatment and final disposal
Transportation of Wastes through Vehicles or Containers
• The body of the vehicle should be of a suitable size
• There should be suitable systems for securing the load during transport
• Empty plastic bags, suitable protective clothing, cleaning equipment, tools, and
disinfectant, together with special kits for dealing with liquid spills, should be
carried in a separate compartment in the vehicle
Safe water supply- Availability of sufficient water supply in market places is a must. In
most of the market places water-supply systems are often poorly designed, poorly
maintained, and/or poorly managed. The market committee is responsible to ensure safe
water supply.

Disinfection of Aircraft and Ship:

Shipment of animals, animal products and foodstuffs by sea and air is economically
important. However, bacteria, viruses, fungi and parasites excreted by animals may
contaminate surfaces. Cleaning is an important step in the sanitizing process and more
than 90% of microorganisms can be removed.
Cleaning and disinfection procedures involve the use of potentially hazardous chemicals
and specialised equipment, and the following basic procedures should be observed to
guarantee the safety of workers and to protect materials and products.
a) The chemicals must therefore be handled with care
b) The electricity supply must be switched off when the washing process is performed.
c) All appliances powered by electricity must be properly maintained and handled.
d) All staff should wear protective masks, boots, coats, trousers and gloves.
e) After fumigation, adequate ventilation is necessary before the re-entry of personnel.
f) Structures, machines and instruments must be protected to avoid corrosion and other
damage.
g) Caution should be exercised to protect products of animal origin or living organisms
Cleaning phase: The cleaning phase is the stage at which the greatest numbers of
microorganisms can be removed. The steps in the cleaning process may be summarized
as follows:
a) remove all gross dirt and all movable equipment and animal facilities
b) rinse surfaces if necessary
c) apply the cleaning solution
d) wash again.

Specific Procedures for Aircraft and Ship Disinfection

The following basic matters must be considered for ship and aircraft disinfection:
- Cleaning and disinfection should be performed regularly after every shipment
- Veterinary authorities should advise of the type of chemical products.
- When some danger or epidemic is suspected, authorities should strengthen the cleaning
and disinfection
- In the airport, a specific, separated area should be set aside for use as a quarantine
station in case of a suspected epidemic.
- Platforms, bridges and gangplanks should be cleaned and disinfected, together with any
other area used for carrying animals and foodstuffs.
The routine procedures may be summarized as follows.
a) Remove gross dirt, straw, hay, food and loose litter. If possible, these materials
should be burned.
b) Wooden or plastic materials, ropes, brushes, chains and blankets should be soaked
in one of the above solutions.
c) Wash the surfaces with a suitable detergent solution.
d) Fumigate after estimation of the volume. Great care should be taken to protect
personnel against exposure to fumigation products, and the premises should be
meticulously sealed during fumigation. For every 25 m3 of space to be fumigated,
1,000 ml of 40% formaldehyde solution and 650 g of potassium permanganate should
be mixed in an open metallic container. The gas should be allowed to act for at least
10 hour before the enclosure is opened. The temperature of the room must exceed
16°C. After fumigation, thorough ventilation is necessary before entry of personnel
and animals.
 Alternatively, chemical disinfection can be performed in a shorter time by spraying or
wetting with a disinfectant solution. After chemical disinfection, the areas treated
should be cleaned (preferably using high-pressure water) to remove any residue.

Questions:
• What is environnemental sanitation ?
• What is improved sanitation ?
• How sanitation barrier prevent disease transmission?.
• List the merits and demerits of water seal latrine
• How you will organize proper sanitary measures during fair and festivals
• What measures you will undertake for proper disposal of wastes from market place,
hospital etc.?
• How proper disinfection in air-craft and ship and cargo can be done?
• How to organize safe water supply, waste disposal and excreta disposal in Disaster?
 Noise

Learning Objectives

At the end of the session the students will be able to

• Define noise
• List sources of noise pollution
• Illustrate the auditory and non-auditory effects of noise
• Aware people about the effects of noise
• Measure sound level

Introduction
Definition of noise: Any sound which is unwanted because it is annoying, interferes,
with speech and hearing, or is intense enough to damage hearing.
▪ Unwanted or Undesired Sound
▪ Wrong sound, which is experienced in a wrong place at the wrong time
▪ Sound without agreeable musical quality.

Definition of noise pollution: Noise pollution refers to freely audible distracting,

irritating or damaging sounds. With this type of pollution, contaminants are not physical
particles, but rather waves that interfere with naturally-occurring waves in the same
environment. Industries, automobiles and some entertainment joints are some of the
sources of noise pollution.
Noise pollution is noise that is loud enough or constant enough to annoy people or cause
a disruption in normal daily activities. Noise pollution is created by humans and is
extreme loud noises that will affect one's hearing and comfort level

Source of noise pollution

• Human-created noise pollution for entertainment, public meeting, loud music,
• Transportation vehicles e.g. aircraft, railroad stock, trucks, buses, automobiles,
and motorcycles all producing excessive noise
• Construction equipment, e.g., jackhammers and bulldozers also produce noise
pollution.
Noise intensity is measured in decibel units.
The decibel scale is logarithmic; each 10-decibel increase represents a tenfold increase in
noise intensity.
Human perception of loudness also conforms to a logarithmic scale; a 10-decibel increase
is perceived as roughly a doubling of loudness. e.g. 30 decibels is 10 times more intense
than 20 decibels and sounds twice as loud;

How to prevent noise pollution: Use horn only when necessary. Follow sound limit
while listening music. Each person can reduce their noise pollution amounts by ranking
levels by hand, do not use a noisy leaf blower. Noise is recognized as a controllable
pollutant. It may be controlled or prevented by following ways:
• Control of noise pollution at source
• Noise producing industries, railway stations, aerodrome, etc. should be located far
away from the residential area
• Entertainment music system should e played at low volume.
• Avoid using loud speaker at night and play at low volume during day time.
• Machines should be well maintained so that it produces less sound.
• Blow horns only when necessary.
• Laws should be framed so tat persons producing unnecessary sounds are
punished.
• Controlling noise pollution by obstructing the path of noise e.g. constructing
sound proof buildings, Plants absorb high frequency sound waves. Thus planting
trees along road side help in controlling noise pollution.

Health effects of Noise

Auditory effect: Causes hearing loss
Noise pollution can cause physical damage to the human ear that is constantly exposed to
sound levels from 80 to 130 decibels.
Hearing loss: Noise-induced hearing loss usually happens slowly, with no pain. Right
after exposure to noise, “ringing” in ears may be felt. After several hours or even a few
days, these symptoms may go away. When exposed to loud noise over and over,
permanent hearing loss may develop. Noise-related hearing loss can be temporary
deafness, or it can be permanent deafness,
Non-auditory effects of noise pollution:
Noise pollution can negatively affect the environment, causing annoyance and health
problems in humans and animals. Apart from hearing loss, noise can cause
• lack of sleep,
• irritability,
• heartburn,
• indigestion, peptic ulcers,
• high blood pressure, and possibly heart disease
• alter endocrine, neurological, and cardiovascular functions in many individuals;
physiological disturbances
• noise-induced stress which may contribute develop mental illness

How to Measure Noise Pollution

Noise pollution refers to extremely high levels of sounds that can cause a nuisance or
even health problems, by damaging the auditory system or disrupting a person's sleep.
These sounds can originate from a number of sources, including road traffic. Noise can
be measured by measuring sound level.
Noise measurement
• Sound Measurement – Sound Level Meter (SLM), Noise Dosimeter

• Hearing Test- Audiometer

Unwanted or undesired sound or wrong sound is noise. Noise not only

causes deafness but it may cause high blood pressure and heart diseases.
Noise-induced stress may contribute develop mental illness

Questions:
• What is noise?
• List sources of noise pollution
• What are the auditory and non-auditory effects of noise?
• How to prevent noise pollution?
• How to measure sound level?
 Housing

Learning Objectives
At the end of the session the students will be able to
• Explain housing,
• List the criteria of good housing,
• List the health problems due to poor housing,
• Advice to improve poor housing condition
• Suggests measures for healthy housing in rural area

Introduction

Every human being needs a shelter to live and to protect himself from environmental
hazards.

A house protects it inhabitants from adverse effects of heat, cold, moisture, dryness and
other ill effects of the environment.

Definition: Housing not only provides physical structure but also fulfill the physiological,
psychological and social needs of the inhabitants.

WHO describes ‘Housing’ as more than the physical structure and substitutes “Housing”
by the term ‘Residential Environment’.

Functions of Housing:
• To provides shelter and privacy
• To provide security and protection from loss of belongings
• To develop mental well-being and happiness of the house holds
• To provide protection from excess heat and cold
• To provide adequate light and without undue glare
Housing Standard:
Housing standard depends on
• geographical location- varies from
• country to country, region to region
• economic condition
• socio-cultural factors-
• customs, education, traditions,
 • national/regional/Local policies
Effects of poor housing condition on health and safety:
Poor housing fails to fulfill physiological, psychological and social needs. A man who
lives in a good house is healthier than those live in poor housing conditions.There should
not more than 2 persons in a single room and floor space for one person should be 70-90
sq.ft. A children between 1 to 10 years is counted as half unit

Hazards and Effects:

Cold and dampness- Stiff joints, muscular pains, respiratory tract disease like common
cold, influenza, diphtheria, TB etc.
Excess heat- Heat stress, heat cramps
Poor lighting- Strain on eyes, accidents
Poor ventilation- Insufficient fresh air, foul smell dusts and fumes
Over crowding- Droplet infection such as measles, mumps, chicken pox, TB etc;
contact disease such as scabies, ringworm etc
Poor / Unsafe water supply- Diarrhoeal diseases, Typhoid fever, Hepatitis etc.
Improper drainage system/stagnant waste water- Breeding place for mosquito
Poor or improper disposal of waste- Breeding place for flies and other insects
Slime, Smooth and polished surface- Falls and accident
Faulty Electric wiring- Electrocution, fire.
Factors related to good housing:
• Site
• Design and Architecture
• Construction
• Ventilation
• Lighting
• Proper sanitation and water supply system
Site: Elevated, independent access from main street, Soil dry & safe, Subsoil
water table below 10 feet.
Set back: Open space all round the house,
Rural area- built up structure should not exceed one third of total area.
Urban area- build up two third of total area.
Floor: Pucca, Impermeable, Easily washed, Smooth free from cracks, crevices,
Damp proof.
 Walls: Reasonably strong , Do not absorb heat and conduct the same, Unsuitable
for harboring rats insects etc
Roof: Not less than 10 ft, Low heat transmittable
Rooms: Not less than 2
Floor area : Living room at least 120 sq. ft; Per person not less than 50 sq. ft
Windows: Living room should have at least two windows, Windows height not
more than 3 ft, Windows area should be one fifth of the floor area with
door two fifth of floor area.
Facilities: Kitchen, Bathroom, Toilet.
Utilities: Water supply, Lighting, Fuel, Waste Disposal, Drainage.
Rural Housing:
Rural housing should have minimum following standard:
There should be at least two living rooms
Space for ample verandah
Built-up area should not exceed one-third of the total area
Separate kitchen and platform for washing utensils
There should be water-seal latrine
Window area should be at least 10% of the floor area
There should safe water source such as tube well
Cattle shed should be 25 feet away from the dwelling house
There adequate facilities for disposal of refuse, garbage and waste water

A man who lives in a good house is healthier than those live in

poor housing conditions.
A good housing can fulfill physiological, psychological and social
needs of a person

Questions:
• What is housing?
• List the criteria of good housing,
• List the health problems due to poor housing,
• What are the criteria for healthy housing in rural area
References:
1) Park K. Textbook of Preventive and Social Medicine. 21st1 Edition Published by
Banarsidas Bhanot Jabalpur, Madhya Pradesh, India 2011, February: pp-868
2) WHO. Environmental Health. World Health Organization,
http://www.who.int/topics/environmental_health/en/
3) Conant J and Fadem P. A Community Guide to Environmental Health. Hesperian
Foundation. Berkeley, California, 2008
4) WHO. Indoor Air Pollution. World Health Organization
http://www.who.int/ceh/capacity/Indoor_Air_Pollution.pdf
5) WHO. Environmental Pollution. World Health Organization
http://www.who.int/topics/environmental_pollution/en/
6) Caussy D. WHO- Field Guide for Detection, Management and Surveillance of
Arsenicosis in South-East Asia Region, World Health Organization, New Delhi, 2005
7) UNEP. Municipal Solid Waste Management. United Nation Environmental
programme http://www.unep.or.jp/ietc/estdir/pub/msw/
8) The Medical Waste Management and Processing Rules, 2008. SRO No.-294-
Law/2008
9) Conant J. Sanitation and Cleanliness for a Healthy Environment. Hesperian
Foundation. Berkeley, California, 2005
10) World Bank. Health Benefits. http://water.worldbank.org/shw-resource-
guide/sanitation-and-hygiene-why-they-matter/health-benefits
11) Healthful Housing? http://labspace.open.ac.uk/mod/oucontent/view.php?id=
451992&section=8.3