Environmental health

WHO definitions

Environmental health was defined in a 1989 document by the World Health Organization (WHO) as: Those aspects of human health and disease that are determined by factors in the environment.^[3] It is also referred to as the theory and practice of accessing and controlling factors in the environment that can potentially affect health.^[4]

A 1990 WHO document states that environmental health, as used by the WHO Regional Office for Europe, "includes both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often indirect) on health and well being of the broad physical, psychological, social and cultural environment, which includes housing, urban development, land use and transport."^[5]

As of 2016^[update], the WHO website on environmental health states that "Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behaviour not related to environment, as well as behaviour related to the social and cultural environment, as well as genetics."^[6]

The WHO has also defined environmental health services as "those services which implement environmental health policies through monitoring and control activities. They also carry out that role by promoting the improvement of environmental parameters and by encouraging the use of environmentally friendly and healthy technologies and behaviors. They also have a leading role in developing and suggesting new policy areas."^[7][8]

Other considerations

The term environmental medicine may be seen as a medical specialty, or branch of the broader field of environmental health.^[9][10] Terminology is not fully established, and in many European countries they are used interchangeably.^[11]

Other terms referring to or concerning environmental health include environmental public health and health protection.^[12]

Pediatric environmental health

Children's environmental health is the academic discipline that studies how environmental exposures in early life—chemical, biological, nutritional, and social—influence health and development in childhood and across the entire human life span.^[13] Pediatric environmental health is based on the recognition that children are not “little adults.” Infants and children have unique patterns of exposure and vulnerabilities. Environmental risks of infants and children are qualitatively and quantitatively different from those of adults. Pediatric environmental health is highly interdisciplinary. It spans and brings together general pediatrics and numerous pediatric subspecialties as well as epidemiology, occupational and environmental medicine, medical toxicology, industrial hygiene, and exposure science.

Air quality

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

Outdoor air quality

Air pollution is globally responsible for over 6.5 million deaths each year.^[28] Air pollution is the contamination of an atmosphere due to the presence of substances that are harmful to the health of living organisms, the environment or climate.^[29] These substances concern environmental health officials since air pollution is often a risk-factor for diseases that are related to pollution, like lung cancer, respiratory infections, asthma, heart disease, and other forms of respiratory-related illnesses.^[30] Reducing air pollution, and thus developing air quality, has been found to decrease adult mortality.^[31]

Common products responsible for emissions include road traffic, energy production, household combustion, aviation and motor vehicles, and other forms of pollutants.^[32][33] These pollutants are responsible for the burning of fuel, which can release harmful particles into the air that humans and other living organisms can inhale or ingest.^[34]

Air pollution is associated with adverse health effects like respiratory and cardiovascular diseases, cancer, related illnesses, and even death.^[35] The risk of air pollution is determined by the pollutant's hazard and the amount of exposure that affects a person.^[36] For example, a child who plays outdoor sports will have a higher likelihood of outdoor air pollution exposure than an adult who tends to spend more time indoors, whether at work or elsewhere.^[36] Environmental health officials work to detect individuals who are at higher risks of consuming air pollution, work to decrease their exposure, and detect risk factors present in communities.^[37]

However, as shown in research by Ernesto, Sánchez-Triana in the case of Pakistan. After identifying the main sources of air pollution, such as mobile sources, such as heavy-duty vehicles and motorized 2–3 wheelers; stationary sources, such as power plants and burning of waste; and natural dust. The country implemented a clean air policy to reduce the road transport sector, which is responsible for 85% of particulate matter of less than 2.5 microns (PM2.5) total emissions and 72% of particulate matter of less than 10 microns (PM10)^[38] Most successful policies were:

• Improving fuel quality by reducing the sulfur content in diesel
• Converting diesel minibuses and city delivery vans to compressed natural gas (CNG)
• Installing diesel oxidation catalysts (DOCs) on existing large buses and trucks
• Converting existing two-stroke rickshaws to four-stroke CNG engines
• Introducing low-sulfur fuel oil (1% sulfur) to major users located in Karachi^[38]

Climate change and its effects on health

Climate change makes extreme weather events more likely, including ozone smog events, dust storms, and elevated aerosol levels, all due to extreme heat, drought, winds, and rainfall.^[45][46] These extreme weather events can increase the likelihood of undernutrition, mortality, food insecurity, and climate-sensitive infectious diseases in vulnerable populations.^[47] The effects of climate change are felt by the whole world, but disproportionately affect disadvantaged populations who are subject to climate change vulnerability.^[48]

Climate impacts can affect exposure to water-borne pathogens through increased rates of runoff, frequent heavy rains, and the effects of severe storms.^[49] Extreme weather events and storm surges can also exceed the capacity of water infrastructure, which can increase the likelihood that populations will be exposed to these contaminants.^[49][50] Exposure to these contaminants are more likely in low-income communities, where they have inadequate infrastructure to respond to climate disasters and are less likely to recover from infrastructure damage as quickly.^[51]

Problems like the loss of homes, loved ones, and previous ways of life, are often what people face after a climate disaster occurs. These events can lead to vulnerability in the form of housing affordability stress, lower household income, lack of community attachment, grief, and anxiety around another disaster occurring.^[48]

Environmental racism

Certain groups of people can be put at a higher risk for environmental hazards like air, soil and water pollution. This often happens due to marginalization, economic and political processes, and racism. Environmental racism uniquely affects different groups globally, however generally the most marginalized groups of any region are affected. These marginalized groups are frequently put next to pollution sources like major roadways, toxic waste sites, landfills, and chemical plants.^[52] In a 2021 study, it was found that racial and ethnic minority groups in the United States are exposed to disproportionately high levels of particulate air pollution.^[53] Racial housing policies that exist in the United States continue to exacerbate racial minority exposure to air pollution at a disproportionate rate, even as overall pollution levels have declined.^[53] Likewise, in a 2022 study, it was shown that implementing policy changes that favor wealth redistribution could double as climate change mitigation measures.^[54] For populations who are not subject to wealth redistribution measures, this means more money will flow into their communities while climate effects are mitigated.^[53][54]

Noise pollution

Noise pollution is usually environmental, machine-created sound that can disrupt activities or communication between humans and other forms of life.^{[citation needed]} Exposure to persistent noise pollution can cause numerous ailments like hearing impairment, sleep disturbances, cardiovascular problems, annoyance, problems with communication and other diseases.^[55] For American minorities that live in neighborhoods of low socioeconomic status, they often experience higher levels of noise pollution compared to their higher socioeconomic counterparts.^[56]

Noise pollution can cause or exacerbate cardiovascular diseases, which can further attribute to a larger range of diseases, increase stress levels, and cause sleep disturbances.^[56] Noise pollution is also responsible for many reported cases of hearing loss, tinnitus, and other forms of hypersensitivity(stress/irritability) or lack thereof to sound(present or subconscious from continuous exposure).^[56] These conditions can be dangerous to children and young adults who consistently experience noise pollution, as many of these conditions can develop into long-term problems, including physical and mental health issues.^[56]

Children who attend school in noisy traffic zones have shown to have 15% lower memory development compared to other students who attended schools in quiet traffic zones, according to a Barcelona study.^[57] This is consistent with research that suggests that children who are exposed to regular aircraft noise "have inadequate performance on standardised achievement tests."^[58]

Exposure to persistent noise pollution can cause one to develop hearing impairments, like tinnitus or impaired speech discrimination.^[59] One of the largest factors in worsened mental health due to noise pollution is annoyance.^[60][61] Annoyance due to environmental factors has been found to increase stress reactions and overall feelings of stress among adults.^[55] The level of annoyance felt by an individual varies, but contributes to worsened mental health significantly.^[61]

Noise exposure also contributes to sleep disturbances, which can cause daytime sleepiness and an overall lack of sleep, which contributes to worsened health.^[61] Daytime sleepiness has been linked to several reports of declining mental health and other health issues, job insecurities and further social and environmental factors declining.

Safe drinking water

Access to safe drinking water is considered a "basic human need for health and well-being" by the United Nations.^[62] According to their reports, over 2 billion people worldwide live without access to safe drinking water.^[63] In 2017, almost 22 million Americans drank from water systems that were in violation of public health standards.^[64] Globally, over 2 billion people drink feces-contaminated water, which poses the greatest threat to drinking water safety.^[65] Contaminated drinking water could transmit diseases like cholera, dysentery, typhoid, diarrhea and polio.^[65]

Harmful chemicals in drinking water can negatively affect health. Unsafe water management practices can increase the prevalence of water-borne diseases and sanitation-related illnesses.^[66][67] Inadequate disinfecting of wastewater in industrial and agricultural centers can also infect hundreds of millions of people with contaminated water.^[65] Chemicals like fluoride and arsenic can benefit humans when the levels of these chemicals are controlled;but other, more dangerous chemicals like lead and metals can be harmful to humans.^[65]

In America, communities of color can be subject to poor-quality water.^[68] In communities in America with large Hispanic and black populations, there is a correlated rise in SDWA health violations.^[68] Populations who have experienced lack of safe drinking water, like populations in Flint, Michigan, are more likely to distrust tap water in their communities.^[51] Populations to experience this are commonly low-income, communities of color.^[69]

Hazardous materials management

Hazardous materials management, including hazardous waste management, contaminated site remediation, the prevention of leaks from underground storage tanks and the prevention of hazardous materials releases to the environment and responses to emergency situations resulting from such releases. When hazardous materials are not managed properly, waste can pollute nearby water sources and reduce air quality.^[70]

According to a study done in Austria, people who live near industrial sites are "more often unemployed, have lower educations levels, and are twice as likely to be immigrants.^[71] With the interest of environmental health in mind, the Resource Conservation and Recovery Act was passed in the United States in 1976 that covered how to properly manage hazardous waste.^[72]

There are a variety of occupations that work with hazardous materials and help manage them so that everything is disposed of correctly. These professionals work in various sectors, including government agencies, private industry, consulting firms, and non-profit organizations, all with the common goal of ensuring the safe handling of hazardous materials and waste. These positions include but are not limited to Environmental Health and Safety Specialists, Waste collectors, Medical Professionals, and Emergency Responders.^[73] Handling waste, especially hazardous materials is considered one of the most dangerous occupations in the world.^[74] Often, these workers may not have all of information about the specific hazardous materials they encounter, making their jobs even more dangerous. The sudden exposure to materials they are not properly prepared to handle can lead to severe consequences.^[75] This emphasizes the importance of training, safety protocols, and the use of personal protective equipment for those working with hazardous waste.

Microplastic pollution

This section is an excerpt from Microplastics and human health.[edit]

This article needs more reliable medical references for verification or relies too heavily on primary sources. (September 2024)

Microplastics effects on human health are of growing concern and an area of research. The tiny particles known as microplastics (MPs), have been found in various environmental and biological matrices, including air, water, food, and human tissues. Microplastics, defined as plastic fragments smaller than 5 mm, and even smaller particles such as nanoplastics (NP), particles smaller than 1000 nm in diameter (0.001 mm or 1 μm), have raised concerns impacting human health.^[76][77] The pervasive presence of plastics in our environment has raised concerns about their long-term impacts on human health. While visible pollution caused by larger plastic items is well-documented, the hidden threat posed by nanoplastics remains under-explored. These particles originate from the degradation of larger plastics and are now found in various environmental matrices, including water, soil, and air. Given their minute size, nanoplastics can penetrate biological barriers and accumulate in human tissues, potentially leading to adverse health effects.^[78][79]

Plastics continue to accumulate in landfills and oceans, leading to pollution that negatively impacts both human and animal health. Notably, microplastics and nanoplastics are now ubiquitous, infiltrating our food chain and water supplies. Studies indicate that humans ingest significant amounts of microplastics daily through food, especially seafood^[80] and inhalation, with estimates ranging from 39,000 to 52,000 particles per person annually^[81] Additionally, the presence of microplastics in human feces suggests widespread exposure and absorption.^[82] In scientific literature, combined microplastics and nanoplastics are referred to as MNPs or NMPs, or NMPPs for nano-and microplastic particles.

Understanding the sources and health effects of nanoplastics is crucial for developing effective public health policies. As plastics are an integral part of modern life, balancing their benefits with the associated health risks is essential. This research aims to provide evidence-based recommendations to mitigate the adverse health effects of nanoplastics, thereby informing future regulatory and policy decisions. The increasing presence of nanoplastics in the environment has raised concerns about their potential impacts on human health. Research has shown that nanoplastics can penetrate biological barriers, induce toxicity, and accumulate in organs, leading to various health issues ^[83]. Nanoplastics have been found in drinking water, food, and air, making human exposure ubiquitous^[84].

Soil pollution