Environmental Health Office of Environmental Health Bureau of - - PowerPoint PPT Presentation

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Environmental Health

Office of Environmental Health Bureau of Epidemiology and Disease Control

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INTRODUCTION

Environmental Health

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What is Health?

• According to the World Health Organization,

health is

– A state of complete physical, mental, and social well-being and not merely the absence of disease

• r infirmity.

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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What is Environmental Health?

• The segment of public health that is

concerned with assessing, understanding, and controlling the impacts of people on their environment and the impacts of the environment on them.

Moeller, Dade. Environmental Health. 1992

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Progression of Disease

Person Disease Death

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Public Health: 3 models

Environment Public Disease Death

Clinical Intervention Model

Environment Public Disease Death

Public Health Intervention Model

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Public Health: 3 models

Environment Public Disease Death

Environmental Stewardship Model

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Environmental health

Q: What is exposure? Q: Are people being affected? A: Eating, drinking, breathing, touching A: Air, soil, water, food, built environment

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A: Chemical, bacteria, physical Q: What are hazardous substances? Q: Where do you find hazardous substances?

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Environmental Contamination

• Chemical

– Air pollutants, toxic wastes, pesticides, VOCs

• Biologic

– Disease organisms present in food and water – Insect and animal allergens

• Physical

– Noise, ionizing and non-ionizing radiation

• Socioeconomic

– Access to safe and sufficient health care

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Environmental Health Fields

• Sanitation

– Inspections of food establishments, water treatment facilities, sanitation facilities for compliance with public health laws/codes

• Environmental epidemiology

– Associations between exposure to environmental agents and subsequent development of disease

• Environmental toxicology

– Causal mechanisms between exposure and subsequent development of disease

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Environmental Health Fields, cont.

• Environmental engineering

– Factors that govern and reduce exposure – Built environment

• Preventive medicine

– Factors that govern and reduce disease development

• Law

– Development of appropriate legislation to protect public health

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Topics in Environmental Health

– Toxicology – Epidemiology – Workplace (Occupational Health) – Air in the Home and Community – Food Safety – Drinking Water – Liquid Waste – Solid Waste – Rodents and Insects – Injury Control – Electromagnetic Radiation – Environmental Law – Standards – Monitoring – Risk Assessment – Energy – Disaster Response – Climate

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Environmental Health Agencies

• Federal

– Environmental Protection Agency – Agency for Toxic Substances and Disease Control – Food and Drug Administration – Centers for Disease Control and Prevention – Indian Health Services

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• State

– Arizona Department of Health Services – Arizona Department of Environmental Quality

• Local

– County Health Departments – County Environmental Services Departments

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ENVIRONMENTAL TOXICOLOGY PROGRAM, ADHS

Environmental Health

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Environmental Toxicology Program

• Funding:

– Through a cooperative agreement with the ATSDR (The Agency for Toxic Substances and Disease Registry)

• Purpose:

– To respond to requests to evaluate potential environmental impacts on public health and provide technical guidance for site activities, while using the best available science

• Outcome:

– This partnership provides ADHS with the necessary resources to investigate environmental health concerns and report findings

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Environmental Toxicology Program

• Respond to communities and agencies that are concerned

people might be being exposed to harmful substances in the environment

• Use public health risk assessment to determine how

hazardous a site is or has been

• Recommend actions that need to be taken to safe guard the

health of community residents

• Educate communities statewide about

hazardous chemicals and substances

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How we will communicate with communities

• Public meetings
• Reports
• Fact sheets
• Web site
• Other

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PUBLIC HEALTH RISK ASSESSMENT

Environmental Health

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What is Risk?

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What is Risk?

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What is Safe?

• Free from harm or risk
• Secure from threat of

danger, harm, or loss

• Zero risk

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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What is Risk?

• Possibility of loss or injury, peril
• The chance of loss; the degree of probability
• f such loss

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Solving the problem

• Risk Assessment
• 1. Define the problem
• 2. Measure its determinants
• Determinant = any factor or variable that can affect the

frequency with which a disease occurs in a population

• Risk Management
• 3. Develop intervention/prevention strategies
• 4. Set policy/priorities
• 5. Implement and evaluate

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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Components of Risk Assessment and Risk Management

Hazard Identification Risk Characterization Exposure Assessment Health Effects Evaluation & Dose-Response Assessment Risk Management

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Health Effects

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• Adverse vs. beneficial
• Acute vs. delayed onset
• Clinical vs. subclinical

manifestations

• Transient (reversible) vs.

chronic (irreversible)

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Severity of Adverse Health Effects

Death Significant disease Manifest dysfunction Clinical nuisance effects Sub-clinical chronic alterations Acute reversible (functional) effects

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

Population Exposed

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Vulnerable populations

• Low socioeconomic status
• Women
• Children
• Elderly
• Ethnic minorities
• Disabled
• Indigenous peoples
• May be more vulnerable because of—

– Genetics – They are not empowered to change their environment

Adapted from: http://ocw.jhsph.edu/courses/EnvironmentalHealth/PDFs/Lecture1.pdf

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BUILT ENVIRONMENT

Environmental Health

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Built Environment

• Where people live, work, and play
• Our environment/community can affect our physical and mental health
• “Health community design” – Planning and designing communities that

make it easier for people to live healthy lives

• Advantages:

– Part of people’s daily routine – Provides opportunities to be physically active and socially engaged – Ensure access to affordable and healthy food, especially fruits and vegetables – Improved air and water quality – Lowered risk of injuries – Decreases mental health stress – May lower crime – Reduce heat island effect – Provide fair access to livelihood, education, and resources

www.cdc.gov/healthyplaces & www.cdc.gov/nceh/ehs/topics/BuiltEnvironment.htm

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Built Environment

• Principles of Healthy Community Design:

– Good pedestrian and bicycle infrastructure (walkability) – Offers access to green space and parks – Good mass transit – Outlets for fresh fruits and vegetables (community gardens and farmers markets) – Creates community centers where people can gather and mingle as part of their daily activities

http://www.cdc.gov/healthyplaces/

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Brownfields and Land Reuse

• Brownfield sites

– Sites receiving EPA funding because they are "abandoned, idled,

• r underused industrial and commercial properties where reuse
• r redevelopment is complicated by real or perceived

contamination." (EPA)

• Land Reuse sites

– "any site formally utilized for commercial and industrial purposes complicated by real or perceived contamination" that has not received funding from the EPA Brownfield Program for redevelopment (ATSDR)

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Redevelopment

• Redevelopment of Brownfields

and Land Reuse sites helps to

– Promote a well-rounded approach to redevelopment – Include health as an important part

• f redevelopment

– Use community resources to promote health – Restore and revitalize communities in a way that is fair to all community groups

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HEALTHY COMMUNITIES INITIATIVE, ADHS

Environmental Health

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AZ Healthy Communities Initiative

• ADHS Nutrition, Physical Activity, and Obesity

Program

• Purpose the initiative:

– Supports Arizona communities that are using, or are interested in using, collaborative approaches to healthy community planning and the promotion of healthy lifestyles – Strives to increase neighborhoods that promote healthier lifestyles, increase evidence on the effectiveness of innovative healthy community planning, and decrease health and social inequities by focusing on the influence of where we live

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AZ Healthy Communities Initiative

• Health Community Toolkit –

– Guidebook for Arizona communities to make changes to create built environment that supports a healthy lifestyle. – http://www.azdhs.gov/phs/bnp/nupao/az-healthy-communities/

• Tempe Streetcar Project –

– ADHS in partnership with Maricopa Department of Public Health established the Health in Policy and Practice Advisory Group, representing Livable Communities Coalition, Arizona Department of Transportation, Arizona State University and the Arizona Chapter of American Planning Association, to complete the first Health Impact Assessment (HIA) in Arizona. – The group prepared a HIA to recommend strategies to ensure health equity in the community surrounding the alignment of the Tempe Modern Street Car. – Health risks that were assessed include air pollution, physical activity, safety and injury prevention, accessibility to resources, neighborhood environment, and livelihood.

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To Learn More…

• Agency for Toxic Substances and Disease

Registry

– www.atsdr.cdc.gov – www.atsdr.cdc.gov/sites/brownfields/overview – www.atsdr.cdc.gov/sites/brownfields/docs/ATSDR _LandReuse.pdf – www.atsdr.cdc.gov/docs/APHA-ATSDR_book.pdf – www.atsdr.cdc.gov/HAC/PHA/index.asp

• Environmental Protection Agency

– www.epa.gov – www.epa.gov/superfund – www.epa.gov/epahome/citizen.htm – www.epa.gov/brownfields – www.epa.gov/smartgrowth/built.htm

• Centers for Disease Control and Prevention

– www.cdc.gov – www.cdc.gov/Environmental – www.cdc.gov/healthyplaces/default.htm 40

• Arizona Department of Health Services

– www.azhealth.gov – www.azdhs.gov/phs/bnp/nupao/az-healthy- communities – www.azdhs.gov/phs/oeh/toxicology

• Arizona Department of Environmental Quality

– www.azdeq.gov – www.azdeq.gov/ceh – www.azdeq.gov/environ/waste/cleanup/brownfie lds.html – www.azdeq.gov/environ/waste/sps