Introduction to Environmental Health

Dr Ibrahim
Shehu Aliyu Gwarondo
Department of Community Medicine and Public Health
Introduction

• Environmental Health is a discipline that deals with the components of

the environment and how they affect human health

• Environmental sanitation is the process involved in taining the

environment such that it doesn’t constitute hazard to man

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Components of environmental health

1. Water supply
2.Refuse disposal
3.Sewage
4.Food hygiene
5.Housing
6. Vector control
7. Atmospheric pollution
8. Other hazard such as radiation, noise etc.

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Water supply

Sources of water
- Rain water
- Surface water
- Underground water :
Shallow well - taps water above the first impervious layer
Deep well (bore hole) - taps water below the first impervious layer
Shallow water is harder and more contaminated while deep water is less
harder and less contaminated

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 Properties of water

Water is a universal solvent

o Physical: colorless, tasteless and odorless
o Chemical: free from harmful chemicals
o Biological: free from microbes

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Qualities of a sanitary well

1. Must be located at least 30m away from a potential source of pollution

2. Should have a concrete structure that surround it called parapet
3. It should have a concrete surrounding called apron
4. It should have a concrete lining inside of about 2ft
5. It should also have a tight water cover
6. It should have a permanent attached water fetcher

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 Water Treatment
• Protection of source: protect from animals and plants
• Screening: separation of rocks, sand and any removable thing
• Storage: ova of schistosoma die after 48hrs and other suspended particles settle
• Coagulation and sedimentation : addition of alum helps the smaller particles to come
together and form bigger particles called coagulation.
When they are bigger, they become heavier and settle down (sedimentation)
• Filtration: using sand filters which are of 2types; Rapid and slow sand filters which
consist of stones and gravels of graded size
• Disinfection: done by boiling, UV-light or chemical e.g. chlorine. A chlorinator is
used which releases 1 part of chlorine per million of water. However when there is
epidemic of water borne disease the amount of chlorine is increased to 1.5part. After
1hr, dechlorination is done using sulphurdioxide and released for consumption
• Coliform count is used to determine water is infected or not, drinking water should
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 Water related diseases
Water Borne diseases Water Shortage diseases
Transmitted faeco-orally Due to Scarcity of water
Cholera Scabies
Trachoma
Typhoid Conjunctivitis
Poliomyelitis Water Arthropod diseases –
Infective hepatitis Transmitted through vectors e.g. mosquitoes
Water Based/Impounded : Filariasis
• Organisms live in water Yellow fever
Malaria
• drinking or coming in contact Dengue
Paragonimiasis – cercaria in uncooked Water chemical related diseases
crayfish – Excess or insufficiency
Dracunculiasis – drinking cyclops in water Fluorosis
Schistosomiasis – cercaria penetration Goitre – Lack of Iodine 8
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 Refuse disposal
• Refuse is solid waste. If allowed to accumulate, it leads to Hazards (potential risk)
1- Biological hazards – favors breeding of vectors (insects and rodents)
- cockroaches and flies – diarrhoea diseases, typhoid fever, paratyphoid, infective
hepatitis
- mosquitoes increases incidence of malaria fever and yellow fever
- Attracts rodents – Lassa fever, plague, Leptospirosis, mpox
- Microbial water contamination with E. coli bacteria, poliomyelitis virus
2- Physical hazards - blockage of drainage, flooding, fire outbreak
3- Mechanical hazards –Lacerations and pricking – tetanus and septic wound
4- Chemical hazards – bad odour smell, water chemical contamination e.g. Lead
or mercury toxicity
5- Psychological hazards – insightfulness (visual irritation), aesthetics and
annoyance
6- Social hazards - Blocking the road – transportation obstacles, increasing
burden on health services, distort socio-economic activities
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Sources of refuse

- Domestic
- Market
- Hospitals
- Industrial activities
- Agricultural
- Educational institutions s
- Natural phenomenon e.g. strong wind, flooding

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The three stages of waste management

- Collection/storage of refuse
• Sacks and drums
• Galvanized steel dustbin
• Public bin
• Colour coded hospital waste bin
- Transportation – hygienic and unhygienic
- Disposal of refuse - hygienic and unhygienic

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Integrated Solid Waste Management

1 Prevention
2 Reduction
3 Re-use
4 Recycling
5 Recovery
6 Disposal

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Methods of refuse disposal

1. Open dumping: Disposing in low-level of land. It is the most insanitary

method of disposal
2. Sanitary land fill or Controlled tipping: availability of land and to
replenish land
3. Composting: Is a process of combined disposal of refuse and night soil
4. Incineration: Is employed in hospital waste management, the waste are
put in a machine at high temperature.
5. Sea disposal or berging: In coastal areas waste are disposed in water e.g.
disposal of nuclear materials

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Types of hospital waste:

1- Domestic waste e.g. Biscuits leader and papers

2- Infectious waste e.g. swap, IV giving set, plaster or swab samples
3- Highly infectious waste such as pathological waste: Body tissues
or blood stain materials e.g. blood bag and containers
4- Pharmaceutical waste: expired drugs, discarded drugs
5- Sharp waste: needle and syringes

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Hospital waste collection

• Domestic waste – Black bin

• Infectious waste – Yellow bin
• Highly infectious waste – Red bin
• Pharmaceutical waste – Brown bin
• Sharps – Safety box

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Sewage management
• Sewage: liquid waste; excreta (urine and faeces)
• Good Excreta Disposal
Should be sited 30m away from water source and downhill
It should not be unsightly and smelly
It should not be accessible to flies and rodents
It should be simple, inexpensive and culturally acceptable
. Sullage- Water from laundry, bathroom and kitchen (grey water)

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 Methods of excreta disposal….1:
 Non water carriage: e.g. pit latrine, VIP latrine and bucket latrine
Employed where there is limited amount of water
- Pit latrine: Has a pit, floor and superstructure, at least 2.5m deep to avoid seeing,
and economies evacuation. Floor should be made of reinforced concrete slab
- Ventilated improved pit latrine(V.I.P): Has a pipe placed outside the house
Fly proof vent placed on it to diverts odor
- Bucket latrine: Is inexpensive but unhygienic as it allows spillage of faeces
Risk of infections – cholera, typhoid, paratyphoid, dysentery, infective hepatitis
and helminthiasis
 Water carriage: - Septic tank and soak away pit
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privy: Faeces drop directly in soak away 17
Methods of excreta disposal….1:

• Chemical toilet: Employed in airplane, trains an luxurious

• Consist of corrosion resistant containers of about 400-500litres

• Contain bactericidal substance e.g. formaldehyde or NaOH
• The excreta is disposed appropriately when it is full

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Disease associated with poor excreta disposal
• Water associated diseases:
-Cholera
-paratyphoid
-Typhoid
-Rota virus
-Dysentery
-Poliomyelitis
-Infective hepatitis
• Food associated: -Ascariasis -Trichuriasis - Enterobiasis
• Skin Penetration: -Hookworm -Schistosomiasis

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Food Hygiene

• Food Hygiene- Deals with the prevention of contamination of

foodstuff and drinks, the utensils and pieces of equipment used in food
preparation, service and consumption.
• Food poisoning: Is an acute gastroenteritis caused by ingestion of
living organisms or their toxins or inorganic chemical substances.
Classified in to: Bacterial (Living organisms) and non Bacterial
(chemicals)
1. Salmonella Food poisoning (salmonella typhimurium)
2.Staphylococcal food poisoning (Staphylococcus aureus)
3.Clostridium food poisoning (Clostridium perfringes)
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 Epidemiology of food poisoning

1. Staphylococcal food poisoning (Staphylococcus aureus)

Incubation period: 1-6hrs Clinical symptoms: Nausea and vomiting
Risk factor: drinking or eating food contaminated with nasal
discharge, boil (Frunculosis) of whitlow (Paronychia) during festival
2. Salmonella Food poisoning (salmonella typhimurium)
Incubation period: 12-24hrs Clinical symptoms: Diarrhoea, vomiting and Fever
Risk factor: Eating snacks, ice cream, salad cream, eggs
3. Clostridium food poisoning (Clostridium perfringes)
Incubation period: 12-24hr Clinical symptoms: Diarrhoea and abdominal pain
Risk factor: drinking or eating semi-preserve meat or diary product that stay over
night,
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 Methods of food preservation
 Drying
 Salting
 Smoking
 Refrigeration
 Heating
 Radiations

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Methods of prevention of food poisoning
• At individual level:
Health education on personal hygiene and proper handling of foodstuff
Prompt and thorough refrigeration of food especially meat and dairy product
Proper cleaning and maintenance of utensils in food preparation, service and
consumption
 Proper cooking of food
• At community level
Vetinary inspection of abbator and proper anti and post mortum inspection of
animals
Avoid use of chemicals in food preservation
Pasteurization of milk
Avoid use of chemicals in meat preservation
Medical examination of food handlers 23
Housing and Health

Housing is the physical structure that man use as shelter and the
environment of that structure including all necessary services, facilities
and equipments for the social and mental wellbeing of an individual.
• Social goal of housing
1. Shelter – protect from adverse effect of climate and pollution
2. Family life – pro-creation
3. Access to community services and facilities
4. Form of investment
5. Security and privacy to ensure dignity
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Housing and health…1 • Structures
• Site selection Suitable materials for construction
Not flooding prone area Non-collapsible
Not close to discharges of industrial Space for cooking facility
waste
Not muddy or sandy Excreater and other forms of waste
disposal
Not favor breeding of vectors Access to portable water
Should be elevated • Surrounding
Have independent access to street Smooth wall with low heat capacity
• Size Weather resistant
 Area of 3.5- 4.5m sq per person Not favor breeding of insects and rodents
Good ventilation • Social amenities
• Surface  Electric power supply
Smooth floor and free from cracks Communication facilities
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Housing and health….2
Space
Window
• At least 2 windows in each room and should be on different walls
• Height at least 1m from the floor
• Window area should be 1/5th floor area
Room
• A house should have at least 2 rooms size at least 20sq feet
Kitchen
• Paved flat form
• Sink
• Facilities for disposal of refuse
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 Overcrowding

• More people living in a single dwelling than there is space for,

• movement is restricted, privacy secluded, hygiene impossible, rest and sleep difficult
• Criteria for overcrowding
• 1.Floor space: -110sq feet: 2 persons 70-90sq ft: 1 person <50ft:not acceptable
• Persons per room: 1 room: 2persons 2 rooms: 3 people
3rooms:5 people 4 rooms : 7people 5 rooms: 10 people
• For any additional ↑room there should be additional people ↑ in house
• Social overcrowding is said to occur if 2 persons of opposite sex not legally married,
>9 years are obliged to sleep in the same room

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Medical condition associated with poor Housing

1.Respiratory Infection- Tuberculosis, Bronchi, Pneumonia, non-

infectious disease- Asthma
2.Skin Infection- Scabies, Ringworm
3.Mosquitoes associated- Malaria, yellow fever, dengue fever, Filariasis,
zika fever
4. Rodents associated – Lassa, Leptospirosis, Monkey Pox, Plague
5.Accidents- Fire outbreak, Building collapse
6. Increase morbidity and mortality
7. Mental disorders- Neurosis (e.g. phobia) and psychosis (e.g.
Schizophrenia
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Radiation hazard
• Radiation is the physical part of the environment. It is the emission of
energy in form of electronegative waves or substance particles
• Classified into ionizing and non-ionizing radiation
• Sources of ionizing radiation exposure
Natural
- Cosmic rays
- Environmental sources – Radon gas – from decay of uranium in soil- from
ground trap in dwellings with poor ventilation - Internal radiation: within our
body tissue
 Man-made:-
- Medical and dental exposure e.g. x-rays
- Occupational exposure: mining, Agricultural phosphate fertilizer
- Radioactive nuclear power, weapon, nuclear medicine
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Health effect of ionizing radiation
The somatic and genetic effects
• Somatic: Immediate
- Acute radiation syndrome
- Radiation sickness
- Anemia
- Thrombocytopenia
• Genetic: Late : seen in offspring's of exposed individuals; chromosome
mutation
- Cancers e.g. Leukemia usually after 10 years (Secular trend of epidemic)
- Birth deformities - congenital malformation
- cataract
- Infertility
- Radio-dermatitis
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Effect of non ionizing radiation

• - Heat exhaustion
• other heat disorders
• keratitis
- sunburns

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Principles of radiation hazard control in occupational
environment
1- Elimination/total enclosure or Substitution (material or method)
2- Containment;
limit time of exposure
ventilation
shielding
isolation
3- Adjunct measures: Health education and promotion
Administrative policy
Personal protective equipment (PPEs)
Environmental monitoring
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Air pollution
• Presence of substances in the concentration/duration that becomes a
nuisance to man, animals or plant
• Normal air consist of 75% nitrogen, 21% oxygen and 0.03% carbon
dioxide, other minute gases
Sources of air pollution
1- Combustion: is a major source and can give rise to the following
chemicals
- Carbon monoxide from automobile exhaust of cars and steel blast furnace
- Hydrocarbons discharged from automobile exhaust
- Organic lead discharged from automobile exhaust
- Sulphurdioxide discharged from burning fossil fuels

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2 - Specific Industrial process
- Hydrogen sulphide discharged from rayon industries, canon dye
making and oil refineries
- Hydrogen fluoride from fertilizer chemical and aluminum
industries
3 - Personal Habit: a) smoking which lead to the discharge of CO and
hydrocarbon
4 - Nature: can contribute to air pollution through pollen grain, dust,
mold spores, vegetable fiber, microorganism

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 Health Effects of Air Pollution
Disease commonly associated with atmospheric air pollution include
 Chronic bronchitis
Asthma
Emphysema
Lung cancer
Irritation of the eye

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Control of Air pollution
• Elimination - Process redesign and equipment modification
 Substitution of raw materials
Wet metals to reduce dust
Use of electrostatic precipitation
• Containment- Site selection: Industrial and residential areas should be
carefully planned so that air pollution will be reduced
• Adjunct measures
Legislation and policy
Health Education on PPEs
Environmental monitoring of gases, fume, vapor and smoke
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Green House Gases
• They are gases that trap heat in the atmosphere e.g.
• Carbon monoxide
• Methane
• Nitrous oxide
• Chlorinated gases
CO enters the atmosphere through burning of fossil fuel
Methane and nitrous oxide emitted during certain agricultural and
industrial activities

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Global warming

Is the rise in the average surface temperature of the earth climate system
Usually caused by green house gases
Leads to various effects like extreme weather events
• Melting of the polar ice caps
• The rising sea level
• Extinction of flora and fauna
• Increase emerging and re-emerging diseases

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Ozone depletion

• Is the gradual thinning out of the ozone layer in the stratosphere

• Caused by the release of chemical compounds containing
chlorofluorocarbon CFCs, usually found in refrigerant and aerosol
spray
• The ozone layer is a thin layer that absorbs a large proportion of UV
light coming from the sun
• Depletion increases UV radiation that reaches the earth surface which
increases skin cancer, eye cataract and genetic and immune disorders

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Noise pollution

• Auditory effect: auditory fatigue, hearing loss which can be temporary or

permanent
• Non auditory effect: this include loss of concentration, irritation, annoyance,
communication difficulty.
Principles of noise control:
Elimination - Process redesign which involve designing less noisy
equipment e.g. sound proof generators
Containment- Site selection of industrial and residential areas
Adjunct measures - Personal protective devices (PPEs) e.g. ear mop
- Health education on the hazard of noise
- Environmental monitoring and Administrative control
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Insecticides

-Insecticides in public health are used for quick knock down or residual
-Knock down contain pyrethrum –short time spray or in mosquito nets
-Residual contain DDT or Benzene hydrochloride, parathion, malathion
Types of Insecticides
• Organochloride: DDT, BHC less toxic
• Organophosphate: Abate, malathion, parathion are more toxic
• Carbamate: Propuxure (baygon)

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Method of application of insecticide
• Water dispersible powder: for residual spraying of buildings and
wall surfaces. Most DDT and Dieldrin as residual insecticide are
usually applied in this form
• Emulsion concentration: most organophosphate are formulated in
emulsion concentration.
• Dust: finely ground mixtures of insecticide and inert diluents e.g talc
commonly used in agricultural pest against cockroaches, flies
• Aerosols, fogs, vapors, smoke and fine spray: fine suspension in the
air of solid and liquid particles of insecticide.
• Pellet and granules: these are lavaecide for use in shallow water
breeding places with much vegetation
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Insecticide poisoning

Can occur through skin contact, inhalation or ingestion

Effects of insecticide poisoning
1- Chlorinated hydrocarbon: signs of acute poisoning by chlorinated
hydrocarbon is convulsion and liver damage.
• Acute poisoning due to swallowing of hydrocarbons you give emetics
• For chronic poisoning due to continued intake of smaller quantities
will lead to nervous symptoms characterize by hyperexcitability,
anxiety and tremors, marked weight loss and loss of appetite.
• Treatment is large doses of phenobarbiturate
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Effect of insecticide poisoning…cont
2-Organophosphate: symptoms are similar to those caused by chlorinated
hydrocarbon but include bronchial disturbance.
• Organophosphate insecticide are cholinesterase inhibitors, so inhibit
cholinesterase which is responsible for breaking down acetylcholine in the
body.
• Leads to symptoms of excessive acetylcholine; headache, blurred vision,
nausea, abdominal cramp, bronchospasm, excessive salivation, muscle
twitching, coma, convulsion.
Treatment is by I.V atropine and 2-pyridinium aldoxin methiodide (2-PAM). In
severe cases, may need artificial respiration before treatment
3-Carbamate: poisoning give rise to rapidly reversible cholinesterase
inhibition complex
• Treatment is with atropine only
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 Miyetti

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