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Introduction:Good health is the fundamental rights of every human beings. Internal and enternal growth of a person is not possible without good health. Good health is essential to lead a quality and successful life. Beyond being a personal responsibility health is a national and international responsibility and also a worldwide social goal. Environment is a main determinant of health status of a community. DEFINITION Health:WHO (1948) Health is a state of complete physical, mental and social well being and not merely an absence of disease or infirmity Roy (Nursing Theorist) ENVIRONMENT:Environment indicates all of the internal and external conditions, circumstances and influences surrounding or effecting the development and behavior of persons or group. ENVIRONMENTAL HEALTH:WHO Who defines environmental health as the control of all those factors in mans physical environment which enercise harmful effects on his physical development health and survival. IMPORTANCE OF ENVIRONMENTAL HEALTH 1) Improving the individual and community health status. 2) Protection against diseases. 3) Providing healthful environment. 4) Encouraging environmental education.

5) Controlling environmental pollution and predicting the environment. 6) Co-ordination within the efforts of environmental health team. The relationship of environment to health has been recognized by nurses since the time of Florence Nogentingale. She was the first nurse to recognize the importance of environmental factors in relation to health. Environment and health have a deep interrelation.

TYPES OF ENVIRONMENT The environment is mainly classified in to  Internal environment  Enternal environment Internal Enviornment:It includes each and every component part, every tissue, organs and organ system and their harmonious functioning within the system. Enternal Envirnment:It consists of those things to which man is eriposed after conception. It is defined as all that which is external to the individual human lost. External environment is again divided in to. 1) Physical environment 2) Biological environment 3) Social environment Other Types of Environment are 4) Occupational environment 5) Socioeconomic environment 6) Moral environment Relation between different components of environment and health can be explained further on basis of following points.

PHYSICAL ENVIRONMENT AND HEALTH Physical environment mainly includes *Air *Sound 1) AIR:Air is the basis of life for all cxatures. Clean air is essential to have good health. Apart from supplying the life giving oxygen, air and atmospheric conditions sevves several functions like cooling the human body by the air contact the special senses of hearing and smell function trough air transmitted stimuli. Human beings need a continuous supply of air. The requirement of air is relatively 10-20m3 per day. For a developing country like India, air pollution was become a great health hazaid. Air pollution:It refers to presence of foreign materials like smoke, harmful gas, dust, vapour and fine particles in the atmosphere which are harmful for human beings, animal, vegetarian etc. SOURCE OF AIR POLLUTION: Household air pollution  Community air pollution  Occupational air pollution House hold air pollution:It is form wood,coal,gas, od used as fuel in homes which produces carbon,dust,smoke etc. community air pollution: Burning foeewood & coal  Decay of plants & animals  Dust & refuses from sleet *Water *Radiation *Food *Hight *Housing *Ventilation *Humedy etc.

*Waste disposal

*Air temparature

 Automobile exliaust  Industries around community. Increasing number of private vehicle contribute to more than 60% of airpollution, which eripels hydrocarbons, carbon monede,

netrogenoxcede, leads etc (especially dual vehicles). Occupational air pollution:Harmful gas from mines, explosions and reactions performed for research and development of nuclear technique, space joueney, atomic power etc. SOURCES & EFFECT OF MAJOR POLLUTANTS

Pollutant Asbestos

Source  Asbestos plant  Asbestos pipe & roofing  Road building.

effects * Cancer *asbestosis (Severe Scarring of lungs)

Carbon monoxide

 Vehicle exhaust  Incomplete combustion of fuel

*Interfire with O2 carrying capacity of blood. *Fatal in high conceufeation and affect lung, beain, heaef

Hydrocarbon

 Combustion of fossil fuels

*Drowsiness *Eyclrretatis *Conghing.

Oxide of Nickogen

Diesel, petroleum, coal combustion, industrial process, natural process such as volcanie cruption.

*Iritiate theoat and eye aggrevate asthma, bronchitis, emphysema, source for acid rain.

DDT (Dichlow diphencyl-Tri drlow ethane) Endosulfan (contaminates air, water,plants)

DDt, Sprays, DDT manufacturing plants.

*Acute poisoningheadache kemor, blurred version.

 Pesticides Iurecticdes.

Long term:Carcinogenic effort civer damage, neueologic & beain distuebance.  Endocrine dirruption Qepeoductuee, developmental dycet, caneer, etc.

Monetoring preventing And Control of Air pollution:Air pollution monitoring in India is done by central pollution control board since 1990, longterm air quality are evaluated on basic of dust, sulphedioxside,lead, ammonia etc. Prevention and Control 1) Containment method:eg:-Enliaust faer air cleaners devices,

actomobete filters. It means the prevention of escape of toxee substances into ambcint air. 2) Replacement method:Eg:- Use of CNG instead of diseal in automobiles replacement of coal based electricity production by hydroelectricpower. 3) Dilution:This is by eritensive planting of trees and vegetation around inelulius & residential area called Green belt. 4) Disinfection of air:- (In Hospitals) It is the best method of protection against air poiiution. Ultraviolet rays air used to disinfect the air in O.T, Isolation

ward, post operative wade etc. Other is the fumigation of rooms using burning of sulphue powder. 5) Legislation :To deceaee the air pollution, Govt of India enated the Air (prevention and control of pollution) Act in 1981 At the Intunatnal level WHO Established an internal network of laboratories for monitoring and study of air pollution. An epedemology study by Kozhikode Medical College confirmed that various abuoeenahtis & duearer are higher among people in Endosulfan speyed areas of Kasargod distreet than among normal population. High levels of t was detected in the blood sample of vellagers in 11 Panchayat. H leads to serious health nazards. Reproducers Health Problems y y Infertility,aboition, IUD still beeth, neonatal child death. Congenital heart diseases, Serzuee and other health problems also. It is found that hormonal abnocnalctes are also seen in children. Analyses of blood samples of al persons from the village showed presence of Endosulfan in blood. It containments air, water and aquatic llife also. Endosulfan is a deadly pesticides banned in many part of

wodd. But in Kerala. It was sprayed for years in government ensured plantains. Today villages who haved close to plantain are paying the price many of them got paralysed or are sercously ill. * C.NS cancer. Consequences of Outdoor Air pollution (1) Acid Rain Pollutant such as sulfuric acid combies with droplets in air, it become acidified. The effect of acid rain destroy leaves, poison to soil and water and kill aquatic life. (2) Green house Effect *Prychiatree problem *M.R * Cerebeal and genetical abnoeenalities &

Referred to as global warming, come from CO2 in atmosphere, formed by burning of fuel. Normally CO2 is converted to oxygen by plants, but the release of carbondioxcide from human activity is higher than the world plants can process, the situation become wore and the carbondioxcide in air increases. Thus build up a blank and kept heat close to surface of earth. Change of even a fuodegree will affect change in dimate. (3) Ozone depletion Release of CFC causes remove of ozone layer leads to formation of holes allowing radiation to reach earth results in serious liazards like skin cancer and wild life damage. Water Water is the basis necessary of life and largest component of body. It is impossible to achive optimum health in the absence of sufe and wholesome water. In a developing country like India, more than 50% of diseases accured by contaminated water. A serious aspect of waterpollution is caused by human activityUrbanisation & industrealisation. The sources of pollution resulting from these are 1) Sewage 2) Industrial and trade waste (toxic agents) 3) Agricultural pollutants (fertilizers, pesticides) 4) Physical pollutants (thermal & radioactive substances)

SOURCES & EFFECTS OF MAJOR WATER POLLUTANTS

Pollutants Metals:1. Cadmium

Sources

Effects

Minus,waste water from metal planting & industries

Damage kidney, RBC causing high BP & tistiuar, anemia

2. Lead

Industries,mines,water Kidney and nervo w pipes disoedir, anemia * Brain damage *Atophy of brain cell *huce & kidney damage

3. Mercury

Pesticides,Industries

4. Asseric

Cheneal waste & pesticides

Possidy carcinognie

5. Chromium

Metal platings

High cone cause carunome

PATHOGENIC ORGANISMS Bacteria Encreta and sewage contamination * Chlora, bacillary dyrentry. E.coli diarrloea, Typhoid and pacatyphoid fluence. Virus Encreta and sewage contamination *Hepalitis A,E,polimyeths rotavirus diarrhea is infauts Protozoans and helmittus Heptospiral Encreta and sewage contamination Ameobic dysentery, woem Intistations. Weids disease.

As per the recent survey six people have died of cholera itself and about 56 people we admitted in various hospitals, now seen in wayanad due to lack of adequate drinking water proposanitation. Also there is a high

incidence of uptosposis causes reported throughout the year. This year itself 74 cares of lephospcioris are reported. So that proper waste disposal & iodent eliminative is critical. PREVENT OF CONTROL OF WATER POLLUTION 1. Purification of waste:Household purification:(a) * Boding : It is a satisfactory method of purifying water fee household purpiee, as it kello bacteria, spoees,cysts and ova. (b) Chemical distinfication:Use of bleaching powder or chlocenated lime. Chlorine, tablets or solution etc. for disinfection of well. Appropriate facilities for large scale purification of water like storage, eltration and disinfection. 2. Waste conservation:I) It includes collecting the rainwater for direct use. In this rain water accumulated on roof of house is transferred to tank through pep. It should be stored in the basement of house or out side it provision should be made for sand filke, even if water is to used for domestic purpose. II) Recharging of ground waste by Raintall water:3. Surveillance of Drinking water quality:It is intented to protect public from water boene diseases. It includes sanitary survey by qualified persons,sampling of water and

Bacteriological surveillance the presumptive colifoem count and faecal ptococci and d.perfringens and colony count. 4. Waste Protection law:To prevent contamination of water the Act (Prevention and control of pollution) was passed by parliament in 1972.

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Swajadhara was lanched in 25th December 2002. It is a commonly led participatory programme,which auis at providing sfe drinking water in rural areas building of awareness water among projects village and community on

management

drinking

encouraging

water

conservation practices along with rain water harvesting. NUTRITION AND HEALTH The relationship can be classified on basis of following points. 1) Proper nutrition for proper physical and mental growth. 2) To prevent specific nutritional y Eg:- PEM, Iodine deficurcy disoedu,anaemic goetre.

3) Proper nutrition protect individual jrom disease y Eg:- malnourished are more prone for TB.

4) Nutrition is directly related to mational, child and family health. 5) Malnutrition is responsible for many communicable diseses, while the diseases like DM, Hypertension, CAD and cancers also have relation with nutritional aspect. Some source of food contamination include excerssive use of fertrilizers, irrigation of crops by contaminated waste, unclean storage and transportation, unhealthy handling and errors in serving food can invite contamination. Malnutrition Cycle: Inadequate datary intable

Appetitle loss Nutrient loss Malabsorplion Altered metabolism

wt loss Growth faltering immunity lowered

Diseases:-Inudence,duectis scueety

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Nutritional problems in public health:(1) How birth weight (2) PEM (kwashioclaoe and marasmus) (3) Xeropthalmia (4) Nutritnal anemia (5) Iodine difiuency disorders. (6) Endemic fluroris (7) Hathyrism FOOD HYGINE AND HEALTH Food hygiene implies hygiene in production handling, distribution and serving of all types of food. The main aum is to prevent food borne illness and food poisoning. With the increase in urbanization,

industrialization, tourism and mass catering system, food borne diseases are on the increases through out the world. Mainly food borne disease are caused by food borne infetus with bacterial, viral, passitive agenta etc and the food born intoxi cations due to natueally occurring forins or forins produced by fungi and bacteria. Adulteration of food is also an important problem causing serious health consequences. Eg:- adulteauties of edible oil with try cresyn phosphate (TCP) results in paralysis and death. PREVENTIVE & SOCIAL MEASURES Problems can be solved only by taking actions at family, community end inleenatnal lecul. At family Level  Proper nutrition education  Education on selection of right kend of local drugs and planning nutritionally adequate food within limits of their purchasing power.  Promote breast feeding improvement of inant and child feeding.

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 Other relative activities the maternal and child health, Immunization, Familyplanning. At community level:Analysis of nutritial problems in terms of population group at resk, type of nutritional deficiencies, dietary and non dietary food contributes to malnutrition, various community nutritional programmes. At National Level: Increase agricultural production  Rural development.  Nutrition related health activities. At International Level:Working of certain agencies like WHO,UNICEF, CARE, FAO in dose collaboration against matrictriction. HOUSING & HEALTH:Housing is not merely a physical structure providing shelter, but also the immediate surrounding and the related community services and facilities. CRITERIA FOR HEALTHFUL HOUSING:Who recommended following criteria for healthful housing. (1) Healthful housing provides physical protection and shelter. (2) Provides adaquatedly for cooking, eating, washing and encretory function. (3) It is designed, constructed and and maintained in such as to prevent the spread of communicable diseases. (4) Provides protection from hazards of exposuce to noise and pollution. (5) Is free of unsafe physical arrangement and of foxic and harmful material.

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(6) Encourage personal and community development social relationships and by their means promotes mental health. EFFECTS OF POOR HOUSING ON HEALTH (1) Accidents:Facility construction or engineering leads to falls steps cancing infuies. (2) More artheopodes:Inefficient high arrangement and poor water supply and deainage increases the number of mosquitoes flies, rat etc. (3) Obstacle in development It affects mental and physical development. (4) More Such as ringwoem, scahies, lepeory. (5) Psychological effects. Inefficient is the exchange of air between outdoor and indoor. The modern concept of ventilative include.  Exchange of impure air with pure air.  Temperature and humidity of air  Pleasant and infection free air. STANDARDS OF VENITILATION (1) 1000-1200 cubic fiet of air supply per healthy person 1hr is consedud sufficient. (2) In hospitals 1200-1800 cubic fiet of space should be reserved for each pahent. (3) Optimum floor area should be between 50 & 100 squarefeet per person, in hospitals for communicable disease ct is 144 squarefeet pre palcent. (4) Minimum distance is 3feet between beds in hospital. (5) In residential buildings ceiling should be at a height of 11-12 feet. Sufficient door, windows and ventilators.

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EFFECTS OF ILLVENTILATION Faligue Irretability Loss of working capacity Insomnia, Dizziness, headschea. Frequent attack of cough, cold & respleatory disorders. In capitals artificial ventilation like air conditing system is more popular for blood banks, operation theatres, CAT scanning and ICUS. its use in three area us of particular value in controlling pathogenic organisms in air. The air is fultered when drawn in to an air conditioned systems from the room the ericess humidily is also removed. Large hospitals install central air conditioning system. SOUND & HEALTH Noise is defined as uncounted sound. It has become a very important Stress factor in the environment of man. A daily exposure up to 85 db is about the limit people can tolerate without damage to hearing. The major sources are railway junctions, traffic sound, around, airports & other domestic sources like radios, transistors, T.V set etc. EFFECTS OF NOISE POLLUTION 1. Auditory fatigue 2. Deafness 3. Change in psychosocial behavior Eg:- tensure, anxiety, insomania etc 4. Physcological changes. (Increase Iteart, BP, Increase ICP affects digestive system leads to peptie ulcer, causes visual disturbances also.) RADIATION AND HEALTH Radiation is a part of mans physical environment.

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Sources of radiations:Natrial sources 1. Cosmic rays 2. Atmosphere radiates Man-made source 1. X-ray 2. Radioadiue fallout 3. Miscallaeneous (T.V set, Iumenous wrest walches) BIOLOGIC EFFECTS OF RADIATIONS Immediate Somative 1) Radiation sleekness 2) Acute radiator syndeome Delayed Herikaemea Carcinogenesis Fetal development abnormalities Genetic 1) Chromosomal mutation 2) Point mutation PREVENTION AND CONTROL 1) Auoidance of unnecessary x-ray 2) Protective measures like lead apeon 3) Diallowing pregnant women & children. WASTE DISPOSAL & HEALTH Waste or Regualr is the unwanted leftonce substances that heve been discaeded or thrown away. SOURCE OF WASTE (1) Domestic source (2) Market and street Refuse (3) Industrial source

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(4) Biomedical waste (Hospital refuse)

HEALTH HAZARDS OF WASTE ON HUMAN HEALTH (1) Increases number of dicreases carrying animals. (causing cholera,plague dyrentry) (2) Acid pollution and foul smell in environment (3) Pollution of waste resources. (4) Destroys the aesthetes. The principal methods of refuse disporal are aumping, controlled tipping, incineration, competing, manupits etc.

HOSPITAL WASTE MANAGEMENT Biomedical waste is the waste generated during diagnosis, treatment or prevention of a diseases. Hospital wastes are infectious, injuries, cytoxorice and chemical wastes causing serious health hazards. Different provisionas and schedules about safe disposal of biomedical waste are discrehed in BMW Act In 1998. Teo schedules; schedule I-categories of Biomedical waste in India. Schedule II- colour coding and type of containce for disposal of biomedical waste. According to it there are 5 colour coding Yellow, Red, Blue, White, Black, Green. The final treatment of waste include incinerate, autoclaving, chemical treatment & secured land fill based on the category of waste. BASIC PHYSIOLOGICAL NEEDS The physiological needs include need for sufficient oxygen, nutrition, optimum temperature and humidity, etc. Oxygen:Especially in a hospital setting there should meet adaquatic oxygen supply facilities. If we are conscdering a private hospital set up many are having cintealised oxygen supply. Which is readly available meets the needs to a great extant. On the Government hospitals, many are lacking this and creates many problems.

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Nutritious And Sanitation Aeradaquate, clear water supply is needed for drinking and also provision for garbage collection PHYSICAL ENVIRONMENT IN HOSPITALS. Healthy physicals environment in a health care settings reduces the incidence of illness and injury shortens the length of treatment, impious or maintain clints functional status and well being. Health care building design should promote wellness by creating physical surroundings that patients are not over crowdedor over

concentrated, provide a variety of space such as a big day room, a dining room that is well liguted and ventilated and a spacious lobby and corre doe gine sufficient attention to natural and artificial ughting. CHARACTERISTICS OF A SAFE ENVIORNMENT A safe environment is an environment in which  Basic needs are met  Physical hazards are reduced  Transmission of pathogins are reduced  Sanitation is maintained  Pollution is controlled. ENVIORNMENTAL HOSPITAL DESIGN (1) Exposure to daylight Research indicates that exposuee to light-day legnt or bright, full spectrum artificial high-is effective in redncing depression even for thore hospitalired with severes depression. Medical studies have reported that hospitaised patients wittin depression many have more favourable outcomes, including shoctue and lers costly stays, if they are assigned to sunnier rooms rathere than rooms that recived loess daylight. It is not only for mental health patients,but also for patients witter cardiovasiular disease, caveu etc. (2) Rednced noises:Research on adults and children has shown that noise is amapor cause of sleep deprivation, co heads results in poor physical and mental function. Studies shown that noise increases stress in adult

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patients and can heighten blood pressure and heart rate. When high performance ceiling likes were installed in a coronary critical care unit (CCU) ina hospital, noise level eleclined and the patients reported that they were quality compared to when low performance ceiling tiles were in place. (3) Ward layouts way finding Ward layouts in older hospitals generally provide long corridor organized around acartial using station whise medications and charts are located. Way finding problems in hospitals are costlky and stressful and affect patients who may unfamiliar with the hospital and are stresses and disoriented. If people get lost, fuecy may get stresses which raisis cortisol level and loweres innune system functioning. (4)

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